What’s the first thing that comes to mind when you hear the words “food intolerance”? I guess it’s gluten intolerance.
Surveys show that up to 20 percent of people believe they have a problem with gluten, a protein found in wheat, barley and rye. Many blame it on intestinal symptoms such as stomach ache, bloating, gas, indigestion, constipation and diarrhea.
These are undeniably unpleasant symptoms, and something is causing them, but is gluten the real culprit?
Undoubtedly, food manufacturers are counting on this, as they are expanding their “free of” ranges (and gluten-free is not cheap).
However, gluten “intolerance” can divide opinion, and some people consider it just an excuse to eat demanding food.
Surveys show that up to 20 percent of people believe they have a problem with gluten, a protein found in wheat, barley and rye. Many blame it on intestinal symptoms such as stomach ache, bloating, gas, indigestion, constipation and diarrhea.
The truth is, I was not entirely convinced. But science (and therefore my opinion!) Has come a long way over the last decade. Gluten intolerance, or non-celiac gluten sensitivity, to give it its scientific name, exists. However, the exact cause, and whether other components of wheat are to blame, as well as gluten, is still uncertain.
But what we do know is that gluten intolerance is much less common than reported. And you need to make sure that this is what you have, as eliminating gluten if it is not necessary can have unintended consequences.
Long-term dietary restriction can be social isolation. Eliminating whole food groups can also mean that you inadvertently reduce other nutrients from your diet.
A study of nearly 200,000 people at Harvard University in the United States found that those who consumed more gluten had a 13% lower risk of developing type 2 diabetes compared to those who had the lowest gluten intake.
This was partly because those who ate gluten-free also tended to eat less grain fiber, which protects against type 2 diabetes.
Another UK study reviewed more than 1,700 foods and found that, on average, gluten-free people were more likely to have less fiber (the preferred nutrient for our gut bacteria) and protein.
With that in mind, it’s no surprise that a gluten-free diet reduces the intestinal bacteria known to produce beneficial compounds that help control blood sugar and stimulate our immune system.
What we do know is that gluten intolerance is much less common than reported. And you need to make sure that this is what you have, as eliminating gluten if not needed can have unintended consequences.
So how do you know if you really have a gluten intolerance? The first is the first: if your symptoms include chronic fatigue, anemia, unexplained weight loss, and mouth ulcers, or if you have type 1 diabetes, thyroid disease, or irritable bowel syndrome, your doctor may want to check for celiac disease, an autoimmune disease that damages the gut.
People with celiac disease should avoid gluten at all costs, even a small crumb of bread that contains it can harm them.
There is a simple blood test for this that a GP can do. It is absolutely vital that you still eat a considerable amount of gluten for at least six weeks before the test, otherwise you will not detect antibodies that indicate celiac disease (the next step is a biopsy).
If you do not have celiac disease, but still have the feeling that gluten is not in agreement with you, it is best to consult a dietitian.
Did you know?
Although oats are gluten-free, most are processed in the same place as gluten-containing grains and are therefore not suitable for those on a gluten-free diet due to cross-contamination.
If that’s not possible, it’s worth trying my four-day trial protocol to get a better idea of whether gluten is really what’s causing your problems (there’s a fuller version in my Eat Yourself Healthy book) .
This way of testing for gluten intolerance, known as a double-blind, placebo-controlled food challenge, is considered the standard method.
Unlike celiac disease, there is no simple test for blood, feces or hair for gluten intolerance, despite what the charlatans will try to sell you. It is not just my opinion, but the advice of bodies such as the European Academy of Allergy and Clinical Immunology.
I use this protocol in the clinic and it has helped hundreds of clients embrace gluten-containing foods in their lives. Keep in mind that anyone with a history of eating disorders should discuss this with their doctor before restricting their diet.
First, you need to exclude all sources of gluten from your diet for two weeks.
In addition to bread, pasta, and cakes that contain wheat, gluten is found in things you might not expect, such as soy sauce and barley pumpkin drinks.
