A fire-roasted veggie sandwich produced with gluten-rich wheat. Image: wEnDy/Flickr/CC BY-NC-ND 2.0
In recent decades, fat, sodium, carbohydrates, sugar and protein have all been targeted as ‘bad’ dietary factors. Right now the focus seems to have shifted to gluten: a protein found in cereal grains, especially wheat but also rye and barley. For a small proportion of consumers, such as those diagnosed with coeliac disease or wheat allergy, the avoidance of wheat and other gluten-containing foods is essential. Symptoms for sufferers can include nausea, vomiting, cramping, bloating, abdominal pain, fatigue and even very serious conditions such as liver disease.
The prevalence in the population of coeliac disease and wheat allergy, while significant, sits between 1-2%.
But the growing number of consumer foods labelled as either gluten or lactose free, and the popularity of restrictive diets like the paleo diet, would suggest more people are making the choice to go gluten or wheat-free – above what the coeliac and wheat allergy statistics would suggest.
To understand more about this trend, we conducted a nationwide survey of nearly 1200 people selected at random from the Australian electoral roll. The aim of the research was not only to quantify the prevalence of wheat avoidance in Australia but also to pioneer understanding of the drivers underpinning this decision.
Wheat avoidance in Australia
The data collected revealed that as many as 1 in 10 Australian adults, or approximately 1.8 million people, were currently avoiding or limiting their consumption of wheat-based products. Women were more likely to be avoiding wheat than men.
The survey also revealed that over half (53%) of those who were avoiding wheat were also avoiding dairy-based foods.
Why is this an issue? According to current Australian Dietary Guidelines, both grain and dairy-based foods are an important component of a balanced diet. They contribute significantly to the daily dietary fibre and calcium intake of both adults and children. They also deliver other important nutrients such as protein, vitamins and minerals, and – if eating whole grain – resistant starch.
So why are people choosing to avoid wheat?
The reasons behind this decision are complex. Some respondents reported that they were avoiding wheat due to a diagnosis of coeliac disease (1.1%), or because a family member has been diagnosed with coeliac disease. Others stated they were avoiding wheat for weight-control or taste preferences.
However, the vast majority of the survey’s wheat-avoiding respondents – which equates to 7% of (non-coeliac) Australians – were avoiding wheat-containing foods to manage a range of adverse symptoms they attributed to the consumption of these products. Symptoms were mostly gastrointestinal in nature (bloating, wind and abdominal cramps) but also included fatigue/tiredness.
When asked if they had any formal diagnosis including that of an intolerance, allergy, or coeliac disease which required them to avoid wheat, most (84%) of these symptomatic individuals said no.
So what sources are people relying on when it comes to making decisions such as avoiding wheat? There is a great deal of information which links the consumption of specific foods to adverse symptoms. According to our data, those who decide to eliminate wheat tend to do so based on advice from sources such as complementary practitioners (for example, naturopaths) family, friends, the media, and to a lesser extent their GP or a medical specialist.
Is wheat really so bad?
Up until recently it was thought that gluten was only really a problem for individuals with coeliac disease. Our findings, plus the extraordinary rise in popularity of the gluten-free diet in Australia and elsewhere, suggest that, apart from coeliac disease and wheat allergy, other conditions associated with the ingestion of wheat are emerging as health care concerns. Currently, the driver of most of the research activity in this area is the concept of non-coeliac gluten sensitivity (NCGS).
NCGS is defined as adverse reactions to the consumption of gluten, where both allergic and autoimmune mechanisms have been ruled out and where gastrointestinal symptoms improve on a gluten-free diet. Many aspects of NCGS remain unclear, including prevalence, clinical spectrum, physiological mechanism and treatment. There is also considerable debate as to whether it is in fact gluten or some other component of wheat that triggers the reported symptoms.
Fructans, for example, are short-chain carbohydrates which are found in wheat-based products, as well as other foods. For a proportion of the general population fructans, along with other short-chain carbohydrates (collectively called FODMAPS), can trigger symptoms like bloating, wind or cramps – by holding water in the gut or through the rapid production of gas by intestinal bacteria.
Our finding that people may be avoiding more than one dietary component at a time has the potential to complicate being able to know exactly which dietary components, and in what doses, are to blame for their symptoms. Further research is needed.
