Does Going Gluten-Free Equal Fabulously Healthy or Fabulously Foolish?

Gluten-free foods are all the rage these days.  Gluten free breads, pizzas, muffins, cookies, cakes, crackers, pretzels and more are everywhere. If there was a good time to have Celiac Disease, today is the day.  Now more than ever we can find goodies in the grocery stores labeled “Gluten-free,” advertised ostensibly in shinny, attractive print.  Pop-culture abounds with messages to, “go gluten free” and the media shouts to us to, “become a gluten free goddess and embrace feeling better and more energetic.” Just as low-carb everything was in vogue during the days of Atkins and South Beach, gluten-free foods have become the new go-to products for health conscious consumers and weight loss seekers. However, does avoiding gluten really confer health benefits? For most people, the answer is an unequivocal no.

Gluten Free Aisle. Flickr: Whatsername?

First of all, it would be helpful to us to understand what gluten is so we know what we are avoiding.  Gluten is simply a compound made of two proteins, gliadin and glutelin, bound together by starch (a carbohydrate). Grains themselves contain three parts: the bran (or hull), the germ and the endosperm.  Whole grains contain all three parts, while processed or refined grains contain just the endosperm.  Because gluten is found in the endosperm, it can be found in all grain products, regardless of processing.  Gluten is pretty much your typical grain product’s reliable sidekick, but unlike processed white bread, odds are eating it will not make you look like Gwyneth Paltrow in Shallow Hal (in which she wore a fat suit).  Additionally, unless you count yourself among the less than 10 percent of people with gluten sensitivity, the consumption of gluten will not be too difficult for your digestive organs, or result in undesirable aches and pains or an allergic reaction.

Celiac disease, aka gluten-sensitive enteropathy, is a disease in which the immune system attacks gluten as if it were a threatening invader, such as a pathogen or a parasite.  The inflammation that results can damage the intestinal lining, leading to malabsorption of many nutrients – including many essential vitamins and minerals.  Symptoms for a person with this carb-lovers nightmare can range from abdominal discomfort, to an itchy rash, to the manifestation of nutrient deficiencies.  Over time, for someone with celiac disease, the ingestion of gluten can increase the risk of intestinal cancer.  There is no doubt that celiac disease can be lethal if gluten is continually eaten and failing to address this condition can result in an tragic, early visit from the grim reaper.  For most people with celiac disease, it was pretty easy to detect because the symptoms are so obvious- quite simply, you eat grains and you feel awful.  However, this can be a hidden cause of health problems, especially in its milder forms that then go undetected. 

Besides celiac disease, it is possible to have gluten sensitivity, which is more common than celiac disease, but much less worrisome.   It is very different from celiac disease because there are no antibodies for gluten present or observed damage to the lining and architecture of the intestine.  People with gluten sensitivity are not at risk for intestinal cancer and are less likely to have nutrient deficiencies as a result of gluten ingestion.  What is intriguing is the numbers of people who are showing signs of gluten intolerance today.   

Compared to ladies living a half-century ago, the women of today are up to four times more likely to develop celiac disease or an intolerance to gluten.1  I repeat, four times from just 50 years ago! This is shocking and I am disturbed that increasing numbers of women cannot enjoy a hearty, all natural fruit pie, or pita pocket unless going out of their way to find gluten-free bread or other grain product.  More women than ever are dealing with grain product hell and no one really understands why it’s happening, although there are a few theories.

It’s been suggested that there are new-age exposures to gluten that may be more likely to trigger immune system responses. Genetic modifications to grain products have increased the gluten content of wheat and other grains in some cases.  It’s also possible that genetic modifications are introducing new chemical compounds into our diets, and some reactions to gluten may be a result of the new company it keeps.  Also all the processed foods eaten today, including white flour products, oils and fried foods damage human immune function.  And thanks to modern food processing, we are now finding the presence of gluten in everything from candy and meats to potato chips and processed breakfast cereals.  The addition of gluten to these low-fiber and low micronutrient-containing products might spark immune reactions in some people.  All of this is speculation and further studies need to be done to figure out why more people are developing adverse reactions to gluten. 

