Should You Eat Gluten-Free?

The science behind gluten and why the term shouldn't atomatically be associated with eating healthy

From about 2009 to 2014 sales of gluten-free products grew 34 percent annually, reaching about $973 million in sales, according to a report by Food Navigator USA.

The same report says that by 2019 that sales total is expected to reach $2.34 billion, which would be a 140 percent increase over another five years.  

Of course, none of this is probably all that shocking to you, since you've likely already heard hype about this supposedly healthy eating trend. In fact, maybe you know someone who's tried it or even you yourself have decided to eliminate gluten from your diet.

But why, all of sudden, have so many become interested in eating "gluten-free," and is it actually healthy, or just another fad diet with no real lasting effects?

Chris Cooper, a Precision Nutrition coach and a NSCA certified fitness professional is among the many who say that it's just a trend.

"For the most part gluten has become the new 'it' thing to blame our weight loss struggles on," says Cooper. "Suddenly everyone has a gluten sensitivity. This gluten-free trend has caught on in part because we want to blame something for why we've gained weight or why we can't lose weight. It's easier to just demonize a certain food group than to actually take a hard look at our nutrition and make a real change."

But what does it mean to be "gluten-sensitive" and how can you tell if you should eliminate it from your diet?

Let’s start with the basics. Gluten is a protein found in wheat, rye, and barley products.  People with celiac disease (a genetic autoimmune disease that damages the small intestine) absolutely must avoid gluten. However, the National Foundation for Celiac Awareness estimates that only about one percent of the U.S. population (or one in 133 Americans) suffer from celiac.

This means that for some, eating a gluten-free diet is much more than a trend, it's essential to maintaining good health.

According to Dr. Alexander J. Rinehart, a practicing Chiropractor, double-board certified Clinical Nutritionist, and Certified Nutrition Specialist, it is also possible to suffer from a gluten sensitivity or allergy, even if you don't have celiac.

"A person can have a positive gluten sensitivity or allergy, but not yet have measurable damage to the absorptive folds of their small intestine, as determined by a biopsy. These individuals would have 'Non-Celiac Gluten Sensitivity' or NCGS," says Rinehart.

Rinehart said that if you're sensitive or allergic to gluten an inflammatory response is triggered by your immune system when it's consumed.

"The inflammatory response can be experienced system-wide, not just in the gut," he said. "A sensitivity or allergy to gluten may lead to neurological or cognitive symptoms, fatigue, a decline in libido and sexual performance, as well as direct damage to the gastrointestinal tract such as in celiac disease."

Additionally, more common side effects associated with gluten intolerance include gastrointestinal discomfort, bloating, constipation, and diarrhea.

However, while there is a possibility that some of the population may suffer from gluten sensitivity, thus far, research surrounding the topic has been widely inconclusive.

Rachele Pojednic, a researcher at Harvard Medical School with a PhD in nutrition says there have been very few clinical trials examining  the effects of eliminating gluten from the diet in non-celiac patients.

“In those that have been done, like one reported in the journal Gastroenterology in 2013, there was no evidence that a gluten-free diet improved gastrointestinal distress in patients with self-reported gluten sensitivity,” she said. “Based on studies like these, we just don’t have the evidence to say that the gluten protein in isolation is actually the problem.”

Plus, Rinehart mentioned that there are many different factors that make testing for a potential gluten sensitivity complicated and inaccurate.

According to him, the best way to detect a potential gluten sensitivity is through a test that seeks to identify the presence of  a common genetic marker  known as "HLA-DQ2/DQ8" that's found in 90 to 95 percent of people with celiac disease.

"If negative, there is a pretty good chance that gluten is not going to be a problem for you," he said. "If positive, you can assume that gluten is a possibility, until ruled out. And, even if ruled out, you should monitor how you feel with gluten-containing products in the future."

If you think you might have a sensitivity to gluten (again, a lack of conclusive research regarding the topic makes it unclear just how much of the population might be sensitive or allergic to the protein) Rinehart recommends getting tested, if possible, and experimenting with a gluten-free diet.

"[It's] recommended to at least try for most people," he said. "But 'most' is not 'everyone' and so that's where many of the black and white opinions derive."

Even when there's no medical need to avoid gluten, those who eliminate it from their diet may end up establishing healthier eating habits. However, for those who decide to go gluten-free by reaching for packaged products that have slapped the trendy term on their label, the opposite might be true.

“Cutting gluten out of your diet most often leads to a reduction in overall calories, simply due to the sheer amount of grain based foods that we eat on a regular basis,” Pojednic said. “Pasta, bagels, bread, and crackers are typically cut from the diet and, early on, are not replaced when people go gluten free. This can lead to noticeable reductions in weight at first. However, over time, most people find ways to reintroduce these calories into their diet by way of 'gluten-free' products.”

She went on to explain that the gluten-free substitutes usually lack nutritional density or quality, especially when compared with many wheat-based foods that are often fortified with vitamins and minerals that typically are not included in gluten-free foods.

“For example, many gluten free cereals are lower in iron, fiber, folate, thiamine, riboflavin, and niacin—all B-vitamins,” Pojednic said. “Moreover, many gluten free products are higher in total and saturated fat because the fat helps create a consistency that gluten would normally have provided, as gluten is the protein responsible for the stretchy or springy nature of many grain foods.”

She also mentioned that many gluten-free products tend to replace whole wheat ingredients with starches, which can have a detrimental effect on blood sugar levels.

Ana Goldseker a Certified Nutritional Consultant and Director of Nutrition for Nava Health and Vitality Center explains how turning to a gluten-free diet with the aim of improving her health, actually led her to gain weight.

"Years ago, I decided to go gluten-free. I had no gastric upset, no belly aches or heartburn, but I did have some extra weight and low energy levels," she explained. "After doing some research, I thought gluten could possibly be the culprit. I went to the market and bought a ton of gluten-free products."

She says she stocked up on everything from gluten-free pastas and breads to cookies and salad dressings.

"They had practically everything available gluten-free and I thought I was in heaven," she said.

However, Goldseker says after a few weeks of following her new supposedly healthy diet, she was disappointed to find that she was gaining weight.

"My clothes were starting to get tighter and my face a little thicker. So I did a bit more research and talked to a mentor of mine," she said.

The mistake she made? Building a diet based on packaged gluten-free products.

"Sure, these things were all gluten-free, but they were also laced with sugar, salt, and other refined grain," Goldseker said. "How can someone get healthy on that? None of it is real, whole food."

The lesson learned: turning to gluten-free products probably won't help you lose weight or improve your overall wellness. Eating whole foods (many of which are usually gluten-free naturally, Goldseker points out) is the better and smarter option.

Ultimately, unless you have a diagnosed medical condition, you probably don’t need to eat gluten-free.

“I don’t think people would experience significant physiologic benefits simply by cutting gluten itself,” Pojednic said. “Whole grains, including wheat-based grains, are truly an important part of a nutritious and balanced diet, and gluten free products are often not great substitutes.”

On the other hand, Pojednic also said that many people would likely benefit from reducing their total caloric intake by cutting out processed wheat products and replacing them with plant based foods like legumes, fruits, vegetables, and non-wheat grains like brown rice and quinoa.

“They probably would feel better overall,” she said. “Based on the science, I’m still not convinced it’s necessarily about gluten, however, but more likely about eating a healthier diet overall.”

*Editor's Note: This story was originally published on Jan. 27, 2015 and was updated on Jan. 30, 2015.