Should you go gluten-free?
Over 22 million Americans are now reaching for gluten-free alternatives, self-reporting that gluten in foods causes them to experience distress afterwards. Celebrities from Gwenyth Paltrow to Oprah Winfrey have all touted gluten-free diets. But less than a decade ago, gluten wasn’t even near top-of-mind when considering what to eat, much less when considering healthy options.
So lets separate myth and fact and get clear about gluten.
What is gluten?
Gluten is a protein that’s found in grains like oats and wheat and barley and rye; it’s the “glue-like” substance that gives dough its chewiness and elasticity, and makes bread rise when it’s baked.
What is celiac disease?
The chief reason to stop eating gluten is if you are seriously allergic to it. About 1 percent of the American population has celiac disease, which is a serious autoimmune disorder that prevents the body from being able to process gluten.
When someone with celiac disease eats gluten, it triggers a response in the small intestines, and over time damages the lining which can prevent absorption of some nutrients. Sustain for a long period of time, it can cause painful symptoms like anemia, bloating, diarrhea.
This is a hereditary disease, and can be determined with a blood test. While most experts agree the 1 percent number is a conservative estimate and celiac disease is underdiagnosed, nobody thinks the real number is ten times that (putting us near the 22 million mark). Beyond celiac disease, there are other reasons why some people feel bad after eating foods with gluten.
Should anyone else avoid gluten?
There are also some people who have wheat allergies—not quite the same as a gluten allergy, but these people would definitely avoid many of the same foods.
And then there is what is now called “gluten intolerance” and “gluten sensitivity,” the former more severe than the latter. Neither of these are specific enough to be tested, so the jury is out on whether these are the real causes of discomfort and bellyaches.
But if eating pastas and bread chronically causes discomfort, you should listen to your body. There are other dietary conditions you can test for that might be masking as a gluten intolerance.
Irritable Bowel Syndrome (IBS) is a common disorder (affecting about 10 percent of adults), where the large intestine easily acts up, and can cause cramping, bloating, gas, constipation, and abdominal pain. It’s generally considered long term and managed by taking care of your lifestyle and diet in a way to minimize symptoms.
The group of foods thought to contribute to IBS is called FODMAP—fructose (when in excess of glucose), fructans, galacto-oligosaccharides (GOS), lactose and polyols (eg. sorbitol and mannitol). You would want to avoid fermented foods and various sugars, which includes a wide range of food from apples and honey to milk or garlic. Most people don’t have any trouble digesting these foods at all, but the sugars they contain end up creating a lot of gas in the small intestine.
Lactose intolerance is another common chronic condition where your body isn’t able to digest lactose sugars—thus causing most dairy products to send you looking for the bathroom. The condition is somewhat hereditary, but not very serious, and can go away over the course of someone’s life.
Vitamin deficiency might be another cause misleading one to diagnose as anti-gluten. A study found that people with iron and folate deficiencies show similar symptoms.
So what does gluten do for you?
One popular opinion among scientists is that gluten itself doesn’t do you much good or bad. Going off gluten itself won’t automatically give you health benefits, though not eating gluten means you should do some research to see what else you would be cutting out of your diet and how to supplement that.
“People who are sensitive to gluten may feel better, but a larger portion will derive no significant benefit from the practice. They’ll simply waste their money, because these products are expensive,” according to Dr. Daniel A. Leffler, director of clinical research at the Celiac Center at Beth Israel Deaconess Medical Center in Boston.
Some caution that adhering to a gluten-free diet when you don’t need to may cause one to avoid otherwise healthy grains, which would be detrimental if you’re replacing them with less healthy options.
For instance, gluten-free breads made with white rice or tapioca flour are lacking in fortified vitamins and fiber, which is a necessity in your diet.
Many people, including many celebrities, have touted health effects from going gluten-free either temporarily or permanently. It’s worthwhile to note that, for many, going gluten-free includes weaning off breads and other refined-flour products that can also be high in sugars and were not healthy additions to a diet to begin with.