Gluten sensitivity can be a frustrating dietary condition to deal with on a day-to-day basis. Here’s help.

Coeliac disease is a chronic disorder, characterised by abnormal sensitivity to gluten, a protein mainly found in wheat. Across the globe, about 1 in 100 people have coeliac disease.

Non-celiac gluten sensitivity (NCGS), another type of gluten sensitivity, is also relatively common, although less is known about this condition.

In countries such as Australia, where wheat is a staple cereal, both conditions are common, and can be quite difficult to cope with.

Risk groups and symptoms

Coeliac disease usually occurs in children just after they’ve been weaned (between 9 months and 3 years), and in adults between the ages of 30 and 40.

Children with gluten sensitivity usually fail to thrive in the second year of life. They develop bloated tummies, lose weight and muscle tissue (wasting), and produce large, pale, bulky stools. These children are also generally unhappy and lethargic, with little or no appetite.

Younger children develop diarrhoea more often than their normal counterparts, while older children suffer from anemia, rickets and growth retardation.

Tiredness is the main symptom in adults with coeliac disease. They also tend to suffer from diarrhea, iron-deficiency anemia and folic-acid deficiency. Many of these adults don’t have any gastrointestinal symptoms like diarrhea or bloating, and their sensitivity to gluten is usually only identified when they’re diagnosed with anemia.

Because of poor absorption of calcium and fat-soluble vitamins, adults with coeliac disease may develop osteoporosis and a vitamin K deficiency. Other symptoms include skin lesions, swelling of the ankles, depression and poor muscle coordination.

Coeliac disease and diet

The most important treatment for coeliac disease or gluten sensitivity is removal of all gluten from