Baby and You

Increasingly, people are now opting to avoid gluten because they believe it’s healthier or it adversely affects them in some way. Although a small number of people need to avoid it, is it wise for others to simply go ‘gluten free’? Duane Mellor digs into the truth

What is Gluten?

There’s a lot of chatter on social and mainstream media about gluten. In fact, if you type ‘gluten is…’ into Google you get the automated responses of ‘…bad’ and ‘…good for you’, so which is true? To understand these questions, we need to know what gluten is and how many people have a real health related issue with it.

Gluten is the group name for a complex mix of storage proteins that are found in grains. Strictly speaking, it’s mainly the proteins found in wheat called gliadin and glutenin. Other grains also contain very similar proteins such as secalin in rye, hordein in barley and avenins in oats and they are all often called ‘gluten’. However, Coeliac UK suggests that although the avenins in oats are similar to gluten, they classify gluten as being limited to wheat, barley and rye. These proteins have an important function in baking and food production and are what allow shortbread to crumble and bread to rise and hold its shape.

Is gluten bad?

Why is there concern about gluten being ‘bad’ for us? Firstly, there’s a small proportion of the population who have a condition where gluten leads their own immune system to attack the lining of their small intestine. This is called coeliac disease and is linked to poor absorption of nutrients, iron deficiency anaemia, increased long term risk of osteoporosis and some cancers of the intestine. A condition related to coeliac disease is a skin complaint known as Dermatitis herpetiformis, and this can also occur in people with coeliac disease.

Other people who also report reacting to gluten in food may have what is called ‘non-coeliac gluten sensitivity’. Other people choose to eat gluten-free foods to reduce intake of substances such as fructans in bread as these can trigger Irritable Bowel Syndrome – also known as IBS. Increasingly however, some people avoid gluten simply because they believe it’s healthier or it adversely affects them in some way.

If you do experience symptoms of bloating, diarrhoea and/or fatigue that you think are associated with eating gluten, then it’s important that you visit your doctor. Your doctor will be able to refer you for the appropriate tests to identify the problem and to diagnose or rule out coeliac disease. Then, if you need to adjust your diet, seek a referral to a dietitian to get personalised dietary advice. This will help you eat a healthy diet whilst removing gluten containing foods and minimising your risk of possible nutritional deficiencies.

Who needs to eat gluten-free?

Coeliac UK suggest that about one person in a hundred have coeliac disease and they need to eat gluten-free. However, around 60 per cent of UK adults have bought gluten-free foods and 10 per cent of households have someone who believes gluten is bad for their health living there.

“Around 60 per cent of UK adults have bought gluten-free foods„

Why is gluten thought to be bad?

Perhaps the name doesn’t help? Perhaps it can sound like gluttony? This, along with the rise in popularity of low-carbohydrate diets, are some of the reasons that have led to a false linking of gluten to weight gain.

Unless you have coeliac disease, the proteins in food are simply broken down like other proteins to amino acids and then digested. The average British adult gets 11 per cent of their daily protein from bread alone, with a similar amount of several B vitamins, iron and calcium. Gluten containing foods make a considerable contribution of nutrients to our diets and so should not simply be eliminated from our diet.

Can gluten be good for us?

Recent research published from Harvard University has suggested that people who follow a low gluten diet are more likely to develop heart disease. This research, based on the big population studies of health professionals in the United States, found that people who ate more gluten in their diet, were 15 per cent less likely to have heart disease than those eating the least. This appears to suggest that eating foods containing gluten may reduce risk of these chronic conditions. However, the real reason may be that wholegrain foods have been linked with reducing risk of heart disease and it’s nothing to do with gluten. Another reason is that in this study, people who ate low levels of gluten may or may not be doing this deliberately, so their diet may not be as nutritious. In essence, it’s impossible to say that the gluten itself offers any protective benefits, but on the other hand, food containing gluten may also contain many other beneficial nutrients.

“10 per cent of households have someone who believes gluten is bad for their health living there„

Eating healthily without gluten

Avoiding gluten is essential for people with coeliac disease and those with medically diagnosed gluten sensitivities. If you, or one of your friends or relatives, are one of these people, it’s perfectly possible to eat a healthy gluten-free diet which can also reduce the risk of developing heart disease.

For example, here’s what you get from wholemeal bread:

Screen Shot 2017-10-23 at 12.21.23

A great start is to choose gluten-free cereals that have been fortified with B vitamins. Then include other foods that provide protein and calcium, such as dairy produce, pulses and seeds. To ensure enough fibre is in your diet, eat plenty of fruit, vegetables and pulses. If you can tolerate oats, then include uncontaminated oats (those grown, milled and processed away from other grains) which provide a valuable source of fibre and other nutrients.

If you need to follow a gluten-free diet, it’s important to look for all sources of gluten in the diet. Gluten can often be found in thickeners for sauces, ready-made foods and even in mixes of herbs and spices. It’s also important to be aware of contamination. For example, toasters may contain crumbs of gluten containing bread, so take care when eating bread that’s been toasted when you are staying away from home.

Reading the food label when out shopping can be a great help. In Europe, 14 allergens must legally be labelled in bold if a food contains them and, fortunately for people wishing to avoid gluten, cereals containing it must be labelled. Coeliac UK also provides information on gluten-free foods both online and on an app you can download onto your mobile phone.

So how can you spot gluten on a label? According to the law, ‘cereals containing gluten’ must be stated as one of the 14 identifiable allergens that are labelled on packed and non-packed foods. This is part of the Food Information for Consumers Regulations which came into force in 2014.

Foods containing one of the 14 allergens must be labelled either in bold within the ingredients and/or underneath stating it contains barley, rye or wheat for example. It cannot be listed as ‘contains gluten’ and must use the name of the cereal itself.

The risk of cross contamination through manufacture in environments where cereals containing gluten are used may also be listed, in this case it could say ‘may contain’. This is not a legal requirement, but many manufacturers label their foods in this way to alert their customers. The example above is from the Food and Drink Federation. In this case, the allergen containing gluten is listed as wheat.

On a final note, if you think you have a problem with gluten, it’s important to get it diagnosed properly by visiting your GP who will refer you to the appropriate consultant if necessary. Dietetic support is vital as a dietitian can help you remove gluten from your diet and include foods that ensure your diet is balanced. They can help you choose foods that provide the nutrients that may be missing when you simply eliminate foods containing gluten. Just because a food is gluten-free, it doesn’t mean it’s healthier!

References available upon request.

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Duane Mellor is an academic dietitian and nutritionist. He has worked in universities both in the UK and Australia. Currently he leads the Nutrition and Health degree at Coventry University.

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