Fight the Fads: Gluten-Free Diets

WHAT IS IT AND WHERE IS IT FOUND?

Gluten is a protein found in wheat, rye and barley (not oats)

It is found in: bread, pasta, breakfast cereals, flour, pastry, pizza bases, cakes and biscuits. Gluten can also be found in processed foods, such as soups, sauces, ready meals and sausages.

WHO SHOULD FOLLOW A GLUTEN FREE DIET?

Only individuals who have been diagnosed with Coeliac Disease are medically advised to follow a gluten free diet.

In people with coeliac disease, a life long autoimmune condition, consuming gluten causes an immune reaction to the lining of the small intestine resulting in a range of symptoms including bloating, diarrhoea, nausea, wind, constipation, tiredness, headaches, sudden or unexpected weight loss (but not in all cases), hair loss and anaemia.

NON-COELIAC GLUTEN SENSITIVITY

Some people have gut symptoms when eating foods with ingredients containing gluten i.e. wheat, barley and rye, even if they don’t have coeliac disease. This is sometimes called gluten sensitivity.

It is not clear how the immune system might be involved and there does not appear to be damage to the lining of the gut. This is a new area and there is a need for more research to understand the condition and who is at risk.

Some researchers report that individuals with non-coeliac gluten sensitivity may experience an improvement in symptoms when following a gluten-free diet. However, it is difficult to rule out the possibility of a placebo effect.

There are no specific diagnostic tests for non coeliac gluten sensitivity.

There is also some debate around whether gluten is the cause of the sensitivity or if other components are to blame, which are also removed from the diet when gluten-containing ingredients are removed, such as Fermentable Oligo- Di- Mono-saccharides and Polyols (FODMAPs) and other non-gluten proteins found in wheat.

I THINK I MAY BE SENSITIVE TO GLUTEN, WHAT SHOULD I DO?

If you are experiencing symptoms when eating foods that contain wheat, barley, rye or oats and think you have a sensitivity to gluten, it’s important to first rule out coeliac disease.

It is not recommended that you try gluten-free diet as a first option if you are experiencing symptoms related to eating gluten. Instead, you should continue to eat gluten and to see your GP as soon as possible to undertake a test for coeliac disease.

It’s essential to keep eating gluten in order for the tests to be accurate.

If you have confirmed test results that indicate that you do not have coeliac disease and other causes of your symptoms have been ruled out, you might wish to discuss the possibility of non coeliac gluten sensitivity with your healthcare team.

🚫 CUTTING OUT GLUTEN – POSSIBLE HEALTH IMPLICATIONS 🚫

The cereal products that contain gluten are very important sources of vitamins, minerals and fibre in our diets and cutting them out can lead to:

Iron Deficiency

Low fibre intake ( <10/day = 50% increased risk colon cancer)

Vitamin B deficiency (low energy)

Folic acid (Vitamin B9) deficiency- (in pregnancy associated with birth defects)

🍗Iron deficiency 🍗

Although we often think of meat as the best source of iron in our diets, in the UK we actually get the majority of our iron from cereal products as we eat these in much larger quantities than meat.

Avoiding gluten means cutting out many cereal products, which can lead to iron deficiency.

For coeliacs, good sources of iron can come from meat such as beef, poultry and fish, or plant based sources such as beans, legumes and leafy green vegetables. These foods are all naturally gluten-free.

To enhance the absorption of non-heme iron (i.e plant-based foods), consume iron rich foods with sources of vitamin C such as a juicy orange.

🍞 Low Fibre and B vitamins 🐝

Gluten-containing cereals are also a primary source of fibre and B vitamins in the UK diet.

To ensure they are getting enough fibre and B vitamins coeliacs should eat a wide variety of gluten-free grains such as maize, polenta, soya, quinoa, millet, buckwheat.

Fruit and vegetables are also of course a good source of fibre vitamins and minerals.

🐝🌱Folic acid (Vitamin B9)🐝🌱

This nutrient is particularly important for pregnant women and women in their child-bearing years. Some of the best sources are yeast, green leafy vegetables, asparagus, broccoli, cauliflower, beans and lentils.

💡Remember 💡: gluten-free products may not be as high in fibre, iron, folic acid and B vitamins as gluten containing counterparts.

Image: pixabay

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