Coeliac Disease

What is coeliac disease?   Gluten is a protein found in wheat, rye, oats, spelt and barley. Those with coeliac disease have an autoimmune reaction to gluten. This affects about 1% of the population. The only treatment is to exclude gluten entirely from their diet. If a person with coeliac disease eats food containing gluten (even a tiny quantity), it damages the lining of their gut leading to symptoms (diarrhoea, constipation, nausea, cramping) and medical complications (malabsorption, osteoporosis, anaemia). The EU law stipulates that 14 specific food allergens are declared on prepacked and non-packed foods. Gluten is one of these allergens. If a food on the menu contains gluten, the exact cereal containing the gluten must also be identified and specified on the menu.   Why follow a gluten free diet?   Those with a diagnosis of coeliac disease must follow a gluten free diet as it is the only treatment available. This diet aims to exclude all dietary sources of gluten and ensure gluten containing foods are substituted with an alternative of similar nutrient quality.   Where is gluten found in food?   As we mentioned, gluten is found in wheat, rye, oats, spelt and barley and any foods made with these cereals. Other sources of gluten to avoid when reading labels of processed foods include; starch or modified starch (check source-allowed if not made from wheat), cereal filler, wheat starch, wheat bran, wheat germ, malt, malt flavouring, malt extract. The Coeliac Society of Ireland provides a comprehensive directory to gluten free foods yearly. The best way to ensure ingredients are gluten free is by reading the label. Allergens are highlighted and written in bold in the ingredient list. In the case of gluten, the cereal containing the gluten must be specified on the label. The crossed grain symbol is nationally and internationally recognised by those who need to follow a gluten-free diet. What about FODMAPS?   Carbohydrates include: bread, pasta, rice, potatoes and sugary foods. Those with irritable bowel syndrome (IBS) are sensitive to certain carbohydrates in food called FODMAPS which are poorly digested and lead to symptoms in certain people such as wind and bloating. Irritable bowel syndrome affects 10-15% of the population. The letters in the word FODMAP each represent a name of each fermentable carbohydrate. The name may not be familiar to you but it refers to the chemical name given to a group of specific carbohydrates. Oligosaccharides (fructans and galactans) are a type of fermentable carbohydrate/type of fibre which are found in wheat, onions, garlic, beans and certain fruit and vegetables. Those who have IBS who have not found relief in following a healthy eating diet, high in fibre and fluid and wish to follow a low FODMAP diet are advised to do so under guidance from a registered dietitian before making unnecessary dietary restrictions.