Are you gluten-free curious?
Gluten is everywhere, from bread and pasta, to biscuits, pastries and even drinks like beer. It’s hidden in foods you wouldn’t expect, such as sausages & lots of processed meats, sauces and gravy. It’s been a staple for thousands of years but going gluten free has been one of the biggest health trends in the last decade. Some take gluten out of their diet for weight loss reasons, and it can work – most of the sugar and poor fat foods are full of gluten. Yet for some it is more than that, it is damaging to their health – massively and life-changingly. If you are someone with coeliac disease, non-coeliac gluten sensitivity or a gluten intolerance, you know that eating this protein will make you very ill, and depending on which of the three you have, even the smallest crumb could knock your health for weeks.
So what is gluten?
Gluten is a collective noun that refers to a number of different proteins found in grains like wheat, barley, rye and anything made from them.
The main proteins found in wheat are glutenin and gliadin, which are very elastic and give bread its stretchy quality. Some products naturally contain gluten, but gluten is also added in extra quantities to foods to add protein and texture, and to bind processed foods together.
You’ll find gluten in the following products (not an exhaustive list!)
Wheat flour
Durham wheat
Bread and breaded or battered foods
Pasta
Noodles
Soy sauce (Tamari soy sauce is gluten free)
Worcestershire Sauce
Many flavoured crisps
Barley squashes
Beer, lager, stout, ales
Cous cous
Bulgar wheat
Pies and pastries
Pizza
Cakes and biscuits
Dumplings and Yorkshire puddings
Breakfast cereals
Muesli
Many packet sauces (powders and liquid sachets)
OTHER INGREDIENTS
Malt extract
Malt vinegar
Barley malt flavouring
Brewer’s yeast
Edible starch
What’s the problem with eating gluten?
The gluten proteins are very hard for your body to break down and, when they don’t break down completely, they cause inflammation in the digestive tract or leak through the wall of your small intestine into your bloodstream, creating an immune response.
Coeliac Disease is the most well-known gluten-related problems. It’s an autoimmune disease triggered by gluten and it causes your body to attack the small intestine, resulting in damage to the lining of the intestine and ensuing malabsorption and malnourishment. It can show as 'failure to thrive' in young children.
It may surprise you to know that less than half of those with coeliac present with the diarrhoea, cramping and nausea most associate with the disease. It’s just as common to be constipated. And lots of coeliacs don’t have gastrointestinal complaints at all but present with anaemia (iron, B12 and folate) as well as neurological disorders (depression, anxiety, brain fog), migraines, ataxia, poor oral health and skin diseases such as psoriasis and dermatitis. Mouth ulcers can also be a sign, if recurring.
Testing for coeliac disease is first by a blood test to look for antibodies to gluten and then perhaps by intestinal biopsy for confirmation. There are a few specialist tests not available on the NHS but run by a lab called Cyrex that I offer clients and that can spot problems before you become very poorly. The benefit of this is if you are already avoiding gluten and don’t want to eat it twice daily for six weeks (a necessity for NHS testing), this test picks up antibodies if you eat it for only one week.
Wheat allergy is an abnormal immune response to one or more proteins found in wheat. Like other true allergies, the body makes a specific inflammatory response and symptoms can be mild or severe, including anaphylaxis, which can cause breathing difficulties and death. Allergies are usually detected using blood or finger-prick testing for IgE antibodies (see my post on allergies)
Non-coeliac gluten sensitivity is a ‘catch-all’ phrase that covers everything else! Advanced testing for gluten-related disorders (I mentioned this above) can pick up if your body is making an unfavourable response to gluten. Or, quite simply, you might know that gluten causes you issues, which can mean anything from milder intestinal symptoms, headaches, joint pain and fatigue, as well as neurological symptoms. While not life threatening, these can still have a profound effect on your health and how you feel and should not be ignored.
Neurological symptoms, really?
Yes. What we’ve come to understand about gluten is that it can cross the blood brain barrier in the same way the proteins slip through the normally tight junctions in the gut. If you’ve ever heard people talking about Leaky Brain, this is what they are referring to. Research has shown that gluten can cause central and peripheral nervous system and psychiatric disorders.
I have one client who had no gastrointestinal issues at all but suffered debilitating fatigue, brain fog, aching joints and depression. Upon testing we discovered she had coealic disease. She has been strictly gluten free for seven months now and is a new person. This took decades to discover and the relief that it wasn’t ‘all in her head’ was (as she had been told....) was overwhelming.
I see a lot of autoimmune clients in my nutrition clinic, including coeliac, type 1 diabetes, Hashimoto’s thyroiditis and psoriasis. One of the first things I ask them to do is cut out gluten due to the inflammation gluten creates in the body. This is due to molecular mimicry. Put simply, this is the body reacts to gluten but because the gluten protein is so similar to proteins in our body, the body starts an immune response towards its own proteins – in your small intestine (coeliac), thyroid (Hashimoto’s), joints (rheumatoid arthritis)…. Going gluten-free can bring tremendous relief of symptoms to this subset of autoimmune sufferers.
