What Does It Mean to Be Gluten Free?

A gluten-free diet excludes all foods containing gluten, a family of proteins found in wheat, barley, rye, and triticale (a hybrid of wheat and rye). The diet is currently the primary treatment for celiac disease and other gluten-related disorders.

Over the past few years, more people without these conditions are choosing to go gluten-free to improve other health concerns. However, there is little research to support this idea.

Many foods are naturally gluten-free. When used appropriately, a gluten-free diet can offer several benefits. However, it can also come with health risks, so it's important to make sure you are still getting all the nutrients your body needs.

Why Would Someone Be Gluten Free?

Many people follow gluten-free diets to treat health conditions related to gluten or wheat. In these cases, avoiding gluten can help relieve unpleasant symptoms.

Celiac Disease

Celiac disease is a condition that occurs when the immune system responds abnormally to gluten, causing damage to the small intestine. This causes gastrointestinal symptoms, including:

• Abdominal pain
• Diarrhea
• Bloating
• Weight loss
• Decreased appetite
• Gas

Over time, the damage to the small intestine can lead to malabsorption of nutrients, resulting in a range of health conditions, including bone loss and anemia.

For people with celiac disease, following a gluten-free diet typically resolves symptoms and can help protect the small intestine long-term.

Non-Celiac Gluten Sensitivity

Another health condition that may be treated with a gluten-free diet is non-celiac gluten sensitivity (NCGS). This condition occurs when a person experiences symptoms after consuming gluten-containing foods but tests negative for celiac disease and wheat allergies.

While NCGS does not cause damage to your small intestine like celiac disease, it often causes similar symptoms. These symptoms include:

• Abdominal pain
• Bloating
• Gas
• Constipation or diarrhea
• Fatigue
• Anxiety

People with NCGS typically experience symptoms within hours or a few days after ingesting gluten. These symptoms resolve when they eliminate gluten from their diets.

Some evidence suggests many people who believe they are reacting to gluten may actually be reacting to other components in wheat, such as fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs).

FODMAPs are short-chain carbohydrates that can ferment in the gut, producing gastrointestinal symptoms like gas, bloating, and abdominal pain.

People who are sensitive to FODMAPs may have irritable bowel syndrome (IBS) rather than NCGS.

Diagnosing NCGS is challenging, as no tests can accurately distinguish those with true gluten sensitivity from those with IBS or other digestive conditions.

Gluten Ataxia

Gluten ataxia is an autoimmune disorder that occurs when the body's immune system attacks the nervous system tissue in response to gluten ingestion. The condition can lead to problems with coordination and balance, speech, and fine motor skills such as writing and vision.

A gluten-free diet may help manage symptoms in those with gluten ataxia. Adopting a gluten-free diet soon after diagnosis can help stop progression of the disorder and prevent further neurological symptoms.

Wheat Allergy

Wheat allergies occur when the immune system overreacts to wheat, causing hives, digestive symptoms, headaches, or in rare cases, anaphylaxis, a life-threatening allergic reaction.

People with wheat allergies must avoid wheat products like bread and baked goods, which means they may consume a reduced gluten diet. However, they do not need to follow a strict gluten-free diet since they can still consume other grains like rye and barley.

Which Foods Are Gluten Free?

Many foods are naturally gluten-free. These include, but are not limited to:

• Fruits: apples, pears, peaches, berries, oranges, melon
• Vegetables: spinach, carrots, radishes, broccoli, onions, potatoes
• Dairy: plain milk, butter, cheese, yogurt, single-flavor ice creams
• Eggs: egg whites, egg yolks, whole eggs
• Meat and fish: unprocessed, fresh cuts of meats, fish, poultry
• Rice: all types, including wild rice, white rice, brown rice
• Beans, nuts, legumes, and seeds: kidney beans, black beans, walnuts, almonds, cashews, chickpeas, chia seeds, flax seeds
• Gluten-free grains: white rice, brown rice, quinoa, buckwheat, corn, gluten-free oats, arrowroot

Gluten-free variations of items that naturally contain gluten are widely available in most grocery stores, making it easier to stick with a gluten-free diet. Make sure to choose only products that carry a certified gluten-free label.

You can also make your own gluten-free foods at home by substituting certain ingredients. For example, use gluten-free flour such as almond flour or buckwheat flour instead of all-purpose flour when baking.

What Are the Benefits of a Gluten-Free Diet?

A gluten-free diet can help those who suffer from celiac disease and NCGS experience symptom relief. It may also help prevent disease progression in individuals with gluten ataxia.

Some research shows a gluten-free diet can help heal the small intestine of individuals with celiac disease, leading to improvements in symptoms of malabsorption, such as diarrhea and oily stools. The researchers also saw improvements in bone mineral density after one year of the diet.

Over the past few years, many people have adopted gluten-free diets due to claims that it will help with headaches, chronic fatigue, weight loss, and depression. However, there is no solid scientific evidence to support these claims.

A gluten-free diet may result in weight loss due to eating fewer sweets and processed foods such as candies, pastries, and baked goods. However, following a well-balanced diet with fruits, vegetables, whole grains, and lean proteins is a more sustainable way to lose weight and likely offers greater benefit.

Are There Risks to Eating Gluten Free?

While gluten-free diets can be beneficial for certain conditions, there are also health concerns for anyone following a gluten-free diet.

Nutrient Deficiencies

Many wheat-based products are high in fiber. They're also fortified with nutrients such as folic acid and iron. Cutting out these foods means you'll be losing these essential nutrients from your diet unless you replace them with another food source.

Research has found that gluten-free diets tend to fall short in many important nutrients, including:

• Fiber
• Vitamin B12
• Vitamin D
• Folate
• Iron
• Zinc
• Calcium
• Magnesium

If you are following a gluten-free diet, it is important to eat a well-balanced diet. Working with a registered dietitian can be a helpful way to ensure that your diet provides all the essential nutrients that your body needs.

Constipation

Some people who follow a gluten-free diet experience constipation because many of the foods eliminated from the diet are high in fiber. Fiber is an essential component of a healthy diet and plays an important role in maintaining regular bowel movements.

You can improve constipation on a gluten-free diet by staying properly hydrated and incorporating fiber-rich gluten-free foods into your diet. In addition to fruits and vegetables, quinoa, beans, nuts, and legumes are all good sources of fiber.

A Quick Review

Gluten is a protein found in wheat, barley, rye, and triticale. A gluten-free diet is necessary for individuals with celiac disease, non-celiac gluten sensitivity, and gluten ataxia to manage their conditions and avoid potential complications.

Most people can tolerate gluten. There is little evidence to suggest that a gluten-free diet will provide any health benefits for those without gluten-related disorders. In fact, following a gluten-free diet may result in nutrient deficiencies and constipation if not carefully planned and monitored.

If you believe you have a gluten-related health condition, it's important to speak with a healthcare provider for proper testing and to determine if a gluten-free diet is appropriate for you.