The term “gluten-free” has become widespread in supermarkets and health food stores, part of a weight-loss or improved-health fad that has emerged in recent years. Yet, most people who buy gluten-free products don’t have celiac disease or even a mild sensitivity to wheat.
Experts estimate that less than 1 percent of Americans have celiac disease, a genetic autoimmune disease in which people can’t eat gluten because it will damage the lining of their small intestine. Consuming the type of protein found in grains such as wheat and barley can trigger an immune response that is not normal. The risks to those with celiac disease can include the inability to properly absorb the needed nutrients from foods.
In some cases, those not diagnosed with celiac disease can have a milder reaction to gluten, which is referred to as non-celiac gluten sensitivity (NCGS). U.S. dietary guidelines recommend that at least half of your daily servings of grains be “whole grain.” That’s about three servings a day for most people. Eaten regularly, whole grains are high in fiber and can help reduce risks of heart disease, diabetes and even certain cancers. Most whole-grain foods contain gluten.
“Celiac disease or NCGS should be something that is diagnosed, beginning with your primary care physician, and not something accepted by reading labels on grocery store products,”says Christopher da Fonseca, M.D. [1], a family medicine physician with Baptist Health Primary Care [2] at Palmetto Bay. “Most people shouldn’t have a problem with gluten. And you definitely shouldn’t change established healthy habits unless you are properly diagnosed.”
The estimated prevalence of celiac disease worldwide ranges from 1-in-10,000 to 1-in-300, he added.
Gluten is the major protein found in some grains. It is present in all forms of wheat, as well as in barley, rye and triticale (a wheat-rye cross). Ingestion of gluten in individuals diagnosed with celiac disease can cause an adverse reaction, which can damage intestinal cells and can lead to potentially serious health problems.
But for everyone else — the vast majority of the population — gluten should not be such a concern that it alters already well-grounded nutritious habits, says Dr. da Fonseca. Many people associate eating gluten-free diets with losing weight and being healthier. But most of these sentiments are rooted in myths and misconceptions. For most people, a gluten-free diet can lack the proper vitamins, minerals, and fiber recommended for overall health.
“People should carefully read the labels of packaged gluten-free foods to determine if added ingredients actually diminish health benefits and may contribute to metabolic problems,” says Dr. da Fonseca. “This can happen as a result of adding more sugars, unhealthy levels of saturated fats or sodium to foods labeled as gluten-free.”
Myth #1: Gluten-Free Foods are Healthier
Going gluten-free without actually consulting with your doctor or dietitian to determine if your body needs it is not a good idea. Gluten by itself doesn’t have many health benefits, but foods that contain gluten – such as whole grains – tend to be higher in fiber and contain a good amount of vitamin B, zinc and iron. So eliminating gluten could actually result in nutritional deficiencies. People with celiac disease often meet with a nutritionist to make sure there diets are appropriate.
Myth #2: Less Gluten Will Improve Your Digestive Health
Many people are under the impression that less gluten will benefit their digestive system and improve metabolism. This may be the case, but only for those with celiac disease or a legitimate gluten sensitivity. Otherwise, removing gluten from your diet won’t have much of an impact. The gluten-free diet is sometimes promoted as a way to lose weight, or as a “healthier” alternative. These claims are unfounded.
Myth #3: Gluten Can Make You Fat
Gluten alone does not make you fat. Indeed, so-called “gluten-free” products, such as breads, may contribute to weight gain by adding extra saturated fat, sugar and sodium as substitutes. Processed gluten-free foods try to compensate for flavor and texture changes which result from the removal of gluten.
Most dietitians say you will benefit from naturally gluten-free foods, including vegetables and fruits, lean meats, fish and poultry, certain whole grains like brown rice and quinoa, reduced-fat or fat-free dairy, nuts and seeds, beans and other legumes, and healthy fats, like extra-virgin olive oil and canola oil. What’s important is the overall food choices made within one’s diet, not whether these selections are gluten-free or not.
How are celiac disease and non-celiac gluten sensitivity diagnosed?
Consult with your physician regarding testing for both conditions. The first step is a panel of blood tests looking for an antibody response to gluten. If these tests are positive, the next step is an endoscopy. A celiac disease diagnosis is confirmed if the endoscopy shows the intestinal cell damage characteristic of the disease.