Is going gluten-free really all that good for you?
Gluten. This seemingly innocuous protein group lives in wheat, rye, barley and other grains. It has become somewhat villainized in the past couple of years. Like carbs and sugar before it, gluten is the next “thing to ditch” to lose weight.
Thing is, unless you’ve been diagnosed with celiac disease, gluten isn’t all that evil.
“Gluten helps to give texture and holds things together,” explains Mark Johnson, a member of the Board of Directors at the Canadian Celiac Association (CCA). The CCA is a charitable organization based in Mississauga, Ontario, that provides information on gluten-free food sources, fosters research and supports celiacs. Johnson joined the CCA after being diagnosed with the disease.
Celiac is an autoimmune disease that causes inflammation of the gut lining, damaging it if the disease is not discovered or diagnosed early enough.
“When gluten is taken in, the immune system activates and destroys the tiny hairs that line the small intestine,” explains Johnson. “This results in an inability of the body to absorb nutrients: protein, fat, carbohydrates, vitamins and minerals, which are necessary for good health.”
When a celiac consumes gluten, their body cannot put nutrients and vitamins to good use. This can lead to malnutrition. Yes, malnutrition. The first signs and symptoms include: anemia, gastrointestinal distress, skin rashes, fatigue, irritability and migraines.
“In the long term, for someone with celiac disease to continue to eat gluten puts them at risk for a number of dangerous conditions, including malnutrition, osteopenia/osteoporosis, and certain cancers of the gut,” warns Johnson. “This is why, at restaurants, we must be vigilant to emphasize that this is celiac disease – an autoimmune disease, not a dietary preference – and that our meals must be strictly gluten-free, with no cross-contamination. If we eat gluten by accident, we could get very sick.”
“Without gluten avoidance, there is risk for complications, and so a diagnosis of celiac disease should not be taken lightly,” says Dr. Elena Verdu, Associate Professor at McMaster University. Dr. Verdu and her team work in the Department of Medicine’s Gastroenterology Division. They research factors that cause gastrointestinal disease, such as celiac disease. “There are many reasons to develop a therapy to help the gluten-free diet, including the fact that many patients with celiac disease continue to be symptomatic after avoiding gluten. The most common explanation for this is that it is very difficult to avoid contamination.”
Gluten contamination is everywhere and some foods are more commonly contaminated than others. Johnson mentions sauces, beans and lentils, imitation fish, deli meats, burgers, hot dogs, canned soups and mixes as the main offenders. For people living with celiac disease, it becomes a matter of reading every label, every time.
Okay, so what about those people going gluten-free for funsies? A gluten-free diet for someone who doesn’t have celiac disease isn’t actually beneficial.
Yes, you read that right. Gluten-free isn’t healthy for non-celiacs.
“The gluten-free diet can be, in the long term, like any other restrictive diet, poor in some nutrients and fibre,” says Dr. Verdu. Whole grains – like those found in baked goods, cereals, pastas and barley – include the all important B-vitamins and fibre. Your body needs these to help you process other nutrients. (B12, for example, works with B9 – aka, folate/folic acid – to make red bloods cells and help iron work better.)
The trend states that going gluten-free is a healthier weight-loss-style diet, but this is wrong. Such diets often have more calories, not fewer, than their gluten-filled counterparts. That’s because more starches and fats are used in gluten-free products to create a wheat-like taste and feel.
“It is important to know that gluten-free baked goods are less healthy than gluten-containing counterparts,” explains Johnson. “They tend to be higher in sugar and fat, and are less likely to be vitamin-enriched. The only groups for whom these products are necessarily healthier are those with celiac disease or non-celiac gluten sensitivity (NCGS).”
Therefore, going gluten-free for non-medical reasons really isn’t beneficial to your health. But if you decide to try it, remember to replace the missing vitamins with supplements or other gluten-free sources. (Spinach, beets, lettuce, turnips, etc.)
And be prepared to fork over more for your weekly grocery bill. A 2008 study by Dalhousie University researchers states that gluten-free foods are, on average, 242 percent more expensive. Even up to 455 percent for certain products.
“The simple reality is that because gluten-free food manufacturers must find pure sources, free of any cross-contamination, the prices will naturally be higher,” mentions Johnson. “It also tends to cost more to use a manufacturing facility that takes the extensive measures necessary to ensure that cross-contamination does not take place.”
Cut down the cost of eating gluten free by shopping smart. “You can eat gluten free by eating products that naturally do not contain gluten, such as fruits, vegetables, milk, real cheese and meats,” says Dr. Verdu. “These products are usually more expensive than processed foods (which usually contain gluten additives) but are part of a healthy diet.”
There is a silver lining. “Prices have come down in recent years, thanks to the rapid expansion in gluten-free food manufacturing and competition among companies,” says Johnson. “However, given the need to ensure pure supply and manufacturing chains, we do not foresee a time when gluten-free baked goods will be equivalent in price to ‘regular’ food.”
Out of curiosity, I went to my grocery store to find out if it was easy to buy gluten-free products. And if I could do it on a budget. As I wandered the aisles, picking up items and then, inevitably, putting them back down, I realized … it’s hard. What few items I could find were super-expensive and the items I thought were surely gluten free weren’t.
