Is a gluten-free diet right or wrong for you? What experts say

Being mindful about one’s diet and its nutritional value is gaining significance in modern times when hidden sodium and sugar in processed foods could put one at risk of obesity and its many dangers. However, fitness-conscious people can at times go overboard in avoiding certain foods to keep health trouble at bay. For instance, the myth about going gluten-free for health benefits, even if one does not have any food intolerance needs to be addressed. Gluten is a protein that’s found naturally in certain grains and at times it’s added to processed foods for improving texture or flavour. While by going gluten-free, one can benefit by avoiding the processed foods where gluten is an ingredient, it also means missing out on important micronutrients and fibre present in wheat, barley and rye, which can lead to nutrient deficiency in the long run. (Also read: What is mediterranean diet; top benefits from weight loss to heart attack prevention)

Gluten-free foods are advised for people who have celiac disease, gluten insensitivity or wheat allergy. While people with celiac disease can’t tolerate gluten in any form and exhibit symptoms like belly pain, nausea, bloating or diarrhoea. People with wheat allergy have symptoms such as skin rash, headache or sneezing when eat the grain. However, they aren’t specifically allergic to gluten and can eat barley and rye.

Going gluten-free for weight loss isn’t recommended as naturally occurring gluten in foods is an important source of micronutrients and one may develop deficiencies with this diet and can face increased risk of cardiovascular issues and high cholesterol.

What is gluten?

“Gluten, a structural protein naturally found in certain cereal grains, usually refers to the combination of prolamin and glutelin proteins present in many cereal grains. These proteins can trigger diseases in some individuals. Grains containing gluten include all species of wheat (common wheat, durum, spelt, Khorasan, emmer, and einkorn), barley, rye, and certain cultivars of oats. Gluten proteins are specifically defined as those found in wheat, although related proteins exist in other cereals,” says Sethulekshmi, Dietitian, Dept of clinical nutrition, Amrita Hospital Kochi.

Is a gluten-free diet recommended for all?

“While a gluten-free diet is an effective treatment for certain conditions, it may lead to micronutrient and mineral deficiencies and a macronutrient imbalance, resulting in higher sugar and lipid intake. The recent popularity of gluten-free diets has increased the availability but also the cost of commercially available gluten-free products,” says Sethulekshmi.

“There is no evidence to support starting a gluten-free diet if you have not been diagnosed with celiac disease, a wheat allergy, or non-celiac gluten sensitivity. For the general population with no sensitivity to gluten, current research has not found any link between consuming gluten and increased inflammation or negative impacts on brain health. Some speculate that modern wheat varieties, which have changed from containing two DNA genomes to six, have led to increases in gluten content that negatively affects some people. However, there are no studies confirming this concern. Quite the opposite – eliminating gluten takes many healthy fibre-rich grains out of one’s diet. Packaged gluten-free foods also tend to have more sugar, fat, and calories with less vitamins and minerals,” says Dr Priyanka Rohatgi, Chief Nutritionist, Apollo Hospitals.

“Gluten, a protein in wheat, barley, and rye, necessitates a gluten-free diet for those with celiac disease, an autoimmune condition causing intestinal damage. Non-celiac gluten sensitivity may warrant reduced gluten intake, but complete avoidance is often unnecessary. Wheat allergy demands strict avoidance due to allergic reactions. For the general population without these conditions, a gluten-free diet lacks proven health benefits and may lead to nutritional deficiencies. Processed gluten-free products can be high in unhealthy components. Seeking guidance from a nutrition expert is crucial before significant dietary changes like going gluten-free,” says Pratiksha Kadam, Consultant, Dietician, Kokilaben Dhirubhai Ambani Hospital Navi Mumbai.

Who can benefit by avoiding gluten?

“Gluten avoidance may be beneficial for some patients with gastrointestinal symptoms, such as those associated with irritable bowel syndrome. However, high-quality evidence supporting gluten avoidance for physical symptoms or diseases not directly caused by immune-mediated responses to gluten is neither robust nor convincing. In fact, gluten avoidance may be associated with adverse effects in patients without proven gluten-related diseases.

Indeed, refraining from gluten may have adverse effects on individuals lacking proven gluten-related diseases,” adds Sethulekshmi.

“While a gluten-free diet is medically necessary for managing conditions like celiac disease, major health organizations agree it offers no health benefits if you do not have a diagnosed gluten-related condition. Unless advised to by your doctor, following an unnecessary gluten-free diet puts you at risk for missing key nutrients while overconsuming additives and preservatives. So experts urge that if you have no diagnosed reaction to gluten, you do not need to cut it from your diet to be healthy,” says Dr Rohatgi.

Side effects of gluten-free diet

Avoiding gluten-containing foods without integrating other nutrient sources into the diet can lead to deficiencies in iron, calcium, fibre, folate, thiamin, riboflavin, and niacin.

“As many gluten-containing products are rich in fibre, it is crucial to obtain dietary fibre from other sources such as beans, lentils, nuts, seeds, and gluten-free whole grains. Fortified bread serves as a significant source of B vitamins, and individuals on a gluten-free diet may be at risk of vitamin B deficiencies, which is particularly concerning for pregnant individuals with celiac disease, as B vitamins are essential for foetal growth and development. Constipation is a common side effect of a gluten-free diet, as it eliminates many popular fibre sources like bread, bran, and other wheat-based products. Incorporating a fibre-rich diet may help promote healthy bowel movements,” adds Sethulekshmi.

Items that may contain gluten:

Bread: wheat-based bread

Pasta: all wheat-based pasta

Cereals: most types of cereal unless labeled gluten-free

Baked goods: cakes, cookies, muffins, breadcrumbs, pastries

Snack foods: candy, muesli bars, crackers, prepackaged convenience foods, roasted nuts, flavoured chips, pretzels

Sauces: soy sauce, teriyaki sauce, hoisin sauce, marinades, salad dressings

Beverages: beer and some flavoured alcoholic beverages

Other items: pizza, couscous, broth

Naturally gluten-free items:

Meat, fish, and poultry: all types except battered or coated meats

Eggs: whole eggs, egg whites, egg yolks

Dairy: unflavoured dairy products, including plain milk, yogurt, and cheese

Fruits: berries, melons, pineapples, bananas, oranges, pears, peaches, etc.

Vegetables: broccoli, tomatoes, onions, peppers, mushrooms, asparagus, carrots, potatoes, etc.

Grains: quinoa, rice, buckwheat, tapioca, sorghum, corn, millet, amaranth, arrowroot, oats (if labelled gluten-free)

Starches and flours: potato flour, cornstarch, corn flour, chickpea flour, soy flour, almond meal or flour, coconut flour, tapioca flour

Nuts and seeds: almonds, walnuts, pistachios, cashews, hemp seeds, chia seeds, flaxseeds, etc.

Spreads and oils: vegetable oils, olive oil, coconut oil, butter, margarine, etc.

Herbs and spices: black pepper, turmeric, oregano, thyme, rosemary, parsley, cilantro, etc.

Beverages: most beverages, except for beer (unless labeled gluten-free)