Should you be gluten free?

Wheat has been a staple of the human diet for around 9000 years. Yet more and more people are choosing to avoid gluten: as evidenced by the explosion of “free-from” products available in the supermarkets! When asked why they choose to avoid gluten, proponents often claim that they feel better for it, or simply that they feel it is a healthier option. On the other hand, dieticians and doctors tend to look unfavourably on such practice unless a person has a demonstrable gluten intolerance. So, should you be avoiding gluten?

Why gluten can be a problem

The term gluten refers to a particular subset of wheat proteins, which give wheat dough its elasticity and chewy texture. During digestion, the wheat protein is broken down into a variety of smaller chemicals but in the case of the gluten component, their particular structure makes them difficult to digest. Some of these digestion-resistant molecules cause adverse reactions in certain people.

The most well known problem is coeliac disease, in which the body mounts an immune attack against gluten. Normally, the lining of our intestines play an active role in determining which substances pass through to the bloodstream. To prevent any large molecules from passing through, the cells that line the small intestine are closely packed together with only tiny gaps between them (these gaps are called tight junctions). If these tight junctions become damaged or open up, it may allow larger substances and even bacteria in the gut to cross into the bloodstream where it can trigger an immune response. One element of gluten, gliadin, appears particularly adept at opening up the tight junctions and especially so in people with coeliac disease. When this phenomenon was first discovered, it was thought that gluten had this effect only in those with coeliac disease but it was later found that gluten can open up the tight junctions to some extent in everyone. Read about why this phenomenon can be a problem for health here.

Apart from coeliac disease there are other gluten-related reactions, such as wheat allergy and non-coeliac gluten sensitivity.

Not just gluten

Wheat (and indeed other grains) contain many plant chemicals that have the potential to cause us problems. While gluten is the most well known, we should also consider the effects of some other components of wheat that may affect health: wheat germ agglutinin, enzyme inhibitors and fructans. Discover more about these different components and why they could be harmful to health here. Some experts feel that people who suffer reactions to wheat may not be reacting to gluten but to one or more of these other components.

Signs you may have a problem with wheat

Reactions to gluten and wheat can manifest as gut issues and/or problems outside the gut. Here are some potential symptoms:

  • Nausea

  • Bloating

  • Heartburn

  • Diarrhoea

  • Constipation

  • Smelly faeces

  • Abdominal pain

  • Headaches

  • Skin rashes

  • Exercise-induced asthma

  • Wheezing

  • Nasal congestion

  • Fatigue

  • Brain fog

  • Depression

  • Anxiety

  • Anaemia

  • Tingling in hands and feet

  • Infertility

  • Joint or muscle pains

  • Weight loss or weight gain.

This is a long list! So should you be going gluten or at least wheat free if you experience any of these? A trial of 4-6 weeks without gluten could be a good idea. This is long enough to see whether you notice any differences. After this trial elimination period, reintroducing some gluten containing foods will further help you to identify if wheat is an issue for you. Before you embark on this course, though, it’s best to keep a food and symptom diary for 2 weeks without changing anything in your diet. Remember that there could be a delay between eating a problem food and any symptom! Bear in mind too, that for many people it is a question of how much gluten is consumed: do you get symptoms on days you have particularly large amounts of wheat/gluten? Any food elimination and reintroduction experiment is best done with guidance from a nutrition expert to ensure that you do not suffer any nutrient deficiencies from avoiding gluten and also to help you identify if gluten or other components of wheat may be responsible for your symptoms.

Downsides of a gluten free diet

Gluten free foods have been shown to have a poorer nutritional profile compared with gluten-containing products, with trans-fat content; lower level of proteins; and vitamin and mineral levels, especially folate, calcium, iron, magnesium and zinc. Gluten free substitute products can be much more expensive than their gluten containing counterparts. The gluten-free foods in the “Free-from” aisle of the supermarket consists mainly of high processed foods which oftentimes have more additives that are required to replace the elasticity and chewiness that gluten confers. Some of these additives, such as emulsifiers and thickeners have been found to adversely affect the lining of the gut and alter the balance of the gut bacteria. Gluten-free junk food is still junk food!

Is there a middle ground?

Many people find they can tolerate some forms of wheat or some gluten containing foods but not others, or that they can cope with small amounts of wheat.

Today’s world is full of wheat! Wheat-based cereals for breakfast, muffins with coffee mid-morning, a sandwich at lunchtime, biscuits with tea in the afternoon, pasta for our evening meal perhaps followed by more biscuits? That’s a lot of wheat! Why not try reducing the load? Perhaps you might avoid sandwiches for lunch if you are having pasta for dinner (or the other way around), choose a non-wheat based breakfast?

Slow fermentation of bread dough as is the case with authentic sourdough can be better tolerated than the standard breads. Supermarket bread is only fermented for an hour or so, compared with up to 3 days for genuine sour-dough. Longer fermentation affects several aspects:

  • The amount of gluten is lower in longer-fermented breads

  • The wild yeast and lactobacillus in the sourdough starter neutralise the phytic acid as the bread proves through the acidification of the dough.

  • The action of yeast and bacteria (in sourdough) can increase the vitamin content of the bread.

For tips on how to go gluten free, see the next post in this series.