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.
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2nd February 2016 at 2:24 pm
Who cares about a diagnosis, as long as you feel better without wheat (& other gluten grains) then go ahead and eat the many other non-gluten grains available. I also recently discovered that sourdough spelt is easier to digest for those with wheat problems so worth a try or even sprouted wheat.
11th January 2016 at 12:48 am
As a mother of a child who was diagnosed as a Coeliac at the age of 3 years, I have had to relearn how to cook the most basic things like bread, biscuits, beef stew and the like. Try explaining to a 3yo, 4yo, 5yo etc that they can go to a birthday party, but they have to take their own food and own cake, so as the burden of trying to find and cook gluten free is not on the hosting parents. In the past seven years, the amount of gluten free products (both identified as being gluten free and gluten free by ingredient – and all Coeliacs know what I am talking about there) has increased astronomically!! Of course, the pricing of such products are as still astronomical as they were 7 years ago – no change there! At the time of our daughter’s diagnosis, we found the best way to explain to her was that she couldn’t eat this thing called wheat, barley, rye and tritcale and we showed her examples. When she asked why, all we could say was that she was a Coeliac and so were we. So we ate a Coeliac’s lifelong diet along with her daughter in support of her. Now, at the age of 10, she is the second tallest in her class, healthy as an ox, not an ounce of fat on her body, and can read ingredient labels and pretty well knows what is a gluten ingredient and what isn’t. We, her parents, still eat gluten free with her, but we know also include gluten back in our diet and our daughter understands that our bodies require it.
In respect to those 84% of people who say “oh, yes, I am a coeliac too” or “I’m gluten intolerant” (the other catch cry of the 84% who can’t be bothered to go through and have an endoscopy, the only 100% way of diagnosing Coeliacs Disease – and yes, my daughter went through that at the age of 3), irritates me to the ends of the earth! So you think you have an issue with gluten, go see your doctor. Or better yet, if you learn to read food labels, you will find that gluten is present in the greater majority of processed foods. Gee, now there is food for thought….lets return to a more natural, healthy and balanced diet with fresh fruits and vegetables. Maybe even buy real meat (unprocessed such as mince, chops, steak – watch the sausages though, they could have gluten in them, same with ham and other deli meats) and cook a meal for yourself and, if you have a family, your family as well. Sure beats eating takeout all the time and a lot less expensive.
So don’t come crying to me and tell me that you have decided that you are gluten intolerant or have coeliacs unless you have an official diagnosis, because you will gain no sympathy from me.
31st March 2016 at 6:39 pm
Hi Michele,
Please bear in mind that for some, myself included, the information and advice we get from gp’s can be quite contradictory and confusing possibly putting people off pursuit of a diagnosis.
I’m still working down the path of finding out why I am incredibly tired and have quite a few other issues when gluten is in my diet. I want to know if I am a coeliac or just have a sensitivity to gluten. I have had conflicting advice from a couple of gp’s so far and that has made the journey of discovery confusing in the main.
I’ve been off gluten now as part of a trial suggested by my regular gp for a couple of months and yes life has improved vastly. I wish I had gone through this 20+ years ago. I’m not looking forward to consuming gluten again for a period of at least 6 weeks to continue this journey due to what it was doing to be before. My partner and I have decided to delay my return to a diet containing gluten and further testing for some time until a few other complications of life have played out. It’s just not worth extra stress to have that in play at this time. So yes I’ll be one of those poor unfortunates that won’t get any sympathy from you for some time, not that I was seeking any.
I can also say from experience that yes social engagements can be very difficult in a gluten saturated world for those who can’t consume it for whatever reason. My son also 3 may well have this future ahead of him as I did thanks to genetics. My mother also has issues with gluten. She settled for as you’d say the easy option of just not consuming it with no conclusive diagnosis.
All I could ever ask for from anyone that has issues with gluten is some help in navigating this confusing path. A number of family fiends who are coeliac have been incredibly helpful in showing us that life is better if you feel better regardless of how you got there. Not to mention the advice on gluten free cooking. For the record, both of them have said if you feel better on a gluten free diet why go back.
If you happen to read this, please take a deep breath and reflect on what you’ve said. Be helpful to those on this journey regardless of their reasons. If we all help each other the world will be a better place.
Michael
10th January 2016 at 2:49 pm
If I eat wheat or other gluten containing products my joints start aching and I feel very tired .
If I eat dairy products my nose , throat , and sinuses get bunged up with mucus .
Both of these give me stomach problems .
If I avoid these then I have no problems at all and feel very well .
11th May 2016 at 10:37 pm
It sounds like Hashimoto’s
5th September 2016 at 10:35 pm
I am the same & am far healthier on a gluten free & minimal dairy diet. I was diagnosed with Hashimotos hypothyroidism decades ago & being on thyroxine did nothing to alleviate my symptoms. Am amazed too how my joints will ache if I occasionally indulge in sugar laden GF processed food or alcohol! Back to the home cooked foods & all the inflammation disappears:)