Currently popular is the gluten-free diet. Many people start a gluten-free diet for overall health, weight loss or a specific health condition. However, the research shows a gluten-free diet is only healthful for a handful of conditions. My hope is this information will help you make an informed decision before starting any diet that requires you to go gluten-free.
First, let's define gluten. Gluten is the name for a protein found in wheat, barley and rye. This protein provides foods with a certain structure. Think of how airy and elastic bread is. This structure is due to gluten.
Next, if you are diagnosed with celiac disease, it is true the only treatment is a totally gluten-free diet. Celiac disease is an autoimmune condition. Eating gluten triggers an immune response that results in damage to the small intestine, which often leads to a limited ability to absorb necessary nutrients. The only treatment for celiac disease is to totally avoid consuming gluten. If you, a friend or family member who has been diagnosed with celiac disease, it is vital to speak with a registered dietitian about which foods (and other gluten-containing items) to avoid. You can find a registered dietitian near you by visiting www.eatright.org/find-an-expert.
Also, if you have a family member or friend who has been diagnosed with celiac disease, you may want to approach get-togethers where there will be food by asking the person with celiac disease what you can do to provide something they can eat. Often, they are happy to bring a dish or snack they can eat, and they should be able to give you ideas of some gluten-free items you can prepare for them with minimal modifications. To find out more about celiac disease, visit the National Institute of Health's National Institute of Diabetes and Digestive and Kidney Diseases page on the topic at www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease.
Another condition people follow a gluten-free diet for is gluten intolerance. According to Catassi et al in the 2013 review article "Non-Celiac Gluten Sensitivity: The New Frontier of Gluten-Related Disorders," people who have non-celiac gluten sensitivity find avoiding some types of gluten helps with a range of symptoms, including abdominal pain, bloating, diarrhea, constipation, headache, fatigue, joint and muscle pain, extremity numbness, dermatitis, depression and anemia. This same article says non-celiac gluten sensitivity is not necessarily triggered by the same gluten proteins that trigger celiac disease.
On the subject of wheat allergy, a condition for which many people assume they must go gluten-free, the only grain that must be avoided is wheat. A person with a wheat allergy does not need to avoid the gluten-containing grains rye and barley. Often, a person with wheat allergy will look for gluten-free items because they are certain those items do not contain wheat.
Autistic spectrum disorder is one more condition for which a gluten-free diet has been proposed to be helpful. According to the research review article "Gluten- and casein-free diets for autistic spectrum disorder" by Millward et al, there is currently not enough evidence to support a gluten-free diet is an effective treatment for autistic spectrum disorder.
Finally, many people start a gluten-free diet for weight loss. According to an article published in 2011 in the Journal of the Academy of Nutrition and Dietetics by Wendy Marcason, RD, there is no scientific evidence to support the claim a gluten-free diet will result in weight loss. According to this article, "Research has shown that adherence to the gluten-free dietary pattern may actually result in a diet that is low in carbohydrates, iron, folate, niacin, zinc and fiber. There is nothing special about a gluten-free diet that can help a person lose weight." According to the 2012 article "Celiac Disease, Wheat Allergy, and Gluten Sensitivity: When Gluten Free Is Not a Fad," following a gluten-free diet can reduce one's quality of life by limiting a person's ability to engage in social activities, travel and eat at restaurants.
Overall, this dietitian's recommendation is to continue to eat gluten-containing items if you do not have celiac disease or gluten sensitivity. For people who do have celiac disease or gluten sensitivity, the good news is there are more and more gluten-free options out there. The food industry is doing well with providing multiple gluten-free items you can even find in the regular aisles of the grocery store. In 2013, the Food and Drug Administration issued a final rule that defined the term "gluten-free" for voluntary food labeling as meaning the food is inherently gluten-free or contains less than 20 parts per million (the accepted safe level for people with celiac disease) gluten. This rule has been enforced since Aug. 5, 2014.
People who have celiac disease or a gluten sensitivity appreciate when the loved ones in their lives make an effort to accommodate their needs.
Lynn Grant R.D., L.D., CDE is a registered dietitian and certified diabetes educator. She works at Capital Region Medical Center and provides diabetes education and outpatient nutrition counseling by appointment. She also writes a nutrition blog, which you can follow at nutritionnotions.wordpress.com.