A gluten-free diet is an eating plan that excludes gluten, a protein found in grains like wheat, barley and rye. While a gluten-free diet is essential for managing conditions like celiac disease and gluten sensitivity, it also has some potential downsides.
Nutrient Deficiencies
One of the main concerns with a gluten-free diet is that it can lead to nutrient deficiencies. Here are some of the key nutrients that may be lacking:
- Fiber – Gluten-containing grains are a major source of fiber in the diet. Fiber is important for digestive health, cholesterol levels, stabilizing blood sugar and maintaining a healthy weight.
- B vitamins – Enriched breads and cereals are fortified with B vitamins like thiamin, riboflavin, niacin and folic acid. Without gluten-containing grains, levels of these vitamins may drop.
- Iron – Fortified cereals, breads and pastas provide a significant amount of iron, an essential mineral. Iron deficiency can cause anemia and other problems.
- Calcium – Some gluten-free products are not enriched with calcium like certain brands of regular breads, pastas and cereals. Inadequate calcium intake can lead to osteoporosis.
Following a strict gluten-free diet may increase the risk of nutrient deficiencies. However, this can be prevented by choosing enriched gluten-free alternatives and eating a balanced diet with a variety of healthy foods.
Weight Gain
While many embrace a gluten-free diet for weight loss, the opposite effect is also possible. Here’s why gluten-free diets may lead to weight gain:
- Higher fat intake – To make up for the lack of gluten, gluten-free products often contain more fat and calories to improve texture and taste.
- More sugar – Gluten-free baked goods frequently have more sugar to help with rising and structural integrity. Excess sugar intake can cause weight gain.
- Lower protein – Gluten-free grains generally have less protein than wheat. Protein increases satiety and helps sustain energy levels.
- High glycemic index – Processed gluten-free products often have a high glycemic index, which causes blood sugar spikes and fluctuations in hunger hormones.
To prevent weight gain on a gluten-free diet, opt for whole, minimally processed foods over substitutes and sweets. Emphasize lean proteins, fruits, vegetables, legumes, nuts and healthy fats.
Financial Burden
Adhering to a strict gluten-free diet can take a toll on your wallet. Here are some of the reasons it may end up being expensive:
- Specialty products – Items made specifically for gluten-free diets are typically pricier than conventional ones.
- Ingredients – Gluten-free flours, starches and thickeners usually cost more than wheat-based ingredients.
- Pre-packaged foods – Ready-made gluten-free meals, snacks and baked goods come at a premium price.
- Dining out – Ordering gluten-free dishes at restaurants often incurs an upcharge.
On average, following a gluten-free diet costs about 30% more than a regular diet. Being diligent about scanning for sales and buying generic brands can help offset the costs.
Social Challenges
Adhering to a strict gluten-free diet can present some social and lifestyle challenges including:
- Dining out – Finding gluten-free options at restaurants and social events can be difficult and limiting.
- Travel – Gluten-free food may be less convenient while traveling, especially in foreign countries.
- Social isolation – The inability to share in pizzas, beers, sandwiches and other social gluten-containing foods can feel excluding.
- Potluck problems – Bringing a personal gluten-free dish is often necessary to ensure safe options at potlucks and parties.
Planning ahead helps overcome obstacles to sticking to a gluten-free diet in social situations. Talking to hosts, reviewing menus beforehand and packing gluten-free snacks ensures you still get to participate.
Quality of Life
Multiple studies show that people with celiac disease who follow a gluten-free diet still tend to have poorer quality of life scores compared to the general public. Here are some of the factors that may explain this finding:
- Dietary restrictiveness – The severe dietary limitations can be socially isolating and psychologically stressful.
- Health concerns – Even with gluten avoidance, intestinal healing and nutrient absorption may be incomplete.
- Need for vigilance – There is a constant need to scan ingredient labels, watch for cross-contamination and question food preparation methods.
- Mixed support – Friends and family may lack understanding about the seriousness of gluten exposure.
Counseling, support groups and education can help improve the wellbeing for those struggling with the burdens of a strict gluten-free diet.
Psychological Challenges
Beyond quality of life impairments, studies indicate there is a higher prevalence of psychological issues among those who follow a gluten-free diet including:
- Depression
- Anxiety
- Eating disorders
- Obsessive-compulsive tendencies
Reasons for these associations may include feelings of isolation, fear of gluten exposure, underlying mood disorders that predispose to gluten intolerance and nutrient deficiencies that affect mental health.
