Is a gluten free diet good for you?
Eating gluten free is something we’re all too familiar with now, with supermarket shelves and cafes full of gluten free foods claiming to be better for you. But is a gluten free diet all that it is made out to be for your health?
What is gluten?
Gluten is a protein found in wheat, rye, oats and barley. It’s microscopic and makes up part of the grain. For most people, it does absolutely no harm and does not need to be avoided. Aside from the huge inconvenience of going completely gluten free, avoiding gluten when you don’t need to can mean eating more highly processed gluten free foods that are high in sugar and low in fibre, and not good for your overall health.
Why are some people intolerant to gluten?
Coeliac disease is when a person is allergic to gluten. It is an autoimmune condition, where the body’s immune system reacts inappropriately to something – gluten in this case. The exact cause of coeliac disease is not known, but there can be genetic links.
When coeliac disease is confirmed, a strict gluten free diet must be followed for life. This is because when someone with coeliac disease eats a food with gluten in it, it causes inflammation, damages the lining of the intestines and over time, can lead to poor nutrition, osteoporosis and cancer. The severity of someone’s symptoms is not an accurate representation of the damage that can be occurring. A person might have only mild symptoms like bloating, but damage can still be happening.
Other people can be intolerant to gluten but not have coeliac disease. Symptoms of this are similar to coeliac disease, like pain and bloating, and changed bowel habits. For these people, the problem may in fact be an intolerance to wheat. If this is the case just wheat can be avoided.
If wheat is eliminated but symptoms continue, the cause may be non-coeliac gluten sensitivity. Avoiding gluten may improve things for sufferers, but care needs to be taken to make sure the diet is still adequate and nutritious.
Testing for coeliac disease
Because coeliac disease is a medical condition with lifelong consequences, a definitive diagnosis is essential. Tests look for the damage that is caused by gluten – so if a gluten free diet has already been followed before testing, the results can be inaccurate. Gluten needs to be eaten prior to testing, with medical guidance.
A blood test can be done to look for immune markers of coeliac disease, but it should not be used to diagnose the condition. The process for a definitive diagnosis is a small bowel biopsy. This is a quick
procedure done under light sedation where tiny pieces of the small intestine are taken and examined under a microscope. The presence of damage to the intestine lining is what confirms coeliac disease.
What is a gluten free diet?
Following a strict gluten free diet is not an easy feat, and requires the help of dietitian. Gluten can be obvious in wheat, rye, oat and barley, but can also be harder to spot. Gluten is in many packaged foods where wheat is used as a thickener, like sauces, lollies and convenience foods. Learning how to read food labels is essential.
Another place gluten can hide is on utensils and things used to cook with. For example, regular bread crumbs on a chopping board or in a toaster need to be strictly avoided by someone with coeliac disease. Most whole, unprocessed foods are naturally gluten free, and getting more of these into your diet is always a good thing. A gluten free diet can be balanced and nutritious when it is well planned out.
Example of a gluten free diet
Breakfast - Gluten free Weet-Bix with a banana and milk
Snack - Milk coffee and a handful of natural nuts
Lunch - Gluten free bread sandwich with plain tuna, whole egg mayonnaise (gluten free), salad, salt and pepper
Snack - Rice cakes with all natural peanut butter
Dinner - Rice noodle stir fry with beef strips, garlic, ginger, gluten free soy sauce, honey, vegetables
Supper - Punnet of strawberries
Prepared by Kara Vogt – Accredited Practicing Dietitian