Why is this a problem NOW?
But - I hear you cry - bread and gluten-containing products have been around for thousands of years so why is this only a problem now?
Gluten-containing grains now form the backbone of the modern diet thanks to an over-reliance on convenience and snack foods, and bread and pasta making multiple daily appearances on family menus. It’s not uncommon for me to find clients grabbing cereal or toast in the morning for breakfast, a sandwich or soup and roll at lunch and a pasta dish or pie in the evening.
We’re just eating way too much.
Add to that, the wheat we eat today is also markedly different from the historic versions that used to be grown thanks to industrial milling that brought us the almost entirely barren white flour and other highly processed foods that see today’s wheat stripped of many of its vital nutrients. Add to that, wheat is now grown very differently with fertilizers and pesticides to increase yields.
Dr William Davis, author of Wheat Belly, had this to say: “This thing being sold to us called wheat – it ain’t wheat. It’s this stocky high-yield plan, a distant relative of the wheat our mothers used to make muffins – light years removed from the wheat of just 40 years ago.”
Is giving up gluten bad for me?
You might have seen articles proclaiming that unless you are coeliac, you MUST eat gluten-containing products or all kinds of bad things that will happen, including nutrient deficiencies.
This is not the case.
Articles citing the supposed nutrient deficiencies when you remove gluten containing foods that have been fortified with B vitamins (ie they have had extra B vitamins added). You could just ensure you eat foods that naturally contain vitamins instead!
As long as you focus on eating real food rather than relying on processed ‘gluten free alternatives’, there is really nothing to worry about.
About ‘gluten free foods’
Don’t make the mistake of thinking gluten free foods are necessarily healthy. When you buy any processed foods like breads, pastries, cakes and biscuits, you are in for a long list of ingredients, some of which you may not have heard of before.
The same is true of gluten free processed food.
Gluten free breads are a case in point. Because the gluten in regular flour gives bread it’s unique texture, it’s hard to recreate gluten free, which is why gluten free bread often contains corn starch, rice flour, tapioca starch and potato flour, which are more likely to spike your blood sugar levels, be lower in fibre and cost more than regular bread.
How to go gluten free
If you suspect you have a problem with gluten, the answer is to eat no gluten at all. Don’t reduce it, don’t save it for treats. Because gluten intolerance provokes an immune response, there’s no halfway house. Even more so with coeliac when the merest crumb will make you feel like you were hit by a truck. That means don’t eat any gluten-containing foods and minimise cross contamination with gluten products. The food industry has come a long way in the last few years, developing products and menus that contain no gluten, but you do need to be vigilant.
To start, you might find going zero gluten a struggle, but label checking and spotting cross contamination hazards will soon become second nature. Here are my biggest tips for following a zero gluten diet:
Become an avid reader of food labels. Get to know which food types and which brands contain gluten and, therefore, need to be avoided.
Don’t afraid to say you need to avoid gluten. Real friends will try to accommodate you, and restaurants have an obligation to point out any potential allergens (and remember you are paying for the meal!)
Carry an emergency snack (nuts, seeds, a protein bar) in case there really is nothing else to eat.
Always plan ahead
Hidden gluten
Hidden gluten is found in many processed foods, including sausages and beefburgers, sauces and gravies. Some products, while they contain no gluten-based ingredients, may have been produced in a factory that handles gluten. This means cross contamination is possible (imagine gluten free food surrounded by puffs of normal flour). These are also ideally avoided. This is why oats can be bought as gluten free or regular. Oats themselves contain no gluten but they are often packaged in an environment where other cereals like barley and wheat are processed.
Most restaurants now offer a gluten free (GF) menu and, if not, can often advise on GF options on a standard menu. If something is not listed as being ‘gluten free’, always ask the waiting staff. If they don’t know, ask them to check with the chef. Sauces are one of the things you always need to check. Check chips are not fried in the same oil used for breaded products.
It’s a good idea to call ahead to find out what the GF options are. You’ll soon build up a bank of favourite destinations you
know can cater for you. Pizza Express, Honest Burger, Prezzo and Zizzi now offer a GF pizza base and pasta. Coeliac UK provides a pretty comprehensive listing. They are worth joining. If you follow me on instagram you will find new places I discover, both locally and whenever I travel around the UK. (@wildapplenutritionltd).
Cross contamination
This can happen very easily in any kitchen – including your own. Grills, pans, chopping boards and utensils may still have traces of gluten on them so wash them diligently. Take care if using normal flour as residues can remain in the air for up to 24 hours and settle on counters. Crumbs are another hazard – you’ll want a separate butter or spread you can designate GF. You’ll also want a new toaster or use toast bags to prevent the transfer of crumbs.
For recipes then look at my blog and also follow me on Instagram and facebook @wildapplenutritionltd or book a free call to discuss what to do next. Link here.
My daughter has coeliac disease and I have non coeliac gluten sensitivity (although I am doing a Cyrex test to be sure it’s not coeliac). I really do understand.
Commenti