No Need to Restrict Gluten for Brain Health, Study Shows

A gluten-free diet is necessary for people diagnosed with celiac disease or gluten sensitivity. However, popular culture has convinced many people to avoid gluten for other conditions, including improved brain health and cognition.

A new study published in JAMA Network Open aimed to see if there was any science behind the popular claim that gluten is associated with poor cognitive function for the general population.

Gluten is a protein that’s found in wheat, rye, barley, and foods made with these ingredients, including bread and pasta.

The Popularity of Gluten-Free Diets

Over the last few years, the popularity of the gluten-free diet soared because of best-selling diet books such as "Grain Brain" and "Wheat Belly", which cherry-picked data to support their claims about the detriments of gluten.

If you’ve read these books, you’ll have seen a gluten-free diet touted as the treatment for everything from asthma to mental health issues to joint pain.

Gallup data shows that the gluten-free diet became so popular in 2015 that about 20% of consumers avoided gluten, even though just 1% of people have celiac disease and about 6% may have non-celiac gluten sensitivity.

Researchers have spent years using science to refute some of the spurious claims in these anti-gluten diet books, including the idea that modern wheat is higher in gluten, and that gluten-free diets are healthier than regular diets.

Taking a Closer Look at Gluten

In this new cohort study, researchers wanted to see if there was any scientific validity to the claims about gluten affecting cognition, memory, and attention span.

Researchers gathered dietary intake information using a food frequency questionnaire and looked at cognitive test scores of 13,494 women (average age 60.6 years) without celiac disease. Gluten intake varied from 4.45 to 8.34 grams per day and was categorized into five quintiles. 

The researchers looked at standardized cognitive scores for these three categories, in which higher scores indicate better performance.

• Psychomotor speed and attention
• Learning and working memory
• Global cognition

What Did the Study Find?

The researchers noted that gluten intake was not associated with cognitive scores in middle-aged women without celiac disease.

After adjusting for various behavioral and health risk factors, the researchers observed no difference in psychomotor speed and attention score, learning and working memory score, or global cognition score across all five quintiles of gluten intake.

This led the researchers to say, “our results do not support recommendations to restrict dietary gluten to maintain cognitive function in the absence of celiac disease or established gluten sensitivity.”

"The results of the study are not surprising to me,” says Emma Backes, a dietitian in Saint Cloud, Minnesota. “It is expected that a normal part of very common foods [gluten] does not cause any adverse outcomes to those who do not need to avoid it.” 

Some People, But Not All, Require a Gluten-Free Diet

“Anyone with celiac disease, wheat allergy, or non-celiac gluten sensitivity needs to avoid gluten,” says Vandana Sheth, registered dietitian and author of "My Indian Table: Quick & Tasty Vegetarian Recipes."

Sheth says if you don’t have one of these conditions, "you can enjoy gluten-containing foods without worrying about it negatively affecting your brain health."

In short, there is no reason to avoid gluten unless it’s medically necessary.

If you do have celiac disease, it’s vital to follow a gluten-free diet for life. Celiac is an autoimmune disease in which gluten triggers an immune reaction linked to digestive issues and cognitive impairment, depression, and anxiety.

Studies on brain health and celiac disease are likely why the link between gluten and cognition is often discussed. But it’s important to note that these studies are only conducted on people with celiac disease or gluten sensitivity; the findings are not generalizable to people without these conditions.

A Nutrient-Dense Gluten-Free Diet

Gluten-free versions of bread, crackers, noodles, and baked goods are often made with rice, corn, tapioca, or other flour. Several studies have shown that some gluten-free foods are lower in fiber and protein but higher in saturated fat compared to their gluten-containing counterparts.

For this reason, try not to avoid gluten-containing foods unless it's medically necessary. Whole-grain rye, wheat, and barley, are high-fiber, nutrient-rich options.

Sheth tells her clients that many gluten-free products are heavily processed. She recommends gluten-free whole grains such as amaranth, millet, teff, and quinoa for clients who can't eat gluten.

“We discuss the importance of having a balanced diet that included a variety of fruits and vegetables, lean proteins, heart-healthy fats, and whole grains,” says Sheth.

It’s great when science can provide clearer answers about health and nutrition, especially when food myths can be quashed. This new research on gluten uses science to debunk theories in books like "Grain Brain."

“Working with clients that have read ‘Grain Brain’ or have similar thoughts really brings forth my passion of eliminating food fears,” says Backes. “I teach how all foods fit into a healthy lifestyle and find that teaching where these misconceptions came from really helps to combat negative food thoughts.”