Do you need a Gluten free diet?

During my practice, I often see patients who have been on gluten exclusion by themselves, for one reason or the other. And many have wondered if this is even needed.

So to help you gain some understanding, and decide what you can do if you ever find yourself confused, between eliminating from your diet or not, I have put some brief info together.

Hope you find it helpful 🙂

What is gluten?

Gluten is a plant protein that is found in Wheat, Rye and Barley. This is made up of proteins, Gliadin and Glutenin. However, Oats do not have gluten but has a similar protein, called Avenin.

Is gluten important?

Gluten is an important part of cooking, especially baking. It tends to offer elasticity and texture to the dough. So, if you have tried gluten-free bread, you know what I am talking about 🙂

But more importantly, it acts as a prebiotic helping feed and builds our gut microbiome.
Many of the foods containing gluten, are a good source of fibre that is not only beneficial for our ‘daily business’ but also great for our gut health.

Let’s bust some Myths about the gluten-free diet :

1: Gluten-free diet is healthier :

This is not true. Many people associate gluten with bread, pasta etc and think that cutting gluten out of diet would make the diet healthier.
However, it is more important is making healthier dietary choices, incorporating varied dietary components, and not eliminating dietary components like gluten from your diet. Gluten-containing products also provide good fibre and eliminating it actually does you more harm than good.

If you think you are having a large quantity of bread etc, think about reducing your portions of carbs like bread, pasta instead of cutting it out and increase intake of fruit, veg and lentils.

2: Gluten-free diet is good for weight loss:

There is not much evidence around this. Several times people notice weight loss after eliminating or reducing gluten from the diet is due to this having an impact on the actual portions and frequency of eating foods high in gluten like bread, pasta etc creating a calorie deficit and has nothing to do with the actual elimination of gluten.

3: Gluten-free diet is good for eradicating digestive symptoms :

This is not always true. Gluten is part of one of the Fermentable carbohydrates called Fructan. That acts as a prebiotic for our good bacteria in the gut. Avoiding it unnecessarily may have an impact on our gut microbiome.
Fructan can in some people, especially with IBS cause digestive symptoms, but it is always advised to be excluded under the guidance of a dietitian.

Risks associated with Unnecessary Gluten Avoidance

Currently, 3.7% of the UK population avoid gluten with only 0.8% being clinically diagnosed with coeliac disease.

Bread is a staple food in many countries, in the UK it is responsible for providing up to ;
• 12% of energy requirements
• 20% carbohydrate requirements
• 12% protein requirements
• 21% fibre requirements

Bread is also low in saturated fat, sugars and since it is fortified it is a source of calcium, manganese and B vitamins (thiamine). This is similar to cereals and cereal products as they are responsible for >40% of fibre intake in the UK among important minerals like iron and calcium.

As gluten-containing food provides so many macronutrients and micronutrients in the UK diet, unnecessary avoidance without appropriate support could cause dietary problems through possible deficiencies. Studies have also found that avoiding gluten can lead to a higher intake of fat and salt intake.

Gluten-free diets have also been found to be more expensive, creating a dent in your pocket.

Gluten is a part of a Fermentable carbohydrate called Fructan and its long-term unnecessary exclusion can have an impact on your good bacteria, affecting your gut health.

Who needs a gluten-free diet?

A gluten-free diet is indicated for people with coeliac disease or non – coeliac gluten hypersensitivity. These are to be diagnosed and advised only by your doctor and dietitian.

Symptoms of the Coeliac disease :

• Diarrhoea
• Bloating
• Indigestion
• Stomach pain
• Constipation
However, it can occur with no symptoms being present at all.

Untreated coeliac disease can cause also prolonged poor nutrient absorption which in turn can lead to:

• Iron-deficiency anaemia
• Osteoporosis
• Intestinal cancer (although this is fortunately very rare)

Having tummy troubles and suspect coeliac disease/gluten sensitivity?

Please don’t cut gluten out until you’ve been tested for coeliac disease.

Around 500,000 people in the UK alone are thought to be living with undiagnosed coeliac disease – so if you think that might be you, here are 2 things worth knowing…

1. If you’re getting tested for coeliac disease, it’s super important to keep including gluten in your diet until the test is done. Otherwise, it’ll be inaccurate.

How much do you need for an accurate test?

The golden rule is to eat 10g gluten a day for at least 6 weeks before the test – that’s about 4 slices of wheat-based bread.

2. Gluten-free doesn’t necessarily mean wheat-free and vice-versa.

Gluten can be removed from wheat, but leaving other wheat proteins – and gluten is in other grains too, such as rye and barley.

Conclusion :

So, remember, unless you have been diagnosed with coeliac disease or another kind of gluten intolerance (diagnosed by your GP or a registered dietitian – not a random home test kit!), cutting out gluten-containing whole grains may do more harm than good. Remember INCLUSION not EXCLUSION.

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