One of the questions I get asked ALL the time is whether gluten is bad for you and if it should be eliminated from the diet. Going gluten-free is really trendy right now, but it may also be necessary for some due to medical issues. Do you need to eliminate gluten? This post breaks down ALL of the info out there about gluten!

Is gluten bad for you?

What is gluten?

Gluten is a protein found in wheat, barley and rye. It gives structure to a lot of products, which is why a common complaint about some gluten-free products is that their textures were odd/mushy/squishy.

We typically hear about gluten being in our grain products like bread, pasta, baked goods.  But is also included in soups and sauces (flour can be used as a thickener), condiments like ketchup, mustard and BBQ sauce, marinades, soy sauce, tomato paste, and pasta sauce. Products that contain barley- such as malt, malt vinegar, and beer- contain gluten as well.

Honestly, I get a bit of a laugh when someone is super insistent that gluten is causing them a lot of health issues but then it turns out they are still drinking beer, unaware that beer contains gluten.

What about oats? Oats themselves do not contain gluten but are at risk for cross-contamination because they are manufactured around *other* products that contain gluten. If you are purchasing oats and need them to be gluten-free then be sure you verify this on the product label prior to purchasing.

Does gluten-free mean low carb?

I have noticed that some people who follow a gluten-free diet, especially for weight loss purposes, tend to use the words “low carb” and “gluten free” interchangeably. Just to be clear, the two are not the same.

Avoiding gluten does not mean low carbohydrate. Food groups that contain carbohydrates such fruits, legumes, starchy vegetables and milk do not contain gluten. You can definitely have a high carbohydrate diet without eating gluten!

Medical Necessity for Eliminating Gluten in Your Diet

Celiac Disease

Gluten can be a cause for medical issues and GI distress for some people. This can be due to celiac disease or just a gluten intolerance/sensitivity. If you think you are having an issue with gluten then it’s not the time to self-diagnose. Get yourself into the doctor ASAP to get tested for celiac disease.

Celiac Disease is an autoimmune disorder in which gluten causes inflammation in the GI tract. This leads to diarrhea and malabsorption, which is why those who have celiac disease are at risk for nutrient deficiencies and malnutrition. Symptoms of Celiac Disease include abdominal pain, diarrhea, vomiting, weight loss, a skin rash, feeling lethargic and anemia. Celiac disease is diagnosed by an antibody blood test and/or a biopsy of the small intestines.

The reason someone with these symptoms needs to get tested for Celiac Disease is because those who have celiac disease and don’t know it are more likely to accidentally expose themselves to gluten and put themselves at increased risk for health issues without even realizing it. This can lead to long-term health issues. Eliminating gluten from the diet prior to a gluten screening can lead to a false negative, which is why getting tested should be the first step. Also, people who have one autoimmune disease are more likely to develop another, so there are lots of preventative things they should be doing!

My former intern Izzy talked a little bit about having Celiac disease at the beginning of one of my podcast episodes and I thought it was really interesting!

Non-Celiac Gluten Sensitivity

Just because someone doesn’t test positive for celiac disease does not mean they can’t have an intolerance or sensitivity. Non-Celiac Gluten Sensitivity is when someone experiences symptoms similar to celiac disease but antibodies and intestinal damage are not present.

This is where evaluating diet and symptoms can get tricky. There’s definitely a placebo effect when it comes to food issues, so definitely go into evaluating your diet with an open mind that gluten could or could not be causing the issue.

 

This study published in the Journal of Digestion in May 2015 found the following:

• 392 patients enrolled who were complaining of gluten-related symptoms
• Only 6.6% were found to have celiac disease
• Only 2% were affected by a wheat allergy
• Only 6.88% were diagnosed with non-celiac gluten sensitivity

Study Conclusion: “86% of patients reporting gluten-related symptoms have neither NCGS, nor CD, nor WA. Self-perceived gluten-related symptoms are rarely indicative of the presence of NCGS.”

Having said that, there are definitely instances where people have severe issues with gluten even though they don’t have celiac disease. You know your body best.

Is gluten bad for weight loss? Should we follow a gluten free diet for healthy eating?

If there’s no medical reason to eliminate gluten then you don’t really need to avoid it in your diet. Unfortunately, our society and diet culture has a habit of nitpicking certain foods and nutrients while avoiding the overall big picture of healthy eating. I think the gluten debate is a perfect example!

Here are some things that concern me if someone is going gluten-free for no real reason except to be diety:

#1: Gluten-free diets eliminate many whole grain products. Whole grains are rich in fiber and they also reduce the risk of chronic diseases like heart disease, stroke and type 2 diabetes. The average American does not get enough fiber. Fiber is super important for satiety!

#2: Products specifically made to be “gluten-free” such as crackers, bread and pasta can be highly processed and expensive. You can check out nutrition labels in the grocery store to see that these types of products still contain carbohydrates, fats and a long list of ingredients. Sometimes gluten-free products have no fiber and a lot of added sugar.

#3: Restrictive diets are difficult to maintain. Instead of focusing on elimination, strive for balance with fresh fruits, vegetables, legumes, whole grains, and lean proteins.

Is gluten bad for diabetes and prediabetes?

There are so many misconceptions about carbohydrates and diabetes, the main one being that people with prediabetes or type 2 diabetes should avoid carbohydrates. This isn’t true! The gluten issue is just kind of piling on to the misconceptions. If you have prediabetes or diabetes then you do not have to avoid gluten!

It’s really important for people with prediabetes and type 2 diabetes to understand how different carbohydrate choices affect their blood sugars. This is true whether or not a carbohydrate contains gluten. Like we discussed a little earlier in this post, not all carbs have gluten anyway, so the gluten debate is kind of a moot point here. And other carbs WITH gluten also have fiber, which is important for blood sugars.

(side note: here’s another post I wrote for prediabetes nutrition tips)

Should someone with PCOS (polycystic ovary syndrome) go gluten-free?

Women with PCOS have increased inflammation in their bodies. Gluten has been shown to increase inflammation as well, so it makes sense to think someone with PCOS should avoid gluten. However, studies don’t really support this theory. I don’t recommend eliminating gluten if you have PCOS because grains with fiber may also help with carb cravings and stabilizing blood sugar.

Summing Things Up

Honestly, it gets a little frustrating seeing people avoid gluten for fun or trend when there are many people out there who wish they could have gluten and medically can’t. I hope this post has clarified some of the information and misinformation out there surrounding the topic. It’s such a complex issue, and each person’s nutrition needs are so individual.

I would love to hear your thoughts and/or experiences when it comes to gluten-free eating!