What you need to know:
- Gluten is a mixture of proteins that occur naturally in wheat, rye and barley
- 7-8% of the world population has celiac disease or a gluten sensitivity
- If you don’t medically need to eliminate gluten, there are some risks to a gluten-free diet
Over the last several years, there’s been increasing discussion about whether a gluten-free diet can be beneficial for weight loss or your overall health if you don’t have a gluten allergy. There’s also been an increasing number of gluten-free options at grocery stores and in restaurants.
But what is gluten, and should you go gluten free?
Gluten is protein that occurs naturally in wheat, rye, and barley. It can also be added to foods for texture or to add elasticity.
But the dietitians we spoke with say there’s no evidence to support that cutting out gluten can help cut calories or weight; in fact, some of the gluten-free foods can have higher calorie, sugar and fat totals than their gluten-containing counterparts.
Gluten is fine for most people, but for the three million Americans (1% of the world population) who have celiac disease, it can have devastating results when gluten triggers an immune response, causing the body to attack the lining of small intestine. There are more than 200 symptoms, including abdominal pain, diarrhea and anemia.
Jane Rose knows that all too well. She had digestive issues for what seemed like forever, but “doctors chalked it up to not having enough fiber or water,” she says. But “in 2016, I found myself getting sick every night and just couldn’t handle the pain.”
As many as 1.5 to 2 million Americans are undiagnosed, which could lead to long-term damage.
“At the ripe age of 20, I had my first colonoscopy and endoscopy, where they found my small intestine was destroyed – a giveaway for celiac disease,” says Rose.
Sara Jank, MS, RDN, CDN, is a clinical nutritionist at Roswell Park Comprehensive Cancer Center. She says, “Very, very small amounts of foods in gluten can severely damage the intestine of patients with celiac disease.”
6-7% of US population have a wheat allergy or non-celiac gluten sensitivity (NCGS).
Registered dietitian nutritionist Kara Lydon, RD, LDN, RYT, says, “With NCGS, the intestines may or may not become damaged, and individuals often experience symptoms such as abdominal pain, constipation, diarrhea, bloating, headaches, and even neurological symptoms such as brain fog, ADHD, fatigue and anxiety.”
Amanda McMahon falls into this category. She had been suffering with digestive issues for a decade, but she tested negative for celiac disease.
“It felt like someone attached a sandbag to my stomach. I was irritable and cranky and tired,” says McMahon.
In April 2020, she ended up in the emergency room with severe abdominal pain, but doctors weren’t able to figure out what was wrong.
“It was a very frustrating process not having answers,” says McMahon.
She decided to try going gluten- and dairy-free.
“Nothing changed immediately. The fact that it wasn’t immediate was really frustrating,” she says. “It was more than just removing the gluten. It was removing dairy, removing eggs, removing sugar, limiting my alcohol, and then taking supplements to help heal my gut. It was six to nine months down the road where I finally felt relief. It was a breath of fresh air and made me feel like I wasn’t crazy.”
If you think you might have a gluten sensitivity (rather than celiac disease), Jank says it is important to work with a dietitian to find out what could be causing your issues. “Take gluten-containing foods out of your diet and keep a food journal of what you eat and your symptoms. Unfortunately, it is sort of an elimination trial and error of sorts. I would do it for a couple weeks and see if you have an improvement in symptoms.”
For people with these conditions, it is critical to avoid gluten, which can be tough, since gluten is in a lot of foods. It’s also important to check labels.
“So many foods that you think are safe have gluten as an additive, everything from soups to candy. I’ve made a lot of mistakes assuming things were safe. That also applies to makeup and any type of hair product— you could be ingesting it without even knowing,” says Rose.
Furthermore, “If something is even cross-contaminated (using a toaster that once toasted regular bread or a fryer that cooks breaded chicken fingers), I will be violently ill for hours with pain you can’t imagine, and then nauseous for the following five days. My stomach will be so sore, I won’t be able to sit up without help from someone,” says Rose.
Both women say going gluten free has significantly improved their quality of life. “I used to think it was normal to be hungry two minutes after eating, turns out I wasn’t absorbing any nutrients, which also led to my constant fatigue, both of which are gone. I’m also just relieved that I won’t suffer the long-term effects of not finding out,” says Rose.
But it is important to work with a dietitian or nutritionists to make sure you’re making up for the lost nutrients.
“Gluten-containing grains provide B vitamins, fiber, zinc, iron and potassium. So if you’re trying gluten-free, focus on a varied diet with fruits, vegetables, gluten-free starches, healthful fats, and proteins to make up for these nutrients,” says Lydon.
“There are gluten-free whole grains that you can include, that we recommend people include to get some of those nutrients as well,” says Jank.