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When you think of gluten, you might picture bread, pastries, or other baked goods. “Gluten is classically defined as the largely proteinaceous mass which remains when a dough made from wheat flour and water is gently washed in an excess of water or dilute salt solution to remove most of the starch and soluble material.” [1] The mass left behind from this wash is a good indicator of how much gluten made up the original product. “‘Gluten proteins’ are defined as those present in this mass and, because similar material cannot be isolated from doughs made with flours from other cereals, gluten proteins are restricted to the grain of wheat.” [1] So, if gluten proteins are only found in wheat grain; then why is it that other grains, like rye and barley, are also said to contain gluten? Related proteins are present in other cereals [...] and these are frequently referred to as gluten in the non-specialist literature and the wider popular media. Even so, if you are following a gluten-free lifestyle for health reasons or personal preferences, these grains should still be avoided.
With hundreds of millions of tons of wheat being consumed globally every year, it is important to know how the gluten proteins found within it affect your health.
Even though diseases related to gluten are extremely rare, there has been a spike in the popularity of gluten-free lifestyles in America. “Individuals may restrict gluten from their diets for a variety of reasons, such as improvement of gastrointestinal and non-gastrointestinal symptoms, as well as a perception that gluten is potentially harmful and, thus, restriction represents a healthy lifestyle.” [2] It is clear that there is a myriad of reasons why people may not consume gluten, however, is gluten really always bad? “Emerging evidence shows that gluten avoidance may be beneficial for some patients with gastrointestinal symptoms, such as those commonly encountered with irritable bowel syndrome, [...] [however] gluten avoidance may be associated with adverse effects in patients without proven gluten-related diseases.” [2] This is important to know because, of course, one should avoid gluten if it really does affect their health negatively, but if someone just decided to stop eating gluten without having any previous health issues related to it, it could lead to negative health effects.
So, what are the positive and negative health effects of cutting gluten out of your diet for those who do not live with celiac disease?
The following list is comprised of conditions that may benefit from following a gluten-free diet [2]:
● Gluten-sensitive irritable bowel syndrome
○ In a study conducted using 34 patients with irritable bowel syndrome who did not have celiac disease, it was found that “sixty-eight percent of patients in the gluten-ingesting group reported inadequate IBS symptom control vs 40% in the placebo group [...]. In addition, gluten-ingesting patients were significantly worse for overall symptoms, pain, bloating, satisfaction with stool consistency, and tiredness within 1 week.” [2] This shows how those with gluten-sensitive irritable bowel syndrome may benefit from a gluten-free diet to avoid the discomfort and pain that comes with some of the symptoms of irritable bowel syndrome.
● Non-celiac gluten sensitivity
○ “There is abundant overlap between IBS, other functional gastrointestinal disorders, and NCGS.” [2] Some symptoms of non-celiac gluten sensitivity that can be brought on by ingesting gluten include: “bloating, abdominal discomfort and pain, altered bowel habits, flatulence, rash, fatigue, headaches, mental disturbances, irritability, depression, bone and joint pain, and even attention deficit disorder.” [2] Since non-celiac gluten sensitivity shares similar symptoms with IBS when an individual consumes gluten, it makes sense that a gluten-free diet would be beneficial in a similar way to those who experience NCGS.
● Schizophrenia or other mental health conditions
○ Although there have been mixed results in studies regarding schizophrenia and the effect of gluten restriction or a gluten-free diet on symptoms, “two studies by Dohan and colleagues reported that individuals had a reduction in schizophrenia symptoms when gluten was excluded from their diets.” [2]
● Atopy
○ Atopy is the “genetic tendency to develop allergic diseases such as allergic rhinitis, asthma, and atopic dermatitis.” [3] Atopy is very common at all stages of life. “A study in a pediatric population showed that 30% of patients with IBS-like gastrointestinal symptoms and mucosal lesions [...] had improvement in both atopic and gastrointestinal symptoms with a GFD.” [2] So, a gluten-free or gluten-restricted diet may help alleviate symptoms related to different allergic diseases.
