Gluten is a protein that’s found in wheat, barley, and rye. With dozens of studies identifying gluten as the culprit behind a huge number of health issues (including acne, attention deficit disorder, depression, fatigue, headaches, stomach problems, and even some cancers), it’s no wonder that about one-third of Americans are now taking steps to avoid it. The market, of course, has responded positively: Sales of gluten-free foods have more than doubled in the last five years, and a number of market research firms expect them to do the same over the next five. But here’s the billion-dollar question: Should you be going gluten free? As with most health-related questions, the answer is complicated. For people with legitimate medical conditions, the answers is a definite “yes.” For everyone else, not so much.
The Case for Gluten-Free
About one in 133 Americans—roughly 3 million of us—has celiac disease, which is a serious autoimmune condition. In people suffering from celiac disease, gluten causes the immune system to attack the small intestines and prevents the body from properly absorbing nutrients from food. Another 18 million Americans may be what’s called non-celiac gluten sensitive. For those people, gluten doesn’t cause physical damage to the intestines, so eating it isn’t as dangerous. But many of its symptoms mimic those of celiac disease. A much smaller number—about 1 million people—have an allergy to wheat, which contains gluten. Untreated (or undiagnosed, which is the case for the majority of people with all of these conditions) gluten-related issues can cause a dizzying array of symptoms, including:
- Skin problems. Acne, eczema, hives, psoriasis, and itchy skin are common, as is a condition called keratosis pilaris (rough, dry patches of skin and tiny bumps on the arms, legs, or butt).
- Digestive problems. Gluten messes with the function of the intestines, causing pain, cramping, bloating, gas, diarrhea, and constipation. It may also cause or aggravate lactose intolerance (trouble digesting dairy products), which in turn can produce some of the symptoms just mentioned.
- Nutrition problems. When gluten damages the intestines, it leaves them less able to absorb vitamins, minerals, and other nutrients from food.
- Balance problems. People with any kind of gluten issues often complain of dizziness or attacks of vertigo.
- Mood problems. Poor nutrient absorption can cause anxiety, depression, sadness, and other mood issues.
- Pain problems. Digestive system problems are often associated with chronic migraines or other severe headaches. Celiac disease is also associated with fibromyalgia.
- Energy problems. Not getting enough nutrients from your food could cause iron deficiency or anemia, which will leave you feeling constantly run down.
- Inflammation problems. Gluten issues can cause swelling of the joints in fingers, hips, knees, and elsewhere.
- Thinking problems. People with gluten issues frequently complain that they feel foggy or confused after eating.
- Behavior problems. Gluten can be associated with attention deficit disorder and other behavioral conditions.
The Case Against Gluten-Free
Thanks to the explosion in the number of gluten-free foods on the market—and to the prominent placement of the phrase “gluten free!” on food packages and restaurant menus—63 percent of Americans believe that a gluten-free diet will improve their physical and/or mental health, according to a national study done by Consumer Reports. The top benefits that survey participants attributed to ditching gluten? General health, better digestion and gastrointestinal function, lower cholesterol, stronger immune system, and weight loss. Unfortunately, the truth about going gluten-free isn’t nearly so appetizing. In fact, a gluten-free diet may have the exact opposite effect of what you expect. For example:
- Vitamins and minerals. Many grains are enriched with iron, folic acid, calcium, and other nutrients. Avoiding grains could cause deficiencies.
- Fiber. We get a lot of our daily intake of fiber from grains. Less grain means less fiber, which could lead to constipation.
- Bacteria. Eliminating gluten may decrease the number of good bacteria in our intestinal tract. That could weaken the immune system.
- Fat and more. Do some package label comparisons. You’ll find that gluten-free alternatives tend to be higher in fat, calories, sugar, and sodium than the regular products.
- Arsenic. Gluten-free products often use rice flour as a replacement. Consumer Reports tested more than 60 products that contained rice and found measurable levels of arsenic in almost every one.
- Your wallet. Gluten-free products cost more—often a lot more—than their gluten-y cousins.
If you suspect that you or someone in your family has celiac disease or another type of gluten issue, do not diagnose it yourself or put yourself (or anyone else) on a gluten-free diet. To diagnose celiac disease, your provider will need to do a blood test and possibly an intestinal biopsy. To diagnose other gluten-related conditions, you may also need to see a dietician or nutritionist.