Does eating gluten-free help if you don't have coeliac disease?

Eating gluten-free is unnecessary for most people without a medical reason and provides no demonstrable health benefit. Scientific evidence that healthy people feel better from it is entirely absent. The diet's popularity is therefore not based on any medical foundation.

The picture is somewhat more nuanced for people who develop digestive complaints after eating wheat without having been diagnosed with coeliac disease or a wheat allergy. This is called 'non-coeliac gluten sensitivity,' and there are indications that reducing gluten intake can ease symptoms in this group. However, the evidence is limited and contradictory. Moreover, it is unclear whether gluten itself is the problem: certain fermentable carbohydrates in wheat (also known as FODMAPs) or other substances in wheat could just as easily be the culprit. Self-diagnosed gluten sensitivity is unreliable in any case, because no blood test or other measurement exists for it. To establish it properly, a controlled test is needed in which you alternately take gluten and a placebo without knowing which one you are receiving.

A gluten-free diet carries concrete risks. Gluten-free substitute products contain on average fewer fibres, proteins, and micronutrients such as folic acid than the regular grain products they replace. This deficiency applies to people both with and without coeliac disease. Anyone eating strictly gluten-free must therefore actively pay attention to this.

The diet also has a practical cost: it is more expensive, socially burdensome, and complex to follow. People who apply it very strictly and avoid eating outside the home report the lowest quality of life. That is a relevant consideration when there is no medical necessity.

For neurological or psychiatric complaints without coeliac disease, the indications that the diet is useful are so sparse that no recommendations can be based on them.