Tuesday, 22 January 2019 08:00

Thinking About Going Gluten Free Featured

Many of us will remember a time when the words “Gluten Free” were a rare occurrence in the supermarkets, restaurants and dinner parties of Australia and most likely only of interest for an unfortunate group of people who knew they had Coeliac Disease. Now it would be unusual not to know someone who claims to be gluten intolerant. A national survey in 2015 reported that 7.3% of us (excluding those with proven or suspected Coeliac Disease) reported adverse effects associated with gluten ingestion. Why the change?

The short answer is that we don’t really know. A major, though only partial, explanation is that many who claim to be gluten intolerant are wrongly attributing their symptoms to the eating of gluten containing foods. When 231 people with claims of gluten intolerance were subject to stringent testing of their symptoms against exposure to dietary gluten, only 16% were shown to have symptoms that were reliably associated with gluten ingestion. This small group at the current time are said to have non-coeliac gluten or wheat sensitivity and are the subject of continuing research.

What this does mean is that most people who blame gluten in their diet for symptoms they experience are mistaken. The type of symptoms that are claimed to be related to such gluten intolerance are wide and varied and most commonly include bloating, abdominal discomfort, bowel upset, indigestion, headache or tiredness.

But does it matter? If you feel better by avoiding the gluten contained in products made from wheat, barley, rye, and to a lesser extent oats why not just avoid them?

People are free, of course, to eat how they like. However, a gluten free diet is not without risk, expenses and inconvenience. Also, their symptoms could signify other conditions and are worthy of medical assessment just to be sure.

Those contemplating a shift to a gluten free lifestyle on the basis of self or non-medical diagnosis should be aware of the following points:

  1. Coeliac Disease is caused by dietary exposure to gluten. The symptoms can vary from severe to very subtle. In Australia it is estimated that 80% of people remain undiagnosed. Without treatment is can lead to poor health, growth restriction in children and long-term risks of osteoporosis and intestinal lymphoma. It can only be treated with strict dietary avoidance of gluten. It requires specific medical tests to be diagnosed or excluded. So if you have symptoms that you link to eating wheat or are worrying you then your first action should be to see your GP for a medical assessment of the problem. A naturopath’s common advice to eliminate wheat in your diet for whatever ails you could be selling you short.
  2. Apart from Coeliac Disease, many of the non-specific symptoms people attribute to eating wheat may have another cause. For instance the commonest cause of chronic abdominal symptoms is irritable bowel syndrome and the symptoms have a great deal of crossover with those said to be due to wheat intolerance. More serious diseases such as ulcerative colitis, Crohn’s disease or even bowel cancer could be missed.
  3. Strict gluten avoidance is difficult and inconvenient. Most people with coeliac disease have professional dietary advice from a dietician as to how to go about it.
  4. Gluten free diets are expensive. A 2016 study found that following a gluten free diet is between 5.6 to 16.7% more expensive than a regular diet.
  5. Gluten free products are not necessarily nutritionally equivalent to their gluten containing counterparts. They may not provide enough trace elements, B group vitamins and dietary fibre.
  6. By avoiding gluten people miss out on an exposure to the whole grains of wheat, barley, rye and oats. A diet containing a sufficient amount of these is associated with a reduced risk of type 2 diabetes, cardiovascular disease and bowel cancer.
  7. In part marketing drives the gluten free movement. Food companies find it in their commercial interest to promote gluten free products as being a healthy alternative and tap into modern food sensibilities in the community. With this publicity, a gluten free lifestyle would appear in the public domain to be a healthy choice. But, for most of us it is not. Don’t let a company’s profit motive dictate your diet.

Unquestionably people with coeliac disease should have a strict gluten free diet. There maybe a small subsection of other people with symptoms who may benefit from avoiding gluten but at this stage it is unclear how to practically identify them. If you are concerned about symptoms and the possibility of gluten intolerance then have this medically assessed first before committing to a dietary change you may not need and could do you harm.

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