Gluten-free eating has gone mainstream! Many restaurants have specialised gluten-free menus and supermarket shelves are bursting with ranges of this- and that-free products. So what is all the fuss about? Why are some people eating gluten-free as a simple dietary choice and not because of a diagnosis of coeliac disease or health-related condition? That is the question on many doctors’ lips and one that leaves them somewhat perplexed. But what exactly is gluten and what how does it affect the body?

Gluten is a protein found in wheat, barley and rye products and is a large molecule that’s very difficult for the human digestive system to break down and digest. It’s found in many of our favourite foods, from bread to pasta to soy sauce and even frozen yoghurt, and for a large number of people who have been diagnosed with a wheat or gluten allergy, intolerance or coeliac disease, eating it can be problematic.

The silent plague

Recently, it has been reported by Coeliac Australia that coeliac disease affects about 1 in 100 Australians. However, 75 per cent currently remain undiagnosed. This means that about 160,000 Australians have coeliac disease but are unaware of it. Coeliac NZ reports that it affects 1 per cent of the population and the numbers are increasing rapidly.

Common symptoms of coeliac disease are the onset of unexplained fatigue, bloating and gassiness that can be noticed within minutes or hours of eating a suspected food. For some people, the skin is affected and hives and skin rashes can also be accompanied by headaches and joint pain.

Looking into the background of coeliac disease and how it affects the body helps to differentiate it from gluten sensitivity. Coeliac disease is an autoimmune disease whereby the intolerance of gluten causes the body to produce antibodies that damage the lining of the small intestine, eroding and destroying it over a period of time and making it impossible for the body to absorb vitamins, minerals and other nutrients from food.

It’s a hereditary condition but both genetic and environmental factors play important roles. However, there is a grey area: some coeliac patients will have no symptoms despite the bowel lining being damaged and, if significant amounts of gluten continue to be eaten, the bowel lining damage accumulates and symptoms of malabsorption can occur along with an abundance of other health-related problems.

For many people who have undiagnosed gluten sensitivities or intolerances, which is about 10 per cent of the population, these irritating symptoms can still be experienced. Have you ever eaten a bowl of pasta only to discover that within an hour your tummy has swollen to the size of a beachball? Talking to your local GP about why this is happening may be greeted with a quizzical stare and raising of an eyebrow. It has yet to be confirmed by the medical profession why some people who have negative coeliac and gluten sensitivity test results still suffer symptoms.

If you’ve indulged in a sweet treat or pizza, for example, and are feeling the after-effects of bloating and abdominal pain, the good news is that once the gluten is no longer in your system, the symptoms will pass until the next time you eat food containing gluten.

Although we’ve come a long way in the treatment of coeliac disease and the standard advice and long-term treatment plan of completely eliminating gluten from the diet to abate the symptoms and regulate the condition is showing positive results, those people who are undiagnosed can often feel confused about whether they should eat gluten-free or not.

Coeliac disease, gluten allergy and gluten intolerance are three completely different things but they do require the same treatment plan and it’s advisable to have tests to see whether you do actually have coeliac disease to help prevent further complications from arising. Your doctor will order blood tests and the two most frequently ordered tests are the endomysial antibody and tissue transglutaminase antibody tests.

If the antibody test results suggest coeliac disease, you’ll then need to confirm the diagnosis with a biopsy of your small intestine. The appearance of dermatitis herpetiformis (DH), an itchy, blistering skin rash, is also a strong indicator of coeliac disease. There are those with CD who will need to stay on the diet for life, while there are others with mild sensitivities who can still enjoy a slice of cake or bowl of spaghetti now and again without long-term consequences.

If you’ve been examined for coeliac disease or gluten sensitivities and have tested negative but still want to try eliminating gluten from your diet for the health benefits, it’s advisable to do it for a period of time under the direction of your doctor or nutritionist and record whether your symptoms are reduced and whether you feel any better. This really is the key to deciding whether to eat gluten-free or not, and trying an elimination diet for a period of four weeks is an option presented by many nutritionists.

