THE GLUTEN DEBATE - Should non-coeliacs go gluten-free?

THE GLUTEN DEBATE - Should non-coeliacs go gluten-free?

Few topics in nutrition have polarised opinion in recent years as much as the debate over gluten. Some argue that removing gluten from your diet is the answer to a long list of ailments, whilst others think that the gluten-free trend has snowballed into an unnecessary, and potentially harmful, commercial juggernaut.

The facts:

  • Gluten is a composite protein found in wheat, rye, barley and their various cross-breeds.
  • Its viscoelastic properties are the reason that foods such as bread have an airy yet chewy texture. This is also the reason why it’s commonly used as a thickener, stabiliser and emulsifier.
  • Coeliac disease is an autoimmune disorder triggered by a reaction to gluten. Symptoms vary widely in range and extremity, primarily affecting the gastrointestinal system but potentially impacting energy, mood, weight, skin health and more.
  • Non-coeliac gluten sensitivity (NCGS) is a condition that causes abnormal immune reactions in people who do not have coeliac disease, and the symptoms are equally varied. There is no diagnostic test for NCGS, so its existence can only be established by excluding other gluten-related disorders.

The debate:

  • Current estimates put the occurrence of coeliac disease at around 1% of the population and NCGS at anywhere between 0.5-13%. But the number of people opting to avoid gluten is thought to be higher.
  • The question is whether it is beneficial for people not suffering from either disease to go gluten-free or whether it could in fact be harmful.

The case against going gluten-free:

  • There is no scientific evidence that a gluten-free diet, without the presence of coeliac disease or NCGS, is beneficial.
  • By unnecessarily avoiding gluten-containing foods, people risk becoming deficient in the nutrients that these foods typically contain, such as fibre and B vitamins.
  • Due to the widely varied symptoms of NCGS, combined with the rise in negative publicity around gluten, some health professionals worry that many people are incorrectly self-diagnosing.
  • Many symptoms which are increasingly being associated with gluten, such as bloating, could actually have alternative causes such as lactose, lectins or FODMAPs.

The case for going gluten-free:

  • Coeliac disease and NCGS have historically been misdiagnosed due to the vagueness of symptoms and absence of diagnostic tests for the latter, so many people may suffer from these diseases without even knowing it.
  • The huge volume of anecdotal evidence of people reporting better health and fewer symptoms after eliminating gluten speaks for itself. Scientific research will catch up in time as the necessary studies are conducted.

Our view:

  • Needless to say, if you think you may suffer from coeliac disease or NCGS, you should consult a doctor.
  • If you don’t suffer from either of these diseases but want to see if your health improves by eliminating gluten, then try it for a period to see if your body reacts positively. But you must plan accordingly to ensure that you don’t damage your diet in the process:

Dos:

  • Ensure that you replace the carbohydrates, fibre and B vitamins that you’ll be losing from gluten-containing foods such as bread and pasta.
  • Opt for naturally gluten-free food alternatives such as brown rice, buckwheat, quinoa, lentils, beans, pulses and potatoes.
  • Always check food labels, as gluten turns up in many unexpected places, including various sauces and dressings.
  • If you eat oats, ensure they are labelled as gluten-free. Oats don’t naturally contain gluten, but cross-contamination in mills is very common and only oats which are labelled as “gluten-free” can guarantee that there is no cross-contamination.

Don’ts:

  • Don’t assume that gluten-free labelled products are healthy. When gluten is removed from a food where it naturally occurs (e.g. bread), it is usually replaced with refined sugars, fat, xantham gum etc., to mimic the taste and texture. The impact on your chemical load, blood sugar levels and calorie count could offset any potential health benefits from removing gluten.
  • Don’t assume that gluten is the only substance that your body may have trouble digesting. For example, lactose (found in dairy) and lectins (found in grains, beans, nuts, seeds, dairy and nightshade fruits and vegetables) can also cause digestive issues for some people.