Beware the quackery if you want to duck out of gluten
THANKS to A-listers such as actress Gwyneth Paltrow and singer Katy Perry (who apparently dedicated her recent hit song The One That Got Away to the pizzas she would never get to eat), you will probably have heard of the joys of a gluten-free diet.
My normal reaction to news of the latest celebrity diet is to dismiss it out of hand. But in the case of gluten – a protein found in grains, such as wheat, barley and rye – I’m not so sure.
I have a personal interest because my niece has coeliac disease, a common autoimmune disease triggered by eating gluten. And my 19-year-old daughter has gone gluten-free, with remarkable results.
Yet I know when it comes to so-called food intolerances there is a lot of misinformation and quackery. So what are the facts?
Coeliac disease occurs when your immune system, mistaking gluten for something dangerous, attacks not only the gluten in the food you’ve just eaten but also the lining of your guts. It can cause abdominal pain, diarrhoea and bloating. But symptoms aren’t always gutrelated. They can include anaemia, bad teeth, fatigue, itchy skin and depression.
And many patients have no obvious symptoms at all, which is why it takes an average of 13 years to get diagnosed, according to British charity Coeliac UK.
About one per cent of us have it and rates have quadrupled in the past 20 years, partly because we’re getting better at diagnosing it, and partly because it’s actually becoming more common.
Undiagnosed coeliac disease is serious because it can lead to osteoporosis (thinning of the bones) and small bowel cancer. It can also cause infertility and multiple miscarriages.
There are also lots of people who respond badly to gluten for reasons we don’t understand. There’s a name for it: non-coeliac gluten sensitivity (NCGS).
Symptoms include cramping, bloating and diarrhoea. Unfortunately, it is hard to diagnose, because there are no reliable tests. Blood tests you get online are, in my opinion, a waste of money. The best way to find out if you have gluten sensitivity is to remove it from your diet for a few weeks and see if your symptoms improve. Then try reintroducing the gluten and see if symptoms return. You may find keeping a symptom diary helpful. There is a free one you can download as cleverguts.com.
So how common are problems with gluten? When Italian researchers recently tested 392 patients complaining of gut problems they thought might be related to gluten, they found that 26 of them had undiagnosed coeliac disease and a further 27 had NCGS. So it turned out that 53 of them, nearly 14 per cent, had problems with gluten.
My daughter Kate tested negative for coeliac disease but at the end of last year decided to put herself on a gluten-free diet. Within days her symptoms – cramps, bloating, ‘brain fog’ and headaches – disappeared.
She left it a few weeks, tried eating pasta, and all her symptoms came back, magnified.
Going gluten-free isn’t easy because so many foods have it in them. Avoid anything with wheat, rye, barley or spelt – that’s most bread, pasta, cereals, cake and biscuits.
You’ll also need to lay off the beer and many processed foods. And be aware that many foods labelled gluten-free are stuffed full of sugar and junk to make them more palatable. You should also be aware that bread and breakfast cereals are often fortified with iron and a range of vitamins, so if you cut them out you may want to take a multivitamin to replace them.
See your GP before starting a gluten-free diet to exclude other things, such as inflammatory bowel disease. Your GP may also want to test you for coeliac disease, because once you go glutenfree, testing will no longer be easy.
As well as gut changes, my daughter has noticed significant changes in mood since altering her diet.
We’re starting to understand how gluten affects the body – but what is still poorly understood is how it affects the brain.
IT’S HARD TO GET A DIAGNOSIS AS THERE ARE NO RELIABLE TESTS