Gluten-free diet

What problems can gluten cause?

In some people, gluten can cause a variety of unpleasant symptoms after it’s eaten such as abdominal pain, diarrhoea, bloating, excessive wind, tiredness, poor concentration and general aches and pains.

Although dietary intolerance to wheat or gluten is felt to be quite common, finding the cause of these symptoms is important to make sure there are no serious medical conditions present such as coeliac disease.

Who should follow a gluten-free diet?

If you have medically diagnosed coeliac disease you must follow a strict gluten-free diet for your whole life. This is because your sensitivity to gluten will never disappear. Every time you eat gluten, even in very small amounts, it will cause damage to your small bowel.

Your doctor may advise you to follow a gluten-free diet for other reasons — for example, if you have irritable bowel syndrome or ‘non-coeliac gluten sensitivity’. This refers to a range of symptoms attributed to eating gluten, such as dermatitis herpetiformis. Their cause and treatment, however, is not well understood.

It’s a good idea to seek guidance about following a gluten-free diet from a dietitian, especially if you have other medical conditions or dietary requirements.

A dietitian can:

• prepare an individual dietary plan
• show you how to read food labels
• make sure your diet is nutritionally balanced
• determine if you need vitamin supplements

You can find an Accredited Practising Dietitian through the Dietitians Australia website.

What foods can I eat on a gluten-free diet?

On a gluten-free diet you can eat:

• foods that are naturally gluten-free such as fresh fruit and vegetables, fresh meats, eggs, nuts and legumes, milk, fats and oils and gluten-free grains such as rice and corn
• products labelled ‘gluten-free’ irrespective of their country of origin
• products that use the ‘Crossed Grain Logo’. This logo is recognised both in Australia and overseas and means the food item is suitable for a gluten-free diet wherever you are
• products that are gluten-free according to their ingredients list

In Australia, products containing any ingredient derived from wheat, rye, barley or oats must be declared on the ingredients panel. Avoid products with statements such as ‘may contain gluten’ because they can be cross contaminated with gluten.

Different countries have different labelling laws, so you will need to research which foods are safe to eat when you travel overseas. For example, very small quantities of oats are permitted in products labelled gluten-free in the European Union.

How do I choose gluten-free foods?

Choosing gluten-free foods requires an understanding of product labels. You also need to become ‘ingredient aware’.

Your state Coeliac Australia association can help you learn these skills and provide resources to help you follow a gluten-free diet.

You will need to pay a fee to join Coeliac Australia and be medically diagnosed with:

• coeliac disease
• non-coeliac gluten sensitivity
• dermatitis herpetiformis (a rare skin condition)
• other medical conditions requiring a gluten free diet

An Accredited Practising Dietitian can also teach you how to choose gluten-free foods and products.

What about eating out?

Most restaurants now have gluten-free options but these tips might make eating out ‘gluten-free’ easier.

• Consult the Coeliac Australia restaurant finder.
• Have realistic expectations. Not everything on the menu will be gluten-free.
• Research ahead of time if you know where you are going to be eating out. For example, check if their menu is online, and if they don’t have gluten-free options listed then give them a call to discuss your needs.
• If you haven’t called ahead of time, tell the waiter that you require gluten-free food as soon as you arrive and ask if they can cater for you. If they can’t, you may need to find another restaurant.
• Be prepared to pay more because providing gluten-free foods for their customers often costs restaurants more.
• If it doesn’t seem right, don’t assume it’s gluten free. For example, if bread is served as an accompaniment to soup then check that the bread is also gluten-free.
• Exercise common sense and patience.

Unexpected sources of gluten when you’re eating out can be stocks and sauces, soy milk, icing sugar or dusting chocolate, salad dressings, chicken salt, dusting or coating flour and oil used for other purposes such as frying foods with a batter that contains wheat flour.

Can anyone follow a gluten-free diet?

Many people think a gluten-free diet is a healthy alternative — but it’s not. Gluten-free food products often have higher fat or sugar contents to make the food tastier and give them a better consistency.

A gluten-free diet is essential for people medically diagnosed with coeliac disease. Others need to be very careful because a gluten-free diet can lack essential nutrients if it’s not balanced well.

Gluten itself doesn’t offer special nutritional benefits but the many whole grains that contain gluten do. They’re rich in an array of vitamins and minerals such as B vitamins, folate and iron, as well as fibre. You may miss out on these nutritional benefits if you follow a gluten-free diet and have not sought professional help from a dietitian to ensure your diet is balanced.