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What is a gluten-free diet: What to know

A gluten-free diet eliminates foods that contain gluten, a group of proteins present in foods such as wheat, rye, and barley.

People who have celiac disease or a non-celiac gluten sensitivity (NCGS) need to follow a gluten-free diet. For a person living with celiac disease, a gluten-free diet is the only current treatment.

This article looks at gluten-free diets in more detail, including what foods to include and avoid, and the possible benefits and risks.

A gluten-free food is a food that does not contain any gluten, a group of proteins present in wheat and other grains. Gluten helps bind baked goods and provides some elasticity to bread.

A gluten-free diet, as the name implies, involves avoiding gluten in foods and drinks completely.

According to the Celiac Disease Foundation, the main three sources of gluten in a diet are products that contain:

A newer grain called triticale, which is a cross between rye and wheat, also contains gluten, as do some other foods.

Anyone following the diet can include any foods that naturally contain no gluten, such as vegetables, fruits, grains such as rice or quinoa, seafood, and meat.

Although anyone can follow it, people living with celiac disease or gluten sensitivity should follow a gluten-free diet for optimal health.

Following a gluten-free diet can help prevent the symptoms of celiac disease and allow the body to heal from damage.

Anyone can follow a gluten-free diet, although most people will not need to in order to live a healthy lifestyle.

Anyone with any of the threeconditions below should consider following a gluten-free diet:

  • celiac disease, an autoimmune disease that causes the immune system to attack the small intestine
  • gluten intolerance, which is when the body cannot metabolize gluten
  • dermatitis herpetiformis, a type of celiac disease in which the immune system attacks the skin instead of the small intestine

The primary concern when following a gluten-free diet is avoiding any foods that contain certain grains. Gluten comes from several sources, including:

Several foods contain these basic ingredients. Common examples include:

  • baked goods, such as bread, muffins, scones, cakes, and cookies
  • pasta
  • cereals
  • beer, including rye beer
  • brewer’s yeast
  • soups
  • malt
  • food coloring

Other products, such as oats, may also contain trace amounts of gluten if a company processes them and wheat-containing products in the same facility.

Although a gluten-free diet restricts several sources of carbohydrates, such as baked goods, pasta, and cereal, a person living with celiac disease or a gluten sensitivity can safely eat several food groups.

The Celiac Disease Foundation recommends that a person living with celiac disease or gluten-sensitivity focus on foods that naturally contain no gluten. Some suggestions include:

  • fresh vegetables and fruits
  • dairy products
  • meat
  • seafood
  • beans and legumes
  • nuts
  • poultry

Several companies now offer gluten-free versions of popular baked goods, from pastas and cereals to breads and sweets. A person should look for a label on the product specifying that it is gluten-free.

In 2013, the Food and Drug Administration (FDA) created standards for the use of the gluten-free label on foods. For a food to use the label, the food must meet the following criteria:

  • naturally gluten-free
  • not made from a gluten-containing grain
  • not derived from a gluten-containing grain that the producer has not processed to remove the gluten
  • contains a gluten-containing grain, but the manufacturers have processed it to remove the gluten

In addition, the FDA rule states:

  • Companies can use these terms interchangeably: “gluten-free,” “free of gluten,” “without gluten,” and “no gluten.”
  • The final product must contain less than 20 parts per million (ppm) of gluten.
  • Manufacturers can use allergen advisory warnings on products they produce in shared facilities as long as the product contains less than 20 ppm of gluten, but the statement does not guarantee the product’s safety.

Additionally, in 2020, the FDA issued a final rule for compliance on the gluten-free labeling of fermented or hydrolyzed foods, such as:

  • yogurt
  • pickles
  • cheese
  • FDA-regulated beers and wines
  • plant proteins to add flavor to soups, sauces, and seasoning

A gluten-free diet carries a few risks. According to a 2018 studythree areas of concern exist, including:

  • Nutritional deficiencies: Cutting out gluten can cause a person to get insufficient nutrients associated with whole grains, such as fiber, iron, and other nutrients. However, well-planned gluten-free diets are unlikely to lead to nutrient deficiencies, so they are suitable to follow for life.
  • Costs: On average, gluten-free products can cost up to 267% more than regular products.
  • Social and psychological impact: Gluten-free eating can make social eating more difficult and cause the development of obsessive behaviors and thoughts.

Although people not living with a gluten-related condition may be interested in a gluten-free diet, evidence suggests that people without celiac disease or gluten sensitivity probably should not follow the diet.

According to a 2018 reviews, the evidence suggesting that a gluten-free diet is good for broad groups of people is not high quality. The authors also note that following a gluten-free diet may cause adverse effects in other groups.

Other sources present similar views. People who may wish to avoid a gluten-free diet include:

  • People trying to self-diagnose: There is a difference in severity between celiac disease and gluten sensitivity. For those with a sensitivity, coming into contact with trace amounts may not have any effect. People living with celiac disease, however, can damage their intestines with even trace amounts of gluten.
  • People looking to lose weight: A gluten-free diet can be restrictive, so it is not a good option for people aiming for weight loss. Instead, a person should follow a balanced, nutritious diet that meets their health and calorie needs.
  • People looking to follow a low carb diet: A gluten-free diet is not the same as a low-carb diet. Gluten-free diets only cut out gluten-containing carbs, such as wheat, rye, and barley. Other sources of carbohydrate, such as potato, rice, starchy vegetables, and quinoa, are suitable to eat.

People considering a gluten-free diet for anything other than gluten sensitivity or celiac disease should ask a doctor whether it is a good choice to help them meet their goals.

People following a gluten-free diet will need to avoid any food, drink, or product that contains the protein.

People with a gluten sensitivity will find that their symptoms improve when they are not eating gluten. People living with celiac disease need to follow the diet to avoid damaging their health.

Although experts advise these individuals to follow a gluten-free diet, there is a lack of evidence to suggest that a gluten-free diet is beneficial for other people. For those not living with celiac disease or gluten sensitivity, the risks of nutrient deficiencies outweigh any unproven benefit of the diet.

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