Gluten is one popular and controversial topic!
Despite the boom in gluten-free products, the health claims made around gluten, and the number of people claiming to eat gluten-free, many of us don’t actually know what gluten is or how it might affect the body.
Lets’ unwrap what gluten is and take a look at the evidence behind the gluten-free fuss.
So, what is gluten?
If you ask someone what gluten is, most of the time they will respond with ‘wheat’ – and we don’t blame them! This can be a confusing topic.
Gluten is a type of protein found naturally in wheat, rye, barley, oats and spelt. Gluten is the broad the name given to the proteins (‘prolamins’ and ‘glutelins’) in these grains. Each grain has a different type of prolamin/glutelin. For example, the wheat prolamin is called gliadin, while the barley prolamin is called hordein, rye is called secalin, and oat is called avenin. Pretty complicated right?!
Gluten is found in a wide range of foods, including bread, cereals, cakes, pizza, crackers, processed meats, pre-made meals, soups and sauces. Gluten has a key role in baking, helping the dough rise and giving it flexibility. This results in the delicious chewy texture we know and love.
Coeliac (see-lee-ak) disease is a serious auto-immune condition. This means that the body mistakenly attacks its own body tissues. This condition affects 1 in 70 Australians, though many of them go undiagnosed.
The small intestine has tiny finger-like projections (called villi), that help to absorb nutrients. When a person with coeliac disease eats gluten, it causes an inflammatory reaction with damage to these villi. They become inflamed and flattened, which can lead to diarrhoea, abdominal pain, vomiting, weight loss, fatigue, mineral/vitamin deficiencies, bone and joint pain and skin rashes.
A formal diagnosis is essential for coeliac disease. A blood test can indicate if you are at risk of coeliac disease, but a small bowel biopsy is necessary to confirm the disease is present.
If you are diagnosed with Coeliac disease, a lifelong gluten-free diet is the only treatment. This is important for a happy gut, good health and improved energy levels. The gluten-free trend means there is a huge range of products now accessible for those who need them.
Gluten sensitivity and wheat fructans
Gluten sensitivity is an emerging area of research, and it is not well-understood. It refers to symptoms that people attribute to gluten; including diarrhoea, constipation, bloating and abdominal pain. Self-diagnosis with gluten-sensitivity can be a problem, therefore it is essential to rule out serious medical conditions with your doctor and discuss the best course of treatment.
If you feel better when you exclude gluten-containing foods, it doesn’t actually mean you are sensitive to gluten! Poor absorption of fermentable sugars (FODMAPs) could be the cause. Many gluten-containing foods also contain fermentable sugars known as ‘fructans’ (sugars found in wheat, rye and barley). In some sensitive people, these fermentable sugars are not absorbed properly. The bacteria in the small intestine feed on these fructans and let off gas, leading to unpleasant gut symptoms.
If you think this sounds like you – your doctor is still the first port of call in diagnosis.
The pitfalls of avoiding gluten
Many people remove gluten from their diet unnecessarily. They may have self-diagnosed with gluten-insensitivity or have beliefs about gluten improving general health or reduce disease.
Studies indicate that gluten does not have negative effects on weight, diabetes or heart disease. Limiting gluten is likely to mean reducing beneficial whole grains, fibre, vitamins and minerals that may reduce the risk of diabetes and heart disease and assist with maintaining a healthy weight. Furthermore, the removal of gluten means that taste and texture can be modified, so salt, sugar and fat are often added to gluten-free products to make up for this.
Overall, avoiding gluten can be challenging. Gluten-free products are generally more expensive, and removing foods you love and encounter daily can be emotionally difficult and require a lot of planning. If you are lucky enough to be coeliac-disease free, then embrace the range of nourishing gluten-containing foods you can enjoy.
By Ellouise Whiltshire for The FODMAP Challenge
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