“To help make it easier to find safe, gluten-free products, the CCA launched the Gluten-Free Certification Program (GFCP),” says Johnson. “For an item to be legally labelled gluten free in Canada, testing must show the product to be below 20 parts per million gluten. When you see the GFCP logo, it means the manufacturing facilities have undergone extensive testing and are subject to audits to make sure that they are producing safe food. This not only makes it easier for those with celiac disease or NCGS to find gluten-free products, but it also makes it much easier for friends and family shopping for these people to find safe, gluten-free foods.”
Gluten-free products have since gone beyond the stereotypical “gluten-free pastas” and “gluten-free breads”. There are a large list of items that you may not have considered as sporting gluten in their ingredient lists. Soy sauce, salad dressing, potato chips, hot dogs, veggie burgers, spices, beer, toothpaste, protein powders and even over-the-counter medicines. These items are being produced without gluten now, making it easier for people who need gluten-free consumables to find them.
While products sporting the GFCP logo are available at every grocery store, they aren’t always found in the same aisle. “The store brands of Wal-Mart (Great Value), Sobey’s (Our Compliments) and Loblaws (President’s Choice) all have an array of products bearing the GFCP logo,” says Johnson. “Finding the ‘gluten-free section,’ if there is one, can be more of a challenge. In Loblaws, they tend to be in the ‘Natural Value’ section. While in Wal-Mart they are more likely mixed with regular grocery. Still, things are much better than they were a few years ago!”
The gluten-free diet trend may be why gluten-free products are more prominent and less expensive than a few years ago. A benefit for those who need to go gluten free.
“I would call this trend a double-edged sword,” says Johnson. “On the positive side, there is now an extremely high awareness of gluten and the gluten-free diet compared to as recently as five years ago … However, the negative side is that, with the majority of individuals following the gluten-free diet for non-medical reasons, there is a tendency, especially in the restaurant world, to perhaps take the gluten-free diet less seriously.”
“There has been a trend to trivialize the need of certain people for a gluten-free food,” mentions Dr. Verdu. “The gluten-free diet is a necessity for people with celiac disease who will get very sick if exposed to even very small amounts of gluten.”
Celiac disease and people who have a medical need for a gluten-free diet need to be treated with respect. They aren’t “going gluten free” for the “health benefits” or to “lose weight”. They’re doing so because even one particle of gluten could ruin their day, and even result in a hospital stay.
“Overall, I would say that gluten free becoming mainstream is a net positive,” says Johnson. “However, there are consistent challenges in making sure people understand that our need for gluten free is very real, and serious, much like a food allergy.”
So, if you don’t have celiac, don’t go gluten free. The benefits aren’t all they’re cracked up to be. If removing gluten from your diet has made you feel better, then get yourself checked out. It’s a serious issue and one that requires the attention of the doctor. Remember, diet fads are just that. Fads. They fade. But being healthy, discovering what causes you to be unhealthy and changing it for a happier, healthier life … that lasts forever.
Think you have Celiac Disease?
35,000 Canadians have been diagnosed with celiac disease but 300,000 Canadians are believed to have celiac but are undiagnosed. If you’re going gluten free because you suspect medical problems, getting a medical diagnosis is very important.
“The CCA does not recommend someone to go gluten free in the absence of celiac disease or NCGS,” states Johnson. “If someone is experiencing health problems, and suspects that the issue may be gluten, it is critical that they be tested for celiac disease before going on the gluten-free diet …. The blood test used to indicate the presence of celiac disease will likely not be accurate if the gluten-free diet is adopted, and the gut may heal, meaning that an endoscopy may erroneously conclude that there is no celiac disease.”
If you get tested and don’t have celiac disease, but going gluten free makes you feel better, you may have a gluten sensitivity. “Some people who do not have celiac disease may be truly sensitive to gluten, or other proteins in wheat, developing symptoms that improve after avoiding gluten-containing foods,” mentions Dr. Verdu. “This is called non-celiac gluten sensitivity or non-celiac wheat sensitivity. The diagnosis, usually of exclusion, needs to be confirmed by a doctor who will exclude first celiac disease.”
Finding a Cure (or at least a treatment)
Dr Elena Verdu and her research team are working to help celiac patients. They study “the factors that lead to an inflammatory reaction in the gut.”
She explains: “Most of the chronic gut conditions that we study have been compared to a ‘perfect storm,’ meaning that many factors come together to promote disease … Our research, as well as that performed in other labs, suggests that the type and activity of the intestinal microbes, which in turn are affected by the food we eat, may influence the severity of diseases such as IBD [Irritable Bowel Disease] and celiac disease.”
In 2014, they discovered that a protein called elafin plays a role in preventing of intestinal damage due to inflammation. “Inflammation is part of a defense mechanism of the body. When it does not resolve and becomes chronic, it leads to disease,” Dr. Verdu explains. “Elafin is a human molecule present in the gut that is produced in response to inflammation to block other molecules, that if not inhibited, can lead to intestinal damage. We found that patients with active celiac disease also have diminished elafin in the upper gut. If one administers elafin to mice with upper or lower gut inflammation, they get better. The research is still in [the] discovery phase, and molecules similar to elafin are also being explored for the treatment of inflammation.”
Research is in progress. It may take time, but there dedicated scientists who want to help develop treatments for celiac disease.