Gluten

 

Gluten is a mix of two proteins (gliadin and glutenin) which are found in many grains, notably wheat, rye and barley and in small amounts in oats.

 

The gluten in cereals affects the texture of baked goods. Kneading enhances the formation of gluten strands so the more a product is kneaded, the chewier it becomes.

 

Grains such as wheat, rye and barley contain gluten. Breads and products (eg. biscuits, cakes) made with these grains will contain gluten. There are also a number of foods which contain ‘hidden’ gluten, such as sausages and stock powders. For a complete list of foods, visit the Manufactured Foods Database (www.mfd.co.nz) and the Coeliac Society website (www.coeliac.co.nz).

 

Oats do contain gluten in very low quantities, so those with coeliac disease are recommended to exclude oats from their diet. Otherwise, if you can tolerate oats they can be included as a beneficial part of your diet.

 

There are some medical conditions where gluten affects the immune system (an immunological reaction):

·   Coeliac disease, where gluten-containing foods cause damage to the small intestine and lead to a reduced absorption of nutrients from food, leading to anaemia, osteoporosis and other conditions.

·   Dermatitis herpetiformis, an uncommon skin condition with watery, red and itchy blisters.

 

Gluten sensensitivity or non-coeliac gluten intolerance is where people develop a variety of symptoms when they eat gluten-containing products. It may depend on how much you eat - you may be able to eat small quantities without experiencing symptoms.

 

There are a number of things that can cause uncomfortable gastrointestinal symptoms. These include an intolerance to other substances, such as amines, salicyates, and sulphites, and also a group called FODMAPs. It may be also due to physical factors such as the amount you eat (too much stretching your stomach) and chewing gum (due to the amount of air you swallow as you chew) Stress may also be a factor in the severity of symptoms.

 

The term FODMAP is short for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are short chain carbohydrates which are not absorbed by our small intestine and which then are fermented by bacteria in the colon, producing hydrogen, carbon dioxide and methane gases. These FODMAPS are listed below, with examples of some of the foods they are found in:

·   Fructans (eg. in wheat, onions, certain vegetables),

·   Polyols (certain fruits, sorbitol)

·   Lactose (dairy products)

·   Galactans (legumes & dried beans)

·   Fructose in excess (certain fruits, dried fruit, and high-fructose corn syrup)

You may only have a problem with one or two of these foods, the trick is determining which. Consult your doctor or dietitan to determine the right way to do this.

 

People with gastrointestinal symptoms including abdominal pain, bloating, wind and diarrhoea often feel better on a gluten-free diet. These people may be suffering from Irritable Bowel Syndrome (IBS). Removing gluten from the diet will also remove FODMAPs, especially fructans which are found wherever one finds gluten so these people find an improvement in their symptoms – they may be doing the right thing, not realising exactly why. In a recent Australian study, high dietary FODMAP intake was consistently associated with IBS symptoms, and the researchers suggested that about three-quarters of sufferers could expect sustained and substantial relief from all IBS symptoms by avoiding FODMAPs.

 

Yes, although there is no evidence that abdominal pain, bloating, wind, diarrhoea and constipation are caused by gluten, it is more likely that other food substances in gluten-containing foods (such as Fodmaps) which are the real culprits and may mean that you are being unnecessarily restrictive in your eating.

 

Not necessarily. Specialised gluten-free products are often higher in fat and sugar to make them taste better. The gluten-free flours used in breads and pastas are often highly refined, low in fibre and have a high GI rating, meaning they aren’t very filling and do not contain beneficial wholegrains.

 

Gluten free diets have been found to be lacking in fibre, calcium, iron and B vitamins. Gluten-free products are more expensive than their traditional counterparts. The choice to go gluten-free should be discussed with your doctor, dietitian or registered nutritionist.

 

Unless you have been diagnosed with coeliac disease or dermatitis herpetiformis, there is no evidence suggesting a benefit from cutting out all gluten

IBS sufferers need to identify which foods are causing their symptoms, and there is often a certain amount of gluten-containing foods you may be able to eat without triggering your symptoms. This needs to be worked through with a dietitian or registered nutritionist.

 

No. This should only be done on the advice of a doctor, dietitian or registered nutritionist. They will guide you on an elimination diet, where all suspect foods are removed for a set time, then gradually reintroduced to find which particular foods caused symptoms to return. Removing foods or food groups from your diet can cause deficiences in some nutrients, which in turn may lead to other health problems in the future. Food intolerance symptoms may be similar to those of other medical conditions, so consultation with your doctor before altering your diet is strongly recommended.

 

No. Removing foods or food groups unnecessarily from your diet can lead to nutrient deficiencies, which in may lead to health problems in the future. It has not been proven that gluten is responsible for symptoms such as bloating, and gluten-containing products (such as wheat bread) form an important part of the NZ diet.

 

 

 

NZNF food allergy and intolerance page: http://www.nutritionfoundation.org.nz/nutrition-facts/nutrition-a-z/food-allergies-and-intolerance

Allergy New Zealand:  www.allergy.org.nz
Coeliac New Zealand Incorporated:  www.coeliac.org.nz
Food Standards Australia New Zealand:  www.foodstandards.govt.nz
Manufactured Food Database:  www.mfd.co.nz

New Zealand Dermatological Society: http://dermnetnz.org/immune/dermatitis-herpetiformis.html

 

To contact a dietitian in your area, www.dietitian.org.nz