Until then, there is a risk that a significant proportion of Australians may be undertaking diets that are unnecessarily restrictive, with the potential danger of associated nutritional imbalances. Also of concern is the finding that the majority of symptomatic respondents appear to be bypassing conventional medical advice in their decision to go wheat-free. We would be remiss not to draw attention to the potential risk here of a serious clinical condition going undetected.
To find out more about our research into diet and lifestyle, visit our website.
10th January 2016 at 5:35 am
I don’t eat bread because of the bloating, but it is not so much the wheat. I can eat pastry. So it is an additive. I can eat mountain bread. It could be the yeast. Some breads are worse than others. I find sour dough bread is better but I don’t eat it regularly. A daily feed on Greek yoghurt is great, in regards to gut problems.
10th January 2016 at 6:33 am
Both a colonoscopy and a barium enema Xray plus other tests found nothing, but when my skin broke out a spin specialist suggest stress. Anxiety or/and stress can produce like symptoms.
9th January 2016 at 11:40 pm
I hate to break the news to you but medical practitioners are useless when it comes to this stuff. They do next to no nutritional training in their degree. It took me years & years to discover that gluten was not my friend – with zero thanks to doctors. You’d think with a family history of bowel disease they’d show more interest. This article belittles people’s efforts to go outside the square to address their health, without addressing why they are forced to in the first place.
5th January 2016 at 8:37 pm
Who funded this research? The Australian Wheat Boatd? If a person finds cutting wheat out of their diet eliminates bloating, stomach cramping and other allergic symptoms why would you not do so – there is no need to get on the medical treadmill to be told there is nothing wrong with you when your own body is quite clearly telling you there is!
9th January 2016 at 10:46 pm
No, feel free to self-diagnose. If something’s making you sick, should you see your GP? Of course not!
10th January 2016 at 9:39 am
That’s not how science works, Anne. There’s a thing called the nocebo effect (like the placebo effect). Essentially, it’s all in the mind.
8th December 2015 at 2:52 am
In my personal experience, GPs understand almost nothing about diet and the impact of various foods on people’s health.
I was fortunate enough to stumble across a doctor who specialises in wellness.
Over the last few years I have adjusted my diet and lifestyle (increased exercise) and have lost 30% of my weight, with the goal of losing a total of 43% of my peak weight.
Lack of wheat, dairy, and processed foods are an important part of losing this weight and feeling better.
I have tested the impact of various foods, by removing, returning, and then removing them from my diet. So I know that wheat, dairy, sugar, and soy are not good for me. I am not a coeliac (I have been tested).
I’m a big fan of the paleo diet, which for me means eating mostly vegetables, some meat and seafood, and various nuts and seeds, and very little fruit (sugar). I still eat carbs, wheat, sugar, and drink beer and other alcohol. Just not as much as I used to.
The most troubling thing for me is the misinformation about food and what is good for us, particularly from so-called experts. They are pushing the barrow as facts, rather than opening their minds and asking if what they have been taught is true. For example, everyone says milk is good for you. Is it? Your article implies that we need to drink milk because of its high calcium content. My understanding is the body is not able to extract the calcium in milk. If that’s the case, where is the value in milk? I avoid most dairy, especially milk, because it makes me feel bad.
9th January 2016 at 9:21 pm
Someone buy this man a drink!
3rd December 2015 at 9:33 pm
It’s interesting that many people ‘diagnosed’ themselves instead of checking with a GP. Maybe you could do a survey on current attitudes to the medical profession and general health and pharmaceutical industries to see what this is about.
4th December 2015 at 5:42 pm
When I told my gp about my symptoms he said that I had irritable bowel, but we did nothing about ii, ie not many suggestions. I found from complimentary medicine that perhaps wheat might be part of the problem. So I cut out wheat, to see what happened. I got somewhat better but still had problems. At the time gluten free was the next step. It seem to help, but is an expensive and annoying diet. Unfortunately it seems to ease my symptoms. Have not tried fod maps…possible. And blood test ruled out coeliac. Although my mother has developed similar symptoms so a genetic test is a next step. Believe me if I did not feel better I would not be gluten free. Oh and yes I get quite sick if I eat gluten containing foods, not just bloating, diarrhoea, skin breakouts and nausea.