Going gluten-free is a life-long necessity for some people, such as those with Celiac disease. But many for many others, going gluten-free is a dietary choice. Many people believe that going gluten-free will lead to improved GI function, weight loss, and/or improved brain function – all claims made by health influencers and bloggers and based on little to no evidence.
But no matter the reason for going gluten-free, if you make the choice to avoid gluten, there are some things you should know. So, read on for what you need to know if you’re going gluten-free.
Disclaimer: As always, this is general information intended for healthy adults who are not pregnant or breastfeeding. Your needs may vary based on medical status, lifestyle, or life-stage. Please never replace generalized health information you’ve read online with individualized clinical care.
What is gluten?
Gluten is made up of a group of storage proteins found in cereal grains. They provide viscous properties to the grains, providing matrix structures to wheat dough, helping to make it stretchy and elastic.
The two major proteins are gliadin (a prolamin) and glutenin. These prolamins are found in wheat, barely, rye, triticale, and some may be sensitive to those found in oats. Gliadin is resistant to gastric, pancreatic and intestinal proteolytic digestion in the GI tract.
In addition to being found in wheat, barely, rye, triticale, and some oat products, gluten is found in wheat products like bread, cereals, pasta, and tortillas. It also sneaks its way into many condiments and sauces, including soy sauce, many commercial dressings, prepared pasta sauces and soups, cosmetics, supplements, and ‘natural flavors.’
And while some small amounts of certified gluten-free oats may be tolerated by those sensitive to gluten, many oats are contaminated with gluten. Total avoidance of gluten is quite the challenge!
Who needs to avoid gluten?
People with Celiac disease must strictly adhere to a lifelong gluten-free diet. In people with this autoimmune disease, glutenin can trigger adaptive immune system responses, leading to atrophy (blunting) of the villi in their small intestine leading to decreased absorption, and subsequent nutritional deficiencies, weight loss, abdominal pain, diarrhea, fatigue, anemia, and skin rashes known as dermatitis herpetiformis.
For the small percentage of the population with Celiac disease, avoiding gluten is essential to avoid chronic intestinal inflammation. Even small amounts that may not cause symptoms can cause subclinical disease, nutritional deficiencies, and increased risks of developing other autoimmune diseases, including diabetes.
Individuals with wheat allergies should also avoid gluten. Wheat is one of the 8 major food allergens, and symptoms may include hives, nausea, headaches, diarrhea, vomiting, eczema, trouble breathing, drops in blood pressure, and anaphylaxis upon exposure to wheat. As with all food allergies, avoidance of the food is essential to avoid potentially dangerous symptoms.
Other people may have a condition known as non-Celiac gluten sensitivity or gluten intolerance. Scientists are still parsing apart exactly what causes gluten sensitivity, but people with this condition may experience headaches, stomach pain, GI upset, and fatigue upon ingestion of wheat products.
While some media outlets falsely claim gluten is toxic, others claim gluten intolerance (besides allergies and Celiacs) is not a real condition. It is, and some people may experience real, adverse symptoms upon ingestion of gluten. People who suspect they may have this condition should see their doctors to rule out Celiacs disease before adhering to a gluten-free diet.
Individuals who are sensitive to FODMAPs may also find wheat-product triggering, as they are high in fructans. FODMAP-sensitive people have different triggers and different symptoms, but in fructan-sensitive individuals, ingesting large amounts of wheat may lead to bloating, gas, and diarrhea. You can read more about FODMAPs here.
But for the vast majority of other individuals, there is no reason to avoid gluten. Avoiding gluten will not necessarily make you any healthier, nor is it a guaranteed means to weight loss. In fact, as you may read in the next section, it may actually put you at risk for nutritional deficiencies and suboptimal dietary patterns.
Nutritional Risks of Going Gluten-Free:
As mentioned above, going gluten-free is essential for people with select medical conditions. Other people seem to try it as a fad diet based on unsubstantiated claims that gluten-free diets are healthier, or promote weight-loss, fertility, or improved brain function.
Either way, there are things you should know about maintaining nutritional status while going gluten-free.
First, if you are going gluten-free for a medical reason such as Celiac disease, it is suggested that you select inherently gluten-free foods (such as rice, fruits, vegetables, quinoa, beans, etc) as opposed to gluten-free versions of normally glutenous foods (like gluten-free snack bars, snacks, or candies) as many are produced in facilities that also process gluten, and may still contain traces of gluten, even if they are labeled gluten-free.
Technically, to be labeled “Certified gluten-free,” a product must have less than 20 parts-per-million of gluten; while this may not cause symptoms in those with Celiacs or other disorders and is generally safe, it can still lead to subclinical disease symptoms or allergic symptoms in sensitive individuals over time, and thus, it’s best to be safe and select naturally gluten-free foods or those processed in totally gluten-free facilities.
Additionally, gluten-free versions of normally gluten-containing foods tend to have higher amounts of sugar and fat, and lower amounts of fiber compared to their gluten-filled counterparts.
Those who eat these products should strive to get dietary fiber from other sources (like fruits, vegetables, legumes, and/or supplements) and be mindful to balance carbohydrates, fat, and protein across meals (without being obsessive, of course) to ensure a proper macronutrient balance for optimal energy and bodily function.
Importantly, while most breads and cereals are fortified with micronutrients, many gluten-free cereal and bread products are not fortified, meaning they are lower in important vitamins and minerals such as thiamine, niacin, riboflavin, folate and iron, all of which are essential for optimal health.
If you are on a gluten-free diet, it’s important to monitor your micronutrient status. Aim to select gluten-free products that are fortified with these micronutrients, eat a variety of fruits, vegetables, nuts, legumes, and seeds to obtain them elsewhere, and/or consider taking a low-dose supplement to fill in any potential gaps.
Furthermore, practice caution when dining out. One study found 32% of restaurant menu items labeled ‘gluten free’ contained gluten, so if you must avoid gluten for a medical reason, be vigilant when eating out of the home!
But what about all those claims made about the miracles of going gluten-free?
In case you missed this earlier in this article, I’ll just reiterate it one more time: claims that a gluten-free diet will transform your life, help you lose weight, improve fertility and brain function, clear ‘brain fog,’ and enhance overall health are unsubstantiated.
While it is possible to be healthy on a gluten-free diet, avoiding gluten is not essential for health unless done out of medical necessity, and gluten-free diets are not considered to be beneficial to health for those without Celiac, wheat allergies, or non-Celiac gluten sensitivity.
Gluten is a protein found in wheat, barley, rye, triticale and oats. Avoiding gluten is a medical necessity for individuals with Celiac disease or wheat allergies. Others with non-Celiac wheat sensitivity or FODMAP sensitivities may feel better if they avoid gluten or consume it in smaller amounts.
But for the majority of people, avoiding gluten has no real health benefits.
Gluten-free products are often higher in fat and sugar, and lower in fiber and micronutrients compared to their counterparts. Those consuming gluten-free diets should strive to consume inherently gluten-free foods most of the time, and ensure they get fiber and micronutrients missed in their diet from other sources, or consider a supplement to fill in any gaps.
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