Go gluten-free

There has been a lot of publicity about gluten-free (GF) diets and weight loss of late and it’s easy for people to mistakenly believe that a GF diet is just another fad diet or weight-loss strategy. A definitive medically based, cause-and-effect study of eating gluten-free and long-term health consequences has not been fully established but many natural health experts and nutritionists believe the effects of gluten on the body do have a direct correlation with diseases and conditions ranging from diabetes to depression, eating disorders to infertility, ADHD to eczema and auto-immune to hormonal disorders.

The immune system reaction in coeliac disease is different from that of gluten sensitivity but it is still a reaction that creates health problems. Dr Alessio Fasano, director of the University of Maryland’s Center for Celiac Research in Baltimore, US, said he was sceptical when he first started hearing about non-coeliac gluten sensitivity a few years ago but has since come to realise that some sufferers are severely impaired and, because doctors aren’t exactly sure what the condition is, it’s difficult to diagnose.

Nutritionists and natural healthcare providers are treating the secondary effects of gluten consumption, such as infections, probiotic imbalance, hormonal imbalance and nutritional deficiencies, with a gluten-free diet and for many people the results are positive, although … “The bottom line for gluten sensitivity,” Dr Fasano says, “is there are very little facts and a lot of fantasy.”

If you’ve made the personal decision to eliminate gluten from your diet for one reason or another, gluten-free living is no mean feat. You may think you have covered all your bases by getting rid of obvious sources of gluten but you may not be aware that gluten sneakily lurks and is hidden in a number of processed foods, including salad dressings, egg substitutes, yogurt drinks and frozen yogurt, deli meats and cold cuts, soy sauce and even beer. A good idea is to check the ingredients and food labels for hidden sources of gluten. Things to be on the lookout for include packaged breadcrumbs and flour in sauces.

You don’t need to go it alone, either. It’s important to seek help from a registered dietitian when you embark on a gluten-free diet. Dietitians trained to design personalised gluten-free diets working with you as an individual and identifying your nutrient needs in accordance with your lifestyle.

A gluten-free eating plan may seem restrictive at first because it eliminates many types of grain products, such as breakfast cereals, as well as breads and pasta. But it’s not as difficult as it sounds and, once you get the hang of it, it will be relatively plain sailing. There are so many wonderful flavoursome and vitamin-rich foods you can eat on your gluten-free expedition, including gluten-free grains, fresh meats, vegetables, dairy and fruit.

If you’re wondering which grains to avoid, eliminate wheat in all its forms, including semolina, spelt, kamut, faro, rye, barley, triticale, oat bran, wheatgerm, bran, gluten, and durum flour. Introduce delicious gluten-free grains such as amaranth, quinoa, buckwheat, polenta and millet into your diet. You can enjoy breads, cereals, crackers and pasta made from almond meal, brown rice flour, potato, arrowroot, tapioca, sago and flax. Oats that are uncontaminated are recommended by most coeliac organisations in Australia and New Zealand.

When shopping, remember that not all products labelled “gluten-free” are healthy foods. Some pre-packaged gluten-free products are jam-packed with sugar and additives to compensate for the lack of gluten. These are not healthy choices and can be expensive, too.

Gluten-free recipes

Complex times call for simple food. If you want to give gluten-free cooking a try, it’s not difficult to make delicious meals at home. Here are three recipes you can tuck into on a gluten-free diet.

 

Super Seeded Bread

You can use any combination of seeds for this loaf: fennel, caraway, linseeds (flaxseeds), sunflower, sesame, pepitas (pumpkin seeds) or chia seeds.

