Every so often a headline appears warning of the dangers of a gluten-free diet: diabetes, coronary heart disease and even arsenic poisoning.
Beyond the sensational messages from our journalists, it is true that some studies reflect a slight association between gluten-free diets and health problems.
Today you will understand why these results are due and a risk real quit gluten that it can affect you.
Not all “gluten-free diets” are the same
Observational studies can find correlations between variables, but they do not clarify whether there is any type of cause-effect between them (more detail).
For starters, these studies look at ‘gluten-free diets’ in general, but there are two approaches possible when eliminating gluten:
- Gluten-free diet, ancestral edition. Based on vegetables, fruits, eggs, fish, meats, nuts and any other food that you can eat directly from nature.
- Gluten-free diet, industrial edition. Based on gluten-free versions of processed foods: gluten-free cookies, gluten-free bread, gluten-free pizza, gluten-free pasta …
Which approach do the majority choose? Unfortunately the second. And the result is an even more processed diet.
If the message people receive is simply «gluten is bad«, You will buy your usual products but with the label«without gluten«. Or if they stop eating bread but swell to rice cakes, the outcome is probably worse. It is the least recommended carbohydrate according to this assessment.
The other problem with these observational studies is the large number of confounding factors present. There are two obvious ones:
- The “gluten-free” group tends to smoke more and drink more alcohol than the group “with gluten” (study). This supports the theory that the gluten-free diet studied is the industrial version.
- There may be reverse causality. People with any disease decide to try a gluten-free diet, generating an association by inverse causality (disease -> gluten-free diet).
This is how this second case is usually reflected:
– I have a health problem. I consulted my brother-in-law, he told me that gluten was bad and I eliminated it.
– Eating more vegetables and tubers?
– Of course not crazy, with these gluten-free cupcakes from the super.
Also, when you think something is healthy you tend to eat more (study), magnifying the problem.
In summary, the main conclusion of the studies on which the headlines are based is really this: The more processed your diet, the more risk of disease. Nothing new. The problem is not a gluten deficit but an excess of industrial food.
To confirm this theory, we should also have controlled clinical trials that effectively demonstrate that a “gluten-free ancestral diet” is better for health. Do we have these studies? Fortunately, yes.
Benefits of an ancestral gluten-free diet
What is the closest thing to an ancestral gluten-free diet? A paleolithic diet. Although my approach is not strictly Paleolithic, it is a good starting point. Remember that during 99% of our evolution we did not eat gluten.
And what happens when you replace foods with gluten (cereals) with unprocessed gluten-free foods (such as root vegetables, vegetables or fruit)? Several studies give us the answer:
- Improve metabolic syndrome conditions (high blood glucose, hypertension, abdominal fat …) to a greater extent than with reference diets (meta-analysis, study).
- Improves glycemic control and lipid profile in people with type 2 diabetes, more than a healthy diet with gluten (study, study).
- Improves glucose tolerance to a greater extent than a Mediterranean diet in patients with coronary heart disease (study).
- Greater reduction in triglycerides in women with obesity with respect to a diet with gluten according to official recommendations (study).
- Greater weight loss and less bloating (study).
If eating a good grain-free diet improves all health indicators, it is clear that the problem is not the absence of cereals, and even less the absence of gluten. And remember, we are talking about controlled clinical trials, where yes we can affirm that the improvements were due to the change of diet.
Note: These studies are not perfect either. In addition to gluten, they eliminate dairy and legumes, and we could not attribute all the improvement to the absence of gluten but, knowing other clinical trials on cereals, it is reasonable to assume that it is the main factor.
Does this imply that everyone will benefit from completely eliminating gluten? Not necessarily. In people with non-celiac sensitivity to gluten (which according to this review could reach 13% of the population) or with autoimmune diseases, it is surely the best option. Higher gluten intake during pregnancy is associated, for example, with a higher risk of type I diabetes in the offspring (study).
If this is not your case, a complete elimination may not be the best strategy.
Are there risks in eliminating gluten?
If you lived in the Paleolithic era, there would be no problem completely eliminating gluten from your life. But the industrial world exposes us to this substance frequently, and cases such as the following are common:
«I had never had a problem with gluten but I eliminated it to try. After several weeks I feel better overall, less bloated, and easily lost several extra pounds. But if one day I eat gluten (birthday cake or dinner with friends) I have a terrible time at the intestinal level, something that did not happen to me before. It’s like I’ve lost tolerance«.
It is a real message (edited for brevity) and it is not an isolated case. Similar experiences come to me almost daily. What’s going on? I’m not sure, but I have a nice theory.
Human genes have barely changed in the last 10,000 years (although we have continued to evolve), and our ability to adapt to new foods is very limited.
But our genes are only part of the equation. We have more bacteria than our own cells (detail), and bacterial DNA evolves much faster than human (detail, detail).
Eliminating gluten can alter the bacterial ecosystem:
- In mice, eliminating gluten produces a different microbiota, although associated, for example, with a lower risk of type 1 diabetes (study).
- In humans, clear changes are also seen within a few weeks, but the impact is difficult to predict (study, study).
If you’ve always eaten gluten and suddenly give it up, your ability to process it in the future may be affected (study). If this occurs, any nutritional slip It will take its toll on the intestinal level. That slice of pizza that you once tolerated now gives you a difficult digestion.
There are two alternatives to avoid this trouble:
- Eliminate gluten for life. If your diet is good, I assure you that you will not have any deficiency (detail).
- Include hormetic doses of gluten With some frequency.
As I said before, if you have any type of autoimmune disease or intestinal problems, option 1 would be the most recommended. Otherwise, option 2 may be interesting.
Hormetic doses of gluten
Being anti-fragile is about using adequate doses of stressors to strengthen yourself. Not tolerating small amounts of gluten can be limiting in a world where you will find it everywhere.
Healthy people can apply the concept of gluten to gluten hormesis: Harmful compounds above a certain threshold can be beneficial in small doses. In practice it would be consume the minimum amount of gluten that maintains your ability to process it without damaging your intestinal permeability.
Unfortunately, no one will be able to tell you what your ideal hornetic dose is, since it is a very individual factor. In people with celiac disease the dose is zero. Others will be able to consume bread at every meal, for life, without any problem. Most will be somewhere in between. In addition, a healthy microbiota has a better ability to process gluten (detail).
In my case, I usually include some quality bread every two weeks, and if I do a cheat meal from time to time, I don’t worry too much about its content either. Gluten can’t with me :).
In healthy people, replacing cereal-based foods with their gluten-free variants can cause problems, generally leading to an even more diet. industrial and a microbiota with less diversity (study).
Replacing gluten-containing cereals with real food improves overall health, but in some cases, a total elimination can alter the microbiota to the point of losing the ability to tolerate it.
A possible intermediate strategy would be limit gluten daily but include some hormetic dose occasionally.
People with intestinal disorders or autoimmune diseases will surely benefit from a 100% gluten-free approach, but always based on real food.