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Should I Go Gluten Free? 4 Risks of a Gluten Free Diet

Published:
Sep 2, 2020
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Updated:
Jun 4, 2021
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Contributor:
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5 minutes

Medically reviewed by

Erica Dermer
Erica DermerErica Dermer
Consumer & Patient Engagement at imaware™
Erica is as a food & wellness expert with an established reputation as a celiac & autoimmune disease influencer. Writing, editing, appearing on TV and publishing her own book, Erica campaigns and supports those with autoimmune diseases.
Learn about our content process
Stefano Guandalini, MD
Stefano Guandalini, MD
Professor Emeritus at University of Chicago
Dr Guandalini is the former chief of pediatric gastroenterology, hepatology and nutrition at the University of Chicago, founder of the University of Chicago Celiac Disease Center and head of the clinical advisory team at imaware™.
Learn about our content process

Going gluten free has become a massive diet trend in the past 5-10 years. Before then, the average grocery shopper probably didn’t know what gluten was. Now, major food companies are creating gluten-free alternatives for the masses. Restaurants boast about gluten-free menu items on TV commercials and on their websites. And a significant number of people that live in the west (at least 5% or more) have switched to a gluten-free diet and almost a third of people have tried to reduce or remove gluten from their diet.

You might think that a gluten-free diet would have you eating healthier, losing weight and feeling more energetic. In reality, none of these are a valid reason to switch to a gluten free diet. The only two reasons to cut out gluten that are backed by science and recommended by physicians are to treat celiac disease or to avoid symptoms of a true wheat allergy.

 

What is gluten?

Gluten is the general name for proteins found in wheat, rye, barley and hybrid grains. The two main proteins; glutenins and gliadins are responsible for the most adverse health effects of gluten, especially for people who have celiac disease.

Why do people go gluten free?

People go gluten free for a variety of reasons, often the main misconception is that gluten is a root cause of health issues, or a ticket to weight loss. Gluten typically isn’t an issue for the majority of people but for those who have celiac disease or a wheat allergy, it can be very dangerous.

 

Celiac disease and gluten

Celiac disease is an autoimmune condition where consuming gluten in any form can cause serious harm, like long-term organ damage. For people with celiac disease, going gluten free isn’t a new way to lose weight. It’s a strict, medically-necessary diet that affects what they eat, the medications they take, and even the hygiene products that they use.

People diagnosed with celiac disease experience a lot of negative effects when they ingest gluten, even when they eat something as small as a few crumbs of bread. Symptoms include digestive issues like bloating, gas, diarrhea, or constipation. As a celiac, you can also experience nutritional deficiencies that cause anemia, weight loss, or even failure to thrive. Eating gluten could also cause skin rashes, neurological issues, and depression or anxiety. Celiac disease is very serious and those diagnosed need to follow a strict diet, free from gluten.

Non-celiac gluten sensitivity

In addition to celiac disease, some people claim to experience ‘Non-celiac gluten sensitivity’, a name given when someone doesn’t have celiac disease or a wheat allergy but still has an intolerance to digesting gluten (or parts of gluten like wheat). This is a medically ‘muddy’ area, loaded with ambiguities. Unfortunately there is no test currently available on the market to find biomarkers that would indicate a sensitivity to gluten or wheat. In most cases, many with non-celiac gluten sensitivity haven’t ruled out celiac disease. People who have tested negative for celiac disease who believe they still have an issue with gluten or wheat should work with a dietitian and explore taking an elimination diet. 

Many others with gluten sensitivity have celiac-like symptoms (such as abdominal discomfort, gassiness, diarrhea and ‘foggy mind’) because of another medical condition all together. For example, some of those with gluten sensitivity may actually be experiencing an issue with FODMAPs - indigestible sugars present in wheat (and many other items) called fructans. Other foods that are part of these FODMAPs include garlic, onions, and beans.

When someone without celiac disease or a wheat allergy switches to a gluten-free diet, not only will they not see the benefits intended, but they actually may run into nutritional risks. While eliminating things like high carbohydrate foods from the average diet may help with weight loss, there are more effective ways to achieve these results.

Let’s explore the four risks of a gluten-free diet that you need to be aware of before changing your diet:

4 risks to a gluten free diet

Here are some risks that people take when they unnecessarily switch to a gluten free diet without a medical need:

1. Lack of fiber

America, as a whole, has a fiber problem. Only about 5% of the US population is achieving enough fiber to meet the recommended guidelines for fiber consumption. America already has an issue with people consuming fiber without taking away easy-to-obtain sources of fiber by going gluten-free. For example, whole wheat bread is an excellent source of dietary fiber.

