With or without gluten? Despite their popularity, gluten-free diets should only be taken by people who have been diagnosed with an intolerance or allergy to this protein or suffer from celiac disease. Otherwise, they will not bring any benefit, on the contrary, refusing gluten without medical indications can have negative consequences.

Gluten is a protein consisting of two main subtypes: glutenin and gliadin. It is found in most grains, such as wheat, barley, rye and their hybrids, and gives bread and confectionery elasticity and consistency. Gluten gives bread and similar products a soft and chewy texture.

Three situations in which you need to give up gluten completely or partially

Most people consume gluten every day – an average of 5 to 20 grams, according to some statistics – and can tolerate it without problems. However, avoiding gluten is important for people with celiac disease, a gluten allergy, or a gluten sensitivity.

• 1. Celiac disease: an autoimmune condition in which the use of gluten causes aggressive reactions of the immune system against the intestinal mucosa. The condition causes inflammation and damage to the small intestine, affecting the proper absorption of nutrients from food. Symptoms can range from digestive symptoms, such as bloating, diarrhea, abdominal pain, to non-digestive symptoms, such as fatigue, irritability, dermatological problems, or weight loss. The only effective treatment is to completely avoid gluten.
• 2. Gluten allergy: Refers to immediate allergic reactions to gluten, although specific gluten allergy is quite rare. An allergy involves an immune system reaction that occurs quickly after eating gluten and is manifested by typical allergy symptoms such as swelling, itching, difficulty breathing, or even anaphylactic shock. Treatment involves completely avoiding gluten and often requires treating symptoms with antihistamines or other medications.
• 3. Gluten intolerance (non-celiac gluten sensitivity): This is a reaction to gluten that does not involve the immune system or cause intestinal damage like celiac disease. People with gluten intolerance may experience digestive or other unpleasant symptoms, such as bloating, abdominal pain, fatigue, or headaches, without specific markers of celiac disease or gluten allergy. Treatment usually consists of eliminating gluten from the diet to relieve symptoms.

How do you know for sure if you should follow a gluten-free diet?

There are no specific medical tests for gluten intolerance, but an attempt is made to eliminate gluten from the diet to see if the symptoms go away. The following tests may be needed to diagnose a gluten allergy or celiac disease:

• Allergological tests that detect specific immunoglobulin E;
• Tests for specific antibodies present in celiac disease – antibodies to transglutaminase, are performed in the Celikey test;
• Genetic testing recommended in the presence of symptoms characteristic of celiac disease, although a positive result does not guarantee the development of the disease;
• Intestinal biopsy to confirm celiac disease, but requires gluten intake for accuracy;
• A gluten elimination diet, used when symptoms improve, is critical in diagnosis.

Food and non-food products containing gluten

If you’ve been diagnosed with celiac disease, a gluten allergy or intolerance, it’s important to avoid any foods that contain this protein, such as:

• any grain products such as wheat, barley, triticale, rye and malt
• bread
• beer
• certain candies
• many desserts
• sponge cake
• French fries
• Easter
• sausages melted
• SOUPS
• sauce mixes
• derived from malt, including malt buns, malt vinegar, brewer’s yeast and malt beer or malt milkshakes
• some types of soy sauce

Other foods, especially processed ones, may contain hidden gluten. Anyone following a gluten-free diet should check the food label to make sure the product is gluten-free.

Products marketed as gluten-free may contain traces of gluten, especially if they were manufactured in a facility that also manufactures wheat-based products.

Non-food products that may contain gluten include:

• lipstick, lip gloss and lip balm
• some medications and supplements

Risks of a gluten-free diet for people who can tolerate it

Although many people believe that gluten-free diets are more nutritious and contain more minerals and vitamins than conventional foods, the opposite is true. Gluten-free foods typically contain less folate, iron, and other nutrients than gluten-containing foods. Also, gluten-free foods tend to be lower in fiber and higher in sugar and fat. Some studies have found a trend toward weight gain and obesity among those following a gluten-free diet (including those with celiac disease).

Grains containing gluten are an important source of nutrients for most people, providing dietary fiber and other nutrients, especially when eaten whole. These products make a significant contribution to providing the daily requirement of fiber necessary for healthy digestion and maintenance of nutritional balance.

Whole grain breads and other whole grain products are natural or fortified sources of the following essential nutrients:

• Iron
• Calcium
• cellulose
• thiamine
• Riboflavin
• niacin
• Folic acid

Thus, following a gluten-free diet can lead to nutrient deficiencies. Some gluten-free breads and cereals may contain different levels of nutrients compared to the products they replace.

Additionally, some gluten-free foods may be higher in fat and sugar than gluten-containing foods. It’s important to read food labels not only to check for gluten, but also to estimate total nutrient content, salt content, calories from fat, and calories from sugar.

According to a 2017 study, gluten consumption alone does not increase the risk of heart disease. But cutting out whole grains to avoid gluten can increase your risk of heart disease.

In addition, the cost of products labeled “gluten-free” is higher than conventional products. Therefore, it is advisable to weigh the risks and benefits before giving up gluten without a medical indication.

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