Gluten free

Gluten free diet – how to make it wholesome

Gluten free diet has been extremely popular in the recent years.

There are many gluten free products on the market. Are they really a healthy choice? Most gluten free flour mixes contain a lot of protein, vitamins (mostly B vitamins) and minerals (magnesium, iron, zinc and copper) compared to grains containing gluten. Unfortunately, they are usually made with starch, salt and sugar. When you’re on gluten free diet, you must look even more closely at product labels and look for a healthy alternative for gluten grains. Doing that makes your diet valuable, helps you avoid a range of ailments and protects you from many illnesses such as type 2 diabetes, cardiovascular diseases, osteoporosis, cancers and many others.

What is gluten?

Gluten is protein fraction insoluble in water and salt, found in grains like: wheat, rye, barley, oat [1], spelt and products made of them.

Gluten has a very low nutritional value but it offers technological advantages and this is why it is so readily used on a large scale in the bakery industry and other sectors. Production of grains is modified so that grains contain more gluten than they did several years ago. It is more profitable. Gluten increases the efficiency and improves the texture of products: it increases their viscosity, elasticity and volume.

Where is gluten? [3]

There many reasons to give up gluten. The most important ones include:

  • coeliac disease,
  • allergy to wheat,
  • sensitivity to gluten (non-coeliac sensitivity to gluten)
Description Diet type Estimated number of patients Diagnostics
Coeliac disease coeliac disease – a lifelong autoimmune disease with genetic background, characterized by permanent intolerance of gluten, which has a toxic effect and leads to atrophy of villi in the small intestine. Food absorption is impaired, which leads to many clinical symptoms. Strict gluten free diet is necessary for a lifetime. Untreated, it leads to serious health problems such as osteoporosis, mental disorders, reduced fertility, digestive tract cancers. 1% – 2% of the population,

incorrectly believed to be a small children’s disease – you cannot grow out of it. It is most frequently diagnosed with adults ranging between 30 and 50 years of age.

It usually means concentration of antibodies: against smooth muscle endomysium (EmA), against tissue transglutaminase (tTG) and antibodies against the so-called new gliadin DGP or GAF.

Additionally: total concentration of IgA antibodies and, if necessary, intestine sample test and genetic tests.

Allergy to wheat Depending on the time of allergic reaction to wheat, it can be divided into immediate allergy, occurring within several minutes from consuming the foods, and late allergy, showing several hours later, and sometimes even after 1-3 days. The first type of reaction depends on wheat-specific antibodies in IgE class, the second type – on IgA, IgM and IgG   antibodies.

 

The therapy is based on strict elimination of wheat from diet. This may not last the entire life. The most common allergy: 10-25% of patients with allergy. Unlike the coeliac disease patients, most children grow out of such allergies. With adults it might last long, however, a lot more of the allergen is necessary to cause the reaction. Skin tests, antibody tests, various food panels. Elimination diet and re-introduction the potential allergen is also very helpful.

 

You should always check whether the suspected allergy to wheat is not coeliac disease and make appropriate tests before beginning the diet.

Sensitivity to gluten

 

 

 

also called non-coeliac sensitivity to gluten – it means the gluten intolerance where consumption of gluten results in adverse effects in a patient – diagnosed after excluding coeliac disease and allergy to wheat. Treatment consists in eliminating gluten from the diet.

There is no evidence as to whether non-coeliac sensitivity to gluten is a permanent disorder (and requires lifetime gluten free diet) or if it can pass.

 

It is hard to diagnose – several per cent – patients are most frequently adults. It should be diagnosed based on gluten challenge and genetic tests (HLA DQ2/DQ8 genes).

Other reasons to give up gluten:

  • autoimmune diseases such as psoriasis, Hashimoto’s disease, diabetes, multiple sclerosis
  • ADHD, autism, schizophrenia – research on this continues
  • care for health

It is important that you do not eliminate products from your diet, without consulting a doctor, guided only by latest fashions. Before eliminating anything from your diet, you should always ask for advice from a qualified dietician or a gastroenterologist. When symptoms indicate that you suffer from coeliac disease, eliminating gluten from your diet might make making a correct medical diagnosis more difficult.

