In case you haven’t noticed, the gluten-free market has exploded within the past five years. This tidal wave of gluten-free popularity took off with endorsements from food blogs and social media hash tags. Even the food industry has played a significant role. Extensive labeling of foods as gluten-free or not has amassed such a following, an estimated one in five Americans include gluten-free foods in their diet.

Yet, most people pulling gluten-free foods off grocery store shelves do not have sensitivity to wheat, barley or rye. In fact, experts estimate that only about seven percent of Americans benefit from avoiding gluten. That means many of us eating gluten-free really don’t need to. Despite this fact, according to the Academy of Nutrition and Dietetics, gluten-free alternatives to traditional foods accounted for nearly $1.6 billion in sales in 2015. Most of this growth is driven by consumers believing gluten-free is healthier and may aid weight loss. So, who should go gluten-free and who should not?

Who benefits from following a gluten-free diet?

Any person diagnosed with celiac disease through an intestinal biopsy will need to follow a gluten-free diet for the rest of their life. Celiac disease is an autoimmune disorder caused by an abnormal immune response to gluten. Gluten is a protein found in wheat, barley and rye that can damage the lining of the small intestine by causing inflammation. When the damage occurs, it reduces the ability of the intestinal lining to absorb nutrients, which can lead to problems such as anemia, osteoporosis, or growth delays in children.

A food label shows this product is not gluten free: Wheat flour and whole wheat flour are derived from gluten-containing wheat. USDA graphic.

Another form of celiac disease called dermatitis herpetiformis (DH), also warrants going gluten-free. DH can trigger the immune system to attack the skin, causing a chronic, itchy bumpy rash that can be quite painful.

One other reason to avoid gluten is to reduce symptoms of gluten sensitivity. Gluten sensitivity is not an autoimmune disease; instead it’s the inability to process gluten, resulting in unpleasant symptoms such as diarrhea, gas, bloating, and constipation.

Anyone who believes they may benefit from a gluten-free diet should be evaluated by their family physician and a gastroenterologist to determine if they have celiac disease, DH or gluten sensitivity. If they do, following a gluten-free diet will help them feel better with fewer symptoms.

Why going gluten-free when not necessary can be harmful?

Joining the gluten-free crowd can be inviting, but self-prescribing a diet devoid of gluten comes with risks including the following:

• You may risk nutritional deficiencies. Gluten-free substitutes, if composed of rice or tapioca, can be lower in fiber than products made with wheat. These gluten-free products may also not be fortified with B vitamins or iron, which are mandatory additions to any processed wheat product in the U.S.
• Gluten-free products are not intended for weight loss. They can contain just as many calories as products made from wheat, barley or rye.
• Many gluten-free baked goods are made with white rice flour or various starches which can contain more fat and sugar to make them bind together and for making them more palatable.

Following a gluten-free diet can be socially challenging.

Many individuals who have followed a gluten-free diet will say they felt better and lost weight when doing so. Likely this is because they rid their diet of processed carbohydrates such as pasta, cookies, and cakes, and began eating more fruits and vegetables instead. Eating more produce is always a win-win for everyone. Deliberately avoiding whole grains containing gluten when you don’t need to is not.

Whole grains are important sources of fiber, the B vitamins (thiamine, niacin, riboflavin, and folate), and minerals such as iron, magnesium, and selenium. Consuming whole grains may also reduce the risk of heart disease, constipation, aid with weight loss, and prevent neural tube defects of babies.

Best advice? Avoid following a gluten-free diet if not medically necessary. Instead, eat a wide-variety of foods, enjoy your meals, and be thankful you can still eat delicious whole grain foods.

Cheryl Mussatto MS, RD, LD is a registered dietitian with a master’s degree in dietetics and nutrition from the University of Kansas, and a bachelor’s degree in dietetics and institutional management from Kansas State University. She is a clinical dietitian for local clinics, an adjunct professor at an area community college where she teaches basic nutrition, and a freelance health and nutrition writer. She is the author of The Nourished Brain: The Latest Science On Food’s Power For Protecting The Brain From Alzheimers and Dementia. Visit her website at www.eatwelltobewellrd.com.