Celiac Disease, Gluten Sensitivity, And If The Average Person Needs To Worry

Is gluten sensitivity a myth, or are there some serious health benefits to avoiding this common food ingredient?

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A decade ago, tasty, gluten-free options were hard to find at your local supermarket. Back then, if you needed to avoid gluten and were lucky enough to find a product you could eat, it almost certainly tasted like cardboard. The gluten-free market has come a long way; honestly, it’s become a cultural phenomenon. These days, it’s difficult to walk through the aisles of a grocery store without seeing the latest assortment of gluten-free products lining the shelves. Even some of our old standbys, like General Mills Rice Chex and Cape Cod Kettle Chips, don the GF label. With the surge in fad diets as of late (The Whole30, The Dukan Diet, and the Paleo diet, to name a few), gluten has been portrayed as the chief food offender in our lives, and people who restrict their intake of it will (hopefully) look and feel better. In certain health and wellness circles, there’s a collective distaste for gluten: It’s bad for your health, the thought process goes, and you should avoid it—and you might have a sensitivity to it, even if you don’t realize it. Does gluten deserve the bad rap it’s getting? There are circumstances, of course, such as wheat allergies and celiac disease, when avoiding gluten is a crucial step to improving your health. But can you be healthy with a diet that includes gluten? Here, we’ll take a more in-depth look at the gluten-free world and whether the average person needs to worry about eating the stuff.

What is gluten?

Gluten is the name given to the naturally-occurring protein found in grains like wheat, rye, triticale (a hybrid of wheat and rye), barley, and more. In cooking and baking, it serves a fundamental purpose—it acts as a binding agent and gives structure, shape, and texture to food like bread, pastries, and pasta. Besides flour-based products, you can also find gluten in a variety of items like soups, salad dressings, condiments, soy sauce, lunch meats, and more. Additionally, oats can become cross-contaminated with gluten if they’re processed in a facility with other grains, so they’re not necessarily gluten-free, either. Furthermore, there are several hidden sources of gluten, so it may not be evident from a food label whether an item contains it. According to the Mayo Clinic and the Celiac Disease Foundation, some of the lesser known names for gluten (or items that may contain it as a hidden ingredient) include:

  • Malt (malt vinegar, malted milk, malt extract, malt syrup, or malt flavoring)
  • Hydrolyzed wheat protein
  • Brewer’s yeast
  • Yeast extract
  • Bulgur
  • Wheat germ and wheat bran
  • Graham flour
  • Matzo or Matzo meal
  • Semolina
  • Spelt
  • Natural flavors
  • Rice syrup

Who needs to be concerned about gluten?

On one end of the spectrum, we have people with celiac disease. When they consume gluten, it triggers an autoimmune response—the gluten causes damage to their small intestines. People who have celiac disease may experience a host of symptoms, which usually appear 46–72 hours after consuming gluten. These symptoms include abdominal pain and bloating, constipation, diarrhea, fatigue, migraines, depression, and more—in fact, the Celiac Disease Foundation reports that there are more than 200 known symptoms of the disease. At present, approximately 3 million Americans are living with this illness, according to the Celiac Disease Center. The disease can be diagnosed using antibody blood tests, genetic testing, and gastrointestinal endoscopies. The recommended treatment is a strict adherence to a lifelong, gluten-free diet and the correction of any nutritional deficiencies.

So, while it’s clear people with celiac disease need to eat a gluten-free diet, what about the rest of us?

Well, making up the rest of the gluten-allergy scale is gluten sensitivity. To learn about these, we talked with Karen Raden, a registered dietitian and certified clinical nutritionist.

[Many people] can benefit significantly from going gluten-free.

Raden has worked in the field of integrative and functional medicine for 20 years. Her clientele includes a mix of people seeking help with chronic health conditions, weight loss, heart disease, digestive disorders, food sensitivities, athletic performance, meal planning, and more. We spoke with her about whether gluten sensitivity is a myth or if there’s actually merit to the idea of non-celiac people removing gluten from their diets. “I believe that gluten sensitivity is not a myth,” Raden says. “Many people have gluten sensitivities and are not aware of this, as symptoms do not always present as digestive disorders … . Gluten sensitivity may show up as neurologic symptoms, headaches, joint issues, muscle aches and pains, weight gain, swelling, mood issues, and more.” Since no laboratory test exists for gluten sensitivity—only for celiac disease and wheat allergies—you need to consult your doctor to determine whether it’s gluten that’s causing those issues. More on that in a bit. “In my experience,” continues Raden, “no one is hurt by going gluten-free, as long as they eat a [nutrient-dense] food plan, including veggies, healthy fats, fruits, and protein. [Many people] can benefit significantly from going gluten-free.”

