In just about every article discussing the growing popularity of gluten-free diets, an expert or two appears three quarters of the way down warning about the “dangers” of attempting a gluten-free diet without medical supervision. The first reaction – from people like you and me who have experienced real benefits giving up gluten-containing foods – is a strong eye roll. “This again?” you think. Next they’re going to say that refined sugar is an important food group and I need a high-carb diet for “brain function” or something similarly inane.
But hey, these are medical experts with acronyms after their names. Maybe we should listen to what they’re saying and investigate their justifications for saying it. What dangers or risks are they actually referring to? Are they real dangers that we should heed, or are we in the clear?
There appear to be three primary arguments against widespread adoption of gluten-free diets. Let’s examine the evidence for and against each.
“Gluten-free diets put you at risk of vitamin and mineral deficiencies.”
Is wheat actually nutritious? Wheat flour must, by law, be fortified with calcium, iron and the B-vitamins folic acid, thiamin, niacin, and riboflavin. Flours commonly used in gluten-free products, such as rice flour, potato flour, corn meal, and tapioca, are not fortified with nutrients. Those are all important nutrients that everyone needs to be healthy, and so by replacing wheat with gluten-free products made from flours without those nutrient fortification stipulations, a newly gluten-free individual can suddenly find himself embroiled in a nutrient-sparse diet. This is a problem, to be sure, but it’s not about lack of gluten. It’s about a lack of fortification.
A recent study attempting to address this question reveals a few of the nutrients we’re supposedly missing from our gluten-free diets. Whole grains are a little better than refined grains, it turns out. After all, the nutrient fortification program is designed to replace some of what the refinement process eliminates. So, what exactly are we missing out on by eliminating gluten from our diet? Whole wheat (which includes the bran and germ) beats out other common starch staples in many nutrients. Here, check out the Wikipedia (I know) page for wheat, which compares the nutrient values in a handy table. Looks impressive, right? But wheat is not the only way to get those nutrients. It’s certainly not the best way. To wit:
Manganese: Also found in nuts, pineapple, and bivalves like mussels and clams.
Betaine: The second richest source after wheat germ is spinach.
Folate: Leafy greens, pastured egg yolks, and animal livers (especially chicken) are very high in folate. So too is kefir, if you go for that kind of thing.
Copper: Ruminant liver once a week gets you all the copper you’ll need. Alternately, eat dark chocolate and oysters.
Zinc: Red meat and oysters.
Selenium: Brazil nuts (just one will do), kidneys, pastured eggs, wild salmon.
In the conclusion of that first study, the authors lament the lack of “high nutritional and tasty cereals that are naturally gluten-free” with which to construct suitable replacement junk food for gluten-free dieters. I can think of a few worthy replacements, but they don’t involve grains. There’s no need for wheat at all, provided you don’t just eat and rely on gluten-free baked goods. Another study confirms this, suggesting that people on a gluten-free diet should increase their intake of fruits and vegetables. This will replace all the micronutrients wheat can offer us, plus the phytochemicals and antioxidants that wheat by and large cannot.
Takeaway: Wheat is an attractive and important source of micronutrients for those folks who won’t eat green vegetables, red meat, nuts, bivalves, and liver. But for those of us who relish those foods and the many other nutrients they provide, wheat offers nothing special. Try not to live on lean steak and green beans or anything crazy like that. Just eat from the incredibly varied Primal table (including the weird stuff every now and then) and you won’t miss the meager offerings of wheat.
“Gluten-free diets decrease levels of good gut bacteria and increase levels of bad gut bacteria.”
A while back, this study made the rounds. Anyone who wanted to ridicule people on elective gluten-free diets could now do it with a study under their belt. Never mind the fact that they rarely actually read the full study. Never mind the fact that they didn’t understand the significance of a shift in gut microbiota composition. They just knew that it was “bad”, that it was proof we gluten-abstainers were foolish and wrong. But the actual study paints a slightly different picture. Actually, a phrase embedded in the quote in the abstract says it all. Healthy gut bacteria decreased and unhealthy bacteria increased parallel to reductions in the intake of polysaccharides after following the GFD.
