4 Things You Should Know Before You Give Up Gluten
Peter H.R. Green, MD, a co-author of the new book Gluten Exposed: The Science Behind the Hype and How to Navigate a Healthy, Symptom-Free Life, offers a reality check before you hop on the g-free bandwagon.
Image courtesy of HarperCollins Publishers
#1 – Gluten Sensitivity Isn't Bunk, but You Probably Don't Suffer from It
"It's very real for some people, but it's usually self-diagnosed," says Green, director of Columbia University's Celiac Disease Center, in New York. "We know from research that a very small portion of people who self-identify as being sensitive to gluten actually are. They probably have a different health issue going on that they don't know about, like irritable bowel syndrome." In that case, avoiding gluten might relieve your symptoms, as it does for some people with IBS, says Green, but the underlying problem is still there and should be addressed. Since there's no medical test for gluten sensitivity (it doesn't show up in blood tests or biopsies of the small intestine like celiac disease does), the best way to figure out whether or not you have it is to talk to your doctor about an elimination diet, during which you slowly cut out any foods that could be causing your problems until you're symptom-free, then reintroduce them one at a time to see which (if any) trigger your issue.
#2 – There Are Real Downsides to Giving Up Gluten if You Don't Absolutely Have To
"Gluten-free flours like rice flour aren't fortified with minerals like wheat flour is," says Green. "So it's not uncommon for people who don't eat gluten to be low on folate and other B vitamins, and iron." They're often not getting enough digestion-aiding fiber either. You could also damage your microbiome, because you need a diet full of variety to fuel healthy diversity among your gut bacteria. "Gluten-free people often have very restrictive diets, eating the same handful of things over and over because they view them as 'safe,'" explains Green. Plus, there's the waistline hazard you already know about: Gluten-free foods are often higher in sugar and fat than their gluten-containing counterparts.
#3 – You Won't Suddenly Have Boundless Energy Like Everyone Says You Will
There's zero scientific evidence that going gluten-free when you don't have celiac or gluten sensitivity will put more pep in your step, says Green. Competitive cyclists without any history of gluten issues were put on a gluten-free diet for one week and a gluten-heavy diet for another (while doing their usual training)—and there was no noticeable difference in their athletic performance, found a small study in Medicine & Science in Sports & Exercise.
#4 – It Matters Who's Recommending It
Part of what's fueling the trend is the shear number of g-free evangelists, but there is a catch. "It's often not traditional medical doctors giving this advice," says Green. "I had a friend whose wife's psychiatrist suggested she go gluten-free for her depression; a patient of mine moved to the Hamptons and got a life coach, and one of the first things the life coach recommended was that he stop eating gluten." It's true that rates of celiac are rising (it's gone up about five-fold in the last 50 years, says Green) and that it's under diagnosed, but if you think you might have it, you should talk to a gastroenterologist—the doctor most likely to be aware of the symptoms (like abdominal pain, diarrhea, bloating, fatigue, numbness or tingling in the hands and feet, or itchy rashes called dermatitis herpetiformis). They will conduct the tests to confirm whether or not you have it, and if diagnosed, they can help you manage the disease and connect you with a nutritionist to make sure you get all of the nutrients you need while eliminating gluten from your diet.
"It's very real for some people, but it's usually self-diagnosed," says Green, director of Columbia University's Celiac Disease Center, in New York. "We know from research that a very small portion of people who self-identify as being sensitive to gluten actually are. They probably have a different health issue going on that they don't know about, like irritable bowel syndrome." In that case, avoiding gluten might relieve your symptoms, as it does for some people with IBS, says Green, but the underlying problem is still there and should be addressed. Since there's no medical test for gluten sensitivity (it doesn't show up in blood tests or biopsies of the small intestine like celiac disease does), the best way to figure out whether or not you have it is to talk to your doctor about an elimination diet, during which you slowly cut out any foods that could be causing your problems until you're symptom-free, then reintroduce them one at a time to see which (if any) trigger your issue.
#2 – There Are Real Downsides to Giving Up Gluten if You Don't Absolutely Have To
"Gluten-free flours like rice flour aren't fortified with minerals like wheat flour is," says Green. "So it's not uncommon for people who don't eat gluten to be low on folate and other B vitamins, and iron." They're often not getting enough digestion-aiding fiber either. You could also damage your microbiome, because you need a diet full of variety to fuel healthy diversity among your gut bacteria. "Gluten-free people often have very restrictive diets, eating the same handful of things over and over because they view them as 'safe,'" explains Green. Plus, there's the waistline hazard you already know about: Gluten-free foods are often higher in sugar and fat than their gluten-containing counterparts.
#3 – You Won't Suddenly Have Boundless Energy Like Everyone Says You Will
There's zero scientific evidence that going gluten-free when you don't have celiac or gluten sensitivity will put more pep in your step, says Green. Competitive cyclists without any history of gluten issues were put on a gluten-free diet for one week and a gluten-heavy diet for another (while doing their usual training)—and there was no noticeable difference in their athletic performance, found a small study in Medicine & Science in Sports & Exercise.
#4 – It Matters Who's Recommending It
Part of what's fueling the trend is the shear number of g-free evangelists, but there is a catch. "It's often not traditional medical doctors giving this advice," says Green. "I had a friend whose wife's psychiatrist suggested she go gluten-free for her depression; a patient of mine moved to the Hamptons and got a life coach, and one of the first things the life coach recommended was that he stop eating gluten." It's true that rates of celiac are rising (it's gone up about five-fold in the last 50 years, says Green) and that it's under diagnosed, but if you think you might have it, you should talk to a gastroenterologist—the doctor most likely to be aware of the symptoms (like abdominal pain, diarrhea, bloating, fatigue, numbness or tingling in the hands and feet, or itchy rashes called dermatitis herpetiformis). They will conduct the tests to confirm whether or not you have it, and if diagnosed, they can help you manage the disease and connect you with a nutritionist to make sure you get all of the nutrients you need while eliminating gluten from your diet.
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