Well we’ve got ourselves in a right sticky old mess (#punny) over the whole gluten thing, haven’t we? Never having had any gluten issues myself I was pretty ignorant on the topic until a couple of years ago when my mother-in-law’s digestion went completely a-rye and she was eventually diagnosed with celiac/coeliac disease - pronounced ‘silly yak’ according to my glu-ru friend Karen (more from her later). Ok, it’s a serious subject enough of the puns!
Did you know that the over-60s are the largest demographic for celiac diagnosis? Shocking eh? I had (previously) assumed that it was something you had from birth or at least developed in early life. So, the first takeaway message is that you can develop celiac disease at any age if you have the gene. We need to backtrack a little here, a few definitions are required...
There are 4 ways people can be affected by gluten (gluten is a protein found in wheat, barley and rye), as follows:
1] CELIAC DISEASE – this is an autoimmune disease which can be tested for and fully diagnosed*. It is caused by your body mistaking gluten for an alien invasion, much like if you had a virus, and producing antibodies to fight it. This causes damage to the gut lining which leads to not just short term symptoms like gut problems, weight loss and fatigue but potentially long term health issues such as coronary artery disease and small bowel cancer. In fact there are over 250 potential symptoms of celiac disease and there is no cure, the only way to manage celiac disease is by following a COMPLETELY GLUTEN FREE DIET.
2] WHEAT ALLERGY – with a wheat allergy it is wheat generally, rather than gluten, that causes an allergic reaction. It can be life-threatening but more common symptoms include breathing difficulties, skin rashes, gut discomfort, runny nose, sneezing and headaches. Wheat has to be completely eliminated from the diet - rye and barley as well as other grains can usually still be eaten.
3] GLUTEN INTOLERANCE – some people experience symptoms similar to celiac disease after eating gluten but do not have the disease. There is no way to definitively diagnose an intolerance, it usually involves following an elimination diet preferably under the supervision of a qualified dietician. Gluten intolerance is not thought to impact health in the longer term, unlike celiac disease.
4] LIFESTYLERS – a growing number of people are cutting out gluten for perceived health or weight loss benefits. This has been reinforced by low carb diets like Paleo and Keto. If you have none of the above conditions there is absolutely no reason to cut gluten out of your diet. Of course, keeping a balance is always a good idea so toast for breakfast, a sandwich for lunch and pasta for dinner might be overkill!
Now back to Karen...
Karen Horan set-up Gluten-Free Singapore (glutenfree.sg) when she moved here 9 years ago. With a celiac daughter and a husband who is gluten-intolerant she found precious little information and support available and she has since become the go-to person for all things gluten-free. I asked her what her opinion was on the whole GF trend and although obviously more awareness of celiac disease is very welcome, she was also clear on the subject of adopting GF as a lifestyle choice; why on earth would you choose to go GF if you don’t have to? It’s such a terribly limiting diet which potentially affects not just your own quality of life but those of the people around you. For people with celiac disease just one crumb of regular bread is enough to be a problem, this is why celiacs need not only completely gluten-free bread, but their own toaster and their own butter (yes even the crumbs in the butter are enough to cause a issue!) and that's just the start of it - eating out can be really problematic. Of course lifestylers don't have to be that strict because gluten isn't going to make them sick but it does put it into perspective doesn't it?
There’s also a school of thought that modern, genetically modified grains are causing more gluten intolerance than ‘back in the day’ when everything was al-rye-ght (last one!). The evidence is mainly anecdotal at the moment and although there may be a grain of truth in it (literally can’t stop!), it’s too simplistic a theory to explain the apparent increase in gluten intolerance. If you have an intolerance even organic and ancient grain products are going to be a problem but for the rest of the population it’s always a good idea to buy the best quality products you can afford - a beautiful artisan, organic sourdough loaf has got to be better than a bag of sliced commercially produced bread full of the cheapest ingredients and a whole lot of preservatives.
If you’d like to watch a short video Karen has put together about celiac disease (also useful if you are a health professional or for education purposes) click here.
Have a great day everyone. We are going to have a very un gluten-free family dinner at the local Italian tonight and I’m going to feel very grateful that we can.
*Very important, if you think you may be celiac and want to be tested DO NOT STOP EATING GLUTEN! The test will only pick up if your body is producing antibodies if you are actually eating gluten. If you stop eating gluten you may get a negative test for celiac disease even if you have it. Once diagnosed you can then move to a GF diet.
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