First, what exactly is gluten?
Gluten is a protein – it’s the ‘glue’ that produces the dough-like consistency of gluten-containing grains. It’s made up of gliadin and glutenin, and it’s gliadin that causes problems for people who are either allergic, intolerant or sensitive to gluten. Gluten is present in wheat, including foods like spelt, durum, kamut, farro, bulgur, semolina, barley and rye.
Why do people go gluten-free?
Usually because they have one of two medical conditions; coeliac disease or gluten intolerance. Coeliac disease is an autoimmune condition and a serious allergy to gluten. Gluten intolerance, meanwhile, happens when gluten acts as an irritant to the gut. It’s estimated 8.5 million people in the UK have gone gluten-free yet around 2% are genuinely intolerant to gluten. Moreover, a recent study found 86% of people who believed they were sensitive to gluten could actually tolerate it.
What are the key signs of a gluten intolerance?
As nutritional therapist Yasmin Alexander explains, the signs of a gluten intolerance aren’t always clear-cut. “You could experience an array of symptoms – some may be gut-related, including bloating, increased gas or changes in bowel movements, while others could be seen elsewhere in the body, such as the skin, affecting airways, muscles and joints. You may suffer from headaches and fatigue, too,” she says.
How do you know if you are intolerant?
As Yasmin advises, the most reliable way to test for a gluten intolerance is through an elimination diet. “You need to keep a detailed food and symptom diary for at least two weeks to try and identify patterns related to gluten consumption. After two weeks, restrict any foods containing gluten for a further two to six weeks, depending on how regularly you see symptoms. It’s important to reintroduce gluten too, to understand where your level of tolerance lies. You may be able to handle one slice of bread, but pushing it to two or three may trigger symptoms,” she says.
What causes a gluten intolerance?
Yasmin believes it could come down to your genes. “There is certainly evidence to show certain genes increase the risk of developing coeliac disease, so there may be some genetic involvement with intolerances, but studies have yet to prove this,” she explains. Yasmin also says intolerances could be linked to IBS and poor gut health, or could be down to an enzyme deficiency. Nutritional therapist Nicola Moore believes our modern lifestyles are to blame. “Gluten now features more heavily than other grains in our weekly food consumption – it’s not uncommon to eat toast for breakfast, a sandwich at lunch and pasta for dinner. This gluten overload could be at the root of increased levels of intolerance. Plus, we are now more exposed to gluten than ever before, which could trigger an intolerance. Food processing has also changed, especially in bread making, meaning additional gluten is added to countless items.”
Lots of nutritionists say everyone who cuts out gluten feels better – why is this?
“Gluten, along with dairy, is one of the most common food groups a nutritionist will advise you to cut out if you are suffering with intolerance-related symptoms,” says Yasmin. “If you think about the types of foods you would be avoiding when removing gluten, this tends to include bread, pasta, cakes, biscuits, pastries and other baked goods, so cutting these out and replacing with a more nutrient-rich diet will instantly make you feel better.” Yasmin also explains that many gluten-containing foods also contain fermentable carbohydrates (FODMAPs), which are notorious for triggering gut-related problems. Interestingly, research points to confusion of gluten intolerance and a FODMAP sensitivity.
Are there any risks to following a gluten-free diet?
If going gluten-free is your way of avoiding carbs or a self-diagnosis for symptoms, it’s worth knowing a gluten-free diet isn’t always healthier. For example, the gluten-free diet is typically low in fibre, iron, B vitamins and other essential minerals. It can also be higher in sugar, salt and fat with gluten-free breads, cereals and snacks often bound together with excess fat to mimic the gluten ‘glue’. A gluten-free diet can also reduce the diversity of your gut bacteria, taking its toll on your gut, and thus overall, health.
What’s the bottom line?
If you think you’re sensitive to gluten, get tested for coeliac disease – the experts say it’s a serious condition that is almost certainly underdiagnosed. And if you don’t have coeliac disease but are still experiencing its symptoms after eating gluten-containing foods, your problems could be a result of FODMAPs, not gluten sensitivity. Some experts say simply reducing FODMAP intake is a much healthier and less restrictive way to improve gut-related symptoms.
For more information on coeliac disease and gluten sensitivity, read the official NHS advice.