With the popularity of gluten-free diets surging, many people ask me if they should consider going gluten-free. Although most questions regarding health and nutrition are highly individual, in the case of going gluten-free the answer is: yes, it might help a lot and probably can’t hurt! Especially if you’re dealing with any type of chronic condition or mystery symptoms.
If you’ve been following me for a while, you know I don’t generally make blanket recommendations like this. However, when it comes to consumption of gluten, the science linking it to poor health outcomes has become very clear. And given the prevalence of these issues in modern life, giving up gluten might be one way to help prevent and address chronic disease.
That said, the prospect of giving up all the delicious gluten-full things in life can seem daunting to downright overwhelming (especially for us bread and pasta lovers). However, when we understand the “why” behind a health recommendation it usually inspires us to give it a try. This is why I want to share these 5 science-backed reasons to go gluten-free. Plus, tips for getting started, including common pitfalls to avoid and my favorite GF, flavor- and nutrient-full brands.
Please note: all the advice and studies I refer to in this article relate to non-Celiac-gluten intolerance or sensitivity. Celiac is a whole other ball game in terms of research, related illnesses, treatment, root causes, and recommendations.
Reason #1: Going gluten-free can benefit those with autoimmunity
As an autoimmune patient and a doctor who specializes in autoimmunity, I always recommend patients with autoimmune disease adopt a gluten-free (and often dairy-free) diet.
The reasons are multi-faceted, but it begins with the gut-autoimmune connection. In functional medicine, we believe that most (if not ALL) chronic conditions, including autoimmunity, begin in the gut. And, as we’ll explore in-depth coming up, gluten has been shown to contribute to intestinal permeability, which winds up creating inflammatory and immune issues…which gluten then exacerbates.1
About ten years ago, an Italian physician named Dr. Alessio Fasano, showed that intestinal barrier function (aka: leaky gut)2 plays an important role in autoimmunity because it “controls the equilibrium between tolerance and immunity to non-self antigens.” In other words, when intestinal barrier function is compromised, the body’s ability to regulate the immune response is out of balance and autoimmunity ensues.
What does this have to do with eating gluten? Well…
In his research, Dr. Fasano identified a protein called zonulin,3 which is released in the presence of small intestinal exposure to bacteria and gluten, among others. Zonulin has been shown to influence the tight junctions in the gut—thus causing an increase in intestinal permeability and autoimmune disease in genetically susceptible individuals.
There is also evidence that going gluten-free can directly benefit autoimmune conditions like Hashimoto’s. A 2019 study by Krysiak et. al shows that a gluten-free diet reduced thyroid antibody titers, and suggests going gluten-free may bring clinical benefits to women with autoimmune thyroid disease like Hashimoto’s.4
In addition, it’s been shown that other non-celiac autoimmune conditions including autoimmune Hepatitis, multiple sclerosis, psoriasis, rheumatoid arthritis, type 1 diabetes, inflammatory bowel diseases, and vitiligo may respond favorably to a gluten-free diet.5, 6
Reason #2: Going GF has been shown to improve symptoms of endometriosis
Women often try out a GF diet to improve symptoms associated with menstruation, menopause, fertility, and overall reproductive health. And often they achieve good results. However, although there are some small studies linking going gluten-free to improvement in these areas (and plenty of clinical and anecdotal evidence) the formal research on how gluten directly affects the reproductive system is still a bit mixed. Yes, we can make a case for how gluten increases inflammation and degrades gut and thyroid health, which can cause reproductive harm, but in terms of a direct formal, double-blind-placebo-controlled link, medical science is still working on it. That said, this is one of those areas where the potential benefit of going GF outweighs the risk.
There is, however, solid evidence that going gluten-free can help relieve the pain associated with endometriosis.
