Don’t fall for all the hype.

What’s more comforting to a celiac disease sufferer than a label that proudly proclaims, “Gluten-Free?” If, like Zooey Deschanel, Elizabeth Hasselback, and golfer Michelle Wie, you need to avoid foods that contain gluten and other related proteins, you’ve been conditioned to look for these seals of approval whenever you’re shopping the grain aisle. But does fruit really need a gluten-free label? And does anyone really need gluten-free shampoo? 

While doctors can easily diagnose celiac disease, an autoimmune condition caused by gluten that causes severe damage to the small intestine, there’s no definitive test to tell if you’re simply sensitive to gluten. According to Mark Flasar, MD, Assistant Professor of Medicine at the University of Maryland School of Medicine, gluten sensitivity is a diagnosis of exclusion. If you don’t have celiac disease, irritable bowel syndrome, or some other gastrointestinal disease, and if your symptoms of nausea, diarrhea, cramping, bloating, and brain fog seem to improve when you take gluten out of your diet, then you might be gluten-sensitive. As Flasar says, “Many of my patients are convinced gluten is the enemy of their gastrointestinal tract.” He tells his patients that there’s no harm in going gluten-free, as long as they don’t limit their diet too much—and as long as they’re willing to pay for expensive gluten-free foods. 

Sheila E. Crowe, MD, Professor of Medicine and Director of Research, Division of Gastroenterology at the University of California, San Diego, agrees. She explains, “While gluten sensitivity is a bit of a fad, if you think you have the symptoms, see your doctor. It’s important to get tested for celiac disease, because in that case, you really do need to be on a completely gluten-free diet. Also, your family members deserve to know, because celiac disease has a genetic aspect. A gluten-free diet can be a very healthy diet if you eat naturally gluten-free foods. If you’re knowledgeable about nutrition and want to go gluten-free, there’s no reason not to. Just bear in mind that we have no data to show any long-term benefit.”

For those who have celiac disease, Rachel Begun, MS, RDN, a nutritional consultant and blogger at The Gluten-Free RD, points out that real danger lurks, even in foods that are naturally gluten-free: “It's important that gluten-free claims are made accurately and with transparency. A good example is when I see French fries labeled as gluten-free on restaurant menus. If the French fries are made with gluten-free ingredients and in a dedicated gluten-free fryer, then labeling them as gluten-free is okay—if they can guarantee no cross contact occurred throughout preparation and service. However, if the French fries made without gluten are fried in the same fryer as foods containing gluten, then they’re not gluten-free. “

It’s also true that many products advertised as gluten-free have just replaced the gluten with high-carb ingredients that might actually be even worse for you.  Begun explains, “A cookie is a cookie, whether gluten-free or not—it's a treat food that should be eaten only occasionally. A healthy gluten-free diet should consist mostly of whole, nutrient-rich foods, including fruits and vegetables, plant-based proteins such as legumes, nuts, and seeds, whole gluten-free grains, and lean cuts of meat, poultry and fish. The ironic thing is that these are the same foods we recommend to the general population for a healthy diet. The only difference is that the whole grains need to be gluten-free.” 

Author of the best-selling Grain Brain, David Perlmutter, MD, agrees. “High-carbohydrate foods like bread, cookies, and sweets dramatically threaten health, whether they’re gluten-free or not,” he says. “The threat to health posed by gluten goes well beyond those who have been diagnosed with celiac disease. New research indicates that, in fact, all humans have some degree of gluten sensitivity.”

And what about that gluten-free shampoo? Not necessary unless you plan to eat it. Says Perlmutter, “If a person doesn’t have celiac disease, it’s probably not critically important to seek out gluten-free shampoos. But anything that’s ultimately consumed, like toothpaste and lipstick, would be best if it’s gluten-free.”  

Because it all ends up in the same place.