The gluten-free diet has become increasingly popular in recent years. A gluten-free diet can be tremendously helpful for some individuals but is not indicated for everyone. Gluten is a protein found in grains including wheat, rye, barley and some oats. Reasons to follow a gluten-free diet include a diagnosis of Celiac disease or a confirmed gluten-sensitivity. Adherence to a gluten-free diet is the primary treatment for individuals with Celiac disease and may help decrease symptoms in those with a gluten-sensitivity. The desire to lose weight or to eat healthier are typically not reasons to follow a gluten-free diet as gluten-containing grains provide a variety of essential vitamins and minerals, including folate, and can be a cornerstone of a healthy diet, if tolerated. Let’s explore this further. 

If you have been diagnosed with Celiac disease you should begin following a gluten-free diet immediately. Celiac disease is a serious auto-immune condition where consumption of gluten causes damage to the small intestine due to an immune response that the body mounts against the gut when gluten is consumed. The human small intestine is lined with small, fingerlike projections called villi that promote nutrient absorption. Consumption of gluten in individuals with Celiac disease causes blunting of the villi and leads to decreased absorption of nutrients. Celiac disease is hereditary and individuals with a first-degree relative who has Celiac disease have a 1 in 10 risk of developing the disease themselves. The only treatment that exists for Celiac disease is a strict, lifelong gluten-free diet meaning that foods containing wheat, rye and barley should be avoided. 

Untreated or undiagnosed Celiac disease can lead to a variety of long term health conditions. Iron deficiency anemia, osteopenia or osteoporosis, infertility, lactose intolerance, central and peripheral nervous system disorders, pancreatic insufficiency, intestinal malignancies and neurological conditions including dementia, migraines and changes in gait are all possible sequelae of undiagnosed or untreated Celiac disease. Although not as critical, a gluten-free diet can also be helpful for those suffering from a gluten sensitivity.

Unlike Celiac disease, a gluten sensitivity isnotan auto-immune condition and is instead more comparable to a lactose intolerance. Individuals who have a gluten sensitivity will not harm their GI tract by consuming occasional gluten but they may experience uncomfortable symptoms such as abdominal bloating, pain, constipation, diarrhea, fatigue, joint pain or brain fog. A gluten-free diet can be very beneficial for these individuals. Individuals with a gluten sensitivity will experience a resolution of their symptoms once gluten is removed from their diet but have a negative Celiac disease test. If you suspect you may have a gluten sensitivity is important to get tested and rule out Celiac disease due to the potential for serious long-term consequences. Adherence to a gluten-free diet is vital for those suffering from Celiac disease and helpful for gluten-sensitive people but may not be the ideal intervention for those who want to lose weight or eat healthier.  

Desiring to lose weight or to follow a healthier diet arenot primary reasons to initiate a gluten-free diet. Complex carbohydrates, such as those found in whole, gluten-containing grains, are an important component of a balanced diet. These grains contain fiber, B vitamins and folate, nutrients that are often lacking in processed, gluten-free products. Cutting gluten-containing foods from one’s diet can initially be helpful in weight loss but is not sustainable for most people and can even be harmful long term. Food restriction for any length of time puts you at risk for vitamin and nutrient deficiencies. A regular movement routine and increasing fresh vegetable intake at each meal is a more balanced way to approach weight maintenance. 

Gluten-free diets can be very beneficial if followed for the right reasons. If you are concerned that you may have Celiac disease it is critical that you make an appointment with your trusted healthcare provider and receive an accurate diagnosis. Left untreated, Celiac disease can cause a myriad of long-term health conditions. Those with gluten-sensitivities may see improvement in gastrointestinal symptoms, mood and energy by following a gluten-free diet. The desire to lose weight or follow a healthier diet are typically not great reasons to cut wheat out of your diet. Nutrition should be individualized and I encourage you to eat in a way that is sustainable and nourishing for your mind and body! 

References:

1. Celiac Disease Foundation.https://celiac.org/about-celiac-disease/what-is-celiac-disease/ 
2. Jones AL. The Gluten-Free Diet: Fad or Necessity?. Diabetes Spectr. 2017;30(2):118-123. doi:10.2337/ds16-0022
3. Niland B, Cash BD. Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients. Gastroenterol Hepatol (N Y). 2018;14(2):82-91.
4. Saturni, Letizia & Ferretti, Gianna & Bacchetti, Tiziana. (2010). The Gluten-Free Diet: Safety and Nutritional Quality. Nutrients. 2. 16-34. 10.3390/nu20100016.