This article, which focuses on how and when to follow a gluten-free diet, is the fourth in our Controversies series.
Given the relentless gluten-free craze out there, millions of people are asking themselves two questions:
- Should I be on a gluten-free diet?
- And if so, what is the best way to eat gluten-free?
The purpose of this article is to answer both of these questions.
A Quick Gluten Review
In our last article, we defined gluten and discussed at great length the three most common gluten-related conditions: celiac disease (CD), wheat allergy and gluten sensitivity (or NCGS, Non-Celiac Gluten Sensitivity).
Around 1 in 100 people has celiac disease and 1 in 1000 suffer from wheat allergies. And while the incidence of NCGS is unknown, it is definitely the most common of the gluten-related disorders.
If you suffer from CD, you need to avoid all gluten—all of your life.
Wheat allergy is most frequent in children and may be outgrown. Avoidance of wheat (and food products made with wheat) is recommended.
Gluten sensitivity is a more vague condition, and the prescription to alleviate it is also less clear. The recommendation is to test yourself for CD. If the results are negative, then the adoption of a whole food, plant-based diet, which includes whole grains, may help you feel better. The emphasis should be on the consumption of whole grains, rather than food products made with whole grain flours. However, if the symptoms persist, you may be a good candidate to follow a gluten-free diet.
What Is a Gluten-Free Diet?
Of the conditions listed above, it is people with celiac disease who absolutely must follow a gluten-free diet. Here are some guidelines.
The first rule for any gluten-free diet is to avoid all food products made from wheat, rye or barley, as well as their variations and hybrids.
This will normally include a wide variety of packaged foods, pasta, cereals, and baked goods.
What is perhaps more important is what you can still eat on a gluten-free diet.
This includes amaranth, buckwheat (or kasha), corn, millet, quinoa, wild rice, sorghum, (gluten-free) oats, brown rice, all root vegetables (like potatoes, yams, sweet potatoes, and cassava root), all legumes (more specifically beans, soybeans, chickpeas, peas and lentils), all green leafy vegetables, all yellow and red vegetables, and all whole fruits.
And here are some ways you can replace wheat:
- Substitute spaghetti with noodles made from buckwheat, quinoa, corn or rice.
- Swap wheat flour wraps with corn tortillas or collard greens.
- Use brown rice lasagna noodles rather than the whole-wheat variety.
- Eat gluten-free oats or brown rice crispy cereal instead of whole wheat cereal.
You can also keep things simple.
For example, have gluten-free oats and fruits for breakfast, a big soup with beans, veggies and brown rice for lunch, and sweet potatoes topped with greens, chickpeas and salsa for dinner.
And always keep in mind:
Just because a product says ‘gluten-free’ does not necessarily mean it is healthful. Gluten-free products can be packed with added sugars, oils, and salt, so read your food labels carefully.
Is Eating Gluten-Free Healthier?
It makes sense. Think about peanuts. Some people have violent, health-threatening peanut allergies, but the majority of us can eat them without a problem.
Health professionals typically recommend that people avoid a gluten-free diet unless it is truly necessary.
That is because whole grains – including gluten-containing grains like wheat, barley and rye promote health. Specifically, eating whole grains has been linked to reduced risk of coronary heart disease, cancer, diabetes, obesity and other chronic diseases.
In a recent two-week study, cyclists were divided into two groups. During the first week, group 1 was given a gluten-free bar to eat while group 2 received a gluten-rich bar. In the second week, they switched. Throughout the study, participants never knew when they were eating gluten or when they were not.
When the researchers examined riders’ performances, they were stunned by the results. No significant differences emerged; their cycling performance and inflammation levels were virtually identical whether the rider ate no gluten or large amounts of it.
The conclusion? “We did not find a beneficial or negative effect of a gluten-free diet for athletes who had no clinical necessity for the diet.”
The Weight Loss Myth
Another popular belief about a gluten-free diet is that it helps you keep the pounds at bay.
Is this true? Can following a gluten-free diet really help you lose weight?
Despite claims that wheat is the culprit behind weight gain and a wide variety of chronic diseases, including diabetes and cardiovascular disease, there is no clear evidence that eating a gluten-free diet will help you in the battle of the bulge. In fact, studies show the exact opposite.
For example, a 2012 study of 1018 patients with CD found that 22 percent of the participants, who were already overweight, gained even more weight after starting a strict gluten-free regime. Moreover, another 16 percent of the patients who initially enjoyed normal or low BMI (body mass index) moved into an overweight BMI category after adhering to a strict gluten-free diet.
Why do people who eat gluten-free fail to lose and, in many cases, actually gain weight?
One reason is that those adopting a gluten-free diet generally eat more calorie-dense packaged foods than whole grains that may be naturally gluten-free. Those packaged foods often contain refined flours, added fats (including free vegetable oils) and sugar, while some gluten-free products also have dairy and eggs.
This is not to say that it is impossible to lose weight when eating gluten-free. You just need to eat a healthful diet based on whole plant foods rather than refined gluten-free packaged foods.
For example, a recent study placed a group of overweight and obese patients on a naturally gluten-free diet, which included fruits and vegetables plus non-gluten whole grains like quinoa and buckwheat. The results were excellent, with the participants experiencing a consistent loss of excess weight.
Once we adopt that lifestyle, we will find that many of our health complaints will likely disappear.