A 2012 study found that painful symptoms of endometriosis decrease after 12 months of gluten-free diet. 75% of participants reported less pain after eating a gluten-free diet for 12 months (pelvic and period pain in addition to pain during sex). Zero participants reported an increase in pain after consuming a gluten-free diet for 12 months.7
The big takeaway from this is: if you have painful periods (even if the root cause hasn’t been identified) going gluten-free is definitely worth a try.
Reason #3: A gluten-free diet improves gut health and can improve IBS symptoms and SIBO
Taking steps to protect, heal, and diversify your gut microbiome is one of the most important things you can do for your overall health.
There are many proven ways to do this including eating a diverse diet, spending time outdoors, gardening, reducing stress, consuming pro- and prebiotics, and going gluten-free.
In addition to Dr. Fasano’s discovery about gluten and intestinal permeability discussed previously, research also has linked gluten consumption to negative changes in gut microbiota, an increased risk of intestinal permeability, aka: leaky gut, bloating, indigestion, flatulence, GERD and a variety of other digestive health issues8, 9
Going gluten-free has also been proven beneficial for those with irritable bowel syndrome. A 2015 study showed that a gluten-free diet improved IBS symptoms in around half of people studied.10 And since we now know that most cases of IBS is caused by the gut infection SIBO (Small Intestinal Bacterial Overgrowth),11 you can bet that going gluten-free is beneficial to those with SIBO as well.
Reason #4: Going gluten-free can help you maintain a healthier weight
We’ve all heard the claims that going on this or that gluten-free diet can help you lose weight…but is it really true?
As much as I’d like to say: yes! When you go gluten-free all the excess weight will just fall off regardless of what else you’re eating, how much you’re moving, and any other contributing conditions you have.…it’s a little more complicated than that.
Let’s start with the good news. There is evidence that going-gluten free can help you lose weight and maintain your weight12. In this study, researchers evaluated a gluten-free diet and its effect on obesity, metabolic syndrome, and cardiovascular risk in non–celiac disease participants from 2009 to 2014. They found that a gluten-free diet was associated with weight-loss over 1 year, lower waist circumference, and HDL compared to the general population. This makes sense as gluten can cause digestive, gut microbiota and inflammatory issues that can create unwanted weight gain.
Now, the complicated part.
As an integrative functional medicine doctor I do consistently observe that many of my patients do lose weight when they give up gluten. BUT, these patients aren’t just giving up gluten.
In addition to going GF, we work on things like stress management, movement/exercise, increasing hydration, cutting out processed foods, reducing sugar/refined carb intake, dialing in their genetic nutritional needs, and treating underlying conditions—all of which greatly contribute to your ability to lose weight and keep it off.
In other words, it’s typically not just giving up gluten that results in long-term weight-loss.
Likewise, I have observed patients, friends, colleagues, etc. who gave up gluten but continued eating all the gluten-free versions of the same processed foods, and they did not lose weight. In fact, some of them gained weight because ultra-processed gluten-free foods contain extra sugar and additives that add up quickly.
The bottom line: yes, going gluten-free can help you lose weight. But if you’re not choosing real GF foods and following a healthy diet and lifestyle, then it probably won’t be enough to tip the scale.
Reason #5: Going gluten-free can improve chronic inflammation
There’s a theme running through this article that ties all the reasons to go gluten-free together: it reduces chronic inflammation. And when you reduce the levels of inflammation in your body, you reduce your chances of succumbing to chronic disease.
The way in which gluten causes chronic inflammation goes back to the gut (as all roads of chronic disease tend to lead).13
Remember in point “Reason #1” we talked about Dr. Fassano’s discovery about how gluten triggers the release of the protein zonulin, which can cause intestinal permeability/leaky gut? When this happens, it makes it easier for undigested food particles, bacteria, and other pathogens to exit the shield of your gut lining and make their way into your bloodstream. Once this happens, it puts your body on red alert resulting in an enhanced inflammatory response designed to nip those foreign invaders in the bud.
