Wheat and Gluten Allergy
Wheat and gluten allergy are topics that have been given a lot of coverage recently. With books like “Grain brain” and “Wheat Belly” topping the best seller lists and celebs like Gwyneth Paltrow promoting a gluten free diet in her cook book, it is not surprising that the number of people on gluten free diets is rocketing especially in the USA where up to 30% of adults follow some sort of gluten free diet.
What is gluten and is it really so bad?
Gluten is the new bad kid on the block convicted, often on scanty evidence, of causing a wide range of gut and other problems.
Wheat is mainly starch with some protein, one of which is gluten. Cereals have been a normal part of our diet for millennia and the gluten increases the nutritional value of wheat. This is true for other cereals like barley, rye and to a lesser extent oats.
So what is the problem?
In a small number of people (particularly some with a specific genetic makeup) the gluten causes immune damage to the intestine leading to a condition known as coeliac disease. This leads to a number of gut problems including pain cramps, diarrhoea nausea and poor absorption of essential nutrients. In children this also leads to poor growth and recurrent illness. In some cases other parts of the body can be affected. For these people with true coeliac disease, gluten avoidance is crucial to good health.
How common is coeliac disease?
about 1% of the American population. For these people it may take a long while to make a correct diagnosis and the treatment (avoiding the offending gluten containing foods) will be lifelong.
What else can cause this picture?
The commonest bowel problem is “irritable bowel syndrome” (IBS) this is a harmless but unpleasant and troubling condition that is frequently stress related. In contrast “inflammatory bowel disease” (IBD) is a more serious illness of unknown cause that leads to chronic inflammation of the intestine. Neither of these is related to gluten.
Is a gluten free diet so bad?
In principle, no it is not. However “gluten free “foods are often much more expensive than gluten containing foods and have no benefit to the average person. Additionally the cereal content of these foods may be replaced by less healthy fats and sugars.
Can I be just a little bit “allergic” to wheat and gluten?
Yes this is possible, it is a less serious condition and this is referred to as wheat or gluten “intolerance”. In this instance reducing the gluten content of the diet can be very helpful.
Some people can be allergic to wheat products and contact with these like breathing in wheat flour can cause a general allergic reaction (like being allergic to bee stings or medication).
What should you do if you are concerned about a bowel problem?
Talk to your doctor who can assess and arrange some specific tests that can help to find the cause. This may include blood tests and a “scope”—either from the top or bottom to view the bowel and take a sample of the bowel wall (biopsy) to help make a diagnosis.
Talk to a dietitian
Dietitians have a specific medical training to enable them to understand the complex interaction between diet and health. In contrast, a so called “nutritionist” requires no medical training at all and their recommendations may often be guided by the products that they sell.
Dietitians are able to assess your diet and scientifically advise you on the best course of action for your particular problem.
Our thanks to Gina Fourie consultant dietitianfor assistance with this article. Gina has a special interest in the subject of food allergy and intolerance and can be contacted at: