Fad or Fact Series. Gluten free for weight loss, health and performance?

Every couple of years a new trend comes along, usually claiming to be the answer to why you haven’t been able to lose weight. Fad or Factsintends to highlight popularised diets and uncover what they are about and are worth a try. This week’s diet looks at the phenomenon of gluten free diet (GFD), to answer the question, are ditching the grains the answer? 

A gluten free diet (GFD) has become popularised due to a belief that it is “healthier”. Endorsed by celebrities as a weight loss phenomenon, athletes claiming it “saved” their careers, or that it causes inflammation throughout the body.

Who should avoid gluten?  Gluten is a general name for the proteins found in wheat, barley and rye. Approximately 1 in 100 people suffer from coeliac disease (CD), an autoimmune disorder where the body’s immune system mistakes gluten as a threat and attacks its own intestine(6), resulting in malabsorption and digestive symptoms (pain, diarrhoea, bloating, to name a few). Lesser known is Dermatitis herpetiformis a rare but persistent skin disease linked to CD. There is also a case for non-celiac gluten sensitivity (NCGS), which is currently difficult to diagnose, affecting 1-6 % of the population (6).

Can removing gluten help weight loss? - Currently, there is no scientific evidence to show that a GFD directly assists weight loss in otherwise healthy individuals (i.e. absence of CD/NCGS). In fact, research suggests that initiation of GFD is linked to the onset of becoming overweight/obese (4). This is likely due to GF foods nutritional composition, which typically have higher fats, sugars than there gluten containing counterparts (1), therefore possibly higher in overall calories. 

Verdict: It seems that GF foods tend to be poorer nutritional density and greater calorie, neither which support optimal health or weight loss. 

Is there risks? - Foods that typically are gluten containing, breads, pasta, etc are rich in important nutritional components for health. Removal of gluten from the diet puts individuals at risk of vitamin D, B12, Folate, iron, zinc, magnesium, calcium deficiencies, all which are essential to optimal human health. Fibre, an essential nutrient for digestion, is typically found in wholegrains. GF products usually lack this as they are made of low fibre refined flours (5). Those who avoid gluten, need to pay notice in order to ensure they optimise diet avoiding any deficiencies. 

Verdict: GFD increases deficiency risk of essential nutrients. When considering optimal  health and weight management, the negative risk of unnecessary avoidance of gluten doesn’t seem to support it. 

Athletic performance (Elite or recreational) - Many athletes have spoken of their avoidance of gluten the “game changer” to their career. A common complaint with intense exercise is GI distress, therefore, a diet the potential reduces GI distress would appeal to most. However, research indicated that following a GFD (in a non-celiac population),  has  no overall effect on performance, GI symptoms, well-being, and a select indicator of intestinal injury or inflammatory markers (2, 3). 

Verdict:From a performance point of view, research doesn’t support a GFD (in non-celiac/NCGS). In fact risk of GFD associated deficiencies may hamper athletic performance.

Why do people achieve weight loss? - The diet is restrictive in nature, therefore naturally reducing the foods you can simply put into your mouth, you are aware and conscious for the first time of what you are actually eating – therefore, is it the simply actions and awareness of what you are eating. So like any diet strategy (calorie counting, macronutrient counting, etc – we will explore more within this series), is it merely a tool which allows a person lose weight due to the behaviours around it, rather than that around what is physically happening in the body? 

Verdict:It may serve as a tool in order to promote, but should associated weight loss (in otherwise healthy population), is not linked to the actual removal of gluten. 

How do I know if I have an issue with Gluten - The market is full of invalid tests, which lack scientific/clinical evidence – taking advantage of vulnerable people desperate to seek an answer for the GI distresses. Celiac disease must be confirmed by blood and biopsy tests, conducted by a medical professional. For those who suspect they may be genuinely sensitive to gluten (but not celiac), using methods of recording (identity possible triggers with symptoms), restrict triggers, and then reintroduce (1 at a time to i.d. your trigger), but should also consult a medical professional for guidance. 

Other Considerations - GFD is costly, the products labelled “Gluten Free” are typically much more expensive than their counterparts. In addition, any diet that drastically prevents ease of eating can be very socially debilitating- just think of trying to go for meals, over to a friend’s having to ask them for a “special menu” – totally acceptable if you are celiac/NCGS, but impairs enjoyment of life. 

The Final Verdict

A GFD is absolutely necessary for a limited population in order to optimise health and overall life. Research fails to support associated health claims and weight loss promise, in fact there appears to be a danger to health (through deficiencies) and even increase weight, not to mention the cost and social implications. If you are suffering from GI symptoms, do not assume cutting gluten is your first protocol, or trust marketing for allergy testing. Consult with a professional in order to have an accurate diagnose and treatment in place. The only real current evidence to adhere to GFD is under celiac disease or NCGS. 

FAD not FACT (unless medically necessary).