Gluten is a protein commonly found in wheat, barley, rye, and some oats. A gluten-free diet means avoiding foods that contain gluten, including bread, noodles, pastas, dumpling skins, pizza, cakes, cookies, beer, ice cream, chocolate, commercially available sauces and condiments, and even some food additives.
The gluten-free diet was originally designed as a therapeutic diet for people with celiac disease. Celiac disease is an autoimmune intestinal inflammatory disease, in which the intake of gluten-containing foods causes an abnormal immune response, resulting in the body’s inability to properly absorb various nutrients. Its symptoms include diarrhea, bloating, abdominal pain, and other intestinal symptoms, and, in the long term, malnutrition.
In recent years, many people without celiac disease have become interested in a gluten-free diet. And even in dermatology clinics, many people worry that their skin problems are related to gluten and ask if they should quit eating foods that contain gluten.
Dr. Pin-chi Chiu, director of Aletheia Holistic Dermatology Center, said that a patient once grudgingly asked him, “I’ve heard that you have to give up spicy and fried foods and gluten if you have acne or rosacea, but what can I eat if it goes on like this?”
“In fact, many people follow the advice that it is good to give up gluten, but they don’t know if it is necessary for them to do so,” Dr. Chiu said, “In reality, you have to observe the association between what you eat and your skin.” According to him, even if we eat the same type of food, it may cause acne for some people, but not for others.
Moreover, different foods often contain a variety of ingredients that can affect skin conditions, and the problem is not necessarily with gluten itself. For instance, some people’s skin improves when they give up gluten, because they eat less of the additives, fats, and refined sugars found in processed foods that contain gluten, such as bread, cookies, and cakes.
To Improve Skin Conditions, Reduce 1 Type of Food First
Dr. Chiu pointed out that he had observed that many skin problems are actually related to an unbalanced diet, such as eating bread, biscuits, cakes and other ultra-processed foods, consuming too much dairy products and/or consuming too many high-calorie, fried, high-salt and high-sugar foods.
Therefore, if you are worried about improper diet causing skin deterioration, the recommended dietary adjustment in stages is:
- The first stage: reduce high-fat, fried, spicy, and stimulating foods
- The second stage: reduce the intake of sugary drinks, dairy products, and ultra-processed foods
- The third stage: reduce gluten-containing foods
At the first and second stages, the main goal is to reduce the intake of ultra-processed foods.
Ultra-processed foods include fried, roasted, and pickled foods, processed meat products (e.g. meat loaf, sausages, ham, and meatballs), cakes, pastries, cookies, carbonated beverages, instant noodles, popcorn, potato chips, canned goods, preserved fruits, and frozen desserts (e.g. ice cream, popsicles, and ice cream bars).
If your skin does not improve in the first two stages, then you should start the third stage. At this stage, Dr. Chiu suggested eating less or no cakes, desserts, pastries, cookies, pizza, and doughnuts.
As for foods such as soy sauce, beer, steamed buns, buns, dumplings, noodles, oatmeal, sandwiches, French baguettes, and pastas, you should observe and record if they affect your skin conditions or cause gastrointestinal symptoms.
For further testing, you can replace gluten-containing foods with rice, sweet potatoes, corn, barley, purple rice, black rice, legumes, or potatoes. Do this for about two weeks and observe any differences in your skin to see if there is a connection between your skin conditions and certain types of food.
Giving Up Gluten Blindly May Entail Several Risks
There are two other issues to consider when you want to give up gluten.
- Gluten-free foods may also have artificial additives
Many processed gluten-free foods still contain high levels of sugar, fat, sodium, and other additives. They have simply replaced the flour with other gluten-free ingredients. Consumption of such refined gluten-free foods can still lead to obesity, blood sugar fluctuations, high blood pressure, and other health problems.
- Nutritional intake may be compromised if gluten is eliminated
A large-scale study involving more than 2 million people and with a duration of over 26 years was published in the British Medical Journal (BMJ) in 2017. It showed that people without celiac disease who adopted a gluten-free diet might have reduced their intake of heart-healthy whole grains, which in turn affected their cardiovascular health.
Conversely, long-term gluten intake is not associated with the risk of coronary heart disease.
Selvi Rajagopal, MD, assistant professor of medicine at Johns Hopkins University, also noted that a gluten-free diet is not suitable for everyone.
She explained that the average person who eliminates all gluten from their diet may be missing out on nutrient-rich whole grains, including fiber and micronutrients, such as vitamin B complex and the minerals iron and magnesium. Whole grains can lower cholesterol levels and even help regulate blood sugar levels. She pointed out that people at risk for heart disease or diabetes need to get enough whole grains in their diet.
People who blindly follow a gluten-free diet are obviously not doing their health any favor. The University of South Alabama School of Medicine published a study in 2018 that listed the potential risks of a gluten-free diet, such as micronutrient and fiber deficiencies, increased fat intake, hyperlipidemia, hyperglycemia, and coronary artery disease.
3 Groups of People Should Give Up Gluten
There are three types of people who theoretically need to adopt a gluten-free diet: celiac disease patients, people allergic to wheat, and people with gluten intolerance.
