Before you pick up that next gluten-free snack, registered dietitian Sally Shi-Po Poon answers five crucial questions about going gluten-free.
Gluten-free diets have gained considerable popularity in the past decade, with many celebrities and athletes praising it as an effective way to achieve better health, weight control and athletic performance. But there's a lack of scientific evidence to support these claims. In fact, there are studies that suggest avoiding gluten may not even be that good for you. Read on to find out the facts.
What exactly is gluten?
Gluten is a protein found in wheat, barley, rye, malt, and oats (unless they are labelled gluten-free). These ingredients are commonly found in bread products, pasta, breakfast cereals, cakes, cookies, batter-fried foods, beer and ale.
There are a number of gluten-free grains and plant foods that are suitable for those on a gluten-free diet. They include amaranth, arrowroot, buckwheat, cassava, corn, flax, legumes, millet, nuts, oats labelled gluten-free, potato, quinoa, rice, sago, seeds, sorghum, soy, tapioca, and teff.
Who should follow a gluten-free diet?
People who have celiac disease should follow a strict gluten-free diet. Celiac disease is a serious genetic, autoimmune illness where the consumption of gluten induces damage to the small intestine and causes nutrient malabsorption. The only treatment is to avoid gluten for life.
Symptoms of celiac include bloating, diarrhoea, nausea, gas, constipation, fatigue, mouth ulcers, unexpected weight loss, hair loss and anaemia. If you think you have celiac disease, do not remove gluten from your diet until your doctor makes a diagnosis. If you remove gluten from your diet too early, it can cause an inaccurate result.
Non-celiac gluten sensitivity
Some people have gut symptoms when eating gluten, such as abdominal pain, bloating, and diarrhoea, even if they don’t have celiac disease. This is called non-celiac gluten sensitivity. Most people with non-celiac gluten sensitivity noted an improvement after following a gluten-free diet.
Is a gluten-free diet healthy for the general population?
Not really. In 2017, experts from the European Society for Paediatric Gastroenterology Hepatology and Nutrition warned that gluten-free products should not be considered a healthy substitute to regular foods because they usually contain higher levels of saturated fat and lower levels of protein.
Also in 2017, a study published in the British Medical Journal found that a gluten-free diet may increase the risk of cardiovascular disease from reduced consumption of hearty whole grains. Gluten-free alternatives to cakes, cookies, muffins, crackers and bread are often made with refined carbohydrates, which have a high glycaemic index and are low in B vitamins, iron, and dietary fibre.
Adopting a gluten-free diet among athletes has become increasingly popular because of perceived ergogenic and health benefits. In 2015, a carefully designed study published in Medicine & Science in Sports & Exercise concluded that a short-term gluten-free diet had no overall effect on exercise performance, gut symptoms, perceived well-being, intestinal injury, and inflammatory responses in non-celiac athletes.
Whether avoiding gluten for a longer period of time would lead to improvement in performance or well-being is yet to be determined. Nevertheless, athletes should always remember that proper nutrient intake and timing are critical components of athletic success.
Before adopting a gluten-free diet...
Before adopting a gluten-free diet, you should consult a dietitian to ensure that you will get all the essential nutrients from a variety of foods, including gluten-free grains, fruits, vegetables, legumes, fish, lean meat, nuts, seeds and dairy.
If you are suffering from gut symptoms such as abdominal pain, bloating, or diarrhoea, you should consult a doctor for medical advice. Self-treatment or delay in treatment can only cause harm in the long-run.