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Gluten or Wheat Intolerance?

One area of nutrition, which often leads to head scratching and confusion for many people, is that of gluten intolerance and how this relates to wheat intolerance. Common questions include; what is gluten, which foods would you find it in, what’s the difference between gluten and wheat intolerance and what does a gluten or wheat intolerance test entail?

What is Gluten?

Gluten is the name given to the protein in a number of grains such as wheat (including wheat varieties such as spelt, kamut, faro, durum, bulgar, semolina), rye, barley, and oats. The name gluten comes from the Latin word for ‘glue’. It gives the dough its elasticity, prevents crumbling and as such plays a vital role in the production of baked goods. Most commonly you would find gluten in bread products, pasta, biscuits, crackers, cereals, beer but also in sauces or processed meat products as a thickener.

Gluten Versus Wheat Intolerance

Gluten intolerance and wheat intolerance are different conditions but obviously cross over with one another, which is where the confusion often comes in. Additionally, the symptoms experienced, although highly individual, can be very similar such as bloating, cramps, diarrhoea, constipation, fatigue, sometimes headaches and a general sense of malaise.

Gluten intolerance means an intolerance to all grains containing gluten; wheat and wheat varieties, rye, barley, and oats. Whereas wheat intolerance is an intolerance just to wheat and wheat varieties, not the other gluten-containing grains. So, as you can imagine being gluten intolerant can be far more limiting than wheat intolerance.

To complicate it further there are two types of gluten intolerance: coeliac and non-coeliac [2, 3]. And the two are completely different in how they manifest and their potential overall impact on health.

Coeliac Disease

Coeliac disease is a condition where the body attacks its own cells following the ingestion of gluten. This results in small intestine becoming damaged and prevents nutrients from being absorbed. The condition affects roughly 1% of the UK population with incidence shown to have increased fivefold over the last 25 years [1].

Symptoms include;

  • Abdominal pain
  • Indigestion
  • Constipation
  • Bloating
  • Flatulence
  • Vomiting (usually only in children)

Gluten and Wheat Intolerance

Non-coeliac gluten intolerance is completely different to coeliac disease. Its far less threatening but is still a digestive issue. The difference is that it doesn’t result in a mutiny of cells, just digestive-related symptoms and discomfort. The symptoms of non-coeliac gluten intolerance and wheat intolerance are nigh identical with the only way to tell the two apart for certain being through blood sample testing.

Intolerance symptoms can include;

  • Bloating
  • Constipation
  • Diarrhoea
  • Fatigue
  • Migraines
  • Skin rashes & Eczema
  • Vomiting
  • Nausea

Testing for Wheat and gluten intolerance

Understanding the presence of either of these conditions is the first step towards making changes. It can be done through an IgG gluten or wheat intolerance test, which is a blood sample test identifying the presence of IgG antibodies created against gluten or wheat [4]. This type of testing will not show the presence or lack of coeliac disease.

Diagnosing Coeliac disease

To identify the presence of this autoimmune condition blood tests for IgA and IgA tissue transglutaminase (tTG) must be carried out. Potentially followed by a biopsy to determine how much damage has been made so far. Patients are encouraged not to begin a gluten free diet until a diagnosis has been made, this is especially important for the blood testing.  

Tailoring Your Diet

If you do find yourself having to cut out gluten or wheat after completing a gluten or wheat intolerance test do not despair! The range of products available in supermarkets is extensive and growing all the time and restaurants and cafes are also offering more and more options to those who need to avoid gluten or wheat.

Those diagnosed with coeliac disease MUST avoid glute, or else they can become very ill. But those who are simply gluten intolerant should avoid gluten containing foods to avoid symptoms. Where possible, choosing products which are naturally gluten-free or wheat-free in place of processed ‘free from’ products, is the best way forward.

On a gluten-free diet, grains such as corn, rice, millet, sorghum, amaranth, buckwheat, and quinoa are all excellent choices. For those who are wheat free, you can also add rye, barley and spelt to the party. Grains that contain gluten include wheat, rye, barley and triticale.

Wheat and Gluten Free Alternatives

Avoiding wheat is much simpler compared to avoiding gluten. The list of foods made with wheat is still quite extensive and avoiding this ingredient can prove challenging for some.  

Gluten and Wheat free alternatives include;

  • Potatoes
  • Rice
  • Gluten-free Bread
  • Fresh Vegetables

Avoiding wheat and gluten can be difficult if you rely on a lot of pre-packaged goods such as sauces and snack bars. The simplest solution to this is to make the majority of your meals from scratch. Not only will it help you avoid both wheat and gluten completely, it can offer various health benefits such as lower salt and sugar intake, more nutritionally dense meals and less accidentally ingested ingredients.

Final Thoughts

It’s not all bad news though. Having to avoid gluten or wheat does force you to avoid baked goods – which most of us would agree is a bonus in terms of looking after our health.

References

 [1] Catassi C, Gatti S, Fasano A. The new epidemiology of celiac disease. J Pediatr Gastroenterol Nutr. 2014 59 Suppl 1:S7-9. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24979197 [Accessed 27 Feb. 2020].

[2] Barbaro, M.R., Cremon, C., Stanghellini, V. and Barbara, G. (2018). Recent advances in understanding non-celiac gluten sensitivity. F1000Research, 7, p.1631. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182669/ [Accessed 27 Feb. 2020].

‌[3] Igbinedion, S.O., Ansari, J., Vasikaran, A., Gavins, F.N., Jordan, P., Boktor, M. and Alexander, J.S. (2017). Non-celiac gluten sensitivity: All wheat attack is not celiac. World Journal of Gastroenterology, [online] 23(40), pp.7201–7210. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677194/ [Accessed 27 Feb. 2020].

‌[4] Lin, S., Yang, X., Xing, Y., Wang, X. and Li, Y. (2019). The Clinical Application Value of Multiple Combination Food Intolerance Testing. Iranian journal of public health, [online] 48(6), pp.1068–1073. Available at: https://www.ncbi.nlm.nih.gov/pubmed/31341848 [Accessed 27 Feb. 2020].

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