Gluten-free food options are everywhere — from sandwich shops to local bakeries to supermarket shelves. But is the (oftentimes) higher price tag worth it?
The label tends to give products a health halo (think: the fancy gluten-free desserts at trendy cafes). Surely that piece of gluten-free pie is a better choice than your standard slice, right? Experts say to back away from the display case. For people with certain medical conditions, a gluten-free diet is medically necessary to help control symptoms. For the rest of us, dietitians say there’s scant evidence that limiting gluten is doing your body any favors. Especially if you're indulging more frequently in baked goods and other processed foods bearing the label.
If you are considering going gluten free to lose weight or improve your health, here's everything you need to know.
What is gluten and is it bad for me?
Gluten is the name of a type of protein found in wheat, rye and triticale (a cross between wheat and rye) that helps give these foods shape and structure. It’s found in a lot of other foods that might not immediately scream wheat or rye, like sauces, salad dressings, malt, beer and food coloring.
For most people, there is no evidence gluten causes problems in the body — or that you reap any benefit from cutting it out, explained Deirdre K. Tobias, ScD, associate epidemiologist at Brigham and Women’s Hospital and assistant professor at Harvard Medical School and Harvard T.H. Chan School of Public Health.
What the research says about a gluten-free diet
The main exception is people with celiac disease, diagnosed via a series of a tests done by your doctor, often including an intestinal biopsy. If you have the chronic condition, eating gluten triggers inflammation in the small intestine that causes a lot of unpleasant side effects (like diarrhea, fatigue, bloating and gas, pain, nausea, vomiting and constipation) and damage over the long-run, leading to complications like anemia, joint pain, nervous system injury, mood disorders and more. “For these people, avoiding gluten completely can help repair and prevent further damage,” Tobias said.
A gluten-free diet is considered treatment for celiac disease and the best option for individuals with the chronic condition to help manage symptoms and prevent long-term complications. It’s also medically necessary for people with a wheat allergy (which can be diagnosed via a blood prick test).
The answer is less clear-cut when it comes to people with gluten sensitivity. People with these conditions report some of the same symptoms as people with celiac disease after eating gluten, but they don’t carry the same specific gene associated with celiac disease.
People often claim to feel significantly better, in terms of having more energy and feeling less bloated, by cutting out gluten, Tobias said. But it’s difficult to know whether those benefits can be linked to cutting out gluten or instead are a result of eating more nutrient-dense foods known to boost energy and overall health. If you start cutting out gluten products, you end up cutting out a lot of refined carbohydrates (white bread, baked goods) and ultra-processed foods (like crackers and candy), and you may be replacing those foods with more fruits, vegetables, nuts and legumes, Tobias explained.
There’s not a standard test for gluten sensitivity, and there is some evidence people wrongly self-diagnose themselves with the condition and actually don’t see a difference in terms of how they feel when they switch from a diet with gluten to one without.
For people without celiac disease, there’s no evidence that eating gluten-free is linked to any health benefits, Tobias said. Research has found there’s no difference in heart disease risk for people eating less gluten compared with people eating more gluten, and that people consuming less gluten tended to eat a less heart-friendly diet.
What will you eat on a gluten-free diet plan?
On the diet, anything without gluten is fair game. Foods you should be eating if you’re following a gluten-free diet include:
- Fresh fruits and vegetables
- Non-processed, lean meats and poultry
- Most low-fat dairy products
You can also eat the following grains that do not contain gluten:
- Rice (white and brown)
You’ll avoid products with gluten, which include anything made of wheat, rye and triticale. It’s worth noting that there are several types of wheat that contain gluten you’ll also have to avoid on a gluten-free diet, like spelt, barley, durum, kamut, emmer and einkorn.
And be wary of oats: they are naturally gluten-free, but they’re often packaged in facilities where gluten products are processed and can contain traces of gluten. If you’re following a gluten-free diet for a condition like celiac disease where even a trace amount of gluten can do damage, look for oats specifically labeled as gluten-free, the Celiac Disease Foundation recommends.
What does a day of eating on a gluten-free diet look like?
Here’s what your meals might look like for a day of eating gluten-free, said Amy Shapiro, RD, founder and director of Real Nutrition in New York City:
- Breakfast: Yogurt parfait made with plain Greek yogurt, gluten-free granola (like Purely Elizabeth), fresh berries and sliced almonds
- Lunch: Gluten-free wrap sandwich (sliced turkey, lettuce, tomato and avocado in a gluten-free wrap); add mustard and spicy peppers if desired
- Snack: High-fiber, gluten-free crackers (like Mary's Gone Crackers) with hummus and carrots
- Dinner: Grass-fed steak with roasted potatoes and asparagus sprinkled with Parmesan cheese
- Dessert: Two squares dark chocolate with tea
Is a gluten-free diet healthy over the long-term?
A gluten-free diet can be a healthy diet for the long term if you’re focusing on whole foods over processed ones — and paying attention that you get adequate amounts of the micro- and macronutrients you need. “If you’re replacing the gluten in your diet with a lot of fruits and vegetables, that can be a good thing,” Tobias said. “But avoid automatically giving products a ‘healthy halo’ just because it’s gluten-free.”
Fiber is one of those macronutrients associated with a lot of long-term health benefits (like reduced risk of heart disease, obesity, diabetes and some types of cancer). The whole grains that we eat in breads, pastas and cereals are a readily available source of fiber, Shapiro said. You can certainly get fiber from other gluten-free foods (like non-starchy vegetables, fruits and beans), but you’ll have to pay attention to the quantities of those foods to make sure you’re getting enough, she said.
Though gluten-free snacks, pastas and frozen meals are now readily available, they are not created equal in terms of nutrient quality, Shapiro explained. Gluten-free breads and snacks, like pretzels, are often made from corn, potatoes and rice products that have been heavily processed. So you’re getting a lot less fiber and they can be higher in sodium and calories compared with the traditional versions of those products that contain gluten. “A lot of people end up gaining weight on a gluten-free diet,” she said.
If eating gluten-free is medically necessary, these products can be really helpful when eaten in moderation and balanced with a lot of other healthy, whole foods. But for everyone else, they’re likely not boosting health in any way, Shapiro said.
The gluten-free diet is similar to:
- A low-carb diet, which limits gluten-containing foods like grains, bread, pasta and baked goods, but also starchy vegetables, fruit and legumes
- The paleo diet, which emphasizes a lot of low-carb foods (and says grains are off limits)
- Whole 30, which excludes grains
The bottom line
Following a healthy version of the gluten-free diet over the long-term requires educating yourself and taking time to read food labels. If it’s medically necessary, following the diet is very important for long-term health. If you don’t have a medical reason to go gluten-free, cutting out wheat products will likely be futile at best. Instead, focus less on cutting gluten and more on increasing the amount of whole foods in your diet, which will naturally make less room for wheat products and processed food without feeling restrictive.