A gluten-free diet aims to avoid gluten — the protein component of a number of grains including wheat, oats, triticale, rye and barley. These grains are commonly found in foods such as cakes, bread and pasta, but many processed foods can also include ingredients from a gluten source. If you’re on a gluten-free diet, you need to be ‘ingredient aware’ and should read food labels carefully to avoid products which may include gluten.
Although gluten-containing foods are a normal part of many people’s diets, around one percent of Australians have a condition called coeliac disease which can make them sensitive to eating gluten.
When people living with coeliac disease eat gluten, their immune system overreacts, damaging the lining of the small intestine over time. This can interfere with their ability to break down and absorb nutrients in food, often leading to reduced absorption of necessary nutrients.
This can lead to serious consequences. Besides causing symptoms like fatigue, stomach cramps and diarrhoea, untreated coeliac disease can result in deficiencies in important nutrients like folate and calcium, reproductive problems such as infertility and miscarriage and may increase the risk of osteoporosis and some cancers.
However, you don’t have to have coeliac disease to have a problem with gluten. Some people have symptoms similar to coeliac disease such as bloating, wind and vomiting but without the same damage to the intestines. This type of gluten intolerance appears to be increasing but the reasons for this aren’t clear. Some experts suggest it may be due to changes in how food is now processed, or that there may be more gluten in a contemporary Western diet.
While the exact cause of coeliac disease is unknown, it seems both genetic and environmental factors are involved. Many people with coeliac disease don’t realise they have it. If you suspect you have a problem with gluten, there are good reasons to see your doctor first.
The symptoms of coeliac disease are similar to those of other conditions, so an accurate and correct diagnosis requires evidence showing the small intestine lining is damaged. Your doctor can refer you to a medical specialist and arrange for the appropriate tests such as a small bowel biopsy. If you’re being investigated for coeliac disease, it’s important that you don’t go gluten free on your own as it can affect the accuracy of the tests and the diagnosis.
Self-diagnosing a problem with gluten and avoiding grains containing gluten can leave you short on important nutrients. Although going gluten free on your own may help to repair the bowel, it may also make the disease causing the problem hard to detect and prevent you from getting the best treatment for you. Speak to your doctor first to reach an accurate diagnosis. They may refer you to an accredited practising dietitian specialising in the treatment of food intolerance or coeliac disease to help you manage your symptoms and your condition.
There is currently no known cure for coeliac disease, but it can be managed with a gluten-free diet. If you have been diagnosed with coeliac disease or a gluten intolerance, you need to know what foods to avoid, and what foods to replace them with to make sure you get all the nutrients you need.
Apart from obvious foods such as bread, cakes and pasta made from grain products containing gluten, other processed products such as battered or crumbed meats, dairy products, canned vegetables, condiments, sweet and savoury snacks and even alcoholic drinks may also contain ingredients from gluten sources.
However, you can still enjoy an interesting and varied diet, and there are now more gluten-free products available. These include bread made with soy flour, rice flour and buckwheat, and pasta made with gluten-free ingredients. Other good options include rice, brown rice, rice noodles, polenta, buckwheat, amaranth, lentils and quinoa.
But just because a food says it’s gluten-free doesn’t always mean it’s healthy — like any other processed foods, some gluten-free products are also high in sodium and saturated fat. Many of them are also low in fibre — so always check the nutritional information on the label.
And remember, you should talk to your doctor or accredited practising dietitian before you make any major changes to your diet.
The Coeliac Society http://www.coeliacsociety.com.au/
Better Health Channel. Coeliac disease. [online] Melbourne, VIC: State Government of Victoria. c1999-2010 [updated Oct 2008, accessed 4 Aug 2010] Available from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Coeliac_disease_and_gluten_sensitivity
Better Health Channel. Gluten-free diet. [online] Melbourne, VIC: State Government of Victoria. c1999-2010 [updated Aug 2009, accessed 4 Aug 2010] Available from: http://www.betterhealth.vic.gov.au
myDr. Coeliac disease. [online] St Leonards, NSW: UBM Medica Australia. c2000-2010 [updated 2 Dec 2009, accessed 4 Aug 2010] Available from: http://www.mydr.com.au/gastrointestinal-health/coeliac-diseaseTop of page
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Last published 31 October 2010