Is There a Downside to Going Gluten-Free if You’re Healthy?

Q: Is there a downside to following a gluten-free or grain-free diet for someone who is not highly sensitive to gluten? Are there any benefits?

A: A gluten-free or grain-free diet can pose risks and is not recommended for someone who is not highly sensitive to gluten. Such a diet is also unlikely to provide any benefits.

“There’s no reason for someone who feels well to start a gluten-free diet to promote wellness,” said Dr. Benjamin Lebwohl, director of clinical research at the Celiac Disease Center at Columbia University. “It is not an intrinsically wellness-promoting diet.”

One of the main problems in avoiding gluten-containing grains like wheat, rye or barley as well as other grains is that it can reduce the overall quality of someone’s diet. “The most common issue people run into when starting a gluten-free diet is fiber intake often plummets,” Lebwohl said. Fiber is important for overall digestive health, so inadequate intake can lead to constipation and other bowel problems; it may also make you not feel as full, which can lead to excess calorie intake and potential weight gain. While grains aren’t the only source of fiber available, they are a good one, and most Americans fail by a long shot to get the recommended intake of about 20-40 grams a day, depending on gender and age.

If following a gluten-free diet means eschewing whole grains, that can be especially problematic, because whole grains are associated with numerous health benefits, especially for heart health. As part of a healthy diet, high intake of whole grains has been associated with reduced risk of heart disease, some cancers, Type 2 diabetes, obesity and death from numerous causes, including infections and respiratory diseases.

Gluten provides elasticity in dough and helps thicken various processed foods, so it can also be found in products like energy bars and deli meats. To compensate for the loss of texture, Lebwohl said, “gluten-free substitutes are often less healthy.”

Starting a gluten-free diet can also “interfere with the ability to detect celiac disease,” said Lebwohl, because the two abnormalities picked up by the primary testing tools for celiac disease can normalize after just a few weeks of eliminating gluten.

Only about 1 percent of Americans have true celiac disease, a serious autoimmune disorder, and should follow a strict gluten-free diet. Another 6 percent or so have non-celiac gluten sensitivity, a milder condition tied to digestive problems and other symptoms that does not result in a positive test for celiac disease; observing whether symptoms improve after a trial elimination of gluten is the main method of diagnosis.

“Avoiding whole grains because you’ve heard gluten is bad is like avoiding whole fruits because you’ve heard fructose is bad,” Katz said in an interview. A diet without gluten is most often associated with the inclusion of what he calls “ultra-processed, gluten-free junk foods” and the exclusion of highly nutritious whole grains. “Avoiding it systematically produces net harm both to diet and to health.”