Gluten-Free Diets

Without GLUTEN, croissants wouldn’t be buttery and fluffy on the inside, fruitcake wouldn’t have that finger-licking moistness and Anzac biscuits wouldn’t crumble beside your cup of tea. Gluten is the main protein found in common grains, responsible for elasticity, crumb structure and moisture retention in doughy baked goods.

But gluten can also be the cause of a long list of problems in those who react to it. The most extreme form of gluten sensitivity is coeliac disease, in which a person’s immune system reacts to minute amounts of gluten in the bloodstream. The result is inflammation of the intestinal tract and poor absorption of essential nutrients, leading to an array of further medical problems.

Those with less severe sensitivity don’t experience an immune reaction but can suffer an array of similar symptoms, ranging from mildly uncomfortable to severely debilitating. The common ones include abdominal bloating, weight loss, diarrhoea and fatigue as well as poor concentration, memory loss, nausea, vitamin and mineral deficiencies, and anaemia.

Until recently, doctors rarely considered gluten intolerance as a diagnosis. It’s now recognised that about 250,000 Australians have coeliac disease, up from estimates of 25,000 just ten years ago. That means at least one in 100 Australians have the condition. At an individual level, the likelihood of having coeliac disease rises to one in ten if someone else in your family has it.

Detection methods have improved but coeliac disease is still seriously under­diagnosed. About 80% of people with the condition don’t know they have it.

This explosion in numbers is not simply due to better awareness and diagnosis. Swedish population-based studies suggest that an increased wheat/gluten intake in infancy increases the risk of coeliac disease – people are being exposed to more gluten, >> more often, at a younger age. Adds Dr Bob Anderson, a consultant gastroenterologist at Royal Melbourne Hospital who is working on a world-first vaccine to treat the disease, "There has been a general dietary shift [away from fat] towards eating more carbohydrates." Dr Anderson says there’s no formal data to prove whether this has led to increased coeliac disease, but it is possible.

And when the carbohydrates turn out to be wheat-based, it’s likely that gluten will be in there somewhere. Specifically, gluten is found in wheat, barley, rye and oats and their derivatives. For anyone who is gluten-intolerant or coeliac, the medical advice is simple: avoid these grains completely, for life.