Following a gluten free diet

Did you know that whilst 1% of the population has gluten intolerance, or coeliac disease, some 19% of the population believe that they have a problem with gluten and follow, to some extent or another, a gluten free diet?

Rather than pass comment on whether someone is or isn’t really gluten intolerant, let’s look more closely at what gluten is and how it can affect us.

What is gluten?

Gluten is made from gliadin and glutenin, both proteins which, when combined, create a gooey bond that gives baked goods flexibility, volume and texture. Gluten is found in wheat, barley and rye and whilst it used to be thought that oats were also a potential source, they contain a protein, which is, if you like, a second cousin once removed of gluten and so tolerated by many people who are gluten-intolerant.

What does it do?

For people living with coeliac disease, gluten causes the villi in the intestines to atrophy, or flatten, which vastly reduces the surface area available for nutrient absorption. Thus a coeliac eating gluten can experience nutrient deficiency which can present in a great number of ways ranging from failure to thrive in children to urgent diarrhea, dry skin, depression and severe discomfort in both adults and children alike.

Can gluten intolerance be tested for?

Yes but ideally you’d have to be eating gluten for a test to be effective. Genetics plays a role in coeliac disease and any predisposition can be tested for as specific genes are found in over 97% of adults with coeliac disease but only 40% of the general population. Additionally blood tests can identify the presence of two types of antibodies produced when the ceoliac is eating gluten.

By the way, the tests one sees advertised online or in health food shops are not usually the same type and look for different antibodies. If these are raised then the assumption is made that the individual is gluten intolerant, a controversial conclusion that is not accepted in the mainstream.

Does it matter if a coeliac has gluten?

Yes, it does matter. They can have unpleasant and immediate physical reactions, but even if they don’t, which is possible, the villi in the intestines will be flattened with continued exposure which will reduce nutrient absorption leading to deficiency problems in the longer term which can be cumulative and more subtle.

For a non-coeliac who has gluten it is hard to say if it matters, as their reasons for avoiding gluten might be non-specific.

Are gluten free foods always healthier than the regular versions?

No, although it could be said that marking a food as ‘gluten-free’ has started to become synonymous with ‘good for you’. Yet taking the gluten out of a familiar food means replacing it with other elements to replicate the familiar texture and feel. Higher levels of fats and sugars are not uncommon which may be a fair price to pay for a ceoliac but isn’t what the other consumers had in mind when they thought they were making a healthier choice.

I feel better when I cut gluten out of my diet, does that mean I am gluten intolerant?

It doesn’t, no, simply because you might be making better food choices as you’ve imposed boundaries on your usual diet. For example, you might not be having biscuits or sandwiches during the day, instead taking lunch from home. Bear in mind that for the GP to successfully test you for gluten intolerance you’d have to be eating gluten, which is a conundrum.

Of course the decision to avoid a food is yours but if you choose to follow a gluten free diet be sure to do your research first, so you can understand the full impact to your health.