While this mystery remains, what is important to keep in mind is that while the number of people with gluten sensitivities may be rising, the number of people who don’t digest it well is still relatively small.  Only 1 percent of the entire population has celiac disease, and gluten sensitivity still only effects 5-10 percent of the population.2,3  For all other people, avoiding gluten provides no health benefits.  Avoiding gluten for 90 percent of the population is like avoiding peanuts when you don’t have a peanut allergy. It is totally needless.  If you experience unpleasant symptoms or stomach upset after eating grain products, then it is well worth a trial of avoiding all gluten containing grains and products and also getting a blood test done to test for celiac disease. 


References:

1. van den Broeck HCde Jong HCSalentijn EM. Presence of celiac disease epitopes in modern and old hexaploid wheat varieties: wheat breeding may have contributed to increased prevalence of celiac disease. Theor Appl Genet.2010 Nov;121(8):1527-39. Epub 2010 Jul 28.

2. Rewers M. Epidemiology of celiac disease: what are the prevalence, incidence, and progression of celiac disease? Gastroenterology. 2005;128(4 suppl 1):S47-S5

3. National Institutes of Health Consensus Development Conference Statement on Celiac Disease, June 28-30, 2004. Gastroenterology. 2005;128(4 suppl 1):S1-S9.

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Comments (25) Read through and enter the discussion with the form at the end
Ginger - January 5, 2012 3:40 PM

Yup, it was **** until I figured it out. My other gluten intolerant friends and I agree, it is way better to know-food isn't everything. Really, I don't miss baked goods and all that anymore. I 'snuck' a flour tortilla about 6 months ago. I can't believe I once thought they were good. It tasted first like dust, then like mud. After one bite, I threw it away. So many of my old favorites and staples are that way now. The secret's in the greens!

Katharine Halpin - January 5, 2012 4:01 PM

I have been off of all grains since late April 2011. I cannot tell you how much better I feel. I highly recommend eliminating grains and assessing your reaction.

Nora Manwiller - January 5, 2012 4:09 PM

While I agree that avoiding gluten does not confer health benefits on those who do not have some type of intolerance. And I also agree that typical "gluten free" alternatives are NOT nutrient dense foods. I have found that gluten sensitivities can take many forms. Personally I notice more energy and overall health being GF. Four of my six children have sensitivities of different kinds. Most of them are cognitive in nature not digestive. Children with autistic spectrum disorders or other learning challenges frequently benefit from a GF diet in my experience. I would personally recommend a GF trial to anyone with ANY health problem. Since negative effects of gluten on increasing numbers of people are poorly understood and the number of body systems that can be affected are so varied, it seems to be a wise, inexpensive, and harmless trial. I have seen people recover from all sorts of annoying health problems after removing gluten from their diets. However the big caveat is that it is NOT a good idea to suddenly flood your diet with refined GF substitutes.

Natalie - January 5, 2012 4:18 PM

Whilst going Gluten Free may not help people doing it just for fun - the test for Celiacs and even allergy tests are very often inaccurate. The Dr I went to told me that. I've always known Gluten was a problem but I kept eating it because I failed the test for Celiacs.

Despite a mostly plant based diet, I suffered manic depression and constant fatigue and fuzziness. Within a week of going Gluten Free it started lifting and now for the first time in my life I can function like a normal person and keep my life organized without feeling constantly hopeless.

The true test was when I went OFF the diet at Thanksgiving - horrible, horrible to feel that way again.

I say give it a shot if you feel unwell - but trade gluten for vegetables and other whole grains. I like Millet, Quinoa and the Brown Rice Pasta. The fad is fine with me, because now everywhere carries stuff I can eat. ;)

Michael - January 5, 2012 4:22 PM

For those of you sensitive to grains. Do you have the same problems with whole, unrefined grains cooked in water? I think I've noticed issues after eating a lot of bread or other baked goods, but I don't notice any negative symptoms eating brown rice, wheatberries or oats cooked in water.

Mia - January 5, 2012 4:31 PM

I'm actually very curious about this topic because I like to occasionally make some seitan as a meat substitute but with all the fuss about gluten I wondered if it was bad. It's probably not a nutrient-dense food but I'm hoping it's not all that horrible?

Lisa - January 5, 2012 4:41 PM

Isn't gluten a wheat protein?
Can't you still have corn, rice and oats? And buckwheat? (which isn't related to wheat)

Gilles Arbour - January 5, 2012 4:55 PM

I found out recently that many of my symptoms were gluten related and avoiding all gluten grains has made a tremendous difference for me. A blood test confirmed the issue.

