Grains are an important part of a healthy, balanced diet for most people. However, some people have conditions that require them to limit or avoid certain grain foods. Before cutting grains from the diet, people should seek a professional diagnosis and consult an Accredited Practising Dietitian to ensure the diet is providing adequate nutrition.
In people with coeliac disease the immune system reacts abnormally to gluten, a protein found in wheat, rye, barley and oats, causing small bowel damage. The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened. The bowel is less able to absorb nutrients and this can lead to various gastrointestinal symptoms and nutritional deficiencies. GLNC encourages individuals with suspected coeliac disease and/or gluten intolerance to seek a qualified medical practitioner to investigate the potential of coeliac disease.
A gluten free diet is the only treatment for coeliac disease. The removal of gluten from the diet of an individual with coeliac disease allows the gut to heal and symptoms to improve. Dietary sources of gluten include any foods made with gluten containing grains including breads, breakfast cereals, crispbreads, pasta, as well as biscuits, cakes, pastry and pizza. Ingredients within packaged foods can also contain gluten and so it is important to be aware of these if you have coeliac disease. GLNC recommends anyone following a gluten free diet seek the guidance and support of an Accredited Practising Dietitian who can help to ensure a they can get enough nutrients from a gluten free diet. For more information about gluten in grains click here.
It is estimated that food allergies affect 2 in 100 adults, and an allergy to wheat is one of the least common food allergies. According to the Australia New Zealand Food Standards Code, foods containing wheat must be labelled to help people identify the allergen.
Symptoms such as headaches, bloating or mouth ulcers after eating indicate a food intolerance, rather than food allergy. Recently research has emerged that suggests the existence of a condition called non-coeliac gluten sensitivity (NCGS). However, NCGS is not yet well understood or easy to diagnose.
Irritable Bowel Syndrome and FODMAPS
Many of the symptoms seen in coeliac disease (such as diarrhoea, abdominal pain, bloating, and wind) are similar to irritable bowel syndrome (IBS), which is a disorder affecting 15% of the population. It is thought that the fructans in grains may contribute to IBS. Fructans can be poorly absorbed in the small intestine which can increase gas and symptoms in patients with IBS. They are a type of FODMAP, which stands for Fermentable Oligo-, Di-, and Mono-saccharides And Polyols. A diet low in FODMAPs can be used as a short term (2-6 weeks) strategy, and it has been found to improve symptoms in 74% of patients with IBS. However the low FODMAP diet is a therapeutic diet to be conducted under the supervision of a specialist dietitian. It is not a long-term diet as research indicates that FODMAPs are probably essential for maintaining a healthy population of gut bacteria which is important for long term health. For more information on the treatment of IBS with a low FODMAP diet visit the Monash University website.
For more information about Coeliac Disease and getting a formal diagnosis visit Coeliac Australia.
For individual nutrition and dietary advice see an Accredited Practising Dietitian (APD). To find a dietitian near you visit the Dietitians Association of Australia.