Gluten: The devil is in the detail
Much to the chagrin of many nutritionists and dietitians, gluten — along with sugar — is often considered an evil to be avoided at all costs. But is this necessary? And what is gluten anyway?
Gluten is a protein found in wheat, barley and rye — and not just in the obvious pasta, cereals and bread, but across the food supply, as it is used as an additive in sauces and processed food products. Cereal companies, for example, add it as an ingredient to produce higher-protein breakfast products.
Gluten is made up of two proteins — gliadin and glutenin — and we actually don’t have the enzymes required to break these proteins down, which means when they hit our digestive tract our immune system recognises them as a foreign body, sparks an immune response and will clear it away. If you have a healthy gut and a resilient immune system this might not be a big deal.
However it does cause problems for some, such as those who have coeliac disease (an autoimmune disease that affects 1-3 per cent of the population). Gliadin causes the body’s immune system to attack its own tissue, breaking down the intestinal wall in the digestive tract. This leads to some serious digestive issues, an inability to absorb nutrients (thus leading to nutrient deficiencies) and an increased risk of developing other conditions as the immune system is severely compromised. It appears that the prevalence of coeliac disease is increasing, though the numbers are also likely due to an increase in diagnosis (like many medical conditions).
Another condition, non-coeliac gluten sensitivity (NCGS), differs in its pathophysiology from coeliac disease and is thought to account for up to 20 per cent of the population who report adverse health issues with gluten.
The symptoms include digestive problems as is the case with coeliac disease (gas, abdominal pain, bloating), but can also include headache or migraine, foggy mind, chronic fatigue, joint and muscle pain, tingling and numbness of extremities, eczema, anaemia and depression. The symptoms can be mild to severe and can reduce quality of life.
There are other constituents of wheat — the predominant source of gluten in the diet for most — that have also been found to be problematic. These include wheat germ agglutinin (WGA) and opioid peptides. In addition to this, modern wheat (as opposed to what we might have found 120 years ago) is treated with glyphosate, a pesticide that kills weeds and can increase the yield of wheat crops just before harvest. Imported wheat (and some local crops) use this as a herbicide. So though gluten itself is not great, these other factors which are known to cause health issues could well be the root cause of adverse health symptoms.As with the low-fat message many years ago, the food industry has jumped on the gluten-free bandwagon and there is now a proliferation of products.
There are many quality products (and very good labelling for the most part) that can help people with coeliac disease or NCGS navigate food products to maintain a gluten-free diet.
Unsurprisingly, though, for every quality product available, there are three more that are anything but, with ingredient lists that read like a laboratory experiment. Whenever a product undergoes an ingredient change, it is important (from a food manufacturing perspective) to try to match the mouth feel, flavour and texture of the gluten-containing original along with ensuring all elements combine successfully. This typically involves upping the calorie, sugar, salt and/or fat content. Together these can make for a health disaster, and this is one of the reasons many people have diet-related health issues in the first place. This is largely why many nutritionists and dietitians take issue with gluten-free diets, and to people avoiding gluten who are not diagnosed to do so.It doesn’t take a brainiac to realise that swapping out cereal and toast for gluten-free grain products does not magically improve the healthiness of a diet and can in fact make it worse.
However, the devil is in the detail of what a gluten-free diet looks like. With a well-formulated diet there is no harm in removing gluten and you’re not at risk of vitamin or mineral deficiency as you will tend to introduce more nutrient-rich foods that are minimally processed as opposed to relying on gluten-free processed substitutes.
If you do experience digestive problems associated with gluten, the subsequent inflammation of the gut lining wall will increase the likelihood of nutrient malabsorption and deficiencies. The removal of gluten in combination with more nutrient-rich choices can help correct this, even in the absence of a diagnosis. By removing a lot of processed food your dietary horizons expand to include a lot more food choices, particularly if your go-to choices are off the menu.
A prime example is a cauliflower pizza base (see recipe or below), or zucchini noodles as opposed to wheat.
Anyone improving their diet is will probably spend more time doing a bit of preparation as a good diet never happens by accident.
Should you go gluten-free?
Outside of a correct diagnosis of coeliac diseaseor NCGS (which can be obtained from your doctor or allergy specialist), you need to become an investigator of your own symptoms.
Do you get frequent headaches or migraines? Do you feel like you want to sleep half an hour after eating your sandwich? Do you experience brain fog or a lack of concentration? Do you have allergies tied to eating specific foods that contain gluten? Do you get bloating, gas or constipation/diarrhoea when you eat gluten-containing foods?
If so, your symptoms might be might be gluten-related. I suggest keeping a detailed food/symptom diary for a week to see if you can relate the symptom to a particular food or meal. Once you have established a connection, get guidance from a nutritionist or dietitian to ensure your nutrient needs are met within a gluten free diet. Then give yourself 30 days on the new diet to allow for the reduction of inflammation around the gut lining.
Of course, the removal of bread (for example) could immediately remove the symptoms you could be experiencing — and this could be all the information you need to suggest you’re better off without bread, and that rice or potatoes are a better choice for your carbohydrate intake at lunch. Nutrition advice from an expert is recommended for changes that are more indepth, or for symptoms that are more severe.
Cauliflower pizza base
½ medium cauliflower, chopped
2 Tbsp psyllium husk
- Heat oven to 200C.
- Blend the cauliflower in a food processor until fine. Add eggs, pesto and psyllium and blend to mix.
- Spread on baking tray lined with baking paper to around 2cm thick, squaring off edges to be slightly higher. Bake for 30 minutes or until cooked.
- To serve, spread base with toppings of your choice and bake until cooked.
See our gluten-free articles and collections
- Suzanne Dale's guide to gluten-free meals
- Gluten-free baking
- Gluten-free desserts
- Gluten-free sweets
- Gluten-free breakfasts
Mikki Williden is a registered nutritionist and lecturer at AUT University, where she lectures in public health nutrition and sports nutrition at the School of Sport and Recreation. Read Bite articles from Mikki or visit mikkiwilliden.com for more.