 Avoiding gluten is a must for people with celiac disease, but a gluten-free diet can have negative impacts. Watch the video to find out why. Over the last decade or so, there's been a growing interest in the medical literature on plant-based eating, beyond just exclusionary terms like vegetarian or vegan. Previous such studies were somewhat limited because they just split people up into either vegetarian or non-vegetarian, excluding some or all animal foods, but without taking into account the quality of plant foods. Vegans could be liven up that, French fries, Oreos, and Coca-Cola. Enter changes in plant-based diet quality in total and cause-specific mortality. The first study to investigate the associations between changes in plant-based diet quality and subsequent risk of death. If you look at overall plant-based diet scores, the more you increase your intake of any plant foods and decrease your intake of any animal foods, the lower your risk of death appears to fall. But that's because people were adding healthy plant foods, like fruits and vegetables. If you just look at people who ate more processed sugary junk over time, their mortality risk goes up. The clinical implications being the increasing intake of healthy plant foods and decreasing intake of not just animal foods, but also animal crackers could lower the future risk of premature death, whereas just reducing the intake of carbs in general, cutting down not just refined carbs and sugars, but healthy, high-carb foods like fruits and whole grains, is associated with increased overall mortality, which could correspond to years of your life being cut short, as well as the risk of dying specifically from heart disease, stroke, and cancer. Why are whole plant foods so good for us? Much of the benefit may be mediated by our microbiome. There are all sorts of things threatening our good gut bugs, like the over-prescription of antibiotics. However, the only factor that has been empirically shown to be important is a diet low in microbiome-accessible carbohydrates. In other words, prebiotics like fiber and resistant starch only found one place in abundance, whole plant foods. We went from high-mac diets to big-mac diets and maybe suffering the consequences. The lack of dietary fiber, which is the main source of max in the diet, is negligibly low compared to how we evolved. Such a low-fiber diet provides insufficient food for our gut microbes, starving ourselves of all the wonderful things they produce for us. A low-fiber diet is a key driver of microbiome depletion, and this loss is implicated in the rampant increase of chronic diseases that now plague the modern world. We evolved, getting perhaps 100 grams of fiber a day. Our gut bugs must have been in heaven. How do you even get close to that? A cup of fruit may only have about 3 grams. A cup of vegetables, 5 grams. Why so little? Because fruits and vegetables are like 80 to 90% water. One has to go to the drier plant foods to really scale it up, like beans, at 15 grams, or intact grains like barley, over 30 grams per cup. But many people are avoiding common grains these days, like wheat, barley, and rye, due to gluten. But there is a dark side of gluten-free diets. Now if you have a condition like celiac disease, well then you absolutely have to avoid gluten. But if not, the downsides include the potential for nutritional deficiencies, like not getting enough fiber, and toxic compounds, for example, the accumulation of heavy metals in people on gluten-free diets. Those following a gluten-free diet had significantly increased blood-mercury levels, more arsenic flowing through their systems. The arsenic is likely due to increased rice consumption, because rice is a major ingredient in gluten-free foods. But you can certainly choose other grains, like sorghum, that's my favorite rice substitute. And the higher mercury may just be because people eating gluten-free diets were tending to eat more fish, for some reason. But the reason that 10 out of 10 of those without celiac disease or recognized gluten sensitivity following a gluten-free diet experienced a pro-inflammatory gastrointestinal environment is likely due to starving your microbial self, not getting enough prebiotics, not getting enough fiber, because you're avoiding grains like wheat. So whatever diet you choose, for whatever reason, make sure you're getting enough fiber.