According to Dr. Chiu, celiac disease is the most serious of these three conditions. Celiac disease patients have a strong inflammatory response to gluten, whenever they come into contact with it, from a young age, even in infancy. For example, they’re prone to diarrhea, malnutrition, and their physical development is also affected. Celiac disease has a lot to do with body type and race, and it is more common in Europe and North America, but less common in Asia.
When people with wheat allergy consume wheat-related foods, they will experience acute allergic reactions, such as rashes, itchy eyes, hives, or swollen lips. This type of allergy is not common, and it is more commonly seen in children and less common in adults.
Gluten intolerant people can have chronic inflammation, immune disorders, or recurrent gastrointestinal discomfort when gluten-containing foods are consumed. As for skin effects, they are often mentioned in connection with chronic inflammatory diseases such as hives, acne, rosacea, psoriasis, and lupus erythematosus. However, there is no clear cause-and-effect relationship between these skin diseases and gluten itself, and the specific connection has yet to be clarified by research.
According to Dr. Chiu, gluten intolerance is the most common of the aforementioned three conditions, but it is also the most difficult to detect. Even if a patient undergoes blood tests or other advanced tests, it is difficult to confirm gluten intolerance 100 percent. It is often recommended to keep a dietary diary to better identify the association.
Follow 5 Major Dietary Principles for Healthy Skin
Skin conditions are related to diet and gastrointestinal tract function.
When a dermatologist encounters a patient with chronic skin inflammation, he or she will often ask if the patient also has diarrhea, flatulence, constipation, irritable bowel syndrome, gastric ulcers, or gastroesophageal reflux. If these conditions exist, the patient will be advised to go to the gastroenterology department to see if they need to improve their intestines and stomach as well.
Dr. Chiu proposed five major dietary principles for the general public, which are beneficial to both skin and overall physical health.
- Avoiding highly processed foods
Over-processed foods are prone to nutrient loss during processing. Moreover, they contain many food additives, such flavorings, preservatives to extend the shelf life, emulsifiers or gelatin to stabilize the ingredients, as well as higher amounts of seasonings and fats to enhance the taste.
Although these additives are in line with regulatory standards, once in the body, the liver needs to metabolize all of these, and the more complex the composition the greater the burden on the body.
- A balanced and varied diet
The body needs a variety of nutrients as much as possible from fresh whole grains and cereals, legumes, fish, eggs, meat, dairy products, vegetables, fruits, fats, nuts, and seeds.
When cooking, try to preserve the original nutrients of the ingredients and reduce over-frying and repeated cooking to avoid nutrient loss.
Dr. Chiu recommended consuming the three major nutrients with an appropriate ratio: 10 percent to 20 percent protein, 20 percent to 30 percent lipids, 50 percent to 60 percent carbohydrates, and moderate hydration. He believes that a “balanced and varied diet” is more meaningful than taking many nutritional supplements every day.
- Consuming as much all-natural food as possible
You should eat food in its original form to get a relatively complete set of nutrients and reduce unnecessary additives.
For example, fresh fruits are better than freshly made juices, commercially available sweetened juices, and dried fruits. When consuming rice, you should select brown rice and avoid processed rice products such as rice cakes. Plain water and unsweetened tea are better than sugary drinks and drinks with too many ingredients.
It is also better to reduce the consumption of complex condiments, such as salsa, salad dressing, mayonnaise, barbecue sauce, steak sauce, sweet and spicy sauce, and black pepper sauce.
- Moderation is important
People tend to eat more food than needed when it is tasty, but the body can only absorb a limited amount of nutrients.
And instead of making the body or skin better, wasteful eating habits will easily produce more problems.
The most important principle is to eat the right amount. For instance, as long as they are consumed in appropriate amounts, milk and eggs are not harmful to the skin and are important sources of nutrition for the body.
- Keeping a dietary diary
If you are worried that your diet is causing skin diseases or chronic allergies, you can keep a dietary diary. You should write down the details or take pictures of the food you eat every day, and observe if your skin changes over a short (days) to medium (weeks) period of time.
In addition, some people may suspect that a certain food has caused them to have acne. It may have instead been due to having a menstrual period of staying up late or experiencing stress. Take note of these factors as you keep a dietary diary and make sure to test reducing or adding foods in your diet absent these factors.
Dr. Chiu reminded us that when testing foods, many people overlook the hidden blind spot of eating out. This is because the spices and seasonings that are added to foods consumed outside are difficult to control, and this is something to be aware of.
Dr. Chiu also emphasized that for most people, dietary choices should not be all-or-nothing, but rather finding a middle ground. Many popular diets nowadays are fads, and more scientific evidence is needed to support these diets’ reasonableness and effectiveness. So it is really important to consider their impact on the body and skin before adopting these diets.
Epoch Health articles are for informational purposes and are not a substitute for individualized medical advice. Please consult a trusted professional for personal medical advice, diagnoses, and treatment. Have a question? Email us at AskADoctor@epochtimes.nyc