Written by Wong Kok Long, AA Pharmacist.
Gluten-free diet has become increasingly popular nowadays. Some people take it as a method to lose weight while some perceive it to be a ‘healthier’ diet. These claims however, are not supported by any evidence 1. In fact, gluten-free diet is only beneficial for individuals with gluten-related disorders.
Gluten is a protein commonly found in wheat, rye, barleys and the derivatives of grains including malts and brewer’s yeast. It is also a vital ingredient in a huge range of breads, pasta and other dough products1. Gluten plays an important role in maintaining the shape of food, yet it is not easily digested by our digestive enzymes.
To individuals who are sensitive to gluten, it may provoke an immune response in the small intestine upon ingestion, subsequently causing a series of gastrointestinal symptoms, including:
- Digestive discomfort and Irritable Bowel Syndrome (IBS) symptoms (abdominal pain, cramping, bloating)
- “Brain fog” difficulty concentrating and trouble remembering information
- Frequent headaches
- Mood-related changes (anxiety and increased depression symptoms)
- Dermatitis, eczema, rosacea and skin rashes
- Nutrient deficiencies, including anaemia (iron deficiency)2
Gluten-related Disorders; Celiac Disease & Non-coeliac Gluten Sensitivity (NCGS)
Celiac disease is a lifelong, autoimmune disease that triggers inflammation in the small intestine with gluten absorption. It affects 1-2% of the population worldwide.3 On the other hand, NCGS is clinically recognised as less severe than celiac disease. While it shares similar symptoms as celiac disease, NCGS shows negative result on celiac disease testing and causes less intestinal damage4.
Both celiac disease and NCGS are best treated with gluten-free diet.
Gluten-free Diet Management Tips:
1) Don’t deprive yourself.
The market has responded to a demand for
2) Prepare most foods at home.
Eat a balanced and varied diet that high in whole foods, plenty of fresh fruits and vegetables6.
3) Always read labels on packaged foods.
Try avoiding ingredients such as
Figure 1.1: Gluten-Free Diet Food Chart (Source: The Root Health)
Gluten FreeDiet: Facts & Myths [Internet]. Gluten Intolerance Group. Updated May 2017 [Cited 2018 Feb 12]. Available from: https://www.gluten.org/resources/getting-started/the-gluten-free-diet-facts-and-myths/
- Adda Bjarnadottir. The 14 Most Common Signs of Gluten Intolerance [Internet]. 2016 Sept 9 [cited 2018 Feb 12]. Available from https://www.healthline.com/nutrition/signs-you-are-gluten-intolerant
- Dr. Peter H.R. Green, Rory Jones. Gluten Exposed. 2016;4:1-24.
- Catassi C, Bai JC, Bonaz B, Bouma G, Calabrò A, Carroccio A, Castillejo G, Ciacci C, Cristofori F, Schumann M, Schuppan D, Ullrich R, Vécsei A, Volta U, Zevallos V, Sapone A, Fasano A (Sep 2013). “Non-Celiac Gluten sensitivity: the new frontier of
gluten relateddisorders”. Nutrients. 5 (10): 3839–53.
- Elke K. Arendt, Fabio Dal Bello.
Gluten freecereal products and Beverages. 2008;1(5):1-22
- Megan Morris. Gluten & Wheat [Internet]. The Root Health. 2011[cited 2018 Feb 14]; Available from http://www.therootofhealth.com/gluten-wheat/
- Gluten-Free Diet for Celiac Disease [Internet]. WebMD. [cited 2018 Feb 13] Available from https://www.webmd.com/digestive-disorders/celiac-disease/tc/gluten-free-diet-for-celiac-disease-topic-overview