Decoding Popular Diets: Gluten-Free

Looking for a hot topic to discuss at your next dinner party?  Try mentioning the word "gluten."  While relatively unknown just a few years ago, gluten has entered the spotlight -  well, at least in terms of awareness!  In reality, gluten has exited the picture, with product development and marketing efforts aimed at removing gluten from foods that commonly contain it and highlighting foods that are newly + naturally void of the ingredient.  So, is it time for you to cut ties with gluten, too?  And what does a diet sans gluten even look like?  Let's discuss.

As a refresher from the diet overview post, here are the basics of the gluten-free diet:

The premise: Eliminate gluten, a protein found in wheat, barley + rye that damages the lining of the small intestine in those with celiac disease.  What's included: Fruits + veggies, meat, seafood, eggs, dairy, legumes, oils, nuts, seeds and wine.  Non-gluten grains like quinoa and rice are good to go too.  What's avoided: Any products that contain gluten! This includes the obvious like wheat, barley and rye along with foods that contain them (pasta, bread, cereal, crackers), but it also includes foods that are less expected like soy sauce and some salad dressings and seasoning mixes.  

The analysis:  For people with a gluten allergy (known as celiac disease), going gluten-free is an absolute necessity (I cannot stress this enough!).  Adopting a gluten-free diet is widely supported and beneficial in those with celiac disease.  Therefore, the analysis for this post focuses on the gluten-free diet for those without celiac disease.  

The changes:  On average, carbohydrates make up nearly 50% of the American diet.  Going gluten-free does not mean going carb-free or even low-carb (this isn't Atkins!), but your carbohydrate profile may shift when pursuing a life without gluten (choosing rice over pasta, or starchy veggies over bread).  Many grocery stores now dedicate a section to gluten-free products, so you can usually find many no-brainer substitutes, like swapping gluten-filled pasta for gluten-free pasta.  But don't assume all gluten-free products are healthier than the equivalent gluten versions.  You may even find an increase in total calories and/or fat in the varieties without gluten! 

The good:   People without celiac disease may see benefits from removing gluten, but those benefits may be correlational rather than causal.  For example, removing gluten often means removing many highly processed foods.  These foods provide little nutritional value, so removing them could result in health improvements that are unrelated to the fact that the foods also contain gluten.  While removing all gluten may be unnecessarily restrictive, cutting out processed foods in exchange for more whole foods is a shift that I can support.  

The questionable:  More research is required to determine the effects of gluten (and going gluten-free) on those without an actual gluten allergy. The majority of current research hasn't proven that going gluten-free leads to health benefits that are directly caused by the removal of gluten.  On the flip side, negative (yet preventable) effects of going gluten-free may include nutritional deficiencies or an increase in caloric intake.  Recent research also found links between the gluten-free diet and high arsenic and mercury levels, potentially related to an increased consumption of products containing rice.  These concerns can be partially alleviated by opting for naturally gluten-free whole foods rather than processed gluten-free options (which may contain rice).  

The recommendations:  When people tell me they are going gluten-free, I'm most interested in their education surrounding the diet and lifestyle structure.  Are they prepared to find whole food replacements for gluten-containing grains + products or do they intend to swap unhealthy gluten-filled foods for similar gluten-free ones (think regular donuts for the gluten-free variety).  I fully support the expanded market to include gluten-free options, but consumers need to be aware that gluten-free is not synonymous with healthy.  Of course, gluten-free foods can be healthy, but the term alone does not equate to healthy (this goes for naturally gluten-free foods too!).  Take a stroll through the candy or soda aisles at your grocery store, and you'll find numerous gluten-free yet sugar-laden options to verify that statement.

If you are still wondering if gluten-free is the right approach for you, here are a few recommendations to consider. 

1.  Discover your "why?" Are you going gluten-free to lose weight or are you trying to remedy other health problems?  If weight loss is your goal, begin by removing highly processed foods from your diet and shifting towards healthier, whole food options.  Gluten alone is likely not the culprit for your weight gain or absence of weight loss.  

2.  If you're experiencing health issues (stomach pain, inflammation, fatigue, etc.) and you think gluten is to blame, get tested for celiac disease.  For the test to be accurate, gluten must be included in your current diet, so reach out to your doctor before removing gluten from your life.  If results show you do not have celiac disease, but you are still interested in removing gluten, do your research to adopt the gluten-free diet in a safe, effective manner.  This should include working with a Registered Dietitian to identify your current eating patterns and food sensitivities and to navigate the potential shift towards gluten-free foods.  Registered Dietitians can devise a plan that will fulfill your nutritional needs while working with you to achieve additional weight management and health goals.  

3.  When following a gluten-free diet, try to emphasize healthy foods that are naturally free of gluten.  Focus on incorporating fruits, vegetables, lean meats and seafood, low-fat dairy products (check the ingredients!), gluten-free grains (quinoa, sorghum, amaranth to name a few), and heart-healthy nuts, seeds, and oils.   While it's ok to reach for a gluten-free cookie every once in a while, recognize that a gluten-free cookie is still a cookie (and likely still full of sugar, butter, and calories)!  Try to limit your overall intake of gluten-free snacks + treats that offer little nutritional value.  Instead, emphasize nutritional powerhouses like fruits and vegetables, and enjoy experimenting with nutritious yet lesser known gluten-free whole grains.  

Do you follow a gluten-free diet?  What's the biggest challenge you've encountered?  Do you follow it strictly or allow for a few exceptions?  What health improvements, if any, have you noticed?  Let me know in the comments below!