The Truth About Gluten: What Coeliac Patients Need to Know
Understanding Gluten and Its Effects on Coeliac Patients
Let's be honest: not many people know what gluten actually is. Even when you've been diagnosed with coeliac disease, it's often difficult to remember exactly what gluten's function is. You just know you need to avoid it. So, to recap:
Gluten is a protein found in grains such as wheat, barley, and rye.
For most people, consuming gluten doesn't cause any issues. But we coeliac patients know better; gluten can trigger an immune response that damages the lining of the small intestine, leading to health complications.
But exactly what could those complications be? And can we be sure they'll actually happen to us?
Well that's what this blog is about: revealing the truth about gluten. And yes, I stress TRUTH because it's remarkable how much rubbish is out there on the internet. As always, you know you can trust me to provide essential information that every coeliac patient should know about gluten to live a healthy, gluten-free life.
Why Coeliac Patients Need to Avoid Gluten
For coeliac patients, even consuming small amounts of gluten can be dangerous. How small? Take a slice of bread. Cut it in half. Then half again. Then half again. Keep halving it until you can't halve it any more. However good your knife skills, you'll never get a piece of bread so small it's small enough to be safe for a coeliac.
Food must not contain gluten that exceeds 20 parts per million for it to be safe for coeliacs. Can you picture that breadcrumb now?!
As for coeliac symptoms, they are so wide-ranging I can't even list them all here (seriously, there are over a hundred different symptoms) but the main ones include stomach pain, bloating, diarrhoea, headaches, and fatigue.
And why does this happen? It's because the body thinks it's being attacked. The immune system decides something bad is happening because it's been triggered by gluten so it damages the villi, which are small fingerlike projections that line the small intestine. I've put a massively enlarged drawing of them here but in real life they're not even 2mm big.
When the villi are damaged, the small intestine can't effectively absorb nutrients from the food we eat, which can lead to nutrient deficiencies, anaemia, and other health problems. It's therefore crucial for coeliac patients to avoid gluten in their diet.
Identifying Gluten in Foods
It might seem challenging to avoid gluten since it's pretty much in every food known to man (or, at least, that's how it feels when you're told to avoid it). But actually, there are plenty of foods that are naturally gluten-free, including meat, fish, dairy, eggs, rice, potatoes, sugar, fruit, vegetables and more.
Nonetheless, that doesn't mean going gluten-free is a breeze. If you've not already realised, it's essential for coeliac patients to learn how to identify gluten-free foods and to read food labels carefully. Gluten is often found in:
Bread, pasta, and other products made from wheat, barley, or rye
Contaminated manufacturing processes (e.g. in bags of oats)
Some processed foods and condiments, such as soy sauce, salad dressings and stock cubes
Food additives, such as malt, binders and flour to prevent food sticking together (e.g. sweets)
Avoid 'May Contain Gluten' Warnings
These can be in really weird places (I've seen them on tins of sweetcorn and bags of pudding rice). Just think of these warnings on labels as 'may contain glass' or 'may contain poison'. One person I know says she thinks of it as 'may have been on top of a dirty nappy'. Avoid.
Gluten-Free Labels
Coeliacs should look for foods with a 'gluten-free' label (Coeliac UK has a crossed grain symbol) or start by looking at products made from rice, corn, or potatoes (checking there's nothing hidden on the label). Keep in mind that gluten can also be hidden in non-food places you might not realise, like your kid's Play-Doh, so be extra careful to wash your hands before eating.
But there's SO MUCH MORE to it than I've just outlined. And if you're keen to read more than this blog post to ensure you're safe, the easiest way to learn is to take an online class, like my 'Get to Grips with Gluten-Free' course (see more here).
Living a Gluten-Free Lifestyle
Adopting a gluten-free lifestyle might seem daunting at first (trust me, I've been there...back in 1999 with no help and no internet), but with a little practice and perseverance, as a coeliac it does get easier and, dare I say it, actually enjoyable.
But to get to that stage, you'll need to start out with the basics. When I took my first tentative steps around a supermarket, I took about two hours to get round and had a few moments of frustration (ahem, quite a few moments of frustration!), but eventually I got to where I am now - i.e. a much better place where I'm not worried about food all the time.
I wish I'd had someone to help me. It would have saved a lot of time & energy.
So to help you avoid the problems I had, below are some newbie coeliac tips:
Choose naturally gluten-free foods, such as fresh fruits, vegetables, meats, fish, poultry, and dairy products.
Short on time? Cook fresh food quickly from scratch (like a stir-fry) to avoid always having to read labels.
Educate yourself about foods that may contain hidden gluten, and always read food labels carefully.
Plan meals and snacks ahead of time to avoid the temptation of grabbing something quick that may contain gluten. I like to keep snack bars in my car glove compartment.
Get creative in the kitchen and find new gluten-free recipes to try (there are SO many gluten-free cookbooks out there - just choose the one that has recipes you're tempted by).
When dining out, make sure to communicate your dietary needs clearly to restaurant staff (over and over again).
Support for Coeliac Patients
Living with coeliac disease and following a gluten-free lifestyle can be challenging at times, but being coeliac doesn't mean you have to face these challenges alone. I'm here, for a start! Plus, there are numerous resources available to help:
Join a support groups to connect with other coeliac patients, share experiences, and get helpful advice. The Gluten-Free Haven is a great place to start!
Consult a registered dietitian or nutritionist to help you create a balanced, gluten-free meal plan (you'll get one on the NHS if you live in England but it may take months; if you want advice now, you can get a wealth of information from a specialist coeliac dietitian in my online program From Bloated To Brilliant).
Stay informed by reading about the latest research on coeliac disease and gluten-free foods.
Attend online workshops to learn more about living a healthy, gluten-free lifestyle.
By making sure you know what gluten really is and where it lurks, you'll avoid some of the calamities I had when I first started out as a coeliac. For a start, it may help you make better decisions about your health and well-being (like wanting to be healthier - for me, it meant I ditched my chocolate for lunch diet).
Embracing a gluten-free lifestyle may require some adjustments (and you shouldn't underestimate these), but the benefits of improved health and symptom relief are well worth the effort. Trust me, as someone who's been doubled over in pain too many times prior to diagnosis, it's wonderful being able to feel well again.
And remember! It's always easier when you've got someone to help. I really recommend taking a look at the online courses below and choosing the ones that you need most.
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