Unfortunately, when the gut is chronically compromised the body remains in a state of chronic inflammation to protect itself. This is a natural and helpful defense response to pathogens, but it isn’t meant to be sustained long-term. Thus, the consistent elevated inflammatory response eventually results in a variety of chronic diseases, including autoimmune conditions, heart disease, obesity, etc.
The big takeaway here is that all chronic disease begins in the gut. Thus, it is wise to avoid things, like gluten, excess stress, etc., that enhance intestinal permeability. I discuss more about how to heal your gut in detail here.
How to get started going Gluten-free
The first step is to get educated and inspired about why you should go gluten-free…which you’ve just accomplished (congrats!).
The next step is to identify the foods that contain gluten…and it’s not just wheat. Here’s a short-list and I’ll link to a more comprehensive list at the end:
Gluten-containing grains to avoid:
In addition, many prepared, packaged, and processed foods contain gluten in hidden places. For example, soy sauce typically contains gluten, so you want to look for GF tamari instead. Same goes for sauces or soups that use wheat flour and butter (a roux) as a base/thickener. Even beer usually contains gluten! This handy guide from the Celiac Disease Foundation covers all your bases (and then some). They even list some gluten-free grains that can contain gluten due to cross-contamination.
My recommendation here is not to freak out and stop eating all grains (unless you’ve been advised by your doctor to do so for health reasons, or you have celiac and need to be really careful), but rather to look for the gluten-free label on any gluten-free grain (like oats, for example) in question.
The 3 Biggest Pitfalls to Avoid when Going Gluten-free
The biggest pitfalls to avoid when going gluten-free are:
#1: To accidentally eat natural food products that contain gluten (many people think that spelt and Einkorn are gluten-free for example, but they’re not).
#2: To think everything labeled “gluten-free” is automatically good for you. A doughnut is still a doughnut, a cookie is still a cookie, and an extra large pizza with double the cheese and toppings is still an extra large pizza with double the cheese and toppings, even if they’re gluten-free.
#3: Choosing white rice flour as your primary go-to. Although white rice flour is a popular GF substitute, just like white flour…it’s not very nutritious (and can be a source of arsenic exposure). Instead, look for gluten-free products that emphasize a blend of more nutrient-rich, whole-food, GF flours like almond, cassava, buckwheat, tapioca, lentil, chickpea, millet flour, quinoa flour, etc.
My favorite real food, junk-free, gluten-free swaps
Now the fun part, what you can eat! Thankfully, eating gluten-free has gotten a heck of a lot easier thanks to pioneering natural foods companies. Here are some of my family’s favorites to replace almost everything gluten-full in your kitchen and pantry:
For pasta try:
For tortillas try:
For crackers try:
Simple Mills Almond Flour Crackers (a great deal at Costco)
For chips try:
For bread try:
For pancakes & waffles try:
For pizza crust:
Etalia Foods is to die for
Simple Mills (mix)
Caulipower Pizza Crust (frozen)
Will I ever be able to eat gluten again?
To be fair, gluten affects some people more than others. And some of my patients do go back to eating gluten here and there once they’ve fully healed.
It’s also worth noting that some people find they can tolerate gluten better when traveling to Europe or other countries. We don’t exactly know why this happens, but it could be due to the lack of glyphosate used to grow and harvest the wheat there. (Originally created as an antibiotic, glyphosate has detrimental effects on the gut, which we will discuss in a future article.) It could also be that people are generally more relaxed while vacationing, which makes everything digest better. Still, as someone living with autoimmune disease (for me, that’s Hashimoto’s) I wouldn’t dabble with gluten.
If you’re unsure whether your chronic condition, autoimmunity, or mystery symptoms could be due to gluten issues, we may be able to help.
If you’re located in Colorado, Michigan, or Texas click here to learn more about our team’s approach to functional medicine and how to become a patient.
Not in our tri-state area? I’d still love to keep in touch (as I will likely broaden my scope of practice in the future). Click here to join the mailing list and/or join the fun on Instagram @drchristinemaren and @heymami.life.