Nutrition Month: Gluten Free Diets - Healthy or Hype?
Updated: Mar 31, 2022
In recent years, many people have jumped on the “Gluten-free bandwagon”; whether they need to or not…but is following a gluten-free diet healthier? Well, if you have Celiac Disease, then you absolutely must avoid gluten. People with Dermatitis Herpetiformis also need to follow a gluten-free diet. If you have Gluten Sensitivity, you should limit foods that contain gluten. But…if you do not have any of these conditions, there is no reason to avoid or limit gluten! In fact, there is no benefit to following a gluten-free diet if you do not need to!
What is gluten?
Gluten is a type of structural protein found in some grains such as wheat, barley, rye, triticale, and some oats. Oats do not naturally contain gluten, however, if they are processed in the same facility where gluten-containing grains are processed, oats may come in contact with those other grains, and therefore will also contain some gluten.
What are the roles or functions of gluten?
Gluten helps give wheat bread its characteristic “spongey” or “stretchy” texture, which traps gas that allows the bread dough to rise and retain moisture. In other word, it helps to hold the bread together. Think of pizza dough being made. Without gluten, the pizza dough would tear easily.
Gluten helps to give bread its soft, chewy texture.
It is also frequently added to some processed foods to prevent them from drying out, and to improve their texture.
In wheat, gluten is the protein that helps the seed store essential nutrients that are necessary for the wheat plant to grow.
Healthy whole grains that contain gluten can feed the beneficial or “good” bacteria in the body.
Why do people decide to follow a gluten-free diet if they don’t need to?
That’s a good question. Unfortunately, there is no shortage of dietary misinformation on the internet, or in other media. For example, when a popular celebrity decides to follow a certain diet “trend”, many adoring fans will also follow that trend because they want to look and feel as healthy as that celebrity appears to be. (…and we know that all celebrities are experts in the fields of nutrition and medicine, right?). There is also no shortage of books about the “evils” of gluten, even though the vast majority of the population has no reason to avoid gluten. Buyer beware.
What is Celiac Disease?
Celiac Disease is an autoimmune condition where a person’s immune system attacks the absorptive cells (known as “villi”) in the small intestine when they eat foods that contain gluten. Think of “villi” as tiny, finger-like projections that line the entire interior of the small intestine, increasing the absorptive surface area of the intestine. Gluten triggers an immune reaction that damages these intestinal cells, and tends to flatten them. Many nutrients are absorbed in the small intestine; so, if the cells are damaged (or flattened), they do not absorb these nutrients properly. This can lead to nutrient deficiencies.
People with Celiac Disease have a slightly increased risk of developing osteoporosis (from malabsorption of calcium), and anemia (from malabsorption of iron).
The only effective treatment for Celiac Disease is a gluten-free diet for life. In fact, people who have celiac disease should have their own toasters and cutting boards, as even a tiny amount of gluten will trigger an immune reaction that will cause further damage to the small intestine. Even being in a kitchen near someone who is baking with wheat flour, can trigger a reaction, as some of the flour could potentially be inhaled.
Because many gluten-free food products often have sugar or fat added to make them more palatable, they are not always healthier choices. These products often lack fibre, so the person with celiac disease needs to make wise grain choices in order to get enough healthy fibre.
What is Gluten Sensitivity (also known as Non-Celiac Gluten Sensitivity, or Gluten Intolerance)?
Gluten Sensitivity is not well-defined. The symptoms may vary from one person to the next; and may include any of the following: bloating, abdominal pain or cramps, diarrhea, constipation, fatigue, headaches, joint pain, or nausea.
There is one very important difference between Celiac Disease and Gluten Sensitivity though: the absorptive surface of the small intestine is NOT being damaged when a person who has Gluten Sensitivity consumes a food that contains gluten!
A person who has Gluten Sensitivity may be able to consume a small amount of gluten without having symptoms. Therefore, the amount (or “dose”) of gluten consumed matters.
There is no medical or lab test to diagnose gluten sensitivity; however, there are tests that can rule out Celiac Disease.
According to the Canadian Society of Intestinal Research, it is estimated that approximately 6% of Canadians may have Gluten Sensitivity.
Why do some people who (do not need to) follow a gluten-free diet claim that they feel better?
Some foods that contain gluten may not be considered as healthful as others. The “less healthy” foods that contain gluten may include most baked goods like cookies, cakes, pastries and pies, battered and deep-fried foods such as onion rings and doughnuts, etc.
If a person eliminates these foods from their diet, they may start to feel better because they are now eating less junk food! Perhaps they are now including more vegetables and fruit, which are beneficial for one’s health.
*Note: pizza can be considered to be a “healthy” food; for example, if the crust is made with whole grains, and a variety of vegetables are used as a topping. Brushing the crust with extra virgin olive oil also has its health benefits; as does a lower sodium tomato sauce.
Many commercial gluten-free foods lack fibre; and often have added saturated fat, sugar, and salt. There are plenty of gluten-free cookies, crackers, and cakes available, but they are not considered to be nutritious.
According to Harvard University’s School of Public Health, consumption of whole grains is associated with better health outcomes. Research has shown that there is a lower rate of medical conditions such as Type 2 Diabetes, heart disease, and stroke among populations that consume higher amounts (two or three servings per day) of whole grains – including wheat.
If you have Celiac disease, it is imperative that you follow a gluten-free diet for life.
If you have Non-Celiac Gluten Sensitivity, you should benefit from limiting foods that contain gluten.
If you do not have Celiac disease, Dermatitis Herpetiformis, or Non-Celiac Gluten Sensitivity, it is not necessary to eliminate gluten from your diet.
Foods that contain whole grains promote healthy gut bacteria which are beneficial for overall health. (For more information about healthy gut bacteria, please see my blog post entitled “How Does my Gut Health Affect my Overall Health?”).
A healthy eating pattern should consist of a wide variety of foods - including whole grains.