When acquaintances learn I am a dietitian, they usually respond in 1 of 2 ways:
Scenario 1 “Oh a dietitian! Well, haha… You do NOT want to see what I eat…” As if I'm the Food Police.
Scenario 2 involves the inquisitive person: “What do you think of the Such-And-Such Popular Nutrition Myth?”, or some personal nutrition-related question. Of these diet and personal health questions, one of the most common ones is, “Should I go gluten-free?”
Gluten-free diets have become very popular. A recent Gallup poll showed that 1 in 5 Americans actively choose to include gluten-free products in their diets. And production has soared; sales for gluten-free foods has increased about 63% the past 2 years. Unfortunately, many people who think gluten-free is healthier don’t know what gluten is. [Check this Jimmy Kimmel clip out for a laugh.]
Anecdotal accounts from friends and family about how GI problems or other health conditions were “cured” by omitting gluten from the diet provide compelling influence in the consideration of omitting gluten yourselves. And media, the food industry, and under-educated nutrition/health/fitness coaches have been spreading a gluten-free mantra with broad and bold health claims. With all the positive noise around going gluten-free, how can you know if it’s right for YOU?
This blog is to help you! Here are some important things to consider if you’ve been wondering where gluten should [or shouldn’t] fit in your diet:
1. You should have a gluten-free diet if you have celiac disease. Celiac disease is an autoimmune condition that causes damage to the intestinal wall when gluten is eaten. People with celiac often have abdominal discomfort, diarrhea, and fatigue. It is diagnosed by a blood test, with a biopsy sometimes to confirm. It tends to run in families and isn't very common (only about 1% of the population). To improve and even eliminate symptoms, people with celiac disease need to avoid gluten. For some, even very small amounts of gluten can trigger symptoms. Here is a great guide to gluten-free living for people with celiac disease: https://celiac.org/index.html. Don’t know if you have celiac disease? Talk to your doctor about your symptoms and whether you should get the blood test.
2. Even if you don’t have celiac disease, you may have a sensitivity to gluten (or, more probable, FODMAPS) that causes symptoms and could benefit from reducing dietary gluten--or FODMAPS. There has not been a lot of research on non-celiac gluten sensitivity, but a couple placebo-controlled studies have shown that some people with celiac-like symptoms who don't produce antibodies to gluten improve their symptoms when they omit gluten. However, the research isn't very clear yet, because conflicting results have occurred in studies, and the biological mechanism of a "sensitivity" hasn't been clarified. Regardless, many people feel significant relief from GI symptoms, and some other non-GI symptoms like headaches and chronic fatigue, when they reduce gluten.
Beyond a gluten sensitivity, the common reports that avoiding gluten improves GI symptoms may be due to the fact that naturally gluten-containing foods tend to be high in fermentable oligo-di-monosaccharides and polyols (or--much easier!--FODMAPS). In people with irritable bowel syndrome (IBS), which often mimics celiac in symptoms and is about 10x more common, reduction of readily fermentable foods (which are simple sugars found in lactose, gluten-containing grains, fruits, legumes, and high-fructose corn syrup) decreases the GI symptoms. For many who benefit from a low FODMAP diet, restoring gut microbiota with probiotics can help relieve symptoms and permit the inclusion of FODMAPS and gluten again in the diet without symptoms.
Another reason why going gluten-free may help people without celiac improve GI symptoms and improve other health problems is that often when people make the behavior change of avoiding gluten, they become more aware of what they are eating... and tend to make more nutritious choices. People start reading labels and noticing what's in the food they eat, and, simply by an increased awareness, they become more thoughtful about what they eat. For this reason, they may gain many health benefits of nutritious eating--loss of excess body fat, increased energy, improved GI function--all of which actually have nothing to do with omitting gluten.
Don’t know if you have gluten sensitivity? Speak with a Registered Dietitian like me! You can contact me here, and I can help you identify triggers—which may or may not actually be related to gluten—and plan diet changes that are right for YOU.
3. If you don't have concerning symptoms and want to improve your nutrition, going gluten-free won't be helpful. There is nothing inherently unhealthy about gluten. In healthy persons, it is digested by enzymes in the gut and by bacteria in the colon, problem-free. There are many gluten-containing foods that are nutrient-dense, high in fiber, and great to include in a balanced diet, such as whole-wheat breads and whole-grain cereals; you may be missing out on nutritious and tasty foods by needlessly avoiding gluten. Food manufacturers are LOVING the confusion about gluten, charging on average over twice as much for gluten-free products as their gluten-containing comparisons. Instead of avoiding gluten, practice balance, variety, and moderation! To use words from Michael Pollan, "Eat food. Mostly plants. Not too much."
For questions or comments, please post or contact me! -Joy