The gluten-free diet (GFD) has grown in popularity but is only medically necessary for a very small segment of the population. Diets that require people to cut out a significant variety of foods should never be recommended for people who are generally healthy. When it comes to the GFD, only about 1% of the population has a diagnosis of Celiac Disease,[1}. Scientific research for non-celiac gluten sensitivity (NCGS) is not reliable. Folks who decide to switch a GFD believing it’s a healthier option make come to realize that this diet can be costly, difficult to follow and over time actually compromise balanced nutrition.
The scientific literature for non-celiac gluten sensitivity is inconclusive
Celiac Disease should be ruled out, along with any possibility of wheat allergy, lactose intolerance, or inflammatory bowel disease before going gluten-free. Symptoms of bloating, diarrhea, abdominal pain, brain fog, and fatigue can occur for various reasons. There’s not enough conclusive evidence for NCGS as it continues to remain mostly a self-diagnosed condition or a diagnosis from alternative health practitioners [2]. It’s not clear in many cases of NCGS whether symptoms are caused by gluten or by other components of the grains that are consumed [1}.
The problem with self-diagnosis
Folks who decide not to seek advice from a health care practitioner for GI symptoms may be more likely to self-diagnose. People who self-diagnose do not have the resources that qualified health professionals do to form an educated opinion regarding food intolerances and allergies and how to treat them. Self-diagnosing can lead to obsessive thoughts around health concerns that can otherwise get answered during a routine health screening. Going on a strict diet as a treatment after self-diagnosing a proposed health condition without guidance from a trained health professional can raise the risk for unhealthy weight fluctuations and vitamin/mineral deficiencies. A diet that is difficult to follow won’t help improve the quality of life and may only serve to increase anxiety and depression around the supposed health condition.
How is your stress level?
Gastrointestinal (GI) symptoms are often misdiagnosed when people are feeling high levels of stress. As stated earlier, GI symptoms can occur for a variety of reasons, including psychosomatic illness. Anxiety and depression often are the source of headaches, backaches, stomach and digestive issues. When the source of reported pain or discomfort isn’t found through traditional testing methods, stigma can result when symptoms aren’t caused by a physical reason. Psychosomatic pain is real and should not be dismissed as it’s all in your head [3]. Just like any chronic or acute illness like diabetes or a heart attack, it should be taken seriously and treated by qualified health professionals.
With eating disorders on the rise since the turn of the century [4], it’s worth a mention here. People who suffer from this illness can also experience a wide array of GI symptoms. Restricting food for a certain period can cause stomach upset, constipation and diarrhea. A stomach that isn’t digesting food regularly loses muscle mass. It’s only when a normalized eating pattern returns, stomach issues often resolve themselves. Eating normally keeps stomach muscles in shape to digest our food. People who regularly skip meals can have unexplainable stomach issues. People who have a fear of gaining weight or have heightened anxiety around health may choose to restrict certain food groups as a way to cope with how they are feeling.
Limitations of the Gluten-free diet
In a research study to determine if GF diets were more nutritious, it was found that people with celiac disease who followed a GFD consumed lower amounts of protein, vitamin E, folate, magnesium, potassium, and sodium compared to gluten-containing diets. Intake of dietary fiber was considerably low due to decreased consumption of grain products and the diet was associated with higher energy and fat intake. It was concluded that GF diets were not nutritionally superior except for sodium intake and may not be heart healthy [5].
Even with the increased availability of gluten-free foods in the marketplace, there’s still fewer choices which make it difficult to find foods to stick to the diet. Gluten-free foods on average cost 2-3 times more than food in their original form [1}. In a restaurant setting, it’s virtually impossible to avoid contamination with gluten foods unless the restaurant has a separate gluten-free area for food prep.
Despite its popularity, there’s no distinct clear-cut medical reason for going gluten-free other than for Celiac Disease. The existence of NCGS is still up for debate. Common sense would dictate unless someone is sure gluten is causing a health issue, why spend more time and hard-earned dollars to adhere to a diet that is hard to follow and can lead to nutritional deficiencies? There are many other ways to eat better without breaking the bank or giving up certain foods.
Green Apple Dietitian 