Gluten-free diet explained: Who needs it, medical tests and safe swaps

National nutrition week: Gluten-free living goes beyond a trend, as it can protect those with gluten-related disorders from serious health issues

You must have heard one of your favourite celebrities talk about gluten-free diets. The benefits may have tempted you to try it, but should you?

 

With growing awareness around coeliac disease, gluten sensitivity and healthy eating, more people are exploring what a gluten-free lifestyle really means.

 

Why do some people need to avoid gluten?

 

Far from being just a trend, gluten-free living is often rooted in genuine health needs. Gluten, a protein found in grains like wheat, barley and rye, is the element that gives dough its elasticity and baked goods their chewiness. But it can also trigger serious complications for those with coeliac disease, gluten sensitivity or wheat allergies. For them, removing gluten isn’t a choice but a necessity.

 

 

"In people with celiac disease, gluten triggers an autoimmune response that damages the lining of the small intestine, making it hard to absorb nutrients properly. Others may have non-celiac gluten sensitivity. While they don’t show intestinal damage, they still experience symptoms like bloating, abdominal pain, fatigue, or brain fog after eating gluten. Then there are those with a wheat allergy. That’s an immune reaction—not just to gluten but to other proteins in wheat as well- that can cause skin rashes, breathing issues, or even severe allergic reactions like anaphylaxis," explained Dr Renuka Dang, dietician with Ujala Cygnus Group of Hospitals.

 

While these terms are often used interchangeably, they aren’t the same.

 

Dr Dang further explained, "Coeliac disease is an autoimmune disorder where the body’s immune system mistakenly attacks the small intestine when gluten is eaten. This damages the intestinal villi—tiny finger-like projections that absorb nutrients—leading to problems like diarrhea, anemia, weight loss, and fatigue."

 

How to check for coeliac disease

 

According to Dr Dang, coeliac disease is diagnosed through blood tests that check for specific antibodies (anti-tTG) and confirmed by taking a small tissue sample from the intestine. The tissue transglutaminase (tTG) antibody test costs between ₹1,000-₹1,600.

 

Talking about wheat allergy, Dr Dang said, "The immune system produces IgE antibodies against proteins in wheat, which can cause symptoms like hives, swelling, nausea, trouble breathing, and, in severe cases, anaphylaxis. This is diagnosed through allergy tests like skin prick testing or blood tests that detect IgE antibodies."

 

The cost for an IgE (Immunoglobulin E) blood test ranges from approximately ₹400 to over ₹2000.

 

"Non-celiac gluten sensitivity doesn’t cause immunity damage or show up on allergy tests, but people still get symptoms such as bloating, fatigue, brain fog, or joint pain after eating gluten. Since there’s no specific test, doctors usually diagnose it by ruling out celiac disease and wheat allergy first," Dr Dang added.

 

What to eat instead of gluten-containing foods

 

The good news is that a wide variety of natural and nutritious alternatives exist.

 

Instead of wheat, barley or rye, you can turn to:

 

• Millets – like ragi (finger millet), bajra (pearl millet) and jowar (sorghum)
• Rice – both brown and white rice are naturally gluten-free
• Quinoa – a protein-rich seed often used in salads and bowls
• Buckwheat – great for pancakes and noodles
• Amaranth – nutrient-dense and versatile
• Legumes and pulses – lentils, chickpeas and beans add protein and fibre

 

Even oats can be safe, provided they are labelled gluten-free, as cross-contamination is common.

 

"For a nutritionally balanced gluten free diet, people need to consult a clinical dietician. They should not start a diet on their own. They need to follow a structured diet plan which is nutritionally balanced," shared Rajeshwari V Shetty, head of department, nutrition and dietetics, SL Raheja Hospital.

 

Living gluten-free isn’t just about what you eat, but also how you prepare it. Using the same toaster, chopping board or spoon can introduce tiny amounts of gluten that may cause reactions.

 

"Meals devoid of gluten should always be prepared, stored, and handled separately from meals containing gluten. Also if spoons or knives or ladles are used for gluten containing food, they should not be again used for gluten free food without washing as this can cause contamination," Shetty said.

 

Gluten-free eating beyond home

 

Eating out, travelling or attending family functions can feel challenging, but it doesn’t have to mean missing out. Many restaurants now offer gluten-free options, and with a bit of planning, you can enjoy meals with ease.

 

"In such situations, you might sometimes need to carry gluten free food items with them especially while travelling. When eating out, you can inquire in the restaurant whether gluten free food items are available or if they can be made available. You can always choose food items that do not contain gluten or carry certain specific gluten free food items with them," explained Shetty.

 

Do you really need to go gluten-free?

 

Gluten-free eating has become a wellness trend, but it is not necessary for everyone. Cutting out gluten without medical need can sometimes cause nutritional imbalances.

 

Dr Dang warned, "There can be several health risks associated, such as whole grains that contain gluten like wheat and barley are also good sources of fibre, B vitamins, iron, and folate. If someone removes gluten from their diet without replacing those nutrients, they may face deficiencies over time. Also, many gluten-free processed foods have less fibre and more added sugar or fat to make up for texture and taste. That can lead to constipation, weight gain, and other metabolic concerns."

 

She added, "Cost is another factor—gluten-free products are often more expensive, and for people without a medical need, avoiding gluten can make eating unnecessarily complicated. Lastly, self-diagnosing and removing gluten before proper testing can make it harder to identify real underlying conditions. If someone suspects a gluten-related issue, a proper medical evaluation may delay the diagnosis of conditions like IBS, coeliac disease, or other digestive disorders."

 

Gluten-free eating can be life-changing for some, but unnecessary for others. The key is understanding your body, getting proper medical advice, and ensuring your diet remains varied and nutrient-rich. 

 

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This report is for informational purposes only and is not a substitute for professional medical advice.