By cutting out something that is good for you in appropriate portions, gluten free dieters choose to forgo the benefits of whole wheat products. Other foods can provide these fibers, but generally, only a few are as rich in fiber as whole wheat. It would take a lot more effort to make up for the lack of these fibers in your diet. Other forms of fiber are grains like oatmeal, popcorn, beans, lentils, and high-fiber fruits and vegetables - which Americans are also notoriously under-eating

Those who have celiac disease need to look for high-fiber foods and whole grains - even in a gluten-free diet. Non-traditional gluten-free grains like buckwheat amaranth, millet, quinoa sorghum and teff are all gluten-free and full of fiber. By making sure that you eat plenty of fiber, you will have better overall gut health and receive antioxidant, anti-inflammatory benefits. These benefits can help reduce the risk of cancer and cardiovascular disease.

2. Increased type 2 diabetes risk

In a study involving a very large number of healthy men and women, research showed that when participants ate gluten, they were less likely to be diagnosed with type 2 diabetes. The study showed that the more gluten was in the diet, the less the risk of diabetes. Fiber, vitamins and nutrients found in healthy foods containing gluten proved to be beneficial to the overall health of the participants.

People who voluntarily switch to a gluten free diet give up foods that are important to maintaining a balanced diet - including fiber, essential vitamins and nutrients - which increases risk for adverse health events.

3. Lack of essential vitamins and nutrients

While there are definitely unhealthy foods that contain gluten, there are also healthy foods that give your body the nutrients it needs to function properly.

Similar to the effects of lack of fiber, going gluten free without a legitimate cause can result in vitamin and nutrient deficiencies. In the US, many grains are fortified or enriched to contain large, added amounts of nutrients. Foods with gluten in them (again: wheat, barley and rye) can be a great source of:

  • Vitamin B:
    • Folic Acid
    • Niacin
    • Thiamine
    • Riboflavin
    • Pantothenic acid
  • Iron
  • Zinc
  • Calcium
  • Phosphorus

People with celiac disease are often tested for nutritional deficiencies when first diagnosed, as many are deficient in key vitamins and minerals due to decreased absorption in the gut. Many take a gluten free multivitamin or individual vitamins to try and make up for this deficit. These people also need to be very diligent about finding alternative ways to get the much-needed vitamins and nutrients, like searching for fortified gluten-free alternatives.

Switching to a gluten free diet by choice means that dieters also need to be mindful of what they eat. This makes it more difficult to maintain a balanced diet, which may lead to completely unnecessary added stress in the grocery store aisles for not much benefit. In addition, research has shown that people on a gluten-free diet have increased levels of heavy metals in their blood and urine - possibly due to the increased consumption of rice in gluten-free foods.

4. Weight gain

It has become popular to voluntarily switch to a gluten free diet because of an expectation to lose weight and be healthier. However, just because something is gluten free does not mean that it’s a route to weight loss.

In fact, many gluten-free baked items like muffins, cookies or brownies are higher in calories and sugar than their ‘normal’ gluten-containing counterparts. Also, a lot of junk food that we indulge in is already gluten free. For example, some french fries and candy bars are not off-limits. There are gluten-free replacements for food like cheeseburgers, loaded nachos, pizza, milkshakes, and other high calorie foods.

Because people are tricked into thinking they’re making a ‘healthier’ decision when they choose a gluten free diet, they don’t take the time to check labels and nutrition facts. This can lead to weight gain and unhealthy choices.

While eliminating pasta and bread and the high carbs that happen to contain gluten from your diets may help with weight loss, there much are more effective ways to achieve these results. If you’re looking to lose weight, focus on healthy lifestyle choices, staying active, and working with a dietitian or medical professional. 

Summary

A gluten free diet is essential for someone living with celiac disease. But going gluten free otherwise may be detrimental to your health. Instead, focus on making healthier gluten choices. Eat whole wheat bread (an excellent source of fiber!) instead of white bread, for instance.

If you think you may have celiac disease, you need to be tested before removing gluten from your diet. The imaware™ home celiac disease test kit is the most comprehensive home celiac test on the market. Order the kit and complete the test at home in minutes instead of spending hours in the doctors’ office. The results will tell you whether you may have celiac disease as well as the likelihood that you will be diagnosed with it in the future.

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