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Should You Avoid Gluten?

By Gabe Mirkin, M.D.

A July 23, 2015, Gallup Poll shows that 21 percent of North Americans are trying to avoid gluten, a component of wheat, when fewer than 1 percent actually need to do so.

If following a gluten-free diet causes people to consume fewer foods made with flour — such as bread, muffins, cookies and pasta — they may lose weight and lower their risk for diabetes, even though these benefits have nothing to do with avoiding gluten.

However, many people hop on the “gluten-free” bandwagon and consume huge amounts of gluten-free flour products, which are just as unhealthful as those made with wheat flour.

The Gluten-Free Foods Industry

The Burdock Group, which specializes in food market research, reports that North Americans spent $9 billion on gluten-free products in 2014, and they estimate that the numbers will increase by 60 percent over the next three years (Food Business News, February 15, 2015).

Gluten-free manufactured foods are often made by replacing traditional wheat flour with flours and starches made from corn, rice or potatoes. These foods cause the same high rises in blood sugar as their gluten-containing counterparts, and are just as likely to cause weight gain and increase risk for diabetes.

Furthermore, because gluten-free products are seldom made with whole grains, they are likely to lack fiber, iron, zinc, folate, niacin, thiamine, riboflavin, calcium, vitamin B12 and phosphorus.

Who Should Avoid Gluten?

Gluten is a protein found in the seeds of wheat, rye and barley. Oats do not contain gluten, but they can be contaminated by it when they are stored in silos that are used to store wheat.

One of every 100 North Americans has celiac disease, in which his or her immunity treats gluten the same way it treats an invading germ. When the gluten is released in their intestines, these people make antibodies that attack gluten and damage the surrounding tissues, which can cause a variety of symptoms, including:

• abdominal bloating and pain

• chronic diarrhea

• vomiting

• constipation

• pale, foul-smelling or fatty stool

• irritability

• fatigue

• bone or joint pain

• osteoporosis

• iron-deficiency anemia

• depression or anxiety

• tingling or numbness in the hands and feet

• seizures or migraines

• missed menstrual periods

• infertility or recurrent miscarriage

• canker sores

• an itchy skin rash

If you think you may have celiac disease, your doctor can do a blood test called celiac panel. If it is positive, you will want to avoid gluten. If the blood test is negative and you still think that you may have celiac disease, your doctor can refer you to a gastroenterologist who will do an intestinal biopsy for celiac disease. If the biopsy is negative, it is very unlikely that your symptoms are caused by gluten.

Health Benefits from Eating Gluten

In spite of all the bad publicity gluten has gotten from the authors of popular diet books, gluten has actually been shown to offer health benefits to people who do not have celiac disease. Gluten has been shown to:

• lower blood pressure (Food Chem, 2011;127:1653–1658)

• lower triglycerides (J Am Coll Nutr, 1999; 18:159–165)

• increase growth of the types of intestinal bacteria that lower inflammation (Brit J Nutr, 2008;99:110–120)

• increase absorption of healthful nutrients (Curr Opin Clin Nutr Metab Care, 2010;13:722–728)

• sensitize cells to insulin to help prevent and treat diabetes (Curr Diab Rep, 2011;11:154–159)

• reduce heart attack risk (Curr Atheroscler Rep, 2010;12:368–376)

Eat Whole Grains Instead of Any Kind of Flour

Whole grains (that have not been ground into flour) do not cause a high rise in blood sugar and they increase insulin sensitivity to help prevent obesity, diabetes and heart attacks (American Journal of Clinical Nutrition, 2003;78(5):965 971; American Journal of Epidemiology, 2003:58(3):243 250; American Journal of Clinical Nutrition, Dec. 12, 2012; American Society for Nutrition, July, 2013).

Whole grains are high in fiber and antioxidants associated with reduced susceptibility for cancer and heart attacks. See Whole Grains are Better than Any Flour

If you decide that you still want to try a gluten-free diet, you are better off avoiding all of the processed foods labeled “gluten free” because most are made from refined carbohydrates that cause high rises in blood sugar and increase your risk for weight gain and diabetes.

Here are some additional articles on the topics of gluten-free and whole grains:

Problems with Gluten-Free Diets

Gluten-Free Doesn’t Make It Good For You

Ignore Grain Brain and Wheat Belly: Eat Whole Grains


Gabe Mirkin, M.D., is a sports medicine doctor and fitness guru. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin has run more than 40 marathons and is now a serious tandem bike rider with his wife, Diana. His website is http://drmirkin.com/. Click to read Gabe’s full bio.

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