Is gluten in your diet helping or harming you? Can going gluten-free lead to weight loss?

It is a family of proteins (glutenins and gliadins) found in wheat, rye and barley. It acts as a binder which holds flour together, giving it the ability to stretch, else it would be hard to make a chappati or naan from wheat dough. From the West to East, humans have consumed gluten-containing breads for thousands of years. Enzymes in our stomach are unable to break down gluten completely, which passes to the small intestine. In patients with a condition known as “Celiac Disease”, ingestion of gluten excites an immune reaction and inflammation of the lining of the gut. Finger-like villi, that are a part of the gut lining and provide a large surface for food absorption, get inflamed and wither away. This results in pain, diarrhoea and poor absorption of nutrients. Joint pain and anaemia are common consequences as are Vitamin D deficiency and fragile bones. The worldwide prevalence of Celiac Disease is 1 in 100. Like most auto-immune diseases, it tends to run in families. Its diagnosis is done through blood tests for antibodies; and an endoscopic biopsy is often needed for confirmation. If left undiagnosed and untreated, it can, at times, have grave consequences.

The good news is that soon after a gluten-free diet is instituted, the abdominal symptoms disappear. The inflammation recedes and normal absorption is restored. The adverse impact on the body can be reversed rapidly just by omitting gluten from the diet.

WHAT IS GLUTEN SENSITIVITY?

What about those who do not have Celiac Disease? There are some who are truly gluten-sensitive and get abdominal symptoms when they consume gluten, and feel better once they eliminate it. Since there are no diagnostic tests for gluten sensitivity, the exact prevalence is difficult to determine but estimates suggest that such sensitivity could be affecting six per cent of the population. At times, those who suffer from IBS (irritable bowel syndrome), a common disorder, also cannot tolerate gluten-containing cereals like wheat. Here the reaction may not be to gluten per se but to poorly absorbable carbs (fructans) which get fermented in the colon and produce bloating and gas because the IBS-afflicted gut is unable to digest them. In these patients, it is the treatment of the primary condition that is important, rather than prescribing gluten-free diets alone. A skin condition called dermatitis herpetifiormis can also be a sign of gluten allergy and is a reason to go gluten-free. Some may have wheat allergy which can be confused with gluten.

CAN ELIMINATING GLUTEN LEAD TO WEIGHT LOSS?

Do gluten-free diets work for weight loss? A common notion among gluten-free enthusiasts is that ridding the diet of gluten results in weight loss. Many people report a loss of weight after going gluten-free, especially in the initial stages. That’s because if you suddenly reduce carbohydrates and cereals in your diet, you are bound to lose some weight. It has nothing to do with gluten. Try replacing wheat with rice in your diet. You will be gluten-free, but you may actually put on weight.

Some believe that gluten is a modern age curse and all should give it up. However, little evidence exists that giving up gluten by an otherwise healthy person without any gluten-related disorders is of any help. Remember that humans have been consuming gluten containing grains for about 10,000 years! There is little evidence that gluten impacts thyroid disease or causes conditions like “brain fog”, two other conditions popularly correlated with gluten.

Who should be on gluten-free diets? Those with proven Celiac Disease or those with non-Celiac gluten sensitivity. Some with IBS may also feel better without gluten or wheat. These groups have to ensure that nutrition is not compromised. Gluten containing whole grains contain fibre and nutrients. Among whole grains, quinoa, brown black or red rice, buckwheat and millets are excellent gluten-free alternatives.

WHY LOW GLUTEN MAY CAUSE PROBLEMS

Those on gluten-free diets may need probiotic support and supplements. Commercially available processed gluten-free diets are often rich in carbohydrates and fat, provide a high amount of calories but lack vitamins and minerals. Transitioning to commercially available gluten-free products could make you miss out on some important nutrients, and the gut flora could change adversely, making you more prone to infections.

Large studies published in 2017 suggested that those on low-gluten diets are actually MORE prone to diabetes and heart disease, likely because of lower whole grain consumption. For most of the population, giving up gluten does not offer any health benefits. Don’t join the gluten bandwagon just because people around you are following this fad or social media is flooded with false information. Only if you suffer from specific gluten-related health issues should you give up gluten. Above all, don’t self-diagnose. Check with your doctor!