Is Eating Gluten-Free a Good Idea?
Mar 18, 2018 Cedars-Sinai Staff
Over the past few years, it's become trendy to go gluten-free. But is it really a good idea?
Celiac disease vs. gluten sensitivity
Gluten refers to a family of proteins found in grains like wheat, rye, and barley. Celiac disease is an immune response against these proteins that involves damage to the lining of the small intestine. The disease can be confirmed by a blood test and upper endoscopy.
"Gluten sensitivity is less well-defined," says Dr. Shirley Paski. "There may be symptoms that correlate with gluten exposure, but no measurable immune response or intestinal damage."
Symptoms for celiac disease and gluten sensitivity can be similar and include:
- Abdominal pain
- Weight loss
- Itchy skin
Celiac disease can also cause migraines, itchy blisters, and fatigue. If celiac disease is ruled out, your doctor or dietician may recommend an elimination diet trial, which can reveal gluten sensitivity.
I've been diagnosed with celiac disease or gluten sensitivity. Now what?
Treatment for both celiac disease and gluten sensitivity is mainly focused on eliminating gluten from the diet—avoiding foods with wheat, barley, and rye.
"Wheat is an ingredient that must be listed on processed foods sold in the US, so this is usually a good place to start when reading a nutrition label," says registered dietitian Katherine Goebel.
"It's not necessary or recommended that someone without celiac disease, wheat allergy, or gluten sensitivity avoid gluten."
Foods like bread, pasta, and beer are commonly recognized as containing gluten, but it can also be found in soy sauce, cream sauces, meat substitutes, salad dressings, marinades, and battered foods.
Pay attention to notes about processing facilities on food packaging too. Oatmeal, which doesn't contain gluten, is often processed in the same facilities as foods with gluten and can be contaminated.
Gluten-free foods can also pick up micro-particles if they touch gluten-containing foods or were prepared using the same utensils.
"You can pick the croutons out of a salad, but they'll still leave behind trace amounts of gluten. Therefore, a new salad should be made, using different utensils and serving bowls," Goebel says.
"Separate sponges and fresh water should also be used to clean all the cookware. I always urge my patients to thoroughly vet restaurants and to bring their own foods to social functions such as BBQs or holiday parties."
There isn't currently a cure for either celiac disease or gluten sensitivity, but adhering to a gluten-free diet can keep you feeling well.
Should I avoid gluten if I don't have celiac disease or gluten sensitivity?
Dr. Paski says a gluten-free diet is not recommended for most people due to complexity, cost, and risk of nutrient deficiencies.
"It's not necessary or recommended that someone without celiac disease, wheat allergy, or gluten sensitivity avoid gluten," Goebel agrees.
"Gluten is a completely harmless protein that occurs naturally in various foods and that the vast majority of people can digest and absorb without issue. A gluten-free diet is highly restrictive and can lead to an inadequate or unbalanced intake of macro- and micronutrients and resulting malnutrition if not followed properly and under the guidance of an MD and RD."
If you think you may have celiac disease or gluten sensitivity, you should speak with your doctor or a dietician before cutting gluten from your diet.