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Gluten Is Perfectly Fine for the Vast Majority of People

There’s almost no proof that going gluten-free will do the average person any favors.
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By some estimates, roughly one in three Americans is actively trying to cut back on gluten, and gluten-free foods are now a $5-billion industry. Those are pretty stupefying figures when you consider there’s almost no proof that going gluten-free will do the average person any favors. In fact, most of the research to date suggests gluten-free diets are unhealthy.

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“The low-gluten fad can cause harm, and there is no evidence of a benefit unless someone has evidence of an allergy to gluten, as in celiac disease,” says Walter Willett, a professor of epidemiology and nutrition at Harvard School of Public Health.

Celiac disease is an inherited autoimmune disorder that affects less than one percent of the population—a rate that seems to be holding steady, not climbing, according to a 2016 study in JAMA Internal Medicine. For celiac patients, eating gluten can cause symptoms ranging from abdominal pain and vomiting to seizures. A blood test can confirm if you have the disease.

A small percentage of people—perhaps up to five percent of the population—may have a condition known as non-Celiac gluten sensitivity (NCGS), says Alessio Fasano, director of the Center for Celiac Research at Massachusetts General Hospital. For these people, gluten seems to cause some of the same symptoms that turn up among celiac patients. But NCGS is controversial; not all gut experts are convinced it’s a real condition, and there’s currently no test to confirm whether a person has it.

Whether or not NCGS is legit, nutrition researchers agree that the vast majority of Americans don’t have any gluten-related issues. For these people, cutting out gluten is more likely to do harm than good. “We have seen that people who do not have celiac disease, but who [do] have low gluten intake tend to have higher risk of type 2 diabetes,” Willett says, citing some of his own research. Another recent study concluded that avoiding gluten could raise a healthy adult’s risk for heart disease. Gluten-free diets may cause these and other issues because they steer people away from nutrient- and fiber-rich whole grains and toward less-healthy alternatives, Willett says.

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“Gluten-free foods are not inherently healthy, and a lot of these commercially-produced gluten-free foods are not good for you by and large,” adds Joseph Murray, a gastroenterologist and professor of medicine at Mayo Clinic in Rochester, Minnesota. Murray says that, even for patients with celiac, he advises caution when it comes to buying gluten-free packaged products. And like Willett, he says missing out on whole grains is a big concern associated with gluten avoidance.

While it may come as a surprise to those who buy the current low-carb hype, whole grain foods have established health benefits. Two large long-term 2015 studies found people who eat heavy amounts of whole grains enjoy significantly lower rates of heart disease and mortality. More evidence suggests eating whole grains lowers your risk for diabetes and some forms of cancer. There’s also a wealth of data backing the benefits of Mediterranean-style diets. While olive oil and fish draw most of the focus when it comes to healthy Mediterranean eating, these plans are traditionally high in whole grains.

Apart from being packed with vitamins, whole grains are great sources of fiber—a type of carbohydrate that feeds healthy gut bacteria and supports digestion. “There’s just this huge spectrum of health benefits associated with high fiber intakes, and whole grains are one of the best and most-affordable sources of fiber,” says Wendy Dahl, an associate professor of food science and human nutrition at the University of Florida. Research shows the average American is already woefully deficient when it comes to fiber. And gluten-free eating is likely contributing to this issue. “People on these anti gluten or anti grain diets—they’re cutting off the largest source of fiber from their diets,” Dahl says.

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On the other hand, there’s no doubt that many gluten-packed foods are crappy for you. Cookies, crackers, baked goods, and other heavily processed grain-based snack foods are on every dietician’s list of foods to avoid. If you tend to eat a lot of this junk, going gluten-free could steer you toward some healthier eating patterns.

There’s also evidence that people with irritable bowel syndrome and some other gut conditions can reduce their symptoms by cutting out some short-chain carbohydrates known as FODMAPs. Since many gluten-containing foods also contain these short-chain carbs, it’s a certainty that some people who cut out gluten are going to feel a bit better. “They benefit, but not from life without gluten,” says Peter Gibson, a professor of gastroenterology at Monash University in Australia. Some of Gibson’s research has shown that people with non-Celiac gluten sensitivity who cut out FODMAPs felt a lot better, while removing gluten from their diets—without their knowing it—didn’t make much difference. He says a low-FODMAP diet would benefit these people more and would not be as restrictive as a gluten-free diet.

But let’s not muddy the waters. The case for or against eating gluten is pretty straight-forward: If you’re dealing with chronic gut pain, diarrhea, unexplained weight loss, or other symptoms that suggest a GI disorder, talk with your doctor. He or she may determine that a gluten-free diet is for you. If you’re not experiencing those symptoms, there is no reason to avoid gluten.

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