Hannah Elizabeth from The Green Machine allergy-friendly food and fitness blog, investigates all things “gluten”.

So what exactly is gluten? And do people without either an allergy or intolerance really need to be following a gluten-free diet?

The prevalence of allergy and intolerance has skyrocketed in recent years. While there is still a long way to go, more substantial research and better education has led to a greater understanding of these medical issues, enabling food producers and establishments to better accommodate those who must stick to certain diets due to intolerance or allergy. Greater public awareness also plays a key role in reducing the sense of social isolation that can come with a diet that has been restricted due to medical conditions.

Gluten is a protein found in wheat, rye and barley. It gives structure, texture and elasticity. Other grains that contain gluten include semolina, spelt, couscous, durum, faro and kamut. Wheat gluten is used in a wide range of foods, particularly products that are processed, such as soy sauce, beer, sauces, salad dressing, batter, cakes and biscuits, noodles, mayonnaise, crackers, cereal bars, crisps and stock cubes.

There is still a lack of understanding about the differences between allergy and intolerance.

This has potentially dangerous consequences, due to the risk of cross contamination or unknowingly consuming a dish that contains gluten. As the list above demonstrates, there are many foods on the market that contain “hidden” gluten.

Nutritional Therapist Jade Stokley Laine (NDip), explains the difference between gluten intolerance, wheat allergy and coeliac disease.

Food allergies are an immune overreaction to a specific food protein. Symptoms of an allergic reaction can range from mild itching to anaphylaxis, and can be potentially fatal. Some people with a wheat allergy can tolerate other gluten-containing grains, however, many may experience a reaction to these too. Wheat allergies are most common in children under three years old but some will outgrow the allergy by adulthood.1

Food intolerances or sensitivities are not an immune response. They are often the result of foods triggering the symptoms of an underlying condition such as IBS, Crohns or Ulcerative Colitis. Healing an underlying intestinal issue can result in the loss of the ‘intolerance’. (Lactose intolerance is an exception, as this is caused by the congenital lack of the lactase enzyme necessary for digesting dairy, and cannot be ‘healed’.)2

 Many people with these conditions find the easiest way of managing their symptoms is to avoid the foods which trigger a response.

However, this does not necessarily mean that ‘gluten intolerance’ is the issue. Most people will report feeling healthier after cutting out processed foods, regardless of whether there is an underlying health issue or not.”3

Coeliac disease is an autoimmune disorder in which the ingestion of gluten causes an immune response damaging the villi, which line the small intestine. We need these tiny villi in order to absorb nutrients from food, so when they are damaged nutrient deficiencies can develop despite adequate nutrient intake. This is why coeliacs often suffer from deficiency symptoms as well as gluten intolerance (GI) symptoms. Whilst the villi are damaged, many other foods may irritate the gut lining and cause GI symptoms, however many foods can be reintroduced after gluten has been cut out of the diet and the villa have regenerated. Coeliacs must avoid gluten to prevent symptoms.

Due to increased demand, the availability of “free-from” products has become more accessible with a much wider range of options.

However, it is important to remember that this increase also includes a rise in processed and refined gluten free products.

When gluten is removed from a food, additional refined sugar, salt or fat is often added to compensate and replicate a similar texture, flavour and/or consistency, making some “free-from” foods heavily processed. Jade recommends whole foods like rice, quinoa or sweet potato as a healthier alternative rather than opting for processed “free from” foods if you have a genuine intolerance or allergy.

Coeliac disease, wheat allergy and intolerances are not managed with pharmaceuticals. The way to prevent symptoms is to remove gluten from the diet. Because of this, many people suffering symptoms that are seemingly related to either allergy, intolerance or coeliac disease, self diagnose and remove gluten from their diet without medical supervision.

It is important not to put yourself on a gluten-free diet before having the appropriate tests conducted by a medical professional.

If you believe you suffer from a medical condition, removing gluten before the appropriate tests can lead to a false negative result or a misdiagnosis4. Speak to your GP who can advise you about any dietary changes should you need them.

It is worth remembering that unless you have a medically diagnosed allergy, intolerance or autoimmune disease (such as coeliac), unprocessed, unrefined wholemeal wheat and grain products can have nutritional benefits. They are a good source of B Vitamins, fibre and magnesium, as well as being an inexpensive source of quality carbohydrates.

Overall, those who feel better when eliminating wheat but do not suffer from an intolerance, allergy or coeliac disease, may do so because they have consumed more unprocessed, whole foods. It may be possible that wheat, in less processed forms, can be safely consumed by those who do not suffer from medical conditions. Ultimately, it seems that the most health-giving diets are those that include the most fresh, whole foods and least processed, refined products.

For more information and a list of symptoms relating to food allergy, intolerance and coeliac disease, read this post on the The Green Machine.

1: https://www.foodallergy.org/allergens/wheat-allergy

2: http://www.nature.com/ajg/journal/v104/n6/abs/ajg2009188a.html

3: https://www.ncbi.nlm.nih.gov/pubmed/23648697

4: http://www.nhs.uk/Conditions/Coeliac-disease/Pages/Diagnosis.aspx