With the rise of gluten-free diets, many people wonder if gluten is healthy or not. In today’s post I take an in-depth look at gluten to help you understand if eating gluten-free is best for you.
If you’re like a lot of people, you’ve probably come across, considered, or perhaps decided to start eating gluten-free. The gluten-free diet has exploded in recent years due to more support for those with Celiac Disease, emerging research on gluten sensitivities, and the overall increase in the prevalence over time of these disorders. Up until recent years, avoiding gluten was actually pretty tricky for those who medically needed to avoid it. Nowadays you’re almost guaranteed to find a gluten-free option most places you go.
I love seeing that there is more support for those who need to follow gluten-free diets. But one thing is certain: the booming gluten-free industry has stirred up a lot of confusion around whether or not going gluten-free is something that everyone should do. In some ways, gluten has become the latest nutrition “villain”.
In this post I’ll be answering shedding some light on what gluten is and whether or not one should avoid it.
So, what even is gluten?
What is Gluten?
Gluten is the name of a family of proteins, gliadin and glutenin, found in certain grains like wheat (and wheat subtypes like spelt and kamut), rye, barley, and products made from them such as bread, crackers, and pasta. It can also be hidden in places like sauces, seasonings, and supplements or medications. Gluten is what makes breads doughy and stretchy and delightful.
Who Should Avoid Gluten?
Today, people are avoiding gluten for a plethora of reasons. For weight loss, headaches, to improve energy, skin, and digestion, or because it is perceived as the healthier option, even though in some cases it is not.
There are 3 distinct groups of folks who should avoid gluten:
- Celiac Disease: People with celiac disease cannot handle gluten, even tiny amounts. In people with Celiac Disease, gluten triggers an immune response that damages the lining of the small intestine. This can lead to malabsorption of nutrients from food, cause bowel irregularities, pain, and can even cause other problems like osteoporosis if left untreated. Celiac Disease is identified via blood test for the presence of antibodies against a protein called tissue transglutaminase. A biopsy of the intestine is done to confirm the diagnosis and a gluten-free diet is essential life-long.
- Gluten Sensitivity: A related condition called Non-Celiac Gluten Sensitivity can generate symptoms similar to celiac disease but without the intestinal damage. Celiac disease and wheat allergy have to be ruled out before diagnosing gluten sensitivity, and as there is currently no validated tests for it, a trial of elimination is usually undertaken. There is some controversy on NCGS mainly because while some people are absolutely sensitive to gluten, there are other non-gluten components of wheat, such as FODMAPs, amylase trypsin inhibitors (ATIs) and wheat germ lectins that may be the reason for symptoms (e.g. bloating, diarrhea), as opposed to the gluten itself. More on this below.
- Wheat Allergy: this is an allergic immune reaction to the grain itself (wheat) that contains gluten
Autoimmune conditions can co-exist with each other. For example, those with Celiac Disease have a higher risk of developing autoimmune thyroid diseases (ATD) like Hashimoto’s or Graves’ because of the effect that gluten can have on other bodily tissues. A 2008 study found that adults with Celiac Disease had 4.4 times the relative risk of hypothyroidism and 2.9 times the risk of hyperthyroidism compared with the general public.
This is why gluten-free diets can be beneficial for other conditions.
Gluten Confusion: Other Factors To Consider
Many people who avoid gluten do so because they believe they are sensitive to it. In some cases, this is true, but gluten-containing grains contain a high-FODMAP short-chain carbohydrate (oligosaccharide) called ‘fructans’ which can cause gas, bloating, and diarrhea because it is rapidly fermented by bacteria in the large intestine. What this means is that gluten may not necessarily the culprit, but rather, FODMAPs might be.
In a double-blind crossover study, 37 participants believed to have gluten sensitivity found no evidence of gluten-specific symptom induction when other dietary triggers were controlled (e.g. FODMAPs). This study also found no changes in markers of intestinal inflammation or immune activation. In this study, there were no clues as to the mechanisms by which gluten may induce symptoms in gluten sensitivity.
The modern wheat we eat today is the product of multiple rounds of hybridization. Industrial food manufacturing has played a role in modern wheat being bred to have higher levels of gluten to make it stretchier and doughier. Gluten is even added as an extra ingredient in many breads and baked goods, not to mention the other additives that help boost shelf life, freshness, and flavour. This could be part of the reason why wheat is harder to digest today than before.
Soaking & Fermentation
As mentioned, other non-gluten components of wheat such as lectins can also play a role in its digestibility. A fundamental step in traditional bread making is long, slow fermentation, but this has been stripped out of the industrial manufacturing process so that loaves can be made quicker as opposed to 16+ hours. Some experts argue that without the traditional soaking and fermentation process where lactic acid bacteria break down parts of the grain (including removing lectins and phytates), many people can experience issues digesting grains.
Maybe you can think of a time when you’ve been really nervous — say, before a presentation — and the nerves gave you diarrhea. Or maybe you can relate to the feeling of “butterflies in your stomach”. The connection between the gut and the brain, known as the gut-brain axis, involves communication via our nervous system and even the microbes that inhabit our large intestine. Stress can directly impact how well we digest our food, and for many people, plays a big role in exacerbating symptoms.
