Is a Grain-Free Diet Healthy? Here's What Dietitians Say
It seems like every year there's a new food group to blame for all your health ailments. First it was gluten, then it was dairy, now it's all grains. Grains (including whole grains) have become the scapegoat for anything from brain fog and digestive issues to weight gain and inflammation. Popular books like Grain Brain and Wheat Belly as well as diets like Whole 30, Paleo, and Keto are adding fuel to the anti-grain fire. But are grains really at fault? We're breaking down everything you need to know before going grain-free.
What is a grain-free diet?
Grain-free diets exclude all grains including wheat, bulgur, spelt, farro, quinoa, rice, millet and products made from grains like pasta, crackers, breads, cereals, some plant milks, and more. Many grain-free plans also consider corn and corn products off limits. Going grain-free is more restrictive than following a gluten-free diet as gluten-free diets still allow some grains and corn.
All foods not made from grains including fruits, vegetables, beans, legumes, nuts, seeds, dairy, fish, meat, poultry, and soy products are still on the table.
Potential benefits of going grain free
One of the biggest benefits of eliminating grains is that it may lead to an increase in other nutritious foods such as fruits, vegetables, beans, nuts, and seeds and a decrease in processed foods and sweets. Many processed grain products "have little nutritional value and are high in fat, sugar, and sodium," notes Lisa Andrews, M.Ed., RD, LD Owner Sound Bites Nutrition, LLC.
There have been claims that grains cause inflammation, leading to a whole host of other health problems. However, research to support this is extremely limited and most of what exists to support this claim is in animal models. In fact several studies have shown that whole grains may actually reduce inflammatory markers in humans.
Who might benefit from grain-free diets?
People with digestive disorders including irritable bowel syndrome (IBS) may experience some symptom relief when removing grains from their diet. "For some individuals, grains may be difficult to digest or cause gastrointestinal distress. Some grains contain FODMAPS (fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols) that could cause gas and bloating," says Andrews. In these cases, small doses or even some grains may be tolerated so it's not always necessary to eliminate all grains.
Pictured recipe: Salmon-Stuffed Avocados
Individuals with autoimmune conditions may also find grain-free diets helpful. "There have been reports that patients have found relief from medical conditions such as fibromyalgia, lupus, multiple sclerosis, rheumatoid arthritis, psoriatic arthritis, Crohn's disease, ulcerative colitis, Grave's disease, and more," says Dr. Divya L. Selvakumar, Ph.D., RD, Founder/Owner of Divine Diets, LLC.
"While the research isn't totally clear, grains contain proteins that are thought to increase intestinal permeability and in turn, increase inflammation in the body. This could be a problem with those suffering from autoimmune conditions, where inflammation leads to flare-ups of symptoms," says Kalee Lundmark, Dietitian and Creator of The Crowded Table.
But removing grains from your diet should not be considered a one-size fits all recommendation, even for people with the above health conditions. While some people, "may see a reduction in inflammatory symptoms such as upset stomach, joint pain, or skin irritation when following a grain-free diet, this is only true for a small percentage of the population. It's important to remember that this is just one of many dietary strategies to manage these conditions. If no benefit is seen after four to six weeks of following a grain-free diet, there is no reason to continue," says Mary Ellen Phipps, M.P.H., RDN, LD, author of The Easy Diabetes Cookbook.
Lastly, a grain-free diet, "may aid in blood sugar management of some people with diabetes," adds Andrews. However, it is not necessary to cut all grains, and eating whole grains may actually reduce risk of diabetes and support blood sugar management, especially when they replace refined grains. (Learn more about the difference between healthy carbohydrates and refined carbs.)
Will a grain-free diet help me lose weight?
It's possible—but rarely sustainable—and depends a lot on what your diet looked like before you cut out all grains. "Removing grains often limits nutrient-poor food choices and increases consumption of fruits, vegetables, and other whole foods, which may lead to weight loss," says Lundmark. This is especially true for someone eating a diet full of processed foods. While some may experience initial weight loss, "the problem is that it is not a sustainable diet and when you start eating grains again, the weight always comes back," says Zuvia Naseem, M.Sc., RD, CDE, Director of Profaz Health Services.
Drawbacks of grain-free diets
"A grain-free diet can be quite restrictive and can be difficult to maintain on a long-term basis," says Selvakumar. Social situations like eating at restaurants and eating at other people's houses can become stressful if you're constantly worrying about what will be available for you to eat. This can be very "isolating for some because of limited options when going out with friends and family," adds Naseem.
Eliminating an entire food group also means missing out on beneficial nutrients. "Whole grains contain a variety of different nutrients that the body needs, such as B-vitamins and trace minerals (e.g. iron, selenium, manganese). Phosphorus and magnesium deficits have also been reported [in people following grain-free diets]," notes Selvakumar.
A grain-free diet, "may be low in fiber unless other foods (fruits, vegetables, beans, or lentils) are included," says Andrews. Whole grains are a good source of fiber, a nutrient that is lacking in many Americans' diets. The Dietary Guidelines for Americans recommend consuming 25-35g of fiber per day, which, according to the USDA 90 percent of women and 97 percent of men do not achieve. Fiber offers many health benefits from digestive health to blood sugar and cholesterol management. When eliminating grains, it's important to emphasize other sources of fiber in the diet.
Who should not follow a grain-free diet?
There truly is only a small percentage of the population that may actually benefit from completely eliminating grains. That said, anyone "with a history of or at risk for an eating disorder should not follow a grain-free diet," says Andrews. The restrictive nature of a grain-free diet could lead to obsessive behavior and even orthorexia.
Because grains can be an important source of B-vitamins and other nutrients, pregnant women (who have higher needs of B-vitamins such as folate and other nutrients found in grains) should be particularly cautious about eliminating grains. In addition, "anyone with a medical history of nutritional deficiencies should not follow a grain-free diet," says Selvakumar. Those with limited access to other nutritious foods, should also be careful about eliminating this food group as both whole grains and fortified grains offer a variety of important nutrients that may not be consumed elsewhere.
Lastly, while some people with diabetes may choose to eliminate all grains, "caution should be taken with patients with diabetes that use insulin," notes Andrews. Removing grains often results in a lower carbohydrate diet, which, if insulin isn't titrated correctly, could lead to hypoglycemia.
What else to know before trying a grain-free diet
"A grain-free diet is not for everyone. Since it eliminates good sources of fiber and nutrients, it is best used in short intervals, not as a long-term solution," says Lundmark. Consider consulting with a registered dietitian nutritionist (RDN) who specializes in the specific health condition you're trying to treat with a grain-free diet to determine if it's the right route for you. Having the support of a dietitian can be helpful in reintroducing some grains in a strategic manner and the RD can help you identify other foods to ensure you meet your overall nutrient needs.
In addition, grain-free packaged products are not necessarily better-for-you than those that contain grains. It's still important to read ingredient and nutrition labels as many grain-free products still contain a lot of added sugar, sodium, and other ingredients you may want to limit.
"A grain-free diet doesn't automatically equal healthier," says Phillips. While it may offer some benefit to specific groups of people, there is no reason to eliminate all grains if you don't fall into one of those groups. A grain-free diet can be hard to follow, feel restrictive, and difficult to maintain for the long term. Instead, reducing the amount of refined grain products you eat and focusing on adding more nutritious whole foods to your diet is likely a better and more sustainable way to reach your health goals.