Should you avoid gluten?

Gluten is in a lot of things we eat, from bread and pasta, to cookies, pastries and even drinks like beer. It’s been a staple for thousands of years but, along with turning vegan, going gluten free has been one of the biggest health trends in the last decade and is almost as divisive. Some claim gluten is damaging their health. Others argue that we are at risk of nutritional deficiencies if we don’t eat it. So what’s the truth?

Like so many things these days, when there is a lot of information and opinion, the waters can become muddied and it’s not always easy to separate fact from fiction. I thought I’d explore the topic so you can decide whether going gluten free is best for you.

What is gluten is and where you’ll find it

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

Kamut

Semolina

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.

Symptoms range from digestive distress like diarrhoea, cramping and nausea (among others) to anaemia, neurological disorders and skin diseases like psoriasis and dermatitis.

Testing for coeliac disease is by intestinal biopsy, usually when the condition is very advanced. There are a few specialist tests not available on the NHS [amend to suit your location] that I can offer clients and that can spot problems before you become very poorly. Email to ask me about this.

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.

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

As some of you know, I have coeliac. After suffering from asthma, hay fever and severe eczema for many years, I was finally diagnosed after having lost 8kg in a short time and suffering diarrhea several times per day. At that point my brain fog was bad and led me to having finish work earlier and I spent most of my weekends sleeping as I was so exhausted. As you can imagine, it took many years to recover.

I see a lot of autoimmune clients in my nutrition clinic, including coeliac, Hashimotos and psoriasis and one of the first things I ask them to do is cut out gluten due to the inflammation gluten creates in the body.

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. That means don’t eat any gluten-containing foods and try to 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.

1. Become an avid reader of food labels. Get to know which food types and which brands contain gluten and, therefore, need to be avoided.

2. 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!)

3. Carry an emergency snack (nuts, seeds, a protein bar) in case there really is nothing else to eat.

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.

Eating out

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. Svenska Celiakiförbundet have a lot of information and can also support with little cards to show staff in several languages. Handy when you travel!

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.