Aside from eliminating gluten, correct balancing of all necessary nutrients is the most important dietary recommendation for individuals on gluten-free diet. You cannot allow for shortages in your diet. You should consume unrefined products containing B vitamins, iron, magnesium, zinc, manganese and dietary fibres. If you buy low quality gluten-free products available at stores, you do not feed your body with many important nutrients. Frequently gluten-free is their only advantage. When you check the labels, most labels of gluten-free products are based on potato starch, corn starch and white rice flour. They lack dietary fibres, have high glycemic index and very few minerals and vitamins. They do not compensate for the deficiencies, which result from giving up wholegrain products. Such diet promotes numerous diseases, including cardiovascular diseases, diabetes and even cancers.

In 100 g Protein

g

Fibre

g

Calcium

mg

Iron

mg

Vit. C

mg

Potassium

mg

Magnesium

mg

Zinc

mg

Foliates

µg

Selenium

µg

GI
Amaranth flour 13,6 6,7 159 7,6 4,2 508 248 2,9 82 18,7 35
White rice flour 7,2 2,3 10 1,1 0 117 36 0,8 10 0 57

Is gluten-free diet dangerous?

NO

Is cereal-free diet dangerous?

YES

Inappropriate diet might lead to serious malnutrition. The need to supplement your everyday diet with meals made using millet groats, buckwheat groats, amaranth, quinoa, leguminous plants and raw rice, and increasing consumption of raw vegetables and fruit is a prerequisite for correctly balanced gluten-free diet. Why is it so important?

People suffering from intolerance to gluten who are on unbalanced diet frequently also suffer from:
  • anaemia caused by iron and B vitamins deficiency,
  • osteoporosis – deficiency and/or malabsorption of calcium, magnesium and vitamin D,
  • allergy to lactose or milk protein,
  • depression,
  • gastrointestinal discomfort,
  • cardiovascular diseases and type 2 diabetes,
  • autoimmune diseases
High quality alternatives to cereals containing gluten:
  • Quinoa
    • it contains just as much wholesome protein as tuna or hen eggs,
    • 3 times more magnesium than white wheat flour,
  • Amaranth
    • 3 times more iron than beef,
    • 2 times more calcium than cottage cheese,
    • 10 times more calcium than white wheat flour,
  • Brown rice
    • 5 times more magnesium than pearl barley,
    • 3 times more manganese than pearl barley
  • Millet
    • 13 times more magnesium than couscous
  • Sorghum
    • 8 times more foliates than pearl barley
  • Buckwheat
    • ½ cup of buckwheat groats covers the RDA (recommended daily allowance) for magnesium for children up to 12 years old in 100%, for women in 70% and for men in 50%
  • Leguminous plants
    • as much protein as poultry
    • 10 times more iron

What are the benefits of well balanced gluten-free diet?

According to “New Scientists”, products such as rye, wheat and barley contain a lot of fructan – substances of plant origin containing fructose and glucose. Fructan frequently causes flatulence, nausea and other “side effects” also associated with gluten. This is why people suffering from illnesses such as irritable bowel syndrome feel much better after eliminating gluten from their diet as they eliminate fructan from it, consciously or unconsciously.

Correctly balanced gluten-free diet with people with coeliac disease allows to balance the diagnostic metabolism parameters.

Gluten-free diet and its influence on your health is subject to consideration of many researchers (e.g. from Harvard Medial School [1]). Studies warning against gluten free diet have been published lately. An article published in the British Medical Journal presented negative consequences of gluten free diet. It put forward the thesis that avoiding gluten might increase the risk of cardiovascular diseases. An analysis of the entire research and its conclusions informs us that the condition resulted not from eliminating gluten, but from incorrectly balanced gluten free diet, based on gluten free products used with a lot of potato starch and corn starch. A fragment of the study reads: ‘It is not gluten. It is the fact that converting to gluten-free diet reduces consumption of wholegrain products that have a positive effect on heart functions. Gluten abstinence frequently means that we consume too little of necessary dietary fiber.

[1] Oat protein (avenin) does not cause an immunological response. However, oats available on the market are strongly contaminated with other grains – that’s why it should be completely eliminated from gluten free diet.

[2] Definition by WHO/FAO

[3] Polish Association of People with Coeliac Disease and on Gluten free Diet: http://www.celiakia.pl/wp-content/uploads/2009/11/poradnik-XII-28.04.2017.pdf; 27.11.2017; 12:14

[4] Benjamin Lebwohl …, Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study, BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1892 (Published 02 May 2017)Cite this as: BMJ 2017;357:j1892