Gut Microbiome
Early research indicates that a gluten-free diet promotes unfavorable changes to the populations of bacteria and microbes that inhabit the gastrointestinal tract. This includes:
- Lower levels of beneficial lactobacilli and bifidobacteria
- Higher levels of inflammatory E. coli and Enterobacteriaceae
Imbalances in gut microbiota are linked to weakened immunity, intestinal barrier impairment and increased infection risk. More studies are underway evaluating how gluten-free diets impact the microbiome.
Lack of Healthful Whole Grains
Cutting out gluten means eliminating all wheat, barley and rye from your diet. As a result, the health benefits associated with whole grains become harder to obtain. Here are some of advantages of whole grains that may be lost on a strict gluten-free diet:
- Fiber for digestive and heart health
- B vitamins that support energy metabolism and brain function
- Minerals like iron for blood health and magnesium for bone health
- Antioxidants that fight disease and inflammation
- Insulin and blood sugar management
- Gut health promotion through prebiotics
- Satiety and weight management
- Reduced risk of heart disease, diabetes, cancer and mortality
Including gluten-free whole grains like brown rice, buckwheat, millet, sorghum, teff and oats whenever tolerated can help recapture some of the many benefits associated with whole grains.
Potential for Unhealthy Eating
In an effort to avoid gluten, people may end up basing their diet around processed junk foods and convenience items made from refined corn, potato, tapioca and rice flours. Here are some of the unhealthy traps of a gluten-free diet:
- Packaged snacks like chips, cookies and candy
- Gluten-free baked goods high in fat and sugar
- Prepared frozen meals and pizza loaded with sodium
- Starchy flours with little nutritional value
- Excessive added sugar to improve taste and texture
- Fried fast foods made with corn or potato flour batters
Falling into unhealthy eating habits can undermine potential benefits of gluten elimination. Focusing on whole foods naturally gluten-free teaches better dietary skills.
Increased Exposure to Arsenic
Rice is a common substitute for wheat used in many gluten-free products. However, rice has been shown to be more susceptible to accumulation of arsenic from soil and water compared to other grains. Chronic exposure to high levels of arsenic has been linked to increased risk for:
- Cancer
- Heart disease
- Neurological problems
- Diabetes
While risks from arsenic in rice are still considered low, over-relying on rice-based gluten-free products may potentially raise concerns. Variety and moderation help minimize any issues.
Higher Mercury Levels
Several small studies have found higher blood mercury levels in those adhering to a gluten-free diet. It is hypothesized that the lack of fortified breads and cereals may lead to impaired mercury excretion. Mercury buildup occurs from sources such as:
- Fish consumption
- Dental amalgam fillings
- Workplace exposures
Higher mercury levels are associated with risks to brain health and nervous system functioning. Choosing low-mercury seafood options and avoiding other mercury sources can help maintain safe levels.
Development of New Food Intolerances
After following a gluten-free diet for a period of time, some people start reacting to other foods they previously tolerated. Several explanations have been proposed:
- Oats – Developing an immune reaction to avenin protein in oats.
- Yeast – Sensitization to yeast antigens found in many gluten-free products.
- Starch – Intolerance to corn, potato or tapioca starch used in replacements.
- FODMAPs – Fermentable carbohydrates like lactose and fructose become problematic.
- Small bowel injury – Continued gut permeability and inflammation causes new trigger foods.
Broadening food restrictions can further impact quality of life and nutrition. Working with an expert can help identify causes and manage newly developed food intolerances.
Increased Eating Disorder Risk
Gluten-free dieting has become popular amongst the general population for reasons beyond medical necessity. However, studies link gluten-free diets to increased risk for:
- Anorexia nervosa – Fixation on healthy eating and dietary control.
- Bulimia nervosa – Purging after gluten “cheating” episodes.
- Orthorexia – Unhealthy obsession with righteous eating.
- Binge eating – Periods of restraint followed by overindulgence.
Those with underlying tendencies or body image concerns may take gluten-free too far. Warning signs include over-restriction, anxiety, guilt, food rituals and decreased quality of life.
Conclusion
While essential for managing celiac disease and non-celiac gluten sensitivity, eliminating gluten has potential downsides. Nutrient shortfalls, higher costs, social challenges, unhealthy eating habits and eating disorders are possible concerns associated with strict gluten-free dieting. Working with a knowledgeable health professional minimizes risks and helps ensure balanced nutrition.
