Following a gluten-free diet is a way of life for those with certain medical conditions. But for the general public, ditching gluten can actually carry some serious nutritional risks.
Gluten is a mix of proteins found in wheat, barley, and rye that gives dough that distinctive elastic, stretchy texture. Although a staple in the American diet, eating foods with gluten can cause serious illness in some people and should be avoided. Gluten-free diets have gained serious traction in popular culture in recent years, touted as a healthier way of eating even among those who can consume gluten safely. But should going gluten-free be recommended for everyone? Will restricting gluten really improve your health?
Celiac disease and gluten sensitivity
For people with celiac disease, gluten activates an immune response that injures the lining of the small intestine, hindering the absorption of important nutrients from food like vitamins A, D, E, B, iron, and calcium. Untreated celiac disease can also cause weight loss, diarrhea, and bloating, and is associated with anemia, osteoporosis, and nerve damage. Treatment for celiac disease is a lifelong diet free of gluten. Gluten sensitivity is a more common condition and is diagnosed in people who do not have celiac disease but who experience abdominal pain, bloating, bowel irregularity, joint and muscle pain, or reduced level of alertness related to eating foods with gluten. For people with both conditions, avoiding gluten usually results in significant symptom improvement.
The gluten-free diet is more popular than ever
Although the prevalence of celiac disease worldwide remains stable at 1%, the demand for gluten-free foods in the United States has skyrocketed. In 2009, 44% of people who were gluten-free did not have a gluten-related disease, and by 2014, this rose to 72%. Sales of gluten-free products were $2.7 billion in 2018 and are expected to more than double by 2025. Persuasive marketing, celebrity endorsements, and personal testimonials of those who have gone gluten-free have fueled this trend, as more and more people are choosing to dodge gluten in the hopes of losing weight, boosting energy, and generally feeling healthier.
Avoiding gluten is not recommended unless medically necessary
Going gluten-free is the gold standard of treatment for people with celiac disease and gluten sensitivity and has also been shown to improve symptoms of other conditions like irritable bowel syndrome (IBS), fibromyalgia, and endometriosis. For otherwise healthy individuals, though, the evidence that a gluten-free diet promotes a healthier lifestyle is much less convincing.
Gluten-free products are largely nutritionally lacking
Gluten-free foods appear to offer no real nutritional advantages over their gluten-containing counterparts. Evidence shows that around half of gluten-free foods are over two times more deficient in protein and most are also lower in dietary fiber. Gluten-free breads and pastas are prepared with starches and refined flours that are low in fiber and are generally not fortified with B vitamins. Packaged gluten-free foods also tend to be deficient in essential nutrients like folate, iron, calcium, and niacin and are usually filled with more calories, fat, salt, and sugar. A 2013 survey confirmed that in fact those who restricted gluten consumed significantly lower amounts of fiber, niacin, folate, iron, and calcium, but much higher amounts of fat, saturated fat, and sodium, than those who did not.
Surprising sources of gluten are found in common foods
Avoiding gluten entirely is not always an easy task. Manufacturers are not required to include all ingredient elements on their food labels, so gluten can lurk in seasonings and flavorings that can be omitted from packaging. Beware of these common foods that may be unexpected sources of gluten:
Sauces and gravies - some use wheat flour as thickener
Beer – most naturally contain gluten
Granola bars – most use oats that have gluten
French fries – some may have batter containing wheat flour
Potato chips – any that contain malt vinegar or wheat starch
Salad dressings – any that contain malt vinegar or soy sauce
Brown rice syrup – sometimes made with barley enzymes
Soy sauce – naturally contains gluten, but choose tamari which is gluten-free