The stress we can experience around food (such as those who fear the effects of eating a certain food) can be enough to create symptoms alone in some cases. Our mind is powerful. If we believe that gluten is going to harm us, we may feel worse or become hyper-vigilant when eating it. Likewise, when we believe gluten-free is healthier for us, we might feel better choosing that option.
Again, there is no doubt that issues digesting gluten exists, but it’s wise to consider all sides of the equation.
Many gluten-containing foods can be less healthy overall, such as burgers, pancakes, and other foods that may be cross-contaminated with gluten such as French fries or creamy sauces. By choosing a salad with grilled chicken over a burger, you may feel better. But the question is, is it the reduction in gluten, or in something else? It absolutely might be the gluten for some people, but in others, it may not.
If you suspect issues with gluten but have not been tested, it’s important to speak to your doctor to rule out conditions like Celiac Disease, but always do so BEFORE going gluten-free so that tests can properly determine if you are reacting to it.
Should You Avoid Gluten? What The Experts Say
Dr. Alessio Fasano, medical doctor, pediatric gastroenterologist, researcher and professor of pediatrics at Harvard Medical School and Harvard T.H. Chan School of Public Health and founder of the Center for Celiac Research is a pretty cool guy. He championed a lot of the research behind gluten and Celiac Disease back in the 1990s.
I really respect his work and what he has done to conduct many studies on what causes certain people to react to gluten. The problem is that many people cite his work without looking at the whole picture, and he states this himself in his book Gluten Freedom. For example, people see that he discovered zonulin (a protein that modulates permeability of tight junctions in the gut) and then they run with it, declaring that gluten cannot be digested by anybody, that it induces an immune response in everybody, and therefore everybody needs to go gluten-free. But they fail to consider everything else he has to say.
Here’s an excerpt from an interview with The Celiac Disease Foundation:
“What is quite clear is that most of our bodies cope with gluten just fine, even though it’s also true that we only started farming gluten-containing crops a few thousand years ago, which in evolutionary terms, is a blink of an eye … We don’t digest gluten completely, which is unlike any other protein. The immune system seems to see the gluten as a component of bacteria and deploys weapons to attack it, and creates some collateral damage we call inflammation … But our bodies are engaging in this war all the time, and for the vast majority of us, there’s a controlled reaction, the enemies are defeated and nothing happens. Very few people eventually lose this battle and may develop celiac disease, gluten sensitivity or wheat allergy … So if you argue on that basis that we should all go gluten free, it’s like saying that we should all get rid of germs or bacteria. That’s ridiculous. Our bodies deal with bacteria all the time. We’re awash with them.”Dr. Alessio Fanaso
So to answer the “should you go gluten-free?” question, there is insufficient evidence to suggest that those with healthy intestinal tissue should permanently avoid gluten. Gluten does not need to be avoided if there are no problems digesting it or no medical conditions warrant its restriction.
Tips for Digesting Grains Better
If you do not medically need to avoid gluten, here are some ways to digest grains a little better overall:
- Try ancient grains. Grains like spelt, kamut, emmer and Einkorn wheat have a different gluten profile than modern wheat (Einkorn for example contains 14 chromosomes vs. 42 in today’s Dwarf wheat). These grains may be better tolerated for some people, and may even be more nutritious. For example, kamut has higher antioxidant phytochemicals (polyphenols, flavonoids, carotenoids) than modern wheat.
- Try sourdough bread. This is a traditional-style, fermented bread made with flour and water that is often digested easier. It also tends to be lower in FODMAPs. You can learn how to make a homemade sourdough starter in my blog post here.
- Try sprouting your grains. You can do this yourself before consuming them, or see if you can find sprouted loaves of bread or tortillas. Brands like Food for Life and Silver Hills are good options. Sprouted grains are easier for the body to digest.
- Explore different grains: I personally believe that we can all benefit from exploring the many nutritious grains (including gluten-free grains) that are available besides just wheat, such as amaranth, buckwheat, teff, millet, oats, sorghum, rice, quinoa, and the wheat-relatives I mentioned such as spelt, einkorn, kamut, and others.
- Enjoy yourself: Lastly, if you don’t have issues digesting gluten, just let your hair down and ENJOY yourself when you want to have that white, doughy, non-sprouted, non-sourdough, non-ancient-grain bread or cupcake or whatever. The above options are there for you if you want them, but there’s no need be stressed or paralyzed with fear over gluten if you do not need to avoid it.
The Bottom Line
I’m not here to tell you to what to eat. You know your body best! If you have found that eating gluten-free makes you feel your best, I applaud you. And if you feel fine eating gluten, that’s great!
Regardless of your approach, I’m coming from the perspective of trying not to fuel food phobia, fear mongering, or disordered eating behaviours. This is because in my years of battling severe digestive flare ups I eliminated many a food–including gluten–for a few years. I no longer experience major digestive problem and as a result I chose to re-introduce gluten into my diet because I no longer wanted to restrict myself unnecessarily. Food restrictions can cause a lot of anxiety and food fear. This is a topic I’ll talk more about soon as I believe this subject is important.
I hope this post was helpful for you in better understanding gluten and its role (or not!) in your diet. Leave any questions or comments below!