Gluten—a protein found in wheat, barley, and rye—has been at the center of debates about food and health. For some people, a gluten-free diet is a medical necessity, as its consumption can trigger adverse reactions. It's also increasingly common to find people, even without a diagnosed related disorder, opting for gluten-free foods. But should we all reconsider our gluten consumption and give up bread, pasta, and even seitan? What does the scientific evidence say? Before changing your diet, it's worth understanding the effects of gluten on the body, with a special focus on gut health, as well as its link to fertility and mental health.

What is gluten and where is it found?

Gluten is a protein complex present in wheat, rye and barley seeds, and widely used in the food industry for its unique properties ¹ .

The term "gluten" comes from the Latin glutinum , meaning "glue," referring to its viscous and elastic characteristics. These properties make gluten useful in foods like breads, pastas, and cakes, giving them a fluffier, more malleable texture. This is also why gluten is often used as an additive in other (naturally gluten-free) products, improving consistency and extending their shelf life.

Gluten's applications don't stop with food: it can be found in cosmetics, medicines, and even kitchen utensils. This widespread use makes strict regulation and effective product monitoring crucial to protect people with gluten-related conditions, such as celiac disease.

What proteins are associated with gluten?

Gluten is made up of a set of proteins called prolamins, which include ¹ :

• Gliadin in wheat
• Secalin in rye
• Hordein in barley

While oats are generally considered a safe alternative for gluten-free diets, their specific proteins, called avenins, can trigger reactions in some people with celiac disease. ¹ Furthermore, cross-contamination during processing can make oats unsuitable for gluten-sensitive individuals. For this reason, it's crucial to choose certified gluten-free oats.

Gluten-related disorders

There are several conditions associated with gluten consumption, which may be autoimmune in origin (such as celiac disease, gluten ataxia, and dermatitis herpetiformis), allergic (wheat allergy), or of a different nature, neither autoimmune nor allergic, as is the case with non- ^celiac gluten sensitivity. Let's understand the differences between these conditions:

• Celiac disease – a chronic autoimmune disease in which gluten ingestion triggers an immune response, damaging the lining of the small intestine in genetically predisposed ^individuals . This condition can lead to malabsorption of nutrients and is associated with symptoms such as diarrhea, fatigue, abdominal pain, and weight loss. Diagnosis is made through a combination of serological tests, which detect the presence of specific antibodies, such as the anti-tissue transglutaminase antibody IgA (tTG-IgA). If the results are positive, an ^intestinal biopsy is recommended for confirmation. Did you know that approximately 1% of the world's population is affected by this disease? ³

• Non-Celiac Gluten Sensitivity – this is a reaction that is not mediated by the immune system ² . Some people report symptoms similar to celiac disease, such as flatulence, abdominal pain, a general feeling of malaise, and fatigue, after consuming gluten, even without a celiac disease diagnosis. Other symptoms may include headache, anxiety, "foggy brain" (difficulty concentrating), joint or muscle pain, dermatitis, or rosacea. Diagnosis is made through a protocol of eliminating and reintroducing gluten into the diet.

• Wheat Allergy - Involves an immune system response to wheat proteins, including but not limited to gluten. ¹ Allergy appears to be associated with the amount or frequency of wheat consumption. Symptoms may include hives, bloating, constipation, flatulence, abdominal pain, a feeling of general malaise, fatigue, and, in severe cases, anaphylaxis. ¹ The diagnosis is made based on a detailed medical history, skin prick tests, specific IgE levels and oral provocation tests ¹ .

In recent years, studies on the impact of gluten on health have become increasingly in-depth, also allowing us to observe its effects on various systems beyond the gastrointestinal tract.

Gluten in reproductive health and mental health

In reproductive health , studies indicate that women with undiagnosed celiac disease face a higher risk of infertility, miscarriages, and premature births due to the inflammation and malabsorption of nutrients caused by gluten intake. ⁴ Therefore, assessing gluten tolerance can be a crucial step for couples experiencing difficulty conceiving.

In the context of mental health , studies have suggested that eliminating or restricting gluten from the diet can reduce symptoms associated with depression, anxiety, and cognitive impairment, and, to a lesser extent, schizophrenia and autism spectrum disorder. ⁵ In the case of Autism Spectrum Disorder (ASD), the relationship between gluten and behavioral symptoms has been increasingly debated. Some studies show that a gluten-free diet can reduce stereotypical behaviors and improve cognition in children with ASD. ⁶ However, more studies are needed to reach definitive and reliable conclusions.

Should you eliminate gluten from your diet?

For most people, there's no scientific evidence to support the need to eliminate gluten from their diet. The decision to adopt a gluten-free diet should be based on specific health needs, not trends or fads!

However, for those suffering from gluten-related disorders, as we saw previously, completely eliminating gluten is essential to avoid symptoms and health complications. In these cases, a gluten-free diet can significantly improve quality of life.

7 strategies to help you implement a healthy gluten-free diet

For those who truly need to avoid gluten, it's essential to ensure a nutritious and balanced diet. There are some simple but important tips for maintaining a healthy gluten-free diet:

1. He chooses naturally gluten-free grains like brown rice, quinoa, corn, buckwheat, and amaranth, which are very rich in nutrients.
2. Avoid processed foods, such as many gluten-free products, which contain more fat, additives, and preservatives. Instead, opt for fresh, minimally processed foods.
3. Ensure fiber intake. Whole foods containing gluten are an important source of fiber—by eliminating them, you'll need to increase your fiber intake from other foods. Increase your intake of fruits, vegetables, nuts, and legumes in your diet.
4. Read food labels carefully, looking for terms like "wheat flour," "malt," and "barley extract." While allergens are usually clearly labeled, prevention is always important.
5. Beware of nutrient deficiencies! A gluten-free diet can lead to deficiencies in macro and micronutrients, such as fiber, B vitamins, iron, magnesium, and ^zinc .
6. Be careful about cross-contamination. Try to strictly separate utensils and surfaces, especially if you live with people who consume gluten, to prevent cross-contamination of your food.
7. Consult a nutritionist. Professional help is important to ensure a nutritionally balanced diet tailored to your individual needs.

Do you have persistent digestive symptoms, unexplained fertility difficulties, or other health conditions, and suspect gluten consumption is responsible? Before making drastic changes to your diet, consult a healthcare professional. This article is a good starting point, but a personalized assessment is crucial to identify what's best for you. After all, what works for one person may not be ideal for another.

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