Mention gluten, and everyone has an opinion. One in four Americans believe that going gluten-free is the right health move,. But only a quarter cite disease or gluten sensitivity as the main reason they nixed it from their diets, per data from The NPD Group.
On the other hand, a number of dieters promoting healthy carbs, including those that contain (you guessed it!) gluten, have been pushing back against the trend.
So what’s the bottom line? Consider this the no-nonsense down-low on gluten—and whether or not it belongs on your plate.
Gluten is a combination of two proteins, gliadin and glutenin. Naturally present in wheat, barley, and rye, gluten breaks down into amino acids in the body’s small intestine, courtesy of specialized digestive enzymes in our body, explains Kendra Perkey, M.S., R.D.
Unless you have celiac disease or a gluten sensitivity, that is.
Affecting less than one percent of the U.S. population, according to a consensus statement from the National Institutes of Health, celiac disease is a condition in which the immune system responds abnormally to gluten, explains Shaista Safder, M.D., gastroenterologist at the Arnold Palmer Hospital Center for Digestive Health and Nutrition. Over time, the immune system’s ‘attack’ response damages the lining of the small intestine and results in an inability to absorb necessary nutrients. Physicians typically diagnose celiac disease through two steps: blood work and a subsequent biopsy of the small intestine.
In non-celiac gluten sensitivities, people often report stomach upset, brain fog, and/or fatigue, symptoms they say are improved by going GF, according to the Celiac Disease Foundation. It remains unclear as to what these issues refer to, but there seems to be a strong link between this non-celiac intolerance and other gastrointestinal issues, like irritable bowel syndrome, says Safder.
There is no test for identifying gluten sensitivities, and many cases are self-diagnosed or identified after monitoring how cutting gluten affects symptoms.
What A Gluten-Free Diet Might Actually Look Like
Going G-free isn’t as simple as saying see-ya to all things wheat. As with any eating protocol that involves eliminating certain foods, going whatever-free doesn’t automatically mean you’re going to be or feel healthier. After all, every time you remove something from your plate, you have to replace it with something else. In this case, what you replace gluten with truly matters. Are you swapping it with whole foods or processed ones?
A diet that’s naturally gluten-free will include fruits, vegetables, legumes, whole grains (quinoa, sorghum, rice, millet, buckwheat, and teff are all GF), dairy, lean meats, and healthy fats such as avocado, nuts, and seeds.
The issue is that there are so many gluten-free foods that are processed, which means you’re still not getting the nutrition you need. Read: a gluten-free cookie is still a cookie.
When Going Gluten-Free Can Set You Free
For people with celiac disease, a strict gluten-free diet can radically improve health and quality of life—if not be altogether lifesaving. “It’s like someone who’s allergic to peanuts cutting all peanut-containing foods from their diet,” explains Bonnie Taub-Dix, R.D.N., founder of Better Than Dieting and author of Read It Before You Eat It. They can’t just reduce their intake —they need to eliminate peanuts (or gluten) completely.
Others who do not have celiac disease claim to feel better on a GF diet, reporting reductions in diarrhea, constipation, and/or bloating. Some say they have more energy. In fact, Safder notes that up to 25 percent of people with IBS report clinical improvement of symptoms after cutting gluten from their diet.
What’s more, a whole food-focused gluten-free diet just so happens to be low in FODMAPs (a variety of fermentable short-chain carbohydrates that cause stomach issues in some people), which are found in wheat, rye, and many packaged food additives, she says. Bonus points: People following a naturally gluten-free diet often wind up cutting out a lot of sugar-laced, processed foods.
When Nixing Gluten Can Actually Hurt Your Health
“There are no real benefits to avoiding gluten when you do not have issues with gluten,” Perkey says. She notes that while many fad and elimination diets have labeled gluten, or grains in general, as “bad,” there is nothing intrinsically wrong with gluten.
What’s more, because wheat (the main source of gluten in the average American’s diet) contains fiber, iron, zinc, folate, niacin, thiamine, riboflavin, vitamin B12, magnesium, and phosphorus, you may end up falling short on these nutrients by nixing gluten, says Taub-Dix, who explains that substitutes for wheat, such as rice, contain significantly less of them.
Because gluten is what gives baked goods and pastas their fluffy, springy texture, many gluten-free food products have to compensate by adding extra sugar, fat, and even food additives to improve their taste, says Perkey. They could even be higher in calories than their gluten-containing counterparts, she adds.
Though many people cut gluten for weight-loss purposes, a gluten-free diet is not a weight-loss diet, and may even have the opposite effect. A review published in the Journal of Medicinal Food suggests that celiac disease patients following a gluten-free diet may actually have an increased risk for becoming overweight.
Even more troubling: 2017 research from the University of Illinois at Chicago found that 73 self-reported gluten-free dieters had elevated urine arsenic levels and blood mercury levels. The study authors speculate this may be due to a possible increase in rice consumption when on a GF diet.
According to the FDA, rice is a leading dietary source of inorganic arsenic because it more readily absorbs arsenic contained in the soil than do other crops. “While the effects of higher arsenic levels are not known, it is something to consider,” Perkey says.
To Gluten Or Not To Gluten?
“If you are thinking about trying a gluten-free diet, ask your doctor if it’s a good choice for you,” Safder says. “It’s true that a gluten-free diet can be healthy. But it can also keep people from getting all of the nutrition they need.”
If you and your doctor decide that a GF eating strategy is right for you, it’s best to cut gluten out under the supervision of a registered dietitian who can make sure that your new diet is a healthy one.