Focus on gluten

About one in ten people avoid gluten in their diet because they have coeliac disease, believe a gluten free diet is healthier or may help to relieve common gut symptoms such as abdominal pain and bloating. Alongside the increasing number of people that avoid gluten there has been a recent 27% rise in sales of gluten free products with everything from gluten-free beer to gluten free pasta appearing on supermarket shelves.

What is gluten?

Gluten is a protein found in three cereals wheat, barley, and rye.

Which foods contain gluten?

Wheat, barley, and rye are cereals are used as an ingredient in a wide range of foods including bread, pasta, breakfast cereals, flour, pastry, pizza bases, cakes, soups, sauces, ready meals, and sausages.[1]

Do oats contain gluten?

Oats contain avenin, a protein like gluten. Research has shown that most people with coeliac disease can tolerate gluten free oats with no problems. Sometimes oats are produced in the same factory as wheat, barley, and rye, and become contaminated so the oats cannot be certified as ‘gluten free’.

What problems does gluten cause if it is eaten?

About one in one hundred people have coeliac disease. Coeliac disease is a serious illness where the body’s immune system attacks its own tissues when gluten is eaten. This causes damage to the lining of the gut and means the body can’t absorb nutrients from food. Coeliac disease is not an allergy or a food intolerance, it is an autoimmune condition.

What are the symptoms of coeliac disease?

The most common symptoms are diarrhoea, food not being absorbed properly, abdominal pain, bloating and other more general symptoms like fatigue, weight loss or an itchy rash.

How is coeliac disease diagnosed?

Testing for coeliac disease involves having:

• blood tests for antibodies
• a biopsy to confirm the diagnosis

Can gluten cause symptoms in people who do not have coeliac disease?

Some people may be sensitive to gluten but do not have coeliac disease. This is called non-coeliac gluten sensitivity. The symptoms of non-coeliac gluten sensitivity can be like those of untreated coeliac disease however the two conditions are different. With non-coeliac gluten sensitivity, it is not clear if the immune system is involved and there does not appear to be damage to the lining of the gut.

Gluten sensitivity

Non coeliac gluten sensitivity is a new area of research. There are no specific diagnostic tests for non-coeliac gluten sensitivity and some debate around whether gluten is the cause of the sensitivity or other components are to blame. These components are also removed from the diet when gluten containing ingredients are removed, for example Fermentable Oligo- Di- Mono-saccharides and Polyols (FODMAPs) and other non-gluten proteins found in wheat.

What should you do if you think you are sensitive to gluten?

If you experience symptoms after eating foods that contain wheat, barley, rye or oats it’s important to rule out coeliac disease. You can check if your symptoms are related to coeliac disease by taking the online assessment devised by Coeliac UK . This will advise whether you should consult your GP for further tests. Please note it is essential to keep eating gluten for the tests to work.

If you get a negative test result for coeliac disease and other causes of your symptoms have been ruled out, you might wish to discuss the possibility of non-coeliac gluten sensitivity with your GP.

Are gluten free diets healthy?

A carefully planned gluten free diet can provide all the nutrients required for health. For more information on how to plan a nutritious gluten free diet see the links below.

For more information on gluten free diets and coeliac disease

Coeliac UK www.coeliac.org.uk

NHS Health A-Z www.nhs.uk (Search coeliac disease)

[1] Gluten is not absorbed through the skin so any traces in cosmetics or other household products should not cause a problem. Always check food labels for gluten if you need to exclude it from your diet.