This article that I wrote was published on The Sunday Times, on the 18th of May, 2014 for coeliac awareness week.
Published on this blog with permission from The Sunday Times.
Gluten-free – the latest cliché in the world of trendy diets. The current popularity of this diet can be largely attributed to bestsellers like ‘’Wheat Belly’’ by Dr. William Davis, and ‘’Grain Brain’’ by Dr. David Perlmutter. Unfortunately these books and much of the anti-gluten propaganda is based on little or no scientific literature. It is a combination of celebrity doctors, popular bloggers and clever marketing strategies that are fuelling the anti gluten sentiments in the general population.
Usually, the first thought that pops into somebody’s head when the word gluten is uttered, is ‘’bread and pasta’’. Gluten is found in wheat, barley, rye and their derivatives. Although gluten is found in yummy breads and cakes, it is also hidden in many unlikely foods like imitation meats, stock cubes, deli meats, sauces, chocolate, ice cream and in so many other processed foods. A gluten free diet is not as simple as eating a burger without a bun. A person who requires a gluten free diet, will become an excellent gluten detective, scrutinizing every label and questioning every person who prepares their meals. Even a trace of gluten can make people with true gluten related medical condition ill.
So, should perfectly healthy individuals follow a gluten free diet for improved well-being or other reasons? That is a personal decision, but I urge you to continue reading before you embark on this lifestyle change.
If anybody eats healthy and unprocessed foods, increases their intake of foods rich in nutrients and fibre, and couples this with regular exercise, they will definitely help to prevent a myriad of health problems. But a gluten free diet that includes highly processed substitute foods is definitely not the way to go. Although gluten itself does nothing for the body, it is found in grains that are high in fibre like wheat. The gluten free diet tends to be lacking in fibre, iron, calcium, thiamine, riboflavin, niacin, and folate if one is not careful. Gluten free products are also packed with sugars and preservatives and are often higher in calories. So substituting gluten containing products with their gluten free counterparts will definitely not improve health or help a person to lose weight
I have seen so many claims about the negative effects of gluten in perfectly healthy people that it is difficult to list them all. Some examples are that gluten causes auto-immune diseases, brain dysfunction, neurological disorders, and even cancer. It is claimed that gluten is inflammatory and that it wreaks havoc in your system in every way imaginable.
The truth is that gluten has been proven to have many negative effects, but only in a small percentage of the population who suffer from certain gluten related medical conditions.
Gluten cannot be tolerated by 1% of the population who suffer from coeliac disease, people with a coeliac related skin condition called dermatitis herpetiformis, and others who have been diagnosed with non-coeliac gluten sensitivity, previously known as gluten intolerance.
Coeliac disease is not an allergy or food intolerance. It is actually an auto-immune, multi- system condition that is triggered off when even a tiny amount of gluten is ingested. Surprisingly, adults with coeliac disease rarely present with classical manifestations such as diarrhoea, weight loss and abdominal pain or bloating. Most present with atypical symptoms, most commonly anaemia. Other symptoms can include constipation, mouth ulcers, recurrent fractures, bone and joint pain, infertility, neurological problems and many others. Repeated ingestion of gluten or a late diagnosis can lead to serious side effects and health problems.
Gluten sensitivity is a recently accepted medical condition in which sufferers test negative for coeliac disease or wheat allergy but have improved symptoms with the removal of gluten from their diets. Although symptoms are similar to those of coeliac disease, no long term damage appears to occur if gluten is ingested.
So what should be done if you suspect your symptoms are related to gluten consumption?
It is important to continue eating gluten until you visit a doctor and get tested for coeliac disease and wheat allergy for accurate results. The gold standard for coeliac disease diagnosis is a simple blood test, followed by an endoscopy if the blood test is positive. If you have stopped eating gluten but wish to be tested for coeliac disease, speak to your doctor.
Some might argue that if a person feels better on a gluten free diet, they should just go ahead and start a gluten free diet. However, it is important to get tested to eliminate the possibility of other health problems, and to distinguish between coeliac disease and non-coeliac gluten sensitivity. People with coeliac disease have an increased risk of other auto-immune conditions and long term complications if a strict gluten free diet is not followed for life. It is also genetic, so family members would need to get tested. Regular follow up, and care of complications would be needed.
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