Gluten is a substance that people are gradually becoming aware of despite the fact that it has been hiding in our food for years. With increasing numbers of people being diagnosed with Coeliac Disease or gluten intolerance, it is important to know what Coeliac Disease is, what gluten is and does, how to ensure that those on a gluten-free diet can avoid foods containing gluten, and what it is like to be gluten-free.
What is Coeliac Disease?
The world’s awareness of gluten has coincided with its improved understanding and diagnosis of Coeliac Disease, a hereditary disorder. When gluten is ingested it can cause symptoms such as constipation, bloating of the abdomen, diarrhoea, nausea, loss of weight, weakness, tiredness, bone pain, headaches and generalised nutritional deficiency. Any of these signs can occur, but many can also be attributed to other illnesses, and in some cases there is simply an unspecific feeling of malaise.
For those whose bodies are incompatible with gluten, antibodies to gluten are produced when it is eaten. They damage the lining of the intestine and cause the villi to flatten and shorten. Villi are slender little protrusions on the intestinal wall whose job it is to augment the surface area of the tissue, thereby increasing its ability to absorb essential nutrients. With a reduced amount of nutrients being taken up by the body due to the compromised villi, symptoms begin and health deteriorates.
Treatment is beneficial, especially for more severe cases of allergy as opposed to mild intolerance. In general terms the person’s bowel habits often become regular again, energy levels increase and nausea stops. If untreated the problem could lead to low levels of red blood cells (anaemia), poor bone density (osteoporosis) or even cancer of the bowel. The key to treating Coeliac Disease sounds simple: eliminate gluten from the diet. But what exactly is gluten, and why is it so difficult to avoid?
What is gluten?
Commonly found in cereal grains like wheat, barley, malt, rye and triticale, gluten is an insignificant-sounding combination of two proteins. The word originates from ‘glue’ in Latin. This is appropriate because it is used in cooking and baking to produce elasticity, as well as to provide a stable, non-crumbly consistency for cakes, biscuits and bread. It is widely used as an additive and can be found in many flavours, thickeners and stabilisers.
Cooking and baking becomes problematic for gluten-free people because it is present in such a high proportion of products that is difficult to avoid. Other types of flour can be used, such as soy, potato, rice, tapioca and maize. However, there are disadvantages including higher price, varying availability, differing texture and density of the flour, unpleasant or unusual flavour, aftertaste and mouth-feel, and the need to use a substitute for gluten so that the finished product holds together. Guar gum and xanthan gum are often used to replace gluten.
The good news is that many supermarkets now stock some of these ingredients, as well as health food stores and online shops. There is an ever-increasing amount of pre-prepared gluten-free breads, baking, cereals, meals, fast food, sauces, snacks, drinks and confectionery in stores too. However, most cost more than their gluten-containing counterparts and many just do not taste the same.
Manufacturers label foods in detail and some restaurants offer nutritional information including the presence or absence of gluten, so it is possible to pedantically read labels and ensure that no gluten is present in the products. Some staff at shops do not understand the subject well enough though, and it is easy to forget that a tiny additive possibly made from gluten might be in a certain food. Eating out a friend’s place can also become difficult despite everyone’s best intentions, because it is easy to let a product which includes gluten slip into the meal without being noticed.
If the remarkable feat of removing gluten from the diet is achieved, unfortunately there can be other downsides as well as the cost, flavour and inconvenience. With some grains now absent from the regular intake of food, gluten-free people need to ensure that their diet includes enough iron, protein, fibre and other nutrients. Many processed foods are artificially fortified, but gluten-free foods are often natural and supplements may possibly be needed if there is not a wide enough range of food eaten.
It is also emotionally tiring and disappointing when it is necessary to miss out on what other people are eating, and to know that it isn’t wise to eat anything without first checking the ingredients carefully. Going out for dinner becomes a trial, finding palatable foods that are affordable and available gets hard, and some people can lose their ability to enjoy food.
Public awareness of gluten and Coeliac Disease is definitely increasing, and this consciousness has so far improved the variety and attainability of gluten-free food for the deserving people who need it. There are also countless groups and online communities where sharing of information, recipes and experiences can help those with Coeliac Disease identify with others in similar situations. Gaining knowledge about the subject is a useful way to help them, and attempting to source tasty, gluten-free food for those we know with Coeliac Disease could help them fit in more at the next morning tea, office party or dinner that they attend. After all, food is part of our daily lives, and everyone needs good, healthy food that they can enjoy.