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Gluten is controversial these days. Most sources claim that it is safe for everyone except those who have celiac disease. On the other hand, some health experts believe that gluten is harmful to most people.
According to a 2013 survey, more than 30% of Americans actively try to avoid eating gluten (1).
This article explains what gluten is and how it can affect people’s health.
Gluten is a family of proteins found in grains, including wheat, rye, spelt, and barley.
Of the gluten-containing grains, wheat is by far the most common.
When flour mixes with water, the gluten proteins form a sticky network that has a glue-like consistency.
This glue-like property makes the dough elastic and gives bread the ability to rise during baking. It also provides a chewy, satisfying texture.
Interestingly, the name gluten derives from this glue-like property of wet dough.
Most people can tolerate gluten with no adverse effects.
However, it can cause problems for people with certain health conditions.
It is an autoimmune disorder in which the body treats gluten as a foreign invader. The immune system attacks the gluten, as well as the lining of the gut (6).
The most common symptoms of celiac disease are:
- digestive discomfort
- tissue damage in the small intestines
- skin rashes
- unexplained weight loss
- foul-smelling feces
For this reason, doctors often find it challenging to diagnose celiac disease. In fact, in one study, 80% of people with celiac disease did not know they had it (9).
Non-celiac gluten sensitivity
Many people do not test positive for celiac disease but still react negatively to gluten.
This condition is called non-celiac gluten sensitivity.
Researchers do not currently know how many people have this condition, but some estimate it to be in the range of 0.5 to 13% (10).
Symptoms of gluten sensitivity include:
- stomach pain
There is no clear definition of non-celiac gluten sensitivity. Still, a doctor may make this diagnosis when a person reacts negatively to gluten, but they have ruled out celiac disease and allergies (11, 12).
However, some experts do not believe that this is a legitimate condition. They think that substances other than gluten cause these adverse effects.
One study looked at 393 people with self-diagnosed gluten intolerance and investigated whether they improved on a gluten-free diet (13).
The results showed that only 26 people had celiac disease, while 2 had a wheat allergy. Only 27 of the remaining 364 people received a diagnosis of gluten sensitivity.
That means that of all the participants who thought they were gluten intolerant, only 55 people (14.5%) had an issue with gluten.
Therefore, many people who think they are gluten intolerant may develop symptoms due to other causes.
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is a common digestive disorder that causes symptoms, including:
- abdominal pain
- diarrhea or constipation or both
It is a chronic condition, but many people can manage their symptoms with diet, lifestyle changes, and stress management techniques.
For an estimated 0.2–1% of the population, a wheat allergy may be causing digestive issues after consuming gluten (17).
Digestive discomfort is the most common indication of gluten intolerance. The person may also have anemia or trouble gaining weight.
To figure out what is causing your discomfort, people can ask their doctor to check for celiac disease first.
There are two main ways to find out if a person has celiac disease (8):
- Blood tests: Several blood tests screen for antibodies. A common one is the tTG-IgA test. If that is positive, the doctor may recommend a tissue biopsy to confirm the results.
- Biopsy from small intestine: A health professional takes a small tissue sample from the small intestine, which a lab analyzes for damage.
If a person thinks they may have celiac disease, they should consult with their doctor before trying a gluten-free diet.
If the person does not have celiac disease, the best way to find out if they are sensitive to gluten is to follow a strict gluten-free diet for a few weeks to see if symptoms improve.
Then, they will have to introduce gluten back into their diet and see if their symptoms return.
If the symptoms do not improve on a gluten-free diet and do not get worse when they re-introduce gluten, then the culprit is probably something other than gluten.
The gluten-free diet test is not a sure-fire way to diagnose the issue, and people should not try this on their own. If a person suspects they may have an issue, they should seek guidance from a healthcare provider and get tested for celiac disease or allergies.
FODMAPs are short-chain carbohydrates found in many foods, including wheat.
Many people are unable to digest these properly, which can cause various digestive symptoms (21).
There is some evidence that many people with “gluten sensitivity” are sensitive to FODMAPs, not gluten.
One study of 37 people with self-reported gluten sensitivity placed participants on a low-FODMAP diet, which reduced symptoms. The researchers then gave them isolated gluten, which did not affect their digestive symptoms (22).
This indicates that FODMAPs may be the culprit for many people who think they react negatively to gluten.
Doctors may recommend that people with IBS follow a low-FODMAP diet. However, many people may find this challenging, which may lead to deficiencies. People should follow this diet with the help of a healthcare professional.
The most common sources of gluten in the diet are:
- cakes, cookies, and pastries
Many processed foods contain wheat. Anyone who wants to avoid gluten will need to read labels carefully.
Some people may find starting a gluten-free diet rather challenging at first.
The first thing a person needs to do is read the labels on everything they eat.
Gluten, especially wheat, is an ingredient in a surprising number of foods.
In this diet, people should eat mainly healthful whole foods, as most whole foods are naturally gluten-free. Avoid processed food, cereals, and grains that contain gluten.
There are a few grains and seeds that are naturally gluten-free and available to purchase online. These include:
However, while oats are naturally gluten-free, they may be contaminated by it. Therefore, it is safest only to consume oats with a gluten-free label.
There are plenty of healthful whole foods that are naturally gluten-free, including:
- fish and seafood
- dairy products
- fats, such as oils and butter
As a rule of thumb, it is better to choose naturally gluten-free food, rather than processed gluten-free products. These tend to be low in nutrients and high in added sugar or refined grains.
Most beverages are also gluten-free, except beer (unless it says it is gluten-free).
For the vast majority of people, avoiding gluten is not necessary.
However, for people with certain health conditions, removing gluten from the diet can make a huge difference.
Furthermore, it is usually harmless to try a gluten-free diet. There is no nutrient in gluten grains that you cannot get from other foods.
If people cut out gluten products and do not properly replace them with other carbs in the diet, they could be at risk for inadequate fiber, calories, and B-vitamin intake. Always consult with a healthcare professional before trying a gluten-free diet.
Make sure to choose healthful foods. A gluten-free label does not automatically mean that a food is healthful and gluten-free junk food is still junk food.