Necessary or Lifestyle?: Gluten-free as a Trend – When Abstinence Really Makes Sense

"Glutenfrei" is a label found on many processed foods that promise added value. The crossed-out wheat ear is intended for people with the autoimmune disorder Celiac disease, who are as dependent on these foods as they are on gluten-free meals in restaurants or alternative baking ingredients. For others, however, the perceived value of "gluten-free" is limited.

Prof. Peter Hasselblatt, head of the gastroenterology clinic at the University Medical Center Freiburg, explains when gluten-free diets are truly necessary and when they might be worth it. He notes that people can feel better and fitter on a gluten-free diet even without Celiac disease. However, scientific evidence that wheat grains have an inflammatory effect has not yet been strong enough to recommend a strictly gluten-free diet to the general population.

If a healthy person has no complaints, there is no need for them to follow a gluten-free diet. In cases of chronic fatigue, unclear skin rashes, or abdominal discomfort, a Celiac disease should be ruled out through a blood test. If that's the case, a gluten-free diet may be worth trying for a few weeks to see if it improves the symptoms.

But if someone is healthy, they will not become any healthier by avoiding gluten. On the contrary, there are risks to consider.

What are the downsides of a gluten-free diet? Hasselblatt explains that forgoing gluten can lead to an imbalanced diet, as gluten-free foods often contain more unhealthy fats and sugars. Studies conducted a few years ago found that people who follow a gluten-free diet may have a slightly higher risk of cardiovascular diseases, possibly due to the exclusion of whole grains, which positively influence the gut flora.

Also, people who avoid gluten often switch to grain substitutes like rice waffles, but research suggests that long-term consumption of these substitutes can slightly increase the body's heavy metal load. It must be noted, though, that no one gets poisoned by eating gluten-free. Nonetheless, one does need a legitimate reason to adopt such a diet, which requires a certain level of commitment, both financially and in terms of daily limitations. It's not a fun lifestyle choice.

Prof. Hasselblatt states that for people with Celiac disease, it is essential to maintain strict gluten-free eating habits throughout life. The immune system reacts against gluten or the gluten component Gliadin in these individuals. If they do not avoid gluten, it can lead to a continuous inflammatory reaction in the small intestine, which can cause long-term complications.

The chronic inflammatory activity is also a significant risk factor for cancer. Additionally, there are people with a food intolerance in the context of a wheat sensitivity. In this case, it is not the gluten but other grain components, known as ATI (Amylase-Trypsin-Inhibitors), that cause gastrointestinal discomfort. To avoid consuming too much gluten and ATI, one could try substituting wheat with other grains like barley, which contain less gluten and ATI.