How do you figure out if you’re actually sensitive to gluten?

In 2012, a report in BMC Medicine suggests there may be a range of gluten-related disorders—from celiac disease to varying degrees of gluten intolerance. Furthermore, a 2016 study in BMJ Journals indicates non-celiac wheat sensitivity is a real condition, and it affects nearly 18 million Americans, according to an estimate by Alessio Fasano, MD. (Some, though, dispute that number). While, as stated above, there are tests to determine whether someone has wheat allergies and celiac disease, there is no specialized testing procedure to officially measure gluten sensitivities. One way to find out if you’ll respond positively to removing gluten is through an elimination diet—a short-term diet that’s used to determine whether certain symptoms are caused or made worse by a particular food. “If symptoms do improve, then reintroduce the gluten-containing foods and see if symptoms come back,” states Raden. “If they do, you can really consider for your own experience if this food is a good option. You can eliminate other foods in a similar fashion to see if you have a sensitivity to those, too.” If you feel better after gluten is removed from your diet, this could be an indicator that you have a gluten sensitivity. If you take gluten out of your diet with no change in how you feel, though, maybe your symptoms are related to something else entirely. Either way, you’ll want to follow up with a medical professional for additional testing or recommendations.

Should everyone go gluten-free?

For many people, going gluten-free has become synonymous with a healthier lifestyle. But there’s no need to hop on the bandwagon just yet. While it might be tempting to make this generalization, many people can consume gluten without any noticeable issues—especially if it’s eaten as part of an overall healthy diet. “I do keep some people on gluten,” says Raden, “especially if they don’t have celiac disease and they do not want to eliminate gluten. … if people are feeling good, have no physical or emotional issues that they want to resolve, and their blood work looks good, … we discuss keeping gluten in their diet—but trying to choose the least processed options.” Plus, going gluten-free doesn’t automatically make you healthier. “If someone eliminates gluten and then chooses to eat mostly gluten-free pasta, gluten-free cookies and cakes, and potatoes, this is not a healthful diet,” adds Raden. In reality, there’s a significant need for more in-depth research on the subject of gluten intolerance and it’s long-term impact on your health. Though many people report being helped by a gluten-free diet, there’s still a lot we need to learn about one of the most abundant proteins on the planet.

How are food companies reacting to the increasing demand for gluten-free products?

The gluten-free market is on track to reach an astounding $7.59 billion value by 2020, according to Statista. With an influx of people desiring gluten-free products, food companies are quick to meet the demand for more food choices.

I do think gluten-free is here to stay.

Yewande Odusanwo is the founder and chief digital marketer at Zora Media, a digital marketing consulting firm for healthy lifestyle brands. Says Odusanwo: “There is a rise in consumers wanting healthy foods and wanting products that are better for their health and contain no artificial ingredients. Companies are seeing growth in consumers purchasing gluten-free products, so they are meeting consumer demand.” In general, customers are shifting their food focus to healthier options: “Brands are scrambling to make their products appear healthier without artificial ingredients or preservatives,” Odusanwo adds. “Plus,” she says, “this trend is happening not only with companies making gluten-free claims; we are seeing these with other nutritional claims by big brands. Consumers no longer trust larger brands to be free of preservatives, so they are trying smaller, niche brands that are positioned as only having all-natural ingredients from day one. I don’t think companies would change if consumers weren’t demanding better ingredients in products and voting with their dollars.” Does Odusanwo see the gluten-free trend ever losing steam? “I do think gluten-free is here to stay. For the consumers that need gluten-free products, they will continue to purchase the brands that offer them products that make them feel better. For others, they will continue to purchase gluten-free products as long as they don’t have to sacrifice taste or price. If they like the taste of the products, then gluten-free is just an added plus,” she says. So whether you choose to eat gluten or go gluten-free, it appears the gluten-free craze isn’t going away anytime soon.