6 Reasons Most Indians Who Think They Are Gluten Intolerant Are Not

Gluten intolerance became a household phrase at roughly the same time gluten-free products arrived in urban Indian supermarkets. The timing matters. When a label exists and products exist to solve it, the label spreads faster than the condition it describes. True non-coeliac gluten sensitivity is real, but it is far less common than the number of people currently avoiding atta would suggest. Coeliac disease, the autoimmune condition where gluten causes measurable intestinal damage, affects an estimated 1 in 100 people globally, and Indian prevalence data from AIIMS and PGI Chandigarh puts the figure in a similar range for the Indian population. The gap between that number and the number of Indians now buying gluten-free flour is wide enough to park a truck in.

Most of the wheat Indians eat heavily is refined, maida in biscuits, bread, naan, and fried snacks. Maida is stripped of fibre and has a high glycaemic load. The bloating, sluggishness, and blood sugar spikes that follow a maida-heavy meal are real. They are not caused by gluten. They are caused by the absence of fibre and the rapid glucose response that comes with a refined carbohydrate. Switch the same person to whole wheat atta and the symptoms often ease. If gluten were the issue, they would not.

Wheat contains fructans, a type of fermentable carbohydrate that belongs to the FODMAP group. Fructans are fermented by gut bacteria and produce gas. The symptoms, bloating, cramping, loose stools, are indistinguishable from what people describe as a gluten reaction. A landmark study published in the journal Gastroenterology in 2018 found that when participants who believed they had non-coeliac gluten sensitivity were given isolated gluten with no fructans, most showed no response. The reaction tracked the fructans, not the gluten. Indian diets are high in other FODMAP-rich foods too, onion, garlic, certain lentils, which makes the picture harder to untangle without proper testing.

A gut microbiome that has been disrupted by repeated antibiotic courses, low fibre intake, or high processed food consumption becomes less efficient at digesting complex carbohydrates of all kinds. Wheat is not singled out, it is simply one of the larger carbohydrate loads in the Indian diet, so it attracts the blame. The Indian Council of Medical Research has flagged rising antibiotic overuse as a public health concern, and urban Indians are among the more heavily exposed populations. Restoring gut diversity through fibre, fermented foods like curd and kanji, and reduced processed food intake often resolves what looked like wheat sensitivity entirely.

The enteric nervous system, the network of neurons lining the digestive tract, responds directly to psychological stress. This is not metaphor; it is physiology. Cortisol alters gut motility, changes the composition of the gut lining, and can trigger symptoms that map onto irritable bowel syndrome. IBS is common, under-diagnosed, and frequently misread as food intolerance. A person who eats roti at a stressful lunch and feels unwell is not necessarily reacting to wheat. The meal and the stress arrive together, and the wheat gets the blame.

Cutting wheat out and feeling better is not evidence that wheat was the problem. When someone eliminates wheat, they typically also eliminate biscuits, bread, most fried snacks, and a large share of their processed food intake. They often eat more vegetables, more rice with dal, more home-cooked food. Any of these changes could explain the improvement. This is a confounding variable, not a controlled experiment. A proper elimination protocol followed by a blinded reintroduction, ideally supervised by a gastroenterologist, is the only way to know whether gluten specifically is the issue.

Coeliac disease can be screened with a blood test, serum anti-tissue transglutaminase IgA antibody, available at most diagnostic labs in India. If that is elevated, an endoscopic biopsy of the small intestine confirms the diagnosis. Non-coeliac gluten sensitivity has no biomarker yet, but ruling out coeliac disease and wheat allergy first is essential. Most people who are certain they are gluten intolerant have never had either test. A gastroenterologist can order both in a single visit. The tests exist, they are accessible, and skipping them in favour of a self-managed elimination diet means living with an answer that may be wrong.

The gut is not a simple system, and wheat is not the only variable in the Indian diet that changed as urban eating patterns shifted. Before restructuring a diet around a diagnosis that was never made, a blood test and one conversation with a doctor will tell you more than six months of avoiding roti.