I’ve noticed when shopping that there a lot of food items that advertise themselves as gluten-free, even foods, such as soda, that never have had gluten! When looking at the ingredients it has seemed to me that many of the gluten free items, especially snacks, have a lot of ingredients typical of ultra-processed foods. My impression has been validated by a study from Canada that found that gluten-free products are more likely to contain ultra-processed ingredients than non-gluten free (Vergeer 2021), and that less processed food items were also less likely to be gluten free. This has implications for people with celiac disease, as another study found that celiac disease patients who consumed more ultra-processed gluten free food had more evidence of oxidative stress and inflammation than those consuming a more Mediterranean type diet. (Nestares 2021).
This is concerning because many people assume that gluten is “bad”, and that a healthy diet is gluten-free. However, a study comparing gluten free and gluten containing foods from menus provided by the United States Department of Agriculture for MyPlate ”healthy” found that the gluten free diet was in fact not healthier than the gluten containing diet (Taetzsch 2018). Most notably, the gluten free diet was significantly deficient in fiber, and some other nutrients, including folate (Cardo 2021) and higher in sugars and fats. Low fiber diets are associated with a range of problems, especially gut problems, stemming from the fact that fiber in the diet is critical for maintaining a population of beneficial gut microbes. Another concern is that many gluten free diets rely heavily on rice as an alternative to gluten containing grains, especially the ultra-processed gluten free foods. Unfortunately, rice commonly contains heavy metals, especially arsenic, which might have implications for health. (Bascuñán 2023).
From these studies it is clearly important that people with celiac disease should make an effort to get enough fiber. Good sources of gluten free fiber include fresh fruits and vegetables, legumes (beans, chickpeas, lentils), quinoa, nuts, and seeds. It is also important that gluten free diets not rely too heavily on rice, and ultra-processed foods.