The gluten-free diet wasn’t hard on the subjects’ gut bacteria because gluten was absent. It was hard on their guts because it was poor in fermentable substrate for the gut bacteria to consume. They replaced whole wheat based foods with refined grains and starches that happened to be gluten-free. Whole wheat is a decent source of prebiotic fiber, if nothing else, and that fiber feeds the bacteria. Rice flour, (cooked) potato flour and starch, tapioca flour, corn meal, and most other gluten-free flours or starches used in gluten-free packaged foods are poor sources of prebiotic fiber. Starved of food, the beneficial gut bacteria get crowded out by the pathogenic bacteria.
If you look at the PDF detailing the RS content of various foods, you’ll see that grains are the top source of resistant starch in the diets of most industrialized nations. They’re not incredible sources, they’re not dense sources, but they’re all most people have. Your average American isn’t making green banana smoothies, eating cooked and cooled potatoes, and stirring raw potato starch into sparkling water. They’re chowing down on wheat and other cereal grains.
Takeaway: If you’re going gluten-free, you have to replace the fermentable fiber in whole grains with the fermentable fibers and resistant starches in fruits, vegetables, green bananas/plantains, cooked and cooled potatoes, and raw potato starch. This will surpass and improve upon the modest amounts of said fibers/resistant starches found in wheat and other gluten grains. Most of you already know this (the subject has received a lot of attention on this blog for years), but it’s important to pass this on to others who may not.
“Gluten-free diets may morph into eating disorders.”
This is an interesting claim, perhaps the most relevant to the Primal crowd. Anyone who takes a keen interest in how specific foods affect their health, both long-term and short-term, runs the risk of lapsing into paralysis by overanalysis. I’m talking about:
Being deathly afraid of a little canola oil (I hate it, but c’mon).
Worrying about the PUFA content of that rotisserie chicken so much that you just go hungry.
About to dig into some BPA-free sardines until you start wondering just what they replaced the BPA with.
Feeling like having some ice cream as a treat, but you end up standing in the aisle with the freezer door open scouring Pubmed on your smartphone for any adverse effects of the stabilizer used in the salted caramel for so long that they all melt and you go home empty-handed.
Taking a wide berth around the bakery counter in Whole Foods to avoid breathing in any airborne gluten particles.
I get all that. Given the choice, I’d have my food cooked in butter or olive oil every time. I’d only consume pastured, bug-eating chickens and their eggs. I wouldn’t eat foods packaged in plastic, would have my butcher pack my meat up in glass tupperware rather than wrap it in plastic. And I avoid gluten as a general rule. But I don’t base my life around it. I don’t let those preferences predominate and overshadow everything else. Because that’s a perfect world and you can’t ever get that. It doesn’t exist. You can’t be perfect. Being perfect is imperfect, even. It takes too much work and too much stress.
Take it from me – a guy who despite being sensitive to the effects of gluten will have a polite bite or two of cake if someone made it for me and really put a lot of care into it. As long as you’re not eating it regularly, as long as you’re just “nibbling” every once in awhile, and as long as you’re not celiac or highly sensitive to gluten, you will be okay. I’ve gotten to the point where those nibbles and those polite bites don’t bother my gut (giving up alcohol has certainly helped with that, as has resistant starch), but a full on slice of cake or a big hunk of bread absolutely will. Find your tolerance point and hover there. Don’t pass it, don’t worry too much if you stay below.
It’s important to distinguish between “preference” and “fear.” I prefer not to eat grains. I don’t fear them. I prefer not to eat a high-carb diet. I don’t fear carbs or think them evil. I prefer to avoid gluten – and feel better when I maintain that. But I don’t fear gluten.
Takeaway: If you’re not celiac or gluten-sensitive, don’t freak out if a stray bread crumb lands on your plate or the sushi place is out of tamari sauce. You’re probably going to be just fine. You consume food. Food isn’t supposed to consume you. Don’t let it.
What’s the bottom line? Provided you have a reasonable head on your shoulders, you shouldn’t require medical supervision to successfully and safely adopt a gluten-free diet. A proper Primal way of eating that includes leafy greens, fermentable fiber, resistant starch, the occasional slab of liver, seafood, and plenty of other nutrient-dense plants and animals will support your gut health, provide sufficient micronutrition, and promote a healthy relationship with food. The “dangers of going gluten-free” are worth noting and are probably relevant for your average consumer scrambling for room on the bandwagon, but I think we’re in the clear.
What are some other “dangers” of going gluten-free? Did I miss anything?
Thanks for reading, everyone.