There are different levels of gluten sensitivity, the most severe form being the autoimmune disorder, celiac disease. Normally, as food travels through the digestive system, small hair-like structures called microvilli help absorb nutrients from food. Unfortunately, when gluten enters the digestive system of a celiac disease patient, the microvilli are attacked by the immune system, causing them to flatten and lose their ability to absorb nutrients.1This can result in symptoms, including: an inability to gain weight, bloating, headaches, and fatigue, which can lead to long-term health conditions, like dementia or infertility.2 The only way to reduce such symptoms is by strict adherence to a gluten-free diet (GFD). However, recent studies have found that living on a GFD may come with a cost.

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Today, gluten is used as a thickening agent or filler in almost anything from soy sauce to salad dressing. To compensate for the lack of gluten, most gluten-free foods contain excessive amounts of sugar, carbohydrates, sodium, and calories. For some, a GFD at first may seem like a healthy alternative to the normal diet. However, for those with celiac disease (CD) it is an obligation that must be followed to improve one’s health. Unfortunately, this consistent diet of sugary foods can cause a person to gain weight and, more significantly, can “lead to deficiencies in iron, calcium, thiamine, riboflavin, niacin, and folate.”3

A study conducted from July 2012 to July 2013 at the Department of Clinical Medicine and Surgery of the University of Naples Federico II, followed 98 newly diagnosed celiac disease patients as they progressed with their gluten-free diet for one year. The objective was to identify a link between a GFD and Metabolic Syndrome (MS), as well as Hepatic Steatosis (HS). MS is a combination of diseases that includes diabetes, high blood pressure, and obesity. Conditions such as physical inactivity or a diet filled with saturated fats and cholesterol increase a person’s risk for getting MS.4

During the same time as diagnosis, the patient’s waist circumference, BMI, blood pressure, lipid profile and glucose levels were recorded. These measurements were then recorded again after one year on a GFD. The results showed a significant increase in all fields except lipid profile, which stayed fairly constant. Of the 98 patients, 29 were diagnosed with MS. Other medical conditions like anemia, hypoalbuminemia, and hypocalcaemia were also noted in some of the patients.5

Risk of HS is also possible for a CD patient on a GFD for at least one year. Hepatic Steatosis describes a buildup of fats and triglycerides on the liver. Certain risk factors, such as type 2 diabetes, insulin resistance, and high cholesterol can increase a person’s chance of developing HS.6 Diagnosis of HS was done with an ultrasound, and experimental results confirmed that the chance of getting HS after starting a GFD is highly possible. HS is most commonly found in people with MS who have celiac disease and are on a GFD.

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Gluten-free diets are complicated to follow and can sometimes become frustrating for patients. Newly diagnosed CD patients are encouraged to meet with a Registered Nutritionist or Dietitian to go over meal plans and strategies when tackling the GFD. Many experiments have confirmed that CD patients who start a GFD are at a greater risk for developing MS than before they started the diet. However, there are experiments that present conflicting results where a GFD is not directly linked to weight gain. For this reason, more research is needed to understand the connection between the gluten-free diet and MS. In any case, newly diagnosed CD patients, as well as formerly diagnosed patients, must be wary of what they eat and the long-term effects of these foods on their body.


1 Fasano, A., & Catassi, C. (2012). Celiac Disease. Clinical Practice, (367), 2419-2426.

2 Silvester, J., & Rashid, M. (2007). Evaluation Of Current Practice Guidelines For Long-Term Follow-Up Of Individuals With Celiac Disease. Journal Of Pediatric Gastroenterology And Nutrition, 21(9), 557–564.

3The Reality Behind Gluten-Free Diets, Nutrition and Health Library. (2015, January 12). Retrieved April 2, 2015, from

4Grundy, S., Cleeman, J., Daniels, S., Donato, K., Eckel, R., Franklin, B., . . . Costa, F. (2005). Interactions among Hepatic Steatosis, Inflammation, and Insulin Resistance: Beyond Common SenseCirculation,(112), 2735-2752.

5Tortora, R., Capone, P., De Stefano, G., Imperatore, N., Gerbino, N., Donetto, S., . . . Rispo, A. (2015). Metabolic Syndrome in Patients With Coeliac Disease on a Gluten-free Diet.Alimentary Pharmacology & Therapeutics, 41(4), 352-359.

6Wu C (2012) Interactions among Hepatic Steatosis, Inflammation, and Insulin Resistance: Beyond Common Sense. J Nutr Food Sci 2:e106. doi: 10.4172/2155-9600.1000e106