We live in the land of the free – sugar-free, salt-free, dairy-free, fat-free, wheat-free and yes gluten-free—all in the pursuit of good health. But are these “freedoms” doing more harm than good? When it comes to gluten-free, that might very well be the case.
The gluten-free diet is not new. Historically, a gluten-free diet was used to manage a rare immune condition called celiac disease. If you have celiac disease and eat foods with gluten, your immune system responds by damaging the small intestine. The damage to the small intestine prevents the body from absorbing needed nutrients and can lead to malnutrition, depression, anxiety, anemia, or weakened bones. In children, it can delay growth.
People with type 1 diabetes, which is also an autoimmune disease, are at increased risk for celiac disease. Approximately 10% of people with type 1 diabetes have celiac disease compared to only 1 % of the total population. That’s because people with one autoimmune disease are at increased risk for other autoimmune diseases. Celiac disease is also more common in Caucasians and more often diagnosed in females. If someone in your family has celiac disease you are also more likely to develop the disease. Type 2 diabetes has a genetic component, but the genes are not associated with celiac disease.
Should You Consider Going Gluten-Free?
There are two other gluten-related disorders—wheat allergy and nonceliac gluten sensitivity (NCGS) that require the avoidance of gluten. In wheat allergy, your body's immune system reacts to wheat. However, the symptoms are very different—itchy eyes or difficulty breathing, but there is no long-term damage to the small intestine. Symptoms of NCGS include tiredness, abdominal pain, gas, diarrhea, muscle cramps and leg numbness. Nonceliac gluten sensitivity also does not damage the small intestine.
Gluten is a protein found in wheat, barley, rye, and sometimes oats—ingredients often used in bread, pasta, and desserts. Gluten can also be found in unexpected sources—such as medications, vitamins, or lip balms. If you have celiac disease or gluten sensitivity, it is essential for you to avoid gluten. In individuals with gluten-related disorders, a gluten-free diet can improve cholesterol levels, promote digestive health and increase energy.
Between 2009 – 2014 the number of Americans who say they've gone gluten-free has tripled. Most of these individuals don't have a gluten-related disorder and are following a gluten free diet believing that avoiding gluten is healthier or could help them lose weight.
However, the opposite is true. A gluten-free diet in healthy individuals is associated with poor nutritional quality and weight gain. This is because many gluten-free products can be high in calories and sugar and a gluten-free diet may not provide enough of the nutrients, vitamins, and minerals the body needs. Research also shows that a diet rich in gluten is associated with a reduction in triglycerides—a type of fat in blood related to heart disease. Other studies show following a gluten-free diet reduced beneficial gut bacteria.
Moreover, a recent study presented at the American Heart Association’s 2017 Scientific Session researchers found that participants who ate more gluten were less likely to develop diabetes than those who followed a low gluten diet. Participants in the study who ate less gluten also tended to eat less cereal fiber which is known to protect against type 2 diabetes. Overweight and obesity are major risk factors for diabetes and studies show a high fiber diet can facilitate weight loss.
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For people with gluten-related disorders, a well planned gluten-free diet is essential. In healthy individuals, there is no evidence that avoidance of gluten will result in any health benefits or weight loss.
Constance Brown-Riggs, MSEd, RD, CDE, CDN is a registered dietitian, certified diabetes educator, national speaker and author of The African American Guide to Living Well with Diabetes.. She is Dannon One Yogurt Every Day Nutrition Advisor.
