Why are you following a Gluten Free Diet, if you don’t have Coeliac Disease?
Did you know that so many people follow a gluten free diet when it is not recommended by a health professional that they do? Many Australians self-diagnose gluten intolerance and avoid gluten. Often this is not necessary. Others may avoid gluten due to presumed ‘health benefits.’ Not all gluten free diets are healthy.
Avoiding gluten is completely necessary if someone has been diagnosed with Coeliac Disease. But if it has been confirmed by a Gastroenterologist that you do not have Coeliac Disease, you may not need to avoid gluten. Do you have friends or family on the gluten free diet? If so, you might want to share this with them.
Coeliac Disease affects about 1 in 70 Australians. All people with Coeliac Disease need to follow a strict gluten free diet, with zero traces of gluten. Here’s a lot more on Coeliac Disease and diagnosis.
Gluten is a protein which is found in wheat, rye, barley, oats and triticale. It is found in most of the cereals and in many processed products. Wheat is a staple of a western diet and can be found in baked goods, breads, pasta, cereal, sauces and dressings. Barley is commonly found in malt, food colour, soup, beer and brewers yeast. Rye can be found in rye bread, pumpernickel, cereals and certain beer. Triticale is often in bread, pasta and cereal. Oats are technically gluten free, however due to farming they often become contaminated with gluten.
I do not have Coeliac Disease, but I feel better eating a gluten free diet . . .
Many people may have some type of gut symptom, so they quit eating gluten and may feel some type of symptom relief. Does this sound familiar? Self-diagnosis of gluten intolerance is very common.
Did you know that it is often not gluten triggering these symptoms? FODMAPs are in fact a very common trigger of gut-related symptoms.
What are FODMAPs?
FODMAPs are a collection of short chain carbohydrates and sugar alcohols found in foods that are broken down by bacteria in the large intestine.
Oligosaccharides include fructans and galacto-oligosaccharides (GOS). Fructans are found in wheat, onion, garlic and some fruits and vegetables and for those that are sensitive to fuctans, gut symptoms may occur following consumption. GOS can be found in some legumes, beans and nuts.
Disaccharides includes lactose which is found in milk products such as cow’s milk, custard and ice-cream.
Monosaccharides represent fructose when in excess of glucose. This is seen in some dried fruit, mango, apples, asparagus, pears, cherries and honey.
Polyols include sorbitol and mannitol, found in stone fruit, mushrooms, cauliflower and some ‘sugar-free’ chewing gum and mints.
If someone is sensitive to FODMAPs, gut-type symptoms (diarrhoea, constipation, bloating, abdominal pain, excessive gas/flatulence, intestinal noises, abdominal distention, alternating bowel habit) may only occur many hours after eating. This is because the small intestine and large intestine are very long (metres), so it takes time for food and FODMAPs to travel through and trigger those symptoms.
Let’s look at how you might feel better eating gluten free foods, when you don’t have Coeliac Disease…
So, it all starts with wheat.
Wheat is made up of gluten, a protein, and fructans, a FODMAP and carbohydrate.
Wheat flour comes from the largest part, the Endosperm or kernel. The Endosperm makes up 80-85% of wheat and is where the gluten (protein) and fructans (carbohydrate).In the food manufacturing process, when gluten is removed, often a lot or all of the fructans are removed.
For those who do not have Coeliac Disease: People who may experience gut symptoms after eating regular slices of bread, may feel better are eating gluten free slices of bread. This is not necessarily because the gluten was removed, but highly likely it is related to the reduction of fructans from the bread.
How do I know if I am sensitive to fructans, and not actually gluten?
Firstly, you need to ensure you do not have Coeliac Disease – so get this formally cleared through a gastroenterologist.
Secondly, seek support from a Gut Health and IBS-trained Dietitian. OSCAR Care Group has a great team of Gut Health Accredited Practising Dietitians, enquire here.
Ask yourself if you are sensitive and experience gut symptoms that start hours after eating the following? Onion, garlic, leek, artichokes, asparagus, dates, prunes, cashew nuts, pistachios - these are some examples of foods high in fructans that naturally do not have gluten. Regular bread and wheat-based cereals are high in fructans and contain gluten.
A Gut Health and IBS-trained Dietitian may help you through food challenges, if appropriate, to identify if fructans trigger your symptoms and what your tolerance may be. Who knows, you or your friends or family may be able to eat gluten again (as long as there is no Coeliac Disease).
Reach out to a FODMAP-trained Dietitian for personalised support through your gut-health journey.
What are the Many Reasons not to follow a Gluten Free Diet?
(if you definitely do not have Coeliac Disease)
Have you noticed how expensive gluten free food is? Whether you buy an item from the supermarket, compared to the same product, but non-gluten free. What about when you order pizza or a burger. That gluten free base or bun costs extra. It might be an extra 50 cents or $5 per meal or item, but every dollar adds up.
When you go to a friend’s house and there are beautiful cakes for tea, and you sit it out even though they look so yummy. Or you make a dietary request for an event prior.
Gluten Free diets are not healthier
Healthy lifestyles can be maintained on the gluten-filled and gluten-free diets. A gluten free diet may be filled with fats and high sugar foods, which may not be ‘healthy’, and vice versa.
You can be incredibly healthy and still eat gluten. If you want to be healthier, include a variety or fruits and vegetables and limit processed and high sugar foods (cakes, biscuits, crackers, beer etc.)
Many people who eat gluten free diets often have a lower fibre intake. Good fibre intake is important for our overall health, including our gut and bowel health. If you don’t have Coeliac Disease, should you really be avoiding gluten?
If you have Diabetes
Wholegrain foods are recommended as the healthier option, particularly if you have diabetes. Wholegrain foods may cause less of a quick spike in your blood sugar levels than many packaged gluten free products which are often refined and have added sugars, thickeners and emulsifiers. Processed packaged gluten free products may not have the health benefits that the wholegrain wheat competitors do.
If you do not have Coeliac disease
If you have Coeliac Disease, gluten causes harm and damage.
If you do not have Coeliac disease, gluten may not cause intestinal damage and long-term health effects. Avoiding gluten and dietary whole grains with an overall low fibre intake may in fact cause more harm than good.
There are so many people that have given up gluten or reduced gluten due to presumed health benefits, symptom relief, trends or fads, myths etc. and many that have reintroduced gluten back into their lives after identifying the real trigger, feeling better than ever.
So, if you are following a gluten free diet right now and you have not got Coeliac disease. It might be time to see a Dietitian and see if you can include gluten in your life again.
By Kiarra Martindale, APD, BBiomedSc, MDiet
Kiarra Martindale is a Gut Health, IBS and FODMAP-trained Dietitian. She is a nationally recognised Accredited Practising Dietitian, Sports Dietitian, Anthropometrist, Nutritionist and Presenter.