This article is the third in a three-part series on gluten-related health conditions and the gluten-free diet. The first article in the series is “When Gluten-Free Eating is the Best Medicine.” The second article in the series is, “Why Have Wheat and Gluten Become So Problematic?”
If you eat a gluten-free diet or want to try one, it’s natural to want to take the easy way out: Eat your standard American fare, such as sandwiches, and replace the wheat bread or tortillas you’re accustomed to eating with gluten-free bread or tortillas.
Although doing so can prevent reactions to gluten, going gluten-free this way can lead to new, non-gluten-related ailments and diseases, such as weight gain, increased blood sugar levels, and insulin-related health conditions. That’s because gluten-free grain flours and starches (i.e., rice flour, corn meal, sorghum flour, millet flour, corn starch, tapioca starch, cassava starch, and potato starch) are high in calories and carbohydrates and high glycemic, meaning that they can spike blood sugar levels.
An alternative to gluten-free bread is lower-carb, lower-glycemic, grain-free tortillas, which can work well on occasion. But the healthiest, most nutrient-rich alternatives to bread are easy-to-fix ones made from vegetables and fruits.
Why Not Go Gluten-Free the Standard Way?
Unwanted weight gain is a common result of eating processed gluten-free breads and other products. In one study published in The American Journal of Gastroenterology in 2006, 82 percent of people who went on a gluten-free diet gained weight in the first two years of eating that way, including 81 percent of the people in the study who were overweight.
A standard gluten-free diet is linked to an increased risk of metabolic syndrome in people who have celiac disease or non-celiac gluten sensitivity.
Metabolic syndrome, sometimes called insulin resistance syndrome, is a cluster of at least three of five risk factors, including large waist size, low HDL cholesterol, elevated blood pressure, blood sugar levels, and triglycerides, which often occur in concert and predispose people to Type 2 diabetes and cardiovascular disease.
A 2020 study found that there was an increase in weight gain and a 20 percent increase in the prevalence of metabolic syndrome in patients with celiac disease who followed the gluten-free diet for six months.
In a study on patients with gluten sensitivity who ate gluten-free for six months, there was no significant weight gain, but there was a 15 percent increase in the prevalence of metabolic syndrome and a 20 percent increase in fatty liver disease, which is an excess of fat stored in the liver—another condition strongly associated with metabolic syndrome.
The Lowdown on Grain-Free Tortillas
Instead of eating gluten-free bread or tortillas, it’s tempting to turn to grain-free tortillas. They’re a better option than their gluten-free counterparts for many people because they’re generally lower in carbohydrates and lower glycemic.
Beware, however: Grain-free tortillas often are made from cassava flour, a high-glycemic, low-nutrient starch, or from chickpea flour, almond flour, or coconut flour, ingredients that can be allergenic and problematic for some people who are intolerant.
A golden rule in nutrition is the simpler and cleaner the ingredients, the better it is for health. Keeping that in mind, almond flour tortillas made by Siete and coconut flour tortillas manufactured by a number of companies can be good grain-free tortilla options.
7 Fresh Produce-Based Alternatives to Bread
When it comes to gluten-free, the healthiest strategy begins when you let go of the belief that your sandwiches have to look like traditional sandwiches or that your wraps must be made with flour-based bread or tortillas.
Instead, think outside the bread box and get creative using vegetables (and two fruit) as alternatives to buns and wraps. Try these seven produce-based ideas for bread substitutes.
Lettuce wraps: Virtually nothing could be more convenient—and lower in carbs—than using large lettuce leaves, such as romaine or Bibb leaves, as tortilla or bread substitutes. Wrap burgers with them, or make BLT (bacon, lettuce, and tomato) “sandwiches,” taco lettuce wraps, fajita wraps, tuna salad wraps, lettuce cups with Asian-based fillings, and more.
Collard wraps: Collard greens, either raw or lightly steamed, also make nice low-carb wrappers. Be sure to remove the prominent spine on each leaf using a paring knife. Start near the bottom, shave away only the thick part of it, and be careful not to cut through the leaves.
You can steam the collard greens for a few minutes until bright and tender, then arrange them on a plate and use a paper towel to pat dry before filling them. Try them with red pepper hummus and assorted vegetables with or without chicken strips.
Endive boats: Buy green or red endive bulbs, cut off the base, and use the leaves as super-low carb boats you can top with the filling of your choice. They can serve as appetizers or light meals. Try them with chicken or tuna salad, or chopped cooked shrimp with diced cucumber, pineapple, cilantro, and lime juice.
Cucumber subs: Believe it or not, this fruit (commonly mistaken for a vegetable) can serve as a refreshing alternative for a submarine bun when you’re making a sandwich! Cut it in half lengthwise, scoop out the middle, and top it with anything for an easy-to-make, open-faced sandwich.
Portobello mushroom caps: Large portobello mushrooms are the general size and shape of hamburger buns. Just remove the stem and cook them, and they make nice, filling, stand-ins for hamburger buns.
To cook them, drizzle or brush the portobello caps with extra-virgin olive oil. Place them on a small baking sheet gill side up and roast the caps for 12 minutes, or grill them for about 5 to 7 minutes on each side.
Season them with salt and pepper, and allow them to cool slightly, release their juices, and dry a bit before using them as buns to sandwich virtually any type of burger.
Thick-Cut roasted sweet potato buns: To make these unusual, higher-carb, small-in-size, but big-on-flavor “buns,” cut sweet potatoes into ½-inch slices and place them on a baking sheet.
Drizzle with a few tablespoons of olive oil or coconut oil, and place in a 400-degree, preheated oven. Roast the sweet potato slices for 5 minutes, then flip them over and roast for another 5 minutes, then remove from the oven and set aside on a plate.
Stack a small broiled turkey burger with sage or a small piece of cooked fish and a few spinach or lettuce leaves on top of each sweet potato slice, and place another roasted sweet potato slice on top. Use a toothpick or skewer to hold each mini-sandwich together.
Apple slices: For a lighter alternative to peanut butter or almond butter and jelly sandwiches, use apple slices as the bread substitute. Slice an apple crosswise, and cut a hole through the center of each slice to make bagel-like apple slices. Use 2 apple slices to make a small sandwich with nut or seed butter in between. Kids love these, and they’re quick, handy sandwiches for adults, too!