The truth about gluten

Until a few years ago, the gluten-free diet was followed mostly by those who required its elimination to prevent a variety of symptoms and health complications.

Now, the gluten-free industry has exploded, with books (often by non-industry professionals) stating that gluten is making us all sick and marketing teams quick to jump on the trend for their food products. Gluten-free products are being marketed as the healthier alternative, endorsed by celebrities, media personalities and even some health professionals. Products that never contained gluten are now proudly stating they’re ‘gluten-free’.

Word also spread quickly that gluten-free eating could result in weight loss. This may have been the case ten years ago when going gluten-free meant going completely without breads, cakes, pastries and a wide variety of unhealthy food choices. You were forced to simplify and return to a diet quite heavily based on healthy wholefoods that are naturally gluten-free. Now, that’s just not the case.

Is the trend harmful?

Today, there are so many gluten-free alternatives it’s a double-edged sword. The trend of gluten-free has allowed so many with coeliac disease to enjoy a much wider range of foods and incorporate some old favourites back into their diet. An increased awareness of gluten-free eating is also improving restaurant choices. However, the ‘trendiness’ of gluten-free eating may be resulting in a more relaxed approach to preparation methods, causing cross-contamination and serious consequences for those who must avoid gluten completely.

For those just following the trend, a gluten-free diet may be doing more harm than good. Simply removing gluten from your diet by replacing cookies, pasta and cakes with gluten-free varieties won’t benefit your health. A gluten-free cupcake is still a cupcake. Plus, many gluten-free packaged products are high in sodium, fat and added sugar in an attempt to make them more palatable. They may also be lower in fibre, iron, folic acid and B vitamins.

So who should go gluten-free?

Current scientific evidence suggests there are only two conditions that require a gluten-free diet.

1. Coeliac disease – an autoimmune condition affecting reportedly one in 100 Australians. Even trace amounts of gluten are harmful, triggering symptoms. Repeated gluten ingestion may result in a host of complications including infertility, osteoporosis, anaemia, and neurological problems. The only treatment is a strict gluten-free diet for life.

2. Non-coeliac gluten sensitivity/gluten intolerance – resulting in digestive symptoms similar to those with coeliac disease, but without the potential long-term detrimental effects. Common complaints include abdominal pain, diarrhoea, bloating and excessive wind, as well as lethargy, poor concentration and general aches and pains. Tolerance levels depend on the individual.

Gluten or FODMAPs?

If you’ve eliminated or cut back on bread, pasta, baked goods and/or opted for gluten-free varieties and felt better, you may not have coeliac disease or gluten sensitivity. You may instead be sensitive to fermented oligosaccharides, disaccharides, monosaccharides and polyols, or FODMAPs. These are a range of easily fermentable carbohydrates that cause digestive distress. Wheat, rye, barley, and oats (gluten-containing cereals) are some of many FODMAP-containing foods as they contain fructans.

Who should I seek for help?

The best way to identify any food intolerances is to see an Accredited Practising Dietitian. A gastroenterologist and GP are also essential to the team who can help you discover what is causing you digestive distress or other uncomfortable symptoms. Together they can identify problematic foods, rule out coeliac disease and other serious medical conditions, and arrange any tests that may be necessary.

See the coealic disease page at daa.asn.au for more information.