Should You Go Gluten-Free?

Gluten-free labels are everywhere—on eggs, vitamin bottles, sauces, crackers, bagels, and even gum. A 2018 study reported that more than $15.5 billion were spent on retail sales of gluten-free (GF) foods. Social media, aggressive marketing campaigns, and reports in mainstream press claiming the benefits of going GF encourage consumers to purchase such products.

Gluten is a family of proteins. Shunning it may or may not be good for your health.

Nutritional epidemiologist Karin Michels, PhD, has devoted her career to researching how health can be optimized through a proper diet. According to her and other experts, eliminating gluten as a general rule may have its downsides.

“There is no good reason to avoid gluten unless you’re intolerant,” says Dr. Michels, professor and chair of the epidemiology department, UCLA Fielding School of Public Health. “By doing so, you’re missing out on important nutrients and fiber that come from grain.”

If you truly have celiac disease, a bite of regular bread can be enough to damage the small intestines. But a study published in Gastroenterology & Hepatology suggests that the majority of people who avoid gluten do so without a confirmed medical diagnosis.

Gluten and Wheat Disorders

Researchers believe that nearly 3 million Americans (about 1 percent) may have celiac disease. Given the wide range of symptoms, people may confuse other disorders with celiac disease, such as wheat allergies and gluten intolerance.

Celiac disease is a genetic autoimmune disorder caused by a reaction to gliadin, a protein contained in wheat and other common grains such as barley and rye. It triggers the body’s immune system to overreact, which damages the small intestine, specifically the villi (small finger-like protrusions that aid digestion). Without properly functioning villi, nutrients aren’t well absorbed, ultimately resulting in malnourishment. People with uncontrolled celiac disease are at risk for vitamin B, iron, and calcium deficiencies, among others. They also have what’s called increased intestinal permeability, which permits toxins, bacteria, and undigested food proteins to seep through the gastrointestinal barrier walls and into the bloodstream. Nutritional deficiencies and increased intestinal permeability can lead to a whole host of health problems.

Symptoms of celiac disease are wide ranging and include chronic diarrhea, recurrent bloating, gas and abdominal pain, anemia, joint pain, and weight loss. To diagnose the disease, a physician will order a blood test for antibodies to gluten. If found, a biopsy of the intestine typically follows. Genetic tests can help identify people who are predisposed to the disease. Not everyone with the gene will get it, but only those with the gene will have it. A strict GF diet currently is the only treatment.

Wheat allergies trigger the immune system to attack wheat proteins. The significant difference between this and celiac disease is that the small intestine is not damaged by a wheat allergy. Symptoms are also different and depend upon which chemicals in the wheat trigger a person’s reaction. Reactivity may be immediate and lead to breathing difficulties, tightness in the chest, itchy throat, dryness in eyes, nasal congestion, rashes and hives. The reaction may also take place a couple of hours after either eating or inhaling wheat. Diagnosis is by way of a blood test, skin prick, and an elimination diet.

Non-celiac gluten sensitivity is an intolerance. The body can’t break down some of the nutrients, and that causes digestive distress and other symptoms, such as abdominal pain, bloating, gas, diarrhea, brain fog, and headache. The small intestine is not damaged. Diagnosis is based on skin prick tests and exclusion diets. Some people may test negative for wheat allergy but still have gluten sensitivity. Symptoms are resolved when foods with gluten are removed from the diet.

It’s important to know why certain symptoms are occurring because gluten may or may not be the culprit. A gastroenterologist is a medical doctor that specializes in digestive diseases. This specialist diagnoses gluten-related conditions and can help you figure out what may be causing your discomfort. If you do have celiac disease, the good news is that a GF diet will, in most cases, help, and the villi in the small intestine will, in time, heal. The disease can affect anyone at any age. And given the broad and generalized symptoms, it can take some medical detective work to determine cause.

What to Eat

Processed products, even GF, are not necessarily healthy, and they’re expensive. For example, a loaf of GF bread can cost about $8, whereas other breads are usually less than half that amount. Compare conventional and GF thin pretzels and you’ll find plenty of unhealthy fillers in the GF versions, such as corn, potato, and rice starch, to make up for the missing binding element of gluten.

Like other healthy eating plans, a GF diet is best if it’s based on whole foods, such as fruits, vegetables, nuts, legumes, lean protein and GF grains. Teff, buckwheat, quinoa, millet, rice, and sorghum are all free of gluten.

So, while marketing messages may have you thinking that eating GF is healthy, what’s important is discovering whether or not you have a medical condition related to gluten. And if not, go ahead and enjoy whole grains with gluten. A whole-grain kernel contains the endosperm, germ, and bran. The bran’s outer coating is rich in fiber, and the inner germ contains important vitamins and minerals. When purchasing products, make sure the label says made from whole grains, not refined grains. So, look for “whole wheat” not just “wheat.” Snack on popcorn, enjoy stone-ground corn tortillas, and try using whole-grain flours when baking. Grains are versatile, deliciously healthy and may lower the risk of heart disease, type 2 diabetes, stroke, and obesity. All good reasons to enjoy them with any meal.

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