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Gluten Free Diet: What is a gluten free diet?

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A gluten-free diet is a nutritional plan that excludes all foods containing gluten, predominantly including wheat, barley and rye. It’s often adopted by those who have an intolerance to gluten and is a must for those with coeliac disease.

Read on to find out more about going gluten free and if it's the right choice for you.

Coeliac vs gluten intolerance

Not all people who are sensitive to gluten have coeliac disease. Whilst the symptoms are similar, the severity and causes can vary.

Coeliac disease is an autoimmune disorder which impacts the gut. When gluten is consumed, the immune system attacks itself, causing damage to the lining of the small intestine and your body’s ability to absorb nutrients.

This is different to having a gluten intolerance, or non-coeliac gluten sensitivity, which doesn’t damage the gut. The exact causes of gluten intolerance aren’t clear and more research is needed to fully understand the condition.

Symptoms of gluten intolerance

Gluten intolerance and coeliac disease cause many of the same symptoms. These include:

  • diarrhoea
  • excessive wind
  • bloating
  • stomach cramps and aches
  • indigestion
  • constipation
  • nausea or vomiting

Symptoms of coeliac disease

Many people with coeliac disease also experience a range of general symptoms due to poor nutrient absorption or malnutrition such as:

  • fatigue
  • anaemia
  • unexpected weight loss
  • vitamin deficiency
  • mouth ulcers
  • itchy skin rash
  • issues getting pregnant or miscarriages
  • anxiety or depression
  • headaches
  • nerve damage or problems such as ataxia that affect balance and coordination

If you suffer from any of the above symptoms, you may have a sensitivity to gluten or have coeliac disease. Take a gluten intolerance test from the comfort of your home to find out if you have either condition.

Health benefits of a gluten-free diet

Going gluten free can be beneficial for those who have symptoms of gluten sensitivity, however you should get tested for coeliac disease before making any changes to your diet.

If you are diagnosed with coeliac disease, then you’ll be told to adopt a gluten-free diet. Removing gluten is the only way to prevent further damage to your gut and reduce the risk of complications later in life.

The benefits of a gluten-free diet for those with coeliac disease are:

  • improved overall digestive health
  • reduced flare ups and symptoms
  • lower risk of future complications such as osteoporosis and some types of cancer

Other claimed benefits include increased energy, less joint pain and weight loss. However this could also be associated with reducing the consumption of unhealthy foods.

Are there risks associated with a gluten-free diet?

Foods that contain gluten are typically rich in important nutrients such as iron, magnesium and protein. One study found that despite the benefits of a gluten-free diet, many people with coeliac disease were lacking in fibre, key vitamins and minerals.

It’s therefore important to ensure you eat a wide range of foods and get enough fibre from gluten free grains, beans, nuts and seeds.

Is there medication for gluten intolerance?

Coeliac disease and gluten intolerance can only be treated by adopting a gluten-free diet. However other treatments may also help to manage general symptoms such as a rash or malnutrition.

Some people may suffer from dermatitis herpetiformis, an itchy rash caused by gluten sensitivity. Removing gluten from your diet may help, but in the short term, depending on the severity of the rash, you may be prescribed medicine.

Your doctor may also recommend taking supplements and vitamins to replace any nutrients as you switch to a gluten free diet, or to account for any deficiencies.

Coeliac disease can also impact the spleen and make you more vulnerable to infection. In this case, you may need vaccinations such as the flu jab, pneumococcal vaccine or Hib/MenC vaccine.

Which foods contain gluten?

Gluten is a protein found in certain grains including wheat, rye and barley. These ingredients are most commonly found in a number of foods, drinks and processed meals as listed below.

Processed foods to avoid

Gluten is used as a binding or thickening agent and therefore can be found in many processed foods. The most common are:

  • pasta
  • bread
  • cereals
  • cakes and pies
  • biscuits, crackers and cookies
  • pastries
  • sweets
  • salad dressings
  • croutons
  • crisps and seasoned snacks
  • fries and chips
  • breaded meat or fish
  • hotdogs and processed lunch meat
  • some soups or sauce based vegetable dishes
  • some gravies and sauces such as soy sauce and teriyaki sauce
  • malt-based products such as syrup or vinegar

Beverages to avoid

  • beer, ale, stout and lager
  • barley squashes
  • malted milk drinks
  • non-distilled liquors

Which foods can you have on a gluten-free diet?

Gluten-free foods and snacks

There are many naturally gluten-free foods and drinks you can enjoy, as well as plenty of gluten-free substitutes such as pasta, bread and pizza bases. These can be found in most supermarkets, health stores or online.

The main gluten-free foods are:

  • meat and fish
  • fruit and vegetables
  • dairy products such as butter, yoghurt, milk and cheese
  • eggs
  • potatoes
  • beans, seeds and nuts
  • rice
  • gluten free flours
  • oil such as olive oil, coconut oil and sunflower oil

Oats are often avoided on a gluten-free diet however they don’t actually contain gluten. They can however become contaminated from other gluten cereals and also contain a protein called avenin which some people are intolerant too.

Gluten-free drinks

Non-alcoholic drinks:

  • water and flavoured water
  • fizzy drinks
  • 100% fruit juice
  • tea
  • coffee
  • sports and energy drinks

Alcoholic drinks:

  • wine and sparkling wine
  • fortified wines such as port, cognac, sherry and port
  • distilled spirits
  • liqueurs
  • cider
  • gluten-free beer

Labelling and terms to look out for

Avoiding gluten isn’t always easy, but once you learn how to read and understand food labels you’ll find it easier to stick to a gluten-free diet.

If a product is labelled as gluten free then by law it can’t contain more than 20 parts per million (ppm) of gluten. This means it’s safe to eat and will be found on various substitutes, uncontaminated oat products and gluten free processed foods.

For everything else, you’ll need to check the ingredients list on the label. Look out for the following terms which will indicate gluten is an ingredient (commonly emphasised in bold):

  • wheat
  • rye
  • barley
  • malt
  • brewer’s yeast
  • spelt
  • oats (unless gluten free)
  • khorasan wheat (commercially known as Kamut®)

You may also find an ‘Allergy Advice’ section which will state if wheat is found in the product. But remember, wheat free doesn’t always mean gluten free, so always check the ingredients.

If you’re diagnosed as having an intolerance to gluten, then going gluten free is a clear next step. The good news is there’s plenty of delicious gluten free snacks and foods to suit your diet.

Want to learn more about what you put in your body? Discover our guide to the Mediterranean diet or how to eat healthy.

References

www.nhs.uk/conditions/coeliac-disease
www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/what-are-coeliac-disease-symptoms
www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/gluten-sensitivity
www.coeliac.org.uk/information-and-support/living-gluten-free/the-gluten-free-diet/food-shopping/food-labels
www.coeliac.org.uk/information-and-support/living-gluten-free/the-gluten-free-diet
https://pubmed.ncbi.nlm.nih.gov/27211234