Gluten-free diet: Is it for everyone?

Dubai: Dubai

If you’re swapping your regular food items for gluten-free products with the hope that you’re in tune with the latest diet, think again.

Despite many influencers and celebrities advocating a gluten-free diet, cutting out gluten from your diet might not be the right move for you.

In fact, gluten is only harmful for people with gluten-related disorders, Tanya Van Aswegen, a dietician at Valiant Clinic, told Gulf News.

These include celiac disease, where eating gluten causes the immune system to destroy villi of the small intestine responsible for absorbing nutrients; wheat allergy, which occurs when a person’s immune system reacts abnormally to wheat proteins; gluten ataxia, a rare genetic neurological autoimmune condition; and non-celiac gluten sensitivity, where gluten intake can cause generalised symptoms such as fatigue and gut symptoms.

The issue is many people simply join the queue at gluten-free aisles in the supermarket because it’s the thing to do. Aren’t thousands of people extolling the virtues of gluten-free foods? But ask these good-intentioned souls about what gluten is, and many of them may find it difficult to explain what it really is.

“Gluten is a general name used for proteins known as “prolamins and gluten”, that is found in wheat, rye, barley and triticale. It helps foods maintain their shape, acting as a glue that holds food together,” explained Aswegen.

A gluten-free diet is one that strictly excludes these proteins found in foods such as food colouring, soups, breads, pastas and cereals, among others.

Contrary to what is being circulated in social media, science shows that most healthy people do not have to avoid gluten.

“In actual fact, if you have an undiagnosed underlying condition related to gluten, such as celiac disease, putting yourself on a gluten-free diet without seeking medical help can make diagnosis very difficult and it could be detrimental to health,” said Aswegen.

She said gluten is associated with wheat and whole grain products that have a lot of benefits when it comes to heart health, controlling blood sugar levels and cholesterol and providing most of our B vitamins and fibre. Gluten can also act as a “pre-biotic” that feeds the good bacteria in our gut.

Many people also mistake a gluten-free diet for a low carb diet, which has been trending the last couple of years.

Sushma Ghag, dietician at Aster Hospital Mankhool, explained that wheat has been assumed to cause weight gain.

“Certain weight loss or crash diets that require to exclude whole grain cereals from an individual’s diet assume that carbohydrate-rich foods are weight inducing. This is the major cause for the increase in people’s fondness for gluten-free food,” she said.

Along with more people going gluten-free and opting for the so-called ‘healthier food options,’ sales of the gluten -free foods have also increased exponentially despite many gluten-free products being highly processed. Generally, the endorsement of food trends by celebrities and the public perception that a gluten-free diet may improve non-specific gastrointestinal problems has also contributed to the growing trend.

“The biggest risk of going gluten-free is missing out on essential vitamins and nutrients from a balanced diet. Avoiding gluten from your diet may also increase the risk of suffering from heart diseases, stroke, and development of diabetes, hyperlipidemia, and other possible nutrient deficiencies,” said Ghag. She confirmed that the consensus is that only people that have been diagnosed with one of four conditions should be avoiding gluten — “unless you are gluten intolerant, there really is no need to go gluten free”.

Warning signs

When it comes to warning signs, there is a lot of overlapping and non-specific symptoms to gluten-related disorders. These include bloating, chronic diarrhoea and/or constipation, pale and foul-smelling stool, nausea and vomiting, fatigue, brain fog, depression, headaches, joint pain, canker sores in the mouth, and skin rashes. Serious conditions such as anaemia (low red blood cell count related to iron or folate deficiency), osteoporosis (decreased bone mass) or infertility might be present, said Aswegen. In children, however, restricted growth and delayed puberty onset could also be a symptom.

Those diagnosed with a gluten-related disorder have to be on a lifelong strict gluten-free diet as the introduction of gluten has significant detrimental effects on their health.

However, those suffering from non-celiac gluten sensitivity need to work with their dietician to determine what their threshold for tolerating gluten is. “As there is no laboratory diagnosis for this disorder, measuring improvement is mostly subjective and some people who are sensitive to gluten might have been able to tolerate a small amount of gluten in their diets,” said Aswegen.

People with perceived non-celiac sensitivity, could actually be sensitive to fructan (a short-chain carbohydrate that forms part of a group called FODMAPs or fermentable oligosaccharides, disaccharides, monosaccharides and polyols) and not necessarily the gluten in food.

These FODMAPs are fermented in the colon and can exacerbate symptoms in people with irritable bowel syndrome (IBS) or sensitive digestive systems.

Are you intolerant to Gluten?

If you suspect you have problems with gluten, seek help from a gastroenterologist and dietician who can do the correct diagnostic tests and/or elimination diets.

Medical tests, blood tests, gut biopsies and skin allergy prick tests are available to diagnose celiac disease and wheat allergy.

Symptoms of celiac disease can range from mild to severe and may include swelling or itching of the mouth or throat, skin rash, hives, itchy eyes, shortness of breath, nausea, diarrhoea, cramps, and anaphylaxis.

A doctor and dietician will look at a connection between your symptoms and gluten intake, often by doing a gluten elimination diet, guided reintroduction, and a food symptom journal to determine if you suffer from non-celiac gluten sensitivity.

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