A friend asked me recently if she should cut gluten after a rough stretch of bloating. A dad at school pickup wondered if the whole family should go gluten-free because his wife did. I get some version of that question every week. My answer starts the same way each time. Some of us need it. Most of us don't. The line between those groups depends on a diagnosis. Then I tell them about a Dutch pediatrician and a famine.

I'm a mom who reads celiac research and ingredient labels closely because my daughter and I live with celiac disease. I leave the diagnosing to the gastroenterologists and allergists who care for us. What I've learned from years of reading is that gluten-free eating has a precise origin and a specific audience. The wellness aisle turned a medical therapy into a lifestyle label.

A Clinical Observation from a Famine

Gluten-free eating has a clinical origin. In the Netherlands during the Dutch famine of 1944 and 1945, pediatrician Willem-Karel Dicke observed that children with celiac disease improved when bread became scarce. When food relief arrived and wheat returned, they became sick again. Dicke had been tracking that pattern since the 1930s, and the famine gave him an unplanned, real-world comparison. His work led to the identification of gluten as the trigger for celiac disease.

Three Conditions, Three Different Reasons

The clinical picture today includes at least three conditions. They are genuinely distinct, and each requires a different approach.

• Celiac disease is an autoimmune disorder. Gluten triggers an immune response that damages the small intestine. The Celiac Disease Foundation estimates that about 1 percent of people worldwide have celiac disease. For this group, gluten-free is a lifelong medical treatment.
• Wheat allergy is an allergic reaction to wheat proteins, often involving hives, swelling, or trouble breathing. A board-certified allergist diagnoses it with skin or blood tests, and treatment means avoiding wheat and sometimes other gluten-containing grains.
• Non-celiac gluten sensitivity is less defined. There is no biomarker. People report symptoms after eating gluten, but controlled studies complicate that picture. A 2018 double-blind crossover trial published in Gastroenterology reported that fructans, a carbohydrate in wheat, triggered symptoms in the participants studied with self-reported non-celiac gluten sensitivity, while gluten did not. Some people react to gluten itself. Some react to other wheat components. A supervised elimination and rechallenge under a clinician's care is how the picture becomes clear.

How the Wellness Aisle Changed the Meaning

By the time I was diagnosed in 2014, gluten-free had sprawled beyond the celiac clinic. Grocery stores had entire aisles of gluten-free cookies, crackers, and frozen meals. Social media accounts talked about gluten as a toxin to avoid for energy, weight loss, and mental clarity. Food companies followed. Gluten-free products multiplied, often priced higher than their wheat counterparts.

The U.S. Food and Drug Administration finalized its gluten-free labeling rule in 2013. That rule set a standard of fewer than 20 parts per million of gluten for any food carrying the label. The standard gave shoppers a reliable threshold, and it gave the gluten-free aisle a definition. The rule also made the marketplace easier for people who needed it.

I benefited from that expansion. More choices made my family's life easier. The cultural shift also created confusion. A parent without a diagnosis started to wonder if gluten was hurting their child, even without symptoms, because wellness culture framed wheat as universally suspect.

A gluten-free label describes one thing: the absence of gluten above a legal threshold. It says nothing about fiber or sugar. Many gluten-free replacement products are built from rice flour, tapioca starch, and potato starch. I have stood in the baking aisle and compared labels. A gluten-free all-purpose blend lists white rice flour first, while the bag of whole wheat flour beside it lists whole wheat flour first. Both can bake a decent muffin. Their nutrition panels tell different stories.

Testing Before Cutting Gluten

I learned this the hard way. Before my diagnosis, I had already started cutting gluten based on how I felt. My doctor asked me to eat gluten again for several weeks before blood tests and a biopsy. Celiac testing looks for specific antibodies, and those antibodies drop when you stop eating gluten, so a test after a gluten-free stretch can return a normal result even when celiac disease is present. Celiac centers across the country give newly diagnosed patients the same instruction: keep eating gluten until testing is complete. Talk to your primary care provider or a gastroenterologist before making changes.

That 20 parts per million standard exists to protect people with celiac. It measures gluten content and nothing else.

What This Looks Like at Our House

For a family managing celiac, gluten-free is a medical boundary. When gluten enters the kitchen through a shared cutting board or a stray crumb, the person with celiac pays the price. Our kitchen is gluten-free from the start. Our daughter Kolbie was diagnosed with celiac disease in 2020, shortly after her type 1 diabetes diagnosis. She loved ramen, and the gluten-free options we found were either full of ingredients I didn't want or tasted like cardboard. That led to a mason jar of seasoning in my spice cabinet, which became the first Clean Monday Meals product. My husband Kevin and I started the company because the products we wanted for our family didn't exist.

Every seasoning, bouillon, ramen noodle, and plant-based protein we make is gluten-free, dairy-free, and soy-free. That baseline exists because our family needs it.

I tell friends without a diagnosis that they can eat whole wheat sourdough if it sits well with them. Food choices should follow the body's actual needs. For my family, that means gluten-free comfort food made with ingredients we recognize. For another family, it might mean a loaf of whole grain bread. Both are reasonable.

More Specific Tests, Fewer Blanket Diets

I expect the next decade to move away from blanket avoidance and toward better testing for the specific compounds, gluten, fructans, or something else, that drive symptoms. That specificity would help more people than another gluten-free snack cake. The history of gluten-free eating starts with a famine and a pediatrician who paid close attention. The future should follow that same specificity.

If you're cooking for someone who is gluten-free by diagnosis, or you're navigating your own, the Clean Monday Meals Recipe App is free and has hundreds of gluten-free, dairy-free dinners.

With love, Janae