One misconception that I hear a lot is that people assume that a ‘gluten free’ option is healthier than any other, even if their bodies do not negatively react to gluten. However, going ‘gluten free’ is not a healthier option if you don’t have celiac disease, a wheat allergy, or non-celiac gluten sensitivity. This post is super dense (sorry!), so if you’re looking for a shortcut, this video does a great job of explaining celiac disease, wheat allergies, and a non-celiac gluten sensitivity.
Celiac disease affects about 1 in 141 individuals (NHANES, 2012) and the only treatment option is a gluten-free diet. It is extremely important that people with celiac maintain a strict gluten-free diet for their entire lives.
But what if you don’t have celiac disease (or a wheat allergy/gluten sensitivity) Then you shouldn’t cut wheat, rye, malt, and barley out of your diet. Studies show that whole grains are protective against cancer, cardiovascular disease, diabetes, and obesity (2). And a lot of the health-related marketing claims surrounding gluten-free products are….exactly that: marketing.
Fun fact: between 2004 – 2011, marketing of gluten-free products grew at an average annual rate of 28% (2). Total sales of gluten-free products in 2012 was estimated at $2.6 billion per year (2). That’s a whooooole lot of incentive for companies to try to convince the public that gluten-free is ‘healthier.’
According to an article published by the Journal of the Academy of Dietetics, “the number-one reason consumers cite for buying gluten-free products is that they are perceived to be healthier than their gluten-containing counterpart (2).”
I also want to emphasize that ‘gluten free’ doesn’t necessarily mean low-calorie. In fact, some gluten-free products actually have more added sugar and/or fat in order to improve the taste.
What does the evidence say?
⇒ There are no published research studies that conclude that consuming a gluten-free diet leads to weight loss in people without celiac disease or gluten intolerance (2).
⇒ Naturally occurring fructan-type resistant starches in wheat can improve gut health by creating a healthy mix of gut bacteria (2).
- In a recent study, 10 healthy subjects went on a gluten-free diet for 1-month. The diet significantly reduced the number of beneficial bacteria in their fecal samples (2).
⇒ Some studies have shown that gluten can be beneficial in individuals with dyslipidemia. For those of you wondering, dyslipidemia is elevated blood cholesterol, and/or triglycerides, and/or low levels of HDL, all of which can contribute to the development of atherosclerosis (2).
- In one study of 24 adults with hyperlipdemia, the participants increased their consumption of gluten for 2 weeks while on a weight-maintenance diet (eating enough to maintain their current weight) and as a result, their blood serum triglyceride levels decreased by 13% (2).
⇒ Gluten may help reduce blood pressure by inhibiting angiotensin 1-converting enzyme (ACE). ACE converts angiotensin I into angiotensin II and degrades bradykinin. Angiotensin II is a vasoconstrictor and bradykinin is a vasodilator, so the inhibition of ACE can help reduce blood pressure (2).
⇒ Gluten can boost the immune system because it has a high glutamine content. Glutamine is an amino acid that is used in the biosynthesis of proteins and has been supplemented in clinical settings to reduce the risk of infection and/or complications in patients after surgery (2).
Overall conclusion: there is no evidence to suggest that a gluten-free diet has significant benefits to the general population without celiac disease, a gluten sensitivity, or a wheat allergy. In fact, consuming a gluten-free diet unnecessarily may have negative health effects. Additional research is needed in order to learn more about the health benefits of consuming gluten, but there is enough published literature to suggest that there are potential consequences associated with avoiding gluten unnecessarily.
For those of you curious, here is some detailed information on celiac disease. If you suspect that you may have celiac disease, gluten intolerance, or a wheat allergy, you can try eliminating gluten from your diet (be careful, it’s in a lot of unexpected foods!) and then reintroduce it to see if you feel differently. I recommend getting a test done to confirm if you do have celiac disease and as always, please consult your doctor with any medical concerns.
What is celiac disease?
Celiac disease is an autoimmune disease in genetically susceptible individuals that is caused by an immunological reaction to gluten (1). In other words, the body releases an immune response in the presence of gluten.
What foods contain gluten?
Any foods that contain wheat, rye, malt and barley.
What happens when someone with celiac disease eats gluten?
When someone eats gluten, the small intestine is exposed to the protein components inside of gluten (such as α-gliadin), which results in a T-cell mediated inflammatory response that damages the intestinal mucosa (1).
Think about it, what happens when you cut yourself? Your body elicits an immune response (inflammation, redness, etc.) The same thing happens inside of your body in the presence of gluten – the immune response signals the T lymphocytes to produce cytokines, which lead the inflammatory response. Cytotoxic T cells will then destroy the enterocytes (enterocytes are cells on the intestinal lining which increase surface area and aid in the uptake of essential nutrients.)
Both the inflammatory and innate immune response will damage the villi by flattening them (villi are hair-like projects on the surface of the intestines that help the body absorb nutrients.) Consequently, there is a reduction in surface area on the villi, thereby reducing nutrient absorption.
How is celiac diagnosed?
There are clinical tests that can identify if a person has Celiac disease. The inflammatory response that I mentioned above produces antibodies that serve as diagnostic indicators of the disease.
What are the symptoms of celiac disease?
- Abdominal pain
- Bone and joint pain
- Muscle cramping
- Peripheral neuropathy
- Skin rash
- Mouth ulcerations
- Iron-deficiency anemia
The only treatment for Celiac disease is a gluten-free diet. In most cases, after cutting gluten from the diet, the villi will return to their normal height and physical symptoms will subside.
Please note that I am not a medical professional and this blog post is not intended to provide medical advice. Please contact a medical professional if you have concerns about your health.
(1) Nahikian-Nelms, M. (2011). Nutrition therapy and pathophysiology. Belmont, CA: Wadsworth, Cengage Learning.1) Pg. 405-408.