But one important point is that Gluten Free foods are NOT necessarily healthy. Pre-made foods that are labeled gluten free are often gluten free junk because they contain a lot of sugar or poor quality low nutrient ingredients.


Rebecca Cody - January 5, 2012 5:33 PM

If you think today's wheat is good for you, you need to read Wheat Belly by a doctor who takes everybody off wheat for a trial period. He finds many people who don't test for gluten intolerance feel much better without it and get over longstanding health issues. I'm away from home and the book, and having trouble remembering the author's name, but it seems to me it may be William Davis or something with similar words.

Today's wheat has been hybridized and changed so drastically in just the last 50 years that it scarcely resembles the wheat that people have eaten for thousands of years. Today's wheat has far more gluten than previously eaten wheat. It contains gluten molecules that have never before been consumed by people. Even if this weren't the case, there is evidence that health declined tremendously thousands of years ago when people first began growing wheat and making it a staple of the diet.

I think the greatest danger from going gluten free is the number of newly introduced gluten free junk foods, which allow people to go gluten free but keep their bad habits intact!

Liz - January 5, 2012 5:53 PM

Question: knowing that some grains have been genetically modified, and that gluten is in many food products, would it be a good idea to avoid these products in order to reduce the possibility of developing an intolerance or sensitivity in the future?

juliebbb - January 5, 2012 10:52 PM

I experience total body fatigue and aching arhritic joints when I eat wheat. It took a long time to figure out what it was, but now that I know, I avoid all wheat products and feel much better. I also avoid most 'gluten free product'. Why? because they are essentially junk food. The flours and baked goods are not usually whole grains, they are highly processed, tapioca starch, arrowroot starch, xanthan gum etc. Not what I want to see on the ingredient list. I prefer not to have to read ingredient lists, so it is much better to stick to naturally gluten free foods, such as fruit, all vegetables, nuts, and get starch from potatoes, yams, and whole grain rice, quinoa etc. No labels, wheatfree and yummy, too. Most processed gluten free food has terrible taste and texture that you can get 'used to' if you must, but I can't imagine anyone eating most of those products just because it is a fad.

Nigel Purchase - January 6, 2012 12:59 AM

I cannot eat wheat or rye or oats without them giving me dreadful heartburn -- as if there is a fire in my stomach. But I was given a gastroscopy and also tested for coeliac disease and I am *not* gluten intolerant. I asked a kinesiologist friend why this should be so and he said he's seeing more and more ppl with this problem, and he attributes it to the use of Round-Up on the wheat.

Laura - January 6, 2012 8:37 AM

Folks who are sensitive to gluten have destroyed their gut flora. Instead of all the franken-gluten-free foods, they should be re-habilitating their guts.

John B. - January 6, 2012 9:17 AM

I donĀ“t know what to think. We have many different opinions (for example Glutem Free Diet) and no reliable statistical information to choose from. I know that for many people only the idea of eating healthy is sufficient to actually become more healthy. Something like placebo effect with drugs. So where is the right answer?

Suzy - January 6, 2012 12:41 PM

There is an anti-grain movement out there that is very popular in the alternative medicine world, but I like the idea that grains have something to offer to our nutritional status, just like all of the other food groups.

My take is that in the SAD we have replaced whole grains with white flour products and other processed forms of grain. This may be why there is more gluten intolerance now than 50 years ago. If we stick to mostly whole foods and avoid processed foods, grains can be part of a healthy diet.
(Of course, if you have Celiac Disease, you will need to avoid those grains that have gluten.)

Hilary - January 6, 2012 7:03 PM

I take your point about most people not being officially 'gluten intolerant'. But I wonder how many are something like me. I was basically healthy, just a bit of joint pain - couldn't lift a heavy pan full of water with one hand, didn't like standing for more than an hour - and occasional indigestion, that kind of thing. Nothing unusual, nothing disabling, nothing you'd think worth mentioning or doing anything about.

Then I changed my diet to lose weight - stopped grains, sugars and industrial vegetable oils - and the joint pain and indigestion vanished long before the weight did. I'm going to guess this is because of the removal of grains.

