These days, just about every food you can think of has a gluten-free alternative, from bagels to pasta to Girl Scout cookies. Heck, we’ve rounded up our fair share of gluten-free pizza, cupcake, and muffin recipes.

However, the prevalence of GF products has resulted in a lot of misconceptions. Gluten-free is often thought of as a fad — or broadly associated with being “healthy” — and not everyone stops to think about what it actually means, or why they should or shouldn’t eat it.

We’re here to clear up what gluten is, who should avoid it, and what it really means to give it up for good.

Gluten, which means “glue” in Latin, refers to a group of proteins found in wheat, barley, rye, and triticale. Biesiekierski JR. (2017). What is gluten? DOI: 10.1111/jgh.13703

It helps foods like pizza dough and pasta keep their structure. For most people, eating gluten will not negatively impact their health. But that’s not the case for everyone.

Celiac disease is an autoimmune disorder in which eating gluten causes the immune system to attack the small intestine. According to the NIH, this can lead to bloating, abdominal pain, chronic diarrhea, weight loss, and fatigue.

For people who have celiac disease (up to 1 percent of the U.S. population), a gluten-free diet isn’t a lifestyle choice, but a treatment plan prescribed by a doctor.

These folks don’t just have to avoid eating foods with gluten. They also have to watch out for cross-contamination (when a gluten-free food comes in contact with gluten-containing foods or dishes), both at home and in restaurants.

If you suspect you have celiac disease, it’s best to see a doctor before trying a new diet. Doing it the other way around — going sans gluten and then seeing a doc — could lead to a false-negative test result.

Experts believe that between 0.5 percent and 6 percent of Americans have what’s called non-celiac gluten sensitivity (NCGS).Igbinedion S, et al. (2017). Non-celiac gluten sensitivity: All wheat attack is not celiac. DOI: 10.3748/wjg.v23.i40.7201

This means that though they don’t test positive for celiac disease, they experience many of the same symptoms (bloating, constipation, diarrhea), which go away (or get better) when they eliminate gluten.

This is what people are talking about when they say they have a gluten intolerance.

NCGS is pretty controversial in the food and nutrition world, and some are skeptical that the condition even exists. “We can’t test for it,” says Ayelet Schieber Goldhaber, MS, RD, CLC, a dietitian at NYU Langone Medical Center. “Gluten sensitivity is really just based on symptoms.”

“There’s no direct danger to eliminating gluten,” Goldhaber says. “But any time you’re removing an ingredient, be careful of how you’re replacing it.”

If you’re experimenting with taking gluten out of your diet, to avoid cross-contamination, it’s a good idea to stick to foods that are naturally gluten-free. These include fruits, vegetables, dairy, and protein-rich food such as fish, nuts, and eggs.

When buying packaged gluten-free foods, double-check the label for sodium and sugar content. These are often added in higher quantities to make foods that don’t contain gluten taste better.

Goldhaber also suggests keeping an eye on your fiber intake; a diet full of fruits, veggies, quinoa, and other gluten-free grains should do the trick.

Also, research shows that people following gluten-free diets are more likely to be deficient in several vitamins and minerals, so taking a multivitamin can help you meet your needs.Diez-Sampedro A, et al. (2019). A gluten-free diet, not an appropriate choice without a medical diagnosis. DOI: 10.1155/2019/2438934

The other thing to keep in mind is that if you go gluten-free and end up feeling better, it’s not necessarily because you have celiac or NCGS.

“I think there can definitely be a placebo effect,” says Jennifer Christman, RDN, LDN, clinical nutrition manager at Medifast. “You’re thinking you’ll feel better and then you do feel better.”

For example, some people may feel better cutting out certain unhealthy gluten-containing foods such as sugary baked goods, fast food, and sweetened cereals. However, the symptom relief may be due to the elimination of highly processed foods — and not necessarily gluten itself.

It’s not the same thing as going carb-free or grain-free

Though gluten is found in several high-carb foods, like wheat bread and barley, eliminating it isn’t exactly the same as adopting a low-carb lifestyle.

“Fruit is gluten-free, but it’s not necessarily a low-carb food,” Christman points out. Other foods like vegetables, beans, and even dairy products contain carbs, but not gluten.

To choose complex carbs that’ll fill you up without gluten, you might look for sweet potatoes, butternut squash, or gluten-free ancient grains such as quinoa or amaranth.

It isn’t just giving up bread and pasta

Gluten can show up in some pretty unexpected places. “Common foods — like soy sauce — can have wheat hiding in them,” says Goldhaber.

Gluten can also lurk in certain types of hot dogs, potato chips, lunch meats, candy bars, salad dressings, and even prepared eggs.

And since ingredient lists don’t typically include the word gluten, it can be tricky to spot unless the package actually says “gluten-free.”

“You want to look for things that say malt extract or malt flavor,” Christman says. “Wheat, barley, rye, and [most] brewer’s yeast are all gluten-containing. And then oats. If they’re not labeled gluten-free, they might contain some gluten because of cross-contamination.”

Also watch out for anything with the words “wheat starch” or “spelt,” Goldhaber adds.

That goes for drinks as well. You’re in the clear for wine night, and most hard liquor is also safe. But you’ll want to refrain from beer and similar products (ales, lagers, etc.), which are usually made from barley or rye and aren’t distilled.

Thankfully, there are so many more gluten-free options today than there were a few years ago, including some pretty tasty beers.

It isn’t automatically healthy

If you want to eat a healthy diet, ditching gluten doesn’t give you carte blanche to eat everything with a GF label. A cookie is still a cookie.

Refined products are typically high in ingredients like added sugars — which should be limited in any healthy diet — no matter if they’re gluten-free or not.

But turning to whole foods and incorporating more fruit, veggies, healthy fat, and protein sources in your diet? Well, that’s a good idea for just about everyone.

It doesn’t necessarily lead to weight loss

Maybe you’ve heard a friend or a celebrity talk about how much weight they’ve lost on a gluten-free diet. In reality, it’s likely not the absence of gluten that made them drop the pounds.

“I think a lot of people find they lose weight, but it’s probably because they’re cutting out a lot of sugar and processed foods that also contain a lot of calories,” Goldhaber says. “It’s really the calories that are making the difference, not the gluten.”

If you do decide to eliminate gluten, you’ll want to speak to a pro first, regardless of your reason, says Christman. “People may self-diagnose,” she says. “But we always encourage people to go talk to their health care professionals before starting a new diet.”