Is gluten the problem? How to tell and what to do about it
Gluten, found in wheat, barley, rye, spelt, and some other grains, is a protein which has an elastic-like quality to it. Think of kneading bread; gluten can be difficult to digest due to its structural makeup. The body has to work hard to break it down so it can be digested and absorbed without causing issues.
Lots of people have trouble digesting gluten, so let's look at some of the reasons why.
Coeliac disease is a condition close to my heart. Over the years I've learned so much about coeliac disease, as my partner had a diagnosis. I was already following a predominantly gluten-free diet, but I didn't realise just how important avoiding any form of gluten and even any gluten contamination was. It really opened my eyes and I became quite passionate about educating people about the disease. As a lot of people follow a gluten-free diet, it can be seen as 'fussy' or 'faddy', but I will clear up that this is 100% not the case. It's a very serious, often misunderstood and misdiagnosed disease! As with all diseases, symptoms and severity of the reaction varies from person to person.
Non-coeliac gluten sensitivity (NCGS)
I thought this was important to address because it's a fairly new phenomenon that's come to light, and it affects people who are neither coeliac or allergic to wheat. As previously mentioned, coeliac disease is a specific condition with set markers and tests, and it is an autoimmune disorder. NCGS differs greatly, as outlined below.
Are you testing negative for coeliac disease yet still having unexplained symptoms? In particular, those symptoms not related to the digestive system are common here, for instance:
- brain fog
- joint pain/muscle aches
- behavioural disturbances
*GI symptoms can still be present and are common.
These could all point to NCGS, but coeliac disease needs to be excluded before you cut out gluten. In simple terms, NCGS occurs when you feel better/have relief of symptoms when you avoid eating gluten, but feel worse on reintroduction. You do not have coeliac antibodies, and biopsies have come back clear. The exact mechanisms of action at play are not the same as in coeliac disease (an autoimmune disorder), and are not completely understood, but they are valid and warrant further research.
Some theories include an immune-mediated hypersensitivity reaction, reactions to FODMAP foods, and poor digestibility of gluten. There is currently no test for NCGS, but it is rather a process of excluding coeliac and wheat allergy, as well as IBS or any other pathologies that could potentially be at play.
Why removing gluten isn't always enough
I'm talking about something called coeliac cross-reactivity. It's about proteins in other foods (usually grains or grain-like foods) which are structurally or molecularly similar to gliadin, the protein which causes a reaction in coeliac disease. The body has produced antibodies that set off an inflammatory response on the ingestion of gliadin, and this can happen with similar proteins that the body mistakes as gluten, for example:
- oats - although gluten-free, they contain avenin which is structurally similar to gluten
Dairy is slightly different, so I'll cover that in another post.
Some people will be more sensitive to cross-reactivity than others, and some won't find it to be an issue at all. It depends on the individual. If you are experiencing symptoms or are just not feeling that great following a gluten-free diet, and you are coeliac, cross-reactivity may be something to consider. Work alongside a practitioner to explore this further and to guide you to safely alter your diet. As usual, working on gut health and repair is imperative.
Why gluten-free products aren't necessarily the best alternative
I'm mainly talking about the 'free-from' alternatives you find in supermarkets, especially bread, although a lot of products in supermarkets, free from or not, are overly processed with too many ingredients these days, but that's another story.
Most gluten-free products are based on:
- potato starch
- sugar under the guise of lots of other names
They are looking to replace the elasticity found in gluten, making it supple and fluffy, which requires a lot of strange ingredients and processing. In addition, they need to ensure shelf life, which comes with a concoction of chemicals too.
Better alternatives are to make your own bread and freeze it, taking slices when you need it. Also seek out products such as pasta that are not in the free-from section, e.g. red lentil and chickpea pasta, which consists of one real food ingredient, and is found with the wheat pastas. Another good option is something like 'vegbred' made from a few simple ingredients.
Seven top tips for avoiding gluten
- Avoid the free-from section for 'replacements', with the exception of pure gluten-free oats and things like tamari.
- Stick to fresh produce including herbs, whole cuts of meat and fish, nuts, seeds, oils, canned beans and pulses, chopped tomatoes, some pastes and condiments, herbs and spices, frozen fruit and veg, products with as few ingredients as possible e.g lentil pasta, and eggs; all real food.
- Instead of bread, gluten-free oatcakes and wholegrain rice cakes can make an easy alternative on the go.
- Make your own bread and dough for things like pizza.
- Source products like buckwheat, gram, tapioca, coconut, and almond flour from a health food store or good supermarket, and keep these as staple replacements for making dough.
- Cook from scratch as much as possible.
- Check labels... if you don't know what you're reading, your body won't recognise it either.