If your symptoms resolve, go to the following test protocol. If your symptoms do not resolve, re-enter restricted foods and consult your GP or dietitian.
The gluten test
After avoiding gluten for two weeks, it’s time to reintroduce it. Each day you will include your test food, either a slice of standard wheat bread or a placebo (which is a wheat-free, gluten-free bread) for up to four days, before switching to the other test food for another food. four days.
This is where you need a friend or family member to dress up the food so you don’t know if you’re going to get wheat bread or the gluten-free version, for example, by mixing, toasting, or shredding it. Continue your gluten-free diet during this trial period.
Day 1: Start with a slice of the test food (you won’t know which one it is) with your food.
Day 2: Assess your symptoms. If you have any, wait a few days for them to decrease and repeat at half the dose of the same test food.
If you have no symptoms, include two slices of the same test food with the food.
Day 3: Re-evaluate your symptoms. If you have any, wait a few days until they run out, and then, using the other test food (i.e., wheat bread or placebo, but remember, you won’t know which one), repeat the steps of the day. 1. If you do not experience any symptoms, include three slices of the test food in two meals.
Day 4: Assess your intestinal symptoms. If you have any, wait a few days for them to slow down and then repeat the steps on day 1 with the other test food.
If you have no symptoms, you can start day 1 using the other test food immediately.
After you have completed both test foods, ask your “assistant” to reveal which test food was which.
If you had no symptoms with wheat bread, you can feel pretty sure that gluten / wheat is not the cause. Hura!
If you only had symptoms when eating wheat bread, try two tablespoons of onion or half a clove of garlic in a meal to confirm if it’s another component of bread, fructans, that’s the problem.
If you have no symptoms after trying onion or garlic, it suggests that you have non-celiac gluten sensitivity. Talk to your healthcare team.
If you also react to onion or garlic and / or placebo, I’ve run out of space here, so stay tuned and everything will be revealed in a future column.
Try this: four ways with dates
I like to think of dates as nature’s fiber-rich sweets. Their chewy sweetness makes them feel indulgent. They are my favorites for a quick treat. Take a Medjool date and cut it lengthwise, removing the pit, and then try one of the following fillings. (You can put the stuffed dates in the freezer for sweet treats prepared for the whole week.)
Services 1
Sweet and salty:
- 1 half dried tomato, preserved in oil
Seeds and nuts:
- 1 teaspoon of nuts to choose from
- Pinch of mixed seeds, toasted
Creamy Tahini:
Chocolate nut:
- A jet of melted dark chocolate
asks Megan
Eating wholemeal bread and rye bothers my gut a lot. The same goes for wholemeal pasta. I have no other symptoms. I am 22 years old.
Henry, by email.
Both grains contain gluten, so to be safe, I recommend that you ask your GP about testing for celiac disease.
This involves a blood test (known as a tTG) to check for antibodies. But for this to be valid, gluten must continue to be incorporated into at least two meals (pointing to the equivalent of four slices of bread or two cups of pasta a day) for the previous six to eight weeks.
If you have already eliminated gluten and reintroducing it causes debilitating symptoms, there is a genetic test for celiac blood, which looks for the human leukocyte antigen genes DQ2 and DQ8, which does not require you to continue eating gluten.
If this is positive, you should reintroduce gluten into your diet and get tested for tTG before a diagnosis can be made. If you do not have celiac disease, you can try to include these grains in your diet in the middle of your normal portion. If you tolerate it better, it is likely that your gut is struggling with another component of these grains called fructans.
They’re generally beneficial because they feed your gut bacteria, so don’t cut them down, but take it easy with the amount you consume in each session while healing your gut.
Contact Dr. Megan Rossi
Email drmegan@dailymail.co.uk or write to Good Health, Daily Mail, 2 Derry Street, London W8 5TT; include contact details. Dr. Megan Rossi cannot enter into personal correspondence. Answers should be taken in a general context; Always consult your GP with any health issues.