 350g (12oz/21/3 cups) gluten-free self-raising flour
11/4 cups mixed seeds
1/4 tsp sea salt
1/4 tsp stevia powder
4 organic eggs
1 tsp apple cider vinegar
3 tbsp grapeseed oil
3 tbsp coconut milk
125ml (4fl oz/1/2 cup) filtered water extra sunflower or other seeds, for topping

Preheat the oven to 175ºC (345ºF/Gas 4). Grease and flour a 20cm × 9cm (8in × 31/2in) loaf (bar) tin.

In a bowl, combine the flour, mixed seeds, salt and stevia.

In a separate bowl, beat the eggs with an electric mixer until pale and fluffy, about 2 minutes. Stir in the vinegar, grapeseed oil, coconut milk and water. Pour the mixture into the dry ingredients and mix well.

Spoon the mixture into the prepared tin, then smooth the surface with the back of a spoon. Scatter some extra seeds over the top.

Bake for 40 minutes or until a skewer inserted in the centre of the loaf comes out clean. Turn out onto a wire rack to cool.

This bread keeps well for a day or two at room temperature but should then be kept in the fridge. It can also be wrapped up tightly and frozen for up to six weeks.

Makes 1 loaf

 

Lamb Burgers with Rosemary

The best thing about these burgers is you can prepare them in the morning, or the day before, and have them ready to go at a moment’s notice, especially if you don’t feel like cooking after a busy day at work. Crunchy daikon chips or turnip fries are the perfect partner to these super-easy crowd-pleasers.

500g (1lb 2oz) minced (ground) lamb, organic if possible
1/2 onion, finely chopped
2 garlic cloves, crushed
1 organic egg, lightly beaten
1 tsp finely chopped rosemary leaves
1 tbsp extra-virgin olive oil
8 slices Super Seeded Bread or other gluten-free bread
1 Lebanese (short) cucumber, thinly sliced
2 tomatoes, sliced
1 avocado, sliced
2 tbsp aïoli

Combine the lamb, onion, garlic, egg and rosemary in a bowl and season well with sea salt and freshly ground black pepper. Divide the mixture into four equal portions, then shape each one into a patty using your hands.

Heat the olive oil in a frying pan and add the patties.

Cook over medium heat for about 6 minutes on each side or until crusty brown on the outside and cooked through.

Meanwhile, toast the bread.

Top four of the bread slices with cucumber, tomato and avocado. Place a patty on each with a dollop of aïoli. Crown them with the remaining toasts and serve straight away.

Serves 4

 

Butternut Cookies

These delicious cookies are a keeper and will elicit a “wow” reaction from all. It’s good to have a box of these on hand for those special occasions or just in case unexpected visitors drop by. If they’re a few days old, you can warm the cookies in the oven for that just-baked flavour.

150g (51/2oz/1 cup) coconut flour
1/4 tsp gluten-free baking powder
11/2 tsp stevia powder, plus extra to dust
Pinch of sea salt
200g (7oz) cashew butter
4 organic eggs, lightly beaten
21/2 tsp natural vanilla extract
2 tbsp coconut oil
2 tbsp coconut milk

Preheat the oven to 175ºC (345ºF/Gas 4) and grease a baking tray.

In a bowl, mix together the coconut flour, baking powder, stevia and salt.

Warm the cashew butter slightly, then mix it with the eggs, vanilla, coconut oil and coconut milk until smooth.

Add to the dry ingredients and mix well to form a dough.

Roll the dough out between two sheets of baking paper to a thickness of 6–8 mm (1/4–3/8in). Cut out shapes using your favourite cookie cutter and place them on the greased baking tray (these cookies won’t spread during baking).

Bake for 20–25 minutes or until crisp and golden. Leave them to cool a little on the tray before transferring to a wire rack to cool completely. Dust with extra stevia if desired. The cookies will keep in an airtight container for several days.

 

Going gluten-free is a personal choice and, although it may not make all your symptoms vanish overnight, it may improve your prognosis for your long-term health and you can enjoy delicious energy-giving and nutritious food in the process.

 

Lee Holmes runs Supercharged Food, an altruistic website helping you to expand your range of healthy food choices.