Gluten is a collective term used to describe the proteins (called promalins), that are found in certain grains including wheat, spelt, farro, barley, oats and rye. Gluten plays an important role in many food products (such as bread and pasta) acting as a glue and when heated the proteins stretch and trap gas which also promotes leavening (rising). This gives bakes goods their characteristic soft and chewy texture.
For some people, their immune system reacts badly to the protein (gluten) found in these grains, known as coeliac disease. For those with coeliac disease, it is important they strictly avoid all gluten, to avoid several gastrointestinal and malabsorptive symptoms and damage to the small intestine. Coeliac disease can be initially screened for via a blood test (it is essential you are including gluten in your diet for at least 6 weeks prior to your blood test) and then diagnosis needs to be confirmed via biopsy. It is estimated 1 in 70 Australians have coeliac disease. It is also important to note, you cannot self-diagnose coeliac disease. It is vital you go see your health professional to get properly assessed.
Non-coeliac gluten sensitivity (NCGS) is a term used to describe a set of symptoms that people link to the consumption of gluten containing foods. They either do not test positive, or have not been tested, and yet find relief from avoiding gluten in their diet. The actual prevalence of NCGS is a topic of debate, as it is typically self-diagnosed.
One thing is for sure, gluten free diets have exploded in popularity in the last 10 years. This can possibly be explained by both the growing awareness and diagnosis of coeliac disease and a common misconception that gluten-free diets are in some way ‘healthier’. In fact, many commercially made gluten-free products (bread, biscuits etc) are lacking in fibre, high in refined carbohydrates and high GI due to their starch and gum content. In contrast, gluten containing whole grains such as barley, rye, oats and spelt are excellent sources of fibre and several nutrients, so it makes sense to include them if you can.
The take home message? For those with coeliac disease, it is essential to eliminate all gluten from the diet. For those with NCGS, avoiding or reducing gluten in the diet may be important/helpful, but it is still important to seek professional advice and not self-diagnose. Most importantly, whether you follow a gluten-free or gluten containing diet, choose wholegrain versions of grains and avoid highly processed flours and their products. Good wholegrain gluten-free choices include quinoa, buckwheat, brown rice, millet, sorghum and teff.