So I'd suggest a 30 day grain-free trial is a pretty painless thing to do that could be interesting for anyone. Of course, there is no need for gluten-free breads, pastas etc. You can just replace grains with vegetables, which are way more nutritious per calorie (and taste better) anyway.

mgm - January 6, 2012 7:15 PM

Went gluten free in May of 2011 to see, as a last resort, if it was the key to migraines, which I have had since the age of four. Bingo - it was like a miracle. I'm 52. I really wish I had figured it out decades ago - I'd have had a different life. The headaches just flat stopped, and I used to get several a month. I also lost weight because, just as a natural consequence, I gave up unhealthy, fattening foods that are carriers for fat and sugar - pastries, pizza, etc. When I found out I could still have corn, brown rice, potatoes (sparingly on the potatoes) I was golden. Rather than getting the weird gluten substitute foods (too much soy and chemicals) I decided to just embrace what I can have and make the most of it. I feel great, lost 15 pounds and am enjoying lots of great food. and pain is no longer my constant companion.

Sara - January 7, 2012 5:56 PM

Mia- I have heard Dr. Fuhrman refer to seitan as junk food. I think it was not because of the gluten but because virtually all of the nutrients in the original wheat have been removed. As you suspected- not nutrient dence. I would not call it "horrible" - like hot dogs or butter or donuts.

Dot - January 9, 2012 2:31 PM

My older daughter suffered with anemia and GI issues for years. Finally had an endoscopy as she was having trouble swallowing. The Dr did a biopsy at the same time, which confirmed celiac disease. Since getting off the gluten she has color in face again and her GI issues are resolved.

Based on that, hubby got the genetic test which was negative. Then I got the genetic test which was positive. I declined the biopsy and just started eating gluten free. I had already been following a vegan diet and trying my best to eat nutritarian (except when I fell off it). Since getting off the gluten, I've had no trouble staying nutritarian and I feel like a million bucks. I had vague GI symptoms and vitamin D deficiency. GI symptoms resolved. I have more energy and have lost a few pounds. I suspect I will not need the vitamin D supplements much longer. Following the nutritarian diet is now a breeze.

Your results might be different, but that's my story!

Amy - January 18, 2012 12:06 PM

I recall reading that Dr. Fuhrman (or possibly an affiliate) stated that those with autoimmune diseases other than celiac disease should also avoid gluten.
I think I read it in his new book: Super Immunity.
I have Hashimotos thyroid disease and my young son has type 1 diabetes. I know that I feel much better when I avoid gluten...so much better. I wonder if I should remove it from my son's diet? Or am I falling for the trendy evil grains trap?

Deana Ferreri, Ph.D. - January 18, 2012 3:30 PM

Amy,
In Super Immunity Dr. Fuhrman does recommend avoiding wheat if you have an autoimmune condition.

Amy - January 22, 2012 3:21 PM

Thanks for the confirmation Dr. Deana!

Mary - January 24, 2012 9:33 PM

Deana,
I would greatly appreciate if you could give the rationale for advising autoimmune patients to avoid wheat. I have Grave's disease, tested negative for celiac's with a blood test but was advised by Dr. Benson that there is a (stool?) test that is better at detecting gluten insensitivity. Could you advise the name of the test and where to get it done? I enjoy bread alot and don't want to cut it out if not necessary. Dr. Benson said the test he referred to could indicate whether it was necessary in my case to cut out gluten. Life would be much simpler if I and others learned if there was a true need or not on an individual basis. Thanks for any info you might share!

JenLamSis - February 29, 2012 10:48 AM

It's taken me 8 years to figure out debilitating arthritis was being aggravated by food sensitivities, particularly nightshade vegetables (potatoes, tomatoes, eggplant & peppers) and additional foods that share a glyco-alkaloid found in nightshades (solanine is found in blueberries, apples, artichoke and okra). I have been playing around with different food eliminations, to see if I have additional food sensitivities, and have found a huge majority of gluten-free products contain potato starch, and can't be tolerated.
Initially going Nutritarian caused my arthritis to get worse, not better, but now that I know it's only a few specific fruits and vegetables, I remain committed to a plant-strong diet. Never turning back!

Melanie - July 13, 2012 12:22 PM

I would like to know where seitan might fall on Dr Fuhrman's nutrition pyramid? Thank you.

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