By: Megan Perez, dietitian at Nourishing Minds Nutrition

Ahh yes. Gluten. By now, most everyone has heard of gluten and many, many people have made an attempt to eliminate it from their diet. It’s safe to say that “gluten-free” is one of the most popular food trends today. Do you currently follow a gluten-free diet? Have you at one time or another? There are more people following this restriction than ever before. But why? What is causing the gluten-free trend, and is it valid?

Let’s start with the basics. What is gluten?

The dictionary defines gluten as a substance present in cereal grains, especially wheat, that is responsible for the elastic texture of dough. I describe it as a spongy protein found in barley, rye, oats, and wheat or BROW (I love acronyms). Gluten acts like glue, giving bread a soft and chewy texture or helping to hold foods and products together. If you have ever tried gluten-free breads, it’s hard to find one that truly compares to the real deal. Aside from breads and cereals, gluten can be found in pastas, sauces, flours, soups, condiments, candy bars, sausages, beer, and more. It can even be found in medications and personal hygiene products.

Who should go gluten-free?

While a majority of people can tolerate gluten, those who have been diagnosed with Celiac disease must avoid all gluten containing foods. Celiac disease is an autoimmune disease in which the ingestion of gluten damages the small intestine and may lead to serious health complications. According to the National Institute of Diabetes and Digestive and Kidney Disease, only one in 141 Americans have Celiac disease. You may develop it as a child or even later in life as an adult. Symptoms of Celiac may include diarrhea, gas, bloating, constipation, weight loss, iron-deficiency anemia, depression, joint pain, migraines, or others. As you can see, there are many symptoms of Celiac that could also overlap with other health conditions or could even be experienced by a healthy individual. Someone with this disease may not have any symptoms at all! The only true way to know is by testing.

Non-celiac gluten sensitivity (NCGS) is another condition gaining in popularity. NCGS may cause symptoms similar to Celiac disease, such as diarrhea, pain, and bloating, but does not damage the intestine. Diagnosis for this condition is typically based on symptoms before and after a gluten-free diet. It is estimated that up to 10% of the non-celiac population may experience gluten sensitivity. People with NCGS often report less gastrointestinal discomfort and improved food tolerance on a gluten-free diet, but more research is needed on this condition.

For a large majority of the population, consuming gluten does not cause negative health effects. There is speculation that consuming gluten may lead to intolerances, leaky gut syndrome, or increased inflammation, but there is not enough research to support this claim at this time. If you have experienced health improvements and feel better by eliminating gluten from your diet, the gluten-free diet may be for you; however, if the act of restriction causes you anxiety or preoccupation around food, I would recommend against this diet. The distress alone can increase inflammation, negating health benefits.

The number of people reporting gluten sensitivity is increasing. A 2015 study in the journal Digestion found that more than 80 percent of people who reported gluten-related symptoms did not have Celiac disease, NCGS or a wheat allergy. This is where I encourage you to remember the brain-gut connection. By fearing certain foods, and increasing stress while eating these foods, you increase the likelihood of having gastrointestinal distress during or after consumption. At Nourishing Minds Nutrition, we are big believers in the power of our mind. We encourage all of our clients to think happy thoughts, repeat positive affirmations, or practice mindful eating techniques when working to improve digestion. If Celiac disease or gluten sensitivity is concerning to you, I recommend getting tested. Working with a dietitian can be a helpful way to navigate a gluten-free diet and cut down on confusion and added stress.

I’m sure you have heard many thoughts and opinions on gluten. It can be hard to decipher the truth from the myths. I’m here to help!

What does the research say?

In September 2019, a double-blind, randomized, controlled trial was published in Gastroenterology showing that eating gluten-containing foods does not cause gastrointestinal symptoms in people without a gluten-related disorder. As with any study, there are limitations such as a small sample size over a short period of time. Despite the limitations, the researchers believe their findings suggest that people should be actively discouraged from starting on a gluten-free diet if they have not been diagnosed with either celiac disease or NCGS.
One of the claims regarding gluten is that it increases the risk of heart disease. However, in the Nurses’ Health Study and the Health Professionals Follow-up Study, researchers found no association between gluten intake and development of coronary heart disease.
According to the American Institute for Cancer Research, people who do not have Celiac disease experience no cancer protection from avoiding gluten . In fact, whole- grain foods containing gluten can be good sources of fiber and phytochemicals that may be cancer-protective.
There is no evidence that supports following a gluten-free diet for weight loss, or that a gluten-free diet is more health promoting than a diet containing gluten. The US Dietary Guidelines Advisory Committee along with the American Diabetes Association, the American Heart Association, and the Academy of Nutrition and Dietetics all support the consumption of grains, especially whole grains. There is evidence to show that including whole grains in the diet is associated with a lower risk of cardiovascular disease, type II diabetes, metabolic syndrome, cancer, and early mortality.

I do want to acknowledge the bias and limitations that occur in most research. There are many people who believe that the gluten we consume today is different than gluten found in food years ago. Further specific research would need to be conducted to determine this. At this time, this is the strongest evidence we have. At the end of the day, we are health-promoting dietitians who want you to feel your best. We practice evidenced based nutrition and also take into consideration your individualized experiences.

I hope that this post was informative and leaves you with some direction if gluten has been concerning for you. I believe that a majority of people can include gluten as a part of a healthy diet. If you are experiencing digestive issues or symptoms of Celiac disease but test results are negative, I recommend working on decreasing your stress around food and incorporating mindful eating techniques such as deep breathing. Working with a non-diet dietitian or reading Intuitive Eating can be a great place to start.

Thank you for this amazing article Megan! Learn more about Megan and her services at Nourishing Minds Nutrition.