5 Factors to Consider Before Following A Gluten-Free Diet
There are many fad diets that become popularized through health and fitness magazines. The gluten-free diet has gained a lot of attention recently even by those who are not truly gluten intolerant or suffer from celiac disease. This trending nutrient focus has been amped by celebrity testimonials and hyped by news coverage. The gluten-free diet surrounds an effort to limit gluten protein intake found in grains such as wheat, rye, oats, and barely. Some physicians warn that going gluten-free is definitely not for everyone; it is not necessarily healthy nor does it inherently promote weight-loss. In fact, many physicians advise that only people with diagnosed gluten sensitivities adopt this special diet. What is interesting about many who end up following a gluten-free diet is not the gluten affect but rather that they end up cutting out a lot of processed grains, starches and poorer food choices - which may in itself help reduce gastrointestinal issues and inflammation over time.
On the other hand, gluten free is very important for people with celiac disease, which is a genetic autoimmune condition. Consuming gluten damages the small intestine over time and prevents the body from absorbing nutrients from certain foods. Common symptoms include gas, intense cramping, bloating, changes in bowel movements and appearance, weight loss, significant fatigue and general weakness. Non-celiac gluten sensitivity produces symptoms similar to those seen with celiac disease, but it is not an autoimmune disorder and does not have a genetic component. Additional symptoms with non-celiac sensitivity are purported to include headaches, skin irritation and muscle pain.
The National Institutes of Health (NIH) estimates that celiac disease may affect over 2 million people in the U.S., or up to about 1% of the population. It is more common in Caucasians, women and people with certain genetic diseases, including Down syndrome and Turner syndrome. Some anecdotal evidence estimates that about 5-6% of the US population may have some degree of non-celiac gluten sensitivity - but there is currently no accepted medical test for this condition, so some argue it is an all-cause diagnosis. It is very important for those with celiac disease to get treatment because it can lead to anemia, osteoporosis and an increased risk for lymphoma, while the repercussions of gluten sensitivity are less clear. Diagnosis for celiac disease requires blood tests to check for certain antibodies, and usually an endoscopy with tissue samples. Interestingly, most people who follow a strict gluten-free diet have not gone through this somewhat rigorous diagnostic process, nor have recognized gluten sensitivity by a physician. While acute changes in the diet seem to be less risk – long term adjustments can have consequences on health and performance.
With the above information, it should be clear that a gluten-free diet is critically important for certain diseased individuals, but for others there are a number of factors to consider before one jumps on the bandwagon of gluten-intolerance.
- A gluten-free diet is not necessarily healthier than a standard balanced diet: “For the general population, there’s no evidence that a gluten-free diet has any beneficial effects,” says Dr. Benjamin Lebwohl, an assistant professor of medicine and epidemiology at Columbia University’s Celiac Disease Center. Interestingly, gluten-free product variations of many products (e.g., pasta) often have more calories and fat to retain a given level of flavor and texture. Many people do not recognize the impact gluten (wheat) protein has on the texture and other qualities of baked goods.
- A gluten-free diet does not necessarily help one lose weight: Many gluten-free products contain select grains that are relatively rich in simple carbohydrates compared to their gluten counterparts (e.g., tapioca). “…there’s no scientific research to support that a gluten-free diet will lead to weight loss”, says Dr. Alessio Fasano, director of the Center for Celiac Research and chief of the pediatric gastroenterology and nutrition division at Massachusetts General Hospital. Most health professionals believe that people who shed pounds from following a gluten-free diet do so because they begin to make overall healthier food choices.
- Cutting out gluten may lead to deficiencies in essential vitamins and minerals: “My general approach is that if one feels well, one should not go on a low-gluten or gluten-free diet,” Dr. Lebwohl says. Unfortunately, gluten-free products tend to be lower in the beneficial components found in wheat, such as fiber and iron. Substituting too many products when unnecessary can possibly lead to select micronutrient deficiencies.
- Following a strict gluten-free diet can be expensive and burdensome: Anyone who has decided to begin a gluten-free diet and makes their first trip to the grocery store with the goal in mind quickly comes to realize how accurate this statement can be. The consumer must check every single label for variations of gluten-containing components. The amount of convenience foods one can purchase diminishes considerably. Most gluten-free products require special facilities with increased production cost - which is passed down to the consumer (e.g., Lenders bagels 6-count = ~$2.00; Udi’s gluten-free bagels 4-count = ~$5.50).
- Find out if you actually have celiac disease or gluten sensitivity before starting the diet: Often, symptoms of celiac disease may be confused with other gastrointestinal disorders such as irritable bowel syndrome (IBS) and/or lactose intolerance. As mentioned earlier, there are several accurate blood tests available for detecting celiac antibodies. However, one should make sure they get tested before switching to a gluten-free diet, or sensitivity may remain incorrectly undetected. Stefano Guandalini, MD, the medical director of the University of Chicago Celiac Disease Center, notes that the true prevalence of gluten sensitivity probably will not be known until biologic indicators exist to diagnose the disorder. He adds, “Someone who needs to be on a gluten-free diet and is closely monitored can benefit tremendously from it. But for everyone else, embracing this diet makes no sense.”
Overall, following a gluten-free diet has its pros and cons but is really only necessary for those with select conditions that impact about 1% of the US population. How the number of proponents for a diet with limited confirmed efficacy for healthy people greatly surpasses this number demonstrates how easily people fall for behaviors that are talked about the most, whether truly relevant to their condition or not. It seems eating a clean diet, rich in nutrients from a variety of plant and animal sources, while avoiding process foods is a safe and effective move.