To Be or Not to Be, Gluten Free? That Is the Question!

August 18, 2016

 
Are you a gluten for punishment?

 

Ten years ago the term ‘gluten free’ was synonymous with eating rice cakes that tasted like cardboard. Today going gluten free is perceived as being ‘healthy’, as well as being a multi-billion euro business with sales of gluten free products increasing at an exponential rate.

 

But what exactly is gluten and why should we avoid it? Or at least, why do we think we need to avoid it? Avoiding something out of necessity and avoiding something out of perception are for entirely different reasons.

 

What is Gluten?

 

The word gluten comes from the Latin word for ‘glue’. It is a protein composite found in wheat and other grains that literally acts like a glue to give elasticity to pizza dough and makes bread chewy. The lack of gluten is what gives gluten free products a bad rep for having a cardboard and flaky like consistency.

 

Gluten is found in grains such as wheat, barley, bulgar, rye, oats, spelt, malt, kamut, triticale, semolina, pumpernickel and faro.

 

Oats that have been specially produced in a way to avoid contamination by wheat, rye, or barley are available, but regular oats on sale in Ireland are not gluten free.

 

Gluten is also hidden in many ingredients that you may not realise. It is often used as a processing aid, binder, filler, or as a carrier for flavourings and spices, so it’s important to read the label. Some examples are sausages, burgers, processed meat, stock cubes, soy sauces, gravy, sauces, processed cheese, processed yogurts and cordials which may contain barley.

 

Gluten is not found in grains such as all varieties of rice, buckwheat, teff, amaranth, quinoa, corn, hominy and millet. Other naturally gluten-free foods are natural raw meat, natural raw fish, shellfish, fruit, fresh herbs, plain individual spices, plain natural nuts and seeds, eggs, and dairy products including milk, cream, butter, natural yogurt, natural cheese and crème fraiche and pure oils and fats.

 

Who Should Avoid Gluten?

 

Coeliac disease is a genetic condition where there is reaction of the immune system to gluten that can damage the small intestine of the digestive tract and prevents absorption of vital nutrients.

 

In Ireland, the prevalence of coeliac disease is approximately 1 in 100, an estimated total of 45,000. Some of the classical symptoms of the disease are steatorrhoea (excess fat in stools and can be especially foul-smelling), diarrhoea, abdominal cramps, weight loss, and bloating.

 

However, other not so obvious signs are recurrent mouth ulcers, heartburn, alopecia, migraines, depression, fatigue or sub-fertility.

 

The disease is not contagious and the only treatment is adhering to a gluten-free diet for life, once a positive diagnosis has been made.

 

Gluten Sensitivity

 

Gluten sensitivity is characterized by symptoms related to the consumption of gluten-containing foods (bloating, gas, abdominal pain and cramping, diarrhoea), but in patients that are not affected with either coeliac disease or wheat allergy. In contrast to coeliac disease, gluten sensitivity does not cause permanent damage or result in nutrition deficiencies.

 

There is no specific blood test for gluten sensitivity and a clinical diagnosis is based on response to a gluten free diet. It recommended that you first get tested for a wheat allergy and for coeliac disease and if both of these are negative, then your doctor may recommend a gluten elimination diet.

 

Gluten sensitivity is around 7 times more common than coeliac disease, an estimated 7% of the population. However, as much as 20% of the population, who have self-diagnosed, claim to have gluten sensitivity. So chances are you don’t have gluten sensitivity, even if you think you do.

 

Gluten sensitivity should be confirmed by your doctor and not self-diagnosed. A gluten elimination diet should be overseen by a knowledgeable physician to reduce the likelihood of a placebo effect (a perceived improvement) occurring during the dietary intervention and to also omit patients from self-diagnosing themselves.

 

Is It Real?

 

New research has shown that gluten sensitivity, or what is perceived as gluten sensitivity, might actually in fact be caused by FODMAPS (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) – a group of poorly digested carbohydrates, which are known to cause gastrointestinal problems. And it just so happens that wheat, barley and rye (gluten containing grains) are all high in FODMAPs.

 

Other common sources of FODMAPs are bread, chocolate, artificial sweeteners, mushrooms, beans, apples and anything that is high in fructose corn syrup.

 

There is still no hard evidence to suggest either way and the underlying causes for gluten sensitivity are yet to be fully understood. However, for people who have self-diagnosed themselves with gluten sensitivity are likely to benefit from lowering their dietary intake of FODMAPs.

 

Gluten Free Trend

 

More and more people are self-diagnosing with gluten sensitivity as the condition seems to be going viral! It is more than likely that not everyone who follows a gluten free diet needs to do so and are only following the trend because of its perceived health benefits.

 

Many people begin to feel better when gluten is dropped from their diet simply because they are eating a healthier diet consisting of more whole unprocessed foods with less junk and processed foods.

 

The placebo effect is also seen in action here – feeling better on a gluten free diet simply because you believe you are doing something positive for your health.

 

Don’t be conned into believing that just because it says gluten free on the label that it is a healthier alternative. Ironically, many gluten free products are less nutritious than their gluten containing counterparts and often have more additives and preservatives.

 

Gluten free diets are also becoming very popular in an attempt to lose weight – yet another diet band wagon to hop on. Cutting gluten from your diet to lose weight is no more than hearsay and propaganda.

 

If people lose weight by cutting gluten from their diet, it is merely coincidence. Causation does not mean correlation – and the weight loss is as a result of cutting out a lot of processed food that are naturally higher in calories, processed fats and carbs.

 

No one single variable is responsible for making people fat, including gluten. Eliminating gluten will not make you lose fat any more than the non-existent magic diet pill. Take personal responsibility for your actions, quit looking for external factors to blame, and acknowledge that you are the only one that can successfully control your behaviours.

 

Find What Works For You

 

Ultimately, more research needs to be done on gluten sensitivities to properly define the benefits of the gluten free diet for those without coeliac disease or wheat allergy.

 

It is unclear just how strict a gluten free diet needs to be for someone who may be gluten sensitive. It is also still unclear if following a gluten free diet will provide you with any health benefits other than simply ‘feeling’ better. Whether that is perceived or actual, who knows?

 

Unless you have been diagnosed with coeliac disease or gluten sensitivity then there’s probably no need to completely eliminate gluten from your diet. You will also save yourself a bucket load of money as gluten free products are up to 3 times more expensive.

 

If you suspect coeliac disease or gluten sensitivity then consult with your doctor and get a proper diagnosis. A gluten free diet is not something you should embark on just because it is on trend. It takes a great deal of education and commitment and it is a permeant lifestyle rather than just something you dip in and out of.

 

Thanks for reading,

Karen

 

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