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Gluten-Free, But at What Cost? The Hidden Risks for Those with Gluten Intolerance or Celiac Disease

Kali Gutensohn, Dietetic Intern at Bastyr University

For people with gluten intolerance or celiac disease, eating gluten-free is important to stay healthy and manage symptoms. However, many gluten-free food options include a lot of processed foods, which can make up as much as 80% of what they eat compared to only 20% in regular diets (NatureDoc, 2024). These foods often use additives like preservatives and emulsifiers to make them taste better, last longer, and feel like regular foods. For example, without these additives, gluten-free bread would often fall apart, taste bland, and spoil quickly (Whelan et al., 2024).

Many processed foods, including gluten-free ones, use seed oils that are high in omega-6 fats (such as safflower, sunflower, grapeseed, and soybean oils). While our bodies need a little omega-6, having too much without enough omega-3 fats can cause more inflammation. Seed oils are often added to ultra-processed foods to improve their texture and shelf life. This can be a problem for people with celiac disease or gluten intolerance because inflammation can make their symptoms worse and has been linked to an increased risk of colon cancer (Ferretti et al., 2012).

To feel your best, it’s a good idea to eat more naturally gluten-free foods that are high in omega-3s, like salmon, walnuts, chia seeds, and flaxseeds. Try to eat fewer processed gluten-free products and choose whole, nutritious foods instead. This can help reduce inflammation and keep your body healthy (Bascuñán et al., 2025).

What Are Ultra-Processed Foods?

Ultra-processed foods are highly altered from their original form. To identify them, check how much the food has been changed from its natural state, whether it contains additives like preservatives or colorings, if it’s mass-produced instead of homemade, and if it’s designed to look better or be more convenient. You can also look for specific signs on the ingredient label, such as low fiber content (less than 1 gram of fiber per serving) or high amounts of added sugars (10 grams or more per serving) and artificial ingredients. While these products seem like quick and easy gluten-free options, they often lack essential nutrients found in naturally gluten-free products (Suárez-González et al., 2021).

The Impact on Gut Health

For someone with celiac disease or gluten intolerance, relying on ultra-processed foods can harm gut health. These foods are often low in fiber and nutrients, which are crucial for maintaining healthy gut bacteria. Additives like emulsifiers can disrupt the balance of bacteria in the gut, leading to inflammation and digestive issues. Over time, this can weaken the gut lining, increasing the risk of conditions like leaky gut syndrome, which is particularly concerning for individuals with celiac disease or gluten sensitivity (Nestares et al., 2021).

Boosting Gut Health with Probiotics

Probiotics can play a key role in keeping gut bacteria balanced, which is crucial for individuals with celiac disease and gluten intolerance. They help by increasing the number of beneficial bacteria in two ways. First, they grow in the gut and promote the growth of existing good bacteria. Second, probiotics compete with harmful bacteria for nutrients and space, preventing bad bacteria from spreading. Including probiotics can help maintain a healthy gut while managing symptoms (Ali & Khan, 2022). Some probiotic strains that can be especially helpful for people with celiac disease or gluten intolerance include:

  • Lactobacillus acidophilus: Supports overall gut health and has been studied for gastrointestinal issues. It’s found in yogurt, fermented dairy products, and kefir.
  • Bifidobacterium lactis: Helps strengthen the gut barrier and modulates the immune response, which can be beneficial for celiac disease. It’s found in yogurt, fermented dairy products, and probiotic-enriched drinks.
  • Bifidobacterium longum: Maintains a healthy gut microbiota and may reduce inflammation. It’s found in miso, sauerkraut, kimchi yogurt, and kefir.
  • Saccharomyces boulardii: A beneficial yeast that supports gut health and helps manage diarrhea. It naturally occurs in some kombucha drinks but is more commonly available as a supplement.
Tips to Limit Ultra-Processed Foods on a Gluten-Free Diet

While ultra-processed gluten-free foods dominate the market, there are healthier options (Suárez-González et al., 2021):

  • Opt for traditional gluten-free bread: Gluten-free 7-grain and seed breads made with simple ingredients are great options.
  • Focus on naturally gluten-free foods: Include lentils, beans, fruits, vegetables, meats, fish, eggs, dairy, nuts, seeds, and healthy fats like olive oil, coconut oil, and avocado oil in your meals.
  • Choose better options from the gluten-free aisle: Look for nutrient-dense options like gluten-free oats, buckwheat, millet, teff, sorghum, and almond or chickpea flours. These items are often available at a lower price in the bulk section. Seeded crackers and granolas are also excellent choices.
  • Bake your own snacks: Homemade gluten-free snacks are typically healthier and can be stored in the freezer for convenience.
  • Bring healthy snacks with you: Carry naturally gluten-free options like dried fruit, nuts, seeds, olives, cheese, or crunchy veggies when you’re on the go.
Key Takeaways

Following a gluten-free diet is vital for people with celiac disease or gluten intolerance, but processed gluten-free foods can cause issues like inflammation and gut problems. Focus on natural, nutrient-rich foods like fruits, vegetables, nuts, naturally gluten-free grains, and omega-3s. Adding probiotics and avoiding additives can improve gut health and reduce risks. Smarter choices lead to better health on a gluten-free diet.

References:
  1. NatureDoc. Reasons to avoid the ultra-processed “free-from” aisle when you are gluten-free. NatureDoc. Published February 25, 2024. Accessed January 1, 2025. https://naturedoc.com/reasons-to-avoid-the-ultra-processed-free-from-aisle-when-you-are-gluten-free/
  2. Whelan K, Bancil AS, Lindsay JO, et al. Ultra-processed foods and food additives in gut health and disease. Nat Rev Gastroenterol Hepatol. 2024;21:406–427. doi: 10.1038/s41575-024-00893-5.
  3. Ferretti, G., Bacchetti, T., Masciangelo, S., & Saturni, L. (2012). Celiac disease, inflammation, and oxidative damage: A nutrigenetic approach. Nutrients, 4(4), 243–257. https://doi.org/10.3390/nu4040243.
  4. Bascuñán, K. A., Araya, M., Rodríguez, J. M., Roncoroni, L., Elli, L., Alvarez, J. D. P. L., & Valenzuela, R. (2025). Interplay of n-3 Polyunsaturated Fatty Acids, Intestinal Inflammation, and Gut Microbiota in Celiac Disease Pathogenesis. Nutrients, 17(4), 621. https://doi.org/10.3390/nu17040621.
  5. Suárez-González, M., Bousoño-García, C., Jiménez-Treviño, S., & Díaz-Martín, J. J. (2021). Gluten-free diet: Nutritional strategies to improve eating habits in children with celiac disease: A prospective, single-arm intervention study. Nutrients, 13(4), 1108. https://doi.org/10.3390/nu13041108.
  6. Nestares, T., Martín-Masot, R., Flor-Alemany, M., Bonavita, A., Maldonado, J., & Aparicio, V. A. (2021). Influence of ultra-processed foods consumption on redox status and inflammatory signaling in young celiac patients. Nutrients, 13(1), 156. https://doi.org/10.3390/nu13010156.
  7. Ali B, Khan AR. Efficacy of Probiotics in Management of Celiac Disease. Cureus. 2022 Feb 8;14(2):e22031. doi: 10.7759/cureus.22031. PMID: 35340497; PMCID: PMC8912170.