● Fibromyalgia
○ In a 2017 study, 75 patients with fibromyalgia, who also had gastrointestinal or extraintestinal issues possibly related to gluten consumption, were put on either a gluten-free diet or a hypocaloric diet for 24 weeks. Researchers found that a “GFD and hypocaloric diet resulted in symptom improvement for both gluten-sensitive and fibromyalgia symptoms.” [2] With fibromyalgia being a very common chronic disorder, it is good to know that following a gluten-free diet may help reduce some of the pain for those who live with this condition.
● Endometriosis
○ A 2012 and 2015 study “evaluated the effects of a GFD in patients with endometriosis and chronic pelvic pain. Both studies claimed an improvement in pain scores after implementation of a GFD for 6 and 12 months, respectively.” [2] Similar to fibromyalgia, endometriosis is a chronic condition, and it is common, with over 200,000 cases per year in America alone. With the chronic pain that many people with endometriosis experience, they may take comfort in knowing that a gluten-free diet may help.
Now that we’ve gone over the benefits of a gluten-free diet, it’s time for the negatives. Pertaining to the negative health effects of a gluten-free diet, the main issue is not getting enough of the nutrients one should be getting in their diet. Another issue is the financial costs of a gluten-free diet.
Let’s go over the lack of nutrients some individuals might experience with their gluten-free diet. A 1999 study and a 2000 study showed that “many gluten-free foods are not enriched and may be deficient in several nutrients, including dietary fiber, folate, iron, niacin, riboflavin, and thiamine” [2]. Getting the right amount of these nutrients is important for our health, so a diet that lacks in these areas will likely lead to deficiencies if the diet is followed for a long time. In order to combat any deficiencies, it is helpful to take supplements to fill in the missing nutrients. Furthermore, a 1998 study and a 2008 study “evaluating the nutritional composition of processed gluten-free products [...] demonstrated higher levels of lipids, trans fat, protein, and salt compared to their gluten-containing counterparts.” [2] Excess consumption of these can lead to multiple adverse health effects, like an increased risk of heart disease, obesity, and high blood pressure. If you are following a gluten-free diet, it is extremely important to try to stay away from too many processed products and stick to whole foods, instead, to avoid adverse health effects.
A gluten-free diet can also negatively affect your finances if you aren’t careful about what you’re purchasing. Two studies in 2008 and 2014 compared the costs of gluten-free and gluten-containing foods in two large-chain grocery stores. “All 56 gluten-free products were more expensive, with a mean unit price of $1.71 compared with $0.61 for gluten-containing products [...]. On average, gluten-free products were 242% more expensive than regular products.” [2] With these statistics, it is safe to say that a gluten-free diet can be significantly more expensive than a gluten-consisting diet if you don’t know where or when to find any deals or sales on gluten-free products. This is where sticking to gluten-free whole foods may also be a better option than buying processed products marked as gluten-free.
So, by now, hopefully, you have a better idea about what gluten is and how it can affect you in both positive and negative ways. If you think you may need to begin a gluten-free diet because of concerns for your health or just for personal reasons, be sure to try to consume mostly unprocessed, whole foods, and keep track of the nutrients you are getting from the gluten-free foods you consume so you know if you should start taking supplements.
References:
1. Shewry P. (2019). What Is Gluten-Why Is It Special?. Frontiers in nutrition, 6, 101. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625226/.
2. Niland, B., & Cash, B. D. (2018). Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients. Gastroenterology & hepatology, 14(2), 82–91. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866307/.
3. Atopy defined. American Academy of Allergy Asthma & Immunology. (n.d.). https://www.aaaai.org/Tools-for-the-Public/Allergy,-Asthma-Immunology-Glossary/Atopy-Defined.
Contributors:
Author: Lauryn Agron
Editor: Kayjah Taylor
Health scientist: Rayven Hall