When I was at dietitian
school long ago we were taught that a gluten-free diet was only for those who
had coeliac disease or an inflammatory skin condition called dermatitis
herpatiformis. About one in 70 to 100 people have coeliac disease. The gluten
triggers the immune system to breakdown the intestinal lining making it
difficult to absorb the nutrients in food. That usually leaves you with
uncomfortable intestines and difficulty in gaining weight or muscle.
Now it seems that gluten-free
foods have become trendy. One US estimate is that one in 10 people have gone
gluten-free at the moment. There are even supermarkets with gluten-free aisles
(see the pic I took in Granada, Spain). Around 10% of all new food product
launches around the world in 2013 were gluten-free. It is now a $5 billion
global market, and just under $100 million market in Australia.
What is gluten?
Let’s clear up a few
points. First know that gluten is a protein naturally occurring in grains like
wheat, barley and rye. I had to point that out because there are some thinking
that it is an evil additive or some toxin to be avoided. Not so. We’ve been
eating it for millennia. The long, interconnected gluten proteins help bread to
rise, providing the characteristic texture and springiness many enjoy.
Gluten-free does not mean
“healthy”. Potato crisp/chips are usually gluten-free. Those gluten-free
muffins are still high in Calories (fat and sugar are gluten-free). A diet
without gluten might be a healthier diet if you are now eating more fruits,
vegetables, nuts and legumes and dropped the croissants and donuts.
Gluten-free for weight loss?
If you are trying to
trim up and decide upon the gluten-free diet as the way to do it, then you are
likely to experience weight loss. That is not because gluten is fattening. It is
because you will eliminate biscuits, cakes, pastries, bread (and therefore
butter and margarine), pizza and most other take-aways, so weight loss and a
better sense of well-being comes from an improved diet. This is the same reason
why a low carbohydrate diet causes weight loss – many kilojoule-dense foods
disappear and you are left pretty much with meat, fish and salad.
Non-coeliac gluten sensitivity
There may be people with
symptoms similar to Irritable Bowel Syndrome who seem to respond to a
gluten-free diet although they do not have gut lining atrophy on biopsy, yet
they respond positively to a gluten-free diet or a wheat-free diet. It is not
entirely clear if that is due to the gluten or to other compounds in grain such
as fructans. If you have a science bent you may want to read a recent paper on the topic (use the link in the top right corner to download the full paper).
What does it all mean?
First, don’t go
gluten-free just because your neighbour or best friend swears by it. If your
guts are telling you that everything is not perfect, then see your doctor about
testing for coeliac disease before you go on a gluten-free diet. If the
test is positive, then a gluten-free diet is your solution. If the tests show
that you do not have coeliac disease then see a qualified dietitian and do
a proper trial on a gluten-free diet to see if symptoms improve. In this case, called
gluten intolerance, you may find that gluten does not need to be totally
eliminated, just reduced to a level that controls your symptoms.
CoeliacAustralia tells us that 80% of people with coeliac disease haven’t been
diagnosed yet, which is 330,000 people by their estimate. You might be one of
those that does feel better on a gluten-free diet, but make sure it is the lack
of gluten that is making you feel better, not the lack of biscuits/cookies and
cakes! If your guts are singing along beautifully then just eat well. And
choose good quality gluten-containing foods.
