Gluten is found in wheat, rye, oats and barley and is often cited as the cause for a variety of unpleasant gastrointestinal symptoms, such as bloating, abdominal pain, nausea, diarrhoea and constipation.
This prompts many people to opt for a gluten free diet; however there are several important things to consider before you decide to go gluten free. If I have any clients suffering from these symptoms, I always send them to their GP or a gastro specialist first to rule out Coeliac disease.
Coeliac disease is a condition where the immune system reacts abnormally to gluten, recognising gluten, as something the body needs to fight.
According to Coeliac Australia, 1 in 70 Australians are affected by Coeliac disease, yet approximately 80 per cent of cases remain undiagnosed. This means a lot of people who have Coeliac disease have no idea, which can be dangerous.
Coeliac disease is a serious condition that can affect many different mechanisms and is not something to be taken lightly. Some people can be asymptomatic (showing no symptoms) and I have definitely seen examples of this. Usually a specialist will ask about a person’s family history.
One client of mine got diagnosed with Coeliac disease and it turned out their siblings also had the disease but did not show any symptoms.
Gastrointestinal symptoms are the most obvious signs of Coeliac disease, but other symptoms include: Fluctuating weight, fatigue, weakness, iron deficiency, bone and joint pains, recurrent mouth ulcers, skin rashes and easy bruising of the skin.
Research also suggests that people can suffer from non-coeliac gluten sensitivity, but the cause and treatment is not well understood. In this case, it may be the malabsorption of fermentable sugars that is causing the problem, not gluten.
How we manage someone who has Coeliac disease and someone who has gluten sensitivity is actually quite different.
If a healthy person decides to go gluten free but the rest of their diet is nutritionally balanced, then that is generally fine and there are no really serious consequences as long as they know what they are doing and are informed about nutrition.
When people cut something out and they don’t replace it with something as nourishing, it can cause a lot of different digestive issues. Wheat-based products form part of the carbohydrate group of foods, carbohydrates being a staple in the western diet.
If people do not approach going gluten free correctly, they may cut out carbohydrates altogether and end up missing out on vital vitamins and minerals.
Whole grains, for example, are very high in magnesium, protein, fibre, manganese, phosphorus and B vitamins; there is the risk of nutrient deficiency if these are not present in a person’s diet.
Another issue is that most people do not know what food even contains gluten- They see packaging that says ‘Gluten Free’ and assume it must be good for them.
Some foods do not actually contain gluten but are marketed as gluten free to attract that type of customer.
Often sugar and fat are added to gluten free products to compensate for taste and flavour, dispelling that myth that gluten free means low calorie.
The one piece of advice that I can give to anyone considering going gluten free is do not self-diagnose: get a proper diagnosis from a specialist before deciding you have an allergy or intolerance.
If you do decide to cut out gluten, find a dietitian that will respect your decision and help ensure that you are getting enough nutrients.