THE holiday season is imminent, and with it come opportunities to put on weight over the party season. So to prevent that, what diet will it be this month? Fat-free? Low-carb? High-carb? High-protein? Wheat-free? Dairy-free? Gluten-free?
The possibilities seem endless, and with so much conflicting information out there, it can be hard to know when to eliminate certain foods.
Gluten-free diets have become popular, and not just for weight loss. But is it good to exclude gluten from the die, and to what extent? Or is this just another fad diet that will pass?
Here are factors to consider:
• What is a gluten-free diet?
People are often confused between wheat-free and gluten-free, and may believe they are following a gluten-free diet, but are actually only following a wheat-free diet.
A gluten-restricted diet is free of gluten-containing foods. Gluten refers to specific peptide fractions of proteins (prolamines) in wheat (glutenin and gliadin), rye (secalin), and barley (hordein). These peptides are generally more resistant to complete digestion by enzymes in the gut, and may reach the small intestine intact.
When following a gluten-free diet, you need to eliminate any foods containing even small traces of wheat, rye or barley, on a wheat-free diet, you only need to exclude wheat-containing products; you can include products containing rye and barely, provided they do not contain wheat.
Oats were once thought to be questionable for people trying to avoid gluten. However extensive studies have shown that they are safe in a gluten-free diet, provided they are consumed in a pure, uncontaminated form. A small percentage of individuals may not even tolerate pure oats.
• When is it necessary to follow wheat free or gluten-free diets?
Some people avoid wheat and gluten because they have allergies, intolerances, food sensitivities, or medical conditions such coeliac disease; others avoid them for control or relief of symptoms of gastrointestinal problems, irritable bowel syndrome, asthma, eczema, or to improve their energy levels; some people eliminate them simply on the basis that they feel it is healthier.
There may be benefits. However some people take it to extremes and avoid certain foods unnecessarily, resulting in a restrictive diet that involves planning.
• What about allergies, intolerances and food sensitivities ?
If you do have an allergy, intolerance or sensitivity to wheat or gluten, then you have to eliminate it from your diet.
Food allergy or hypersensitivity is an immune response to a food (usually a protein) resulting in an adverse reaction. Symptoms are caused by unique response to the food, rather than the food itself, and vary significantly from person to person.
Food intolerance is an adverse reaction to a food that does not involve the immune system, and occurs because of the way the body processes the food or components in the food.
Food sensitivity refers to an adverse reaction to a food or component of the food, when it is not clear whether the reaction is due to food allergy or intolerance.
• Coeliac disease (CD) or gluten-sensitive enteropathy
This is characterised by a combination of factors: genetic susceptibility, exposure to gluten, an environmental trigger, an auto-immune response. In the normal, healthy individual, gluten is harmless. However in people with coeliac disease, these peptides trigger an inflammatory response which causes a more general immune response.
Symptoms can be similar to classic gastrointestinal symptoms — diarrhoea, malodorous stools, abdominal bloating, apathy, fatigue and poor weight gain. Not everyone presents with symptoms, and 50% of coeliac patients have few or no obvious symptoms.
The diagnosis of coeliac disease is made from a combination of clinical, laboratory and histological evaluations. Lifelong, strict adherence to a gluten-free diet is the only known treatment for coeliac disease.
Those eliminating wheat or gluten on the basis of symptom management are likely to feel better, but may not need to be as strict. Wheat and gluten in the form of refined carbohydrates, such as white bread, rolls, pies and pastries, often trigger unpleasant symptoms such as bloating, gas and irregular bowel movements.
These foods often contain added sugars and/or fats, and are often nutrient poor. They may interfere with sugar and insulin control, which may affect energy levels and appetite control. For this reason, people may feel better when eliminating these products from the diet. This does not always mean all wheat needs to be excluded.
Healthier, higher-fibre wheat options in controlled portions, such as high fibre breads, crackers or cereals or a whole-wheat couscous or pasta may be well tolerated and result in the same improvements.
• Is there any harm in avoiding gluten or wheat or both?
When eliminating any food from the diet, it is important that suitable substitutes are made. As well as an important source of carbohydrate, many wheat-and gluten-containing products are an important source of fibre, vitamins and minerals. Replacements need to be made to avoid deficiencies, as a varied, balanced diet is a key component of healthy eating,
It is also important not to assume all gluten-free products are necessarily healthy. Some are still reasonably refined, and low in fibre, or may be high in undesirable sugars or fats or dense in calories. While there is a place for gluten-free products, care must still be taken to choose healthier options, and eliminate gluten for the right reasons.
Following a gluten-free diet, and a wheat-free diet to a lesser extent, involves planning. Many foods contain gluten, and reading labels is essential.
Eating out also creates challenges; you need to confirm with the chef if the food is in fact gluten-free. It may look like a gluten-free option, but there may be traces of gluten from sauces or ingredients that were used.
• How to follow a gluten-free diet
If you think you may be gluten intolerant, or need to remove gluten from your diet for health reasons, it is advisable to seek professional help to educate you on sources of gluten, suitable alternatives, and to ensuring that your diet is healthy and well balanced.
As a starting point, here is a summary on foods to avoid:
• Wheat, rye, barley or any foods containing these grains, such as bran, bulgur wheat, couscous, durum flour, malt, semolina, spelt and any flours, except for those made from allowed grains.
confectionery items, such as commercial mixes, cakes, biscuits, rusks, muffins, pretzels.
• Breaded, crumbed and battered foods.
• Gelatinised, modified starch.
• Malted milks and drinks containing wheat.
• Meat, chicken and fish that contain MSG, HPP or HPV, polony and sausages.
• Many sauces, dressings, mayonnaise, gravies, soup powders, commercial puddings, and condiments, such as soy sauce, contain starch (always check labels).
Alternative gluten-free foods that can be included are:
• Corn, potatoes, sweet potatoes, rice, quinoa, millet, buckwheat, amaranth, popcorn, gluten-free pasta, polenta, gluten-free crackers (corn or rice-based), and cereals free of restricted grains.
• Fresh and frozen vegetables (free of sauces with gluten).
• Fresh, dried and stewed fruit
• Corn flour used as a thickening agent, and gluten-free flours used as a substitute for wheat flour, for example amaranth, arrowroot, corn, chickpea, rice, tapioca
• Most milk, cheeses and yoghurts (be careful of yoghurts that contain modified starch in them)
• Beef, lamb, pork, veal, poultry, fish, plain cold meats such as roast beef, smoked turkey, chicken or ham without crumbs, MSG, HPP or HPV or restricted grains,
• Legumes prepared with allowed grains, tofu and tempeh.
• Nuts, seeds, pure nut butters
• Jenny Meyer is a registered dietician in private practice in Johannesburg.
How to get it right
Try this tasty salad, which uses the gluten-free grain quinoa, along with other gluten-free ingredients, such as almonds, lentils, dates, or vary it by creating your own combination.
Nutty quinoa salad (Serves 4)
• 2 cups cooked quinoa
• ½ cup raw almonds
• 6 dates, chopped
• 3 tbs finely chopped coriander
• 2 tbs olive oil
• 1 tin lentils, drained, rinsed
Mix the quinoa, almonds, dates, lentils and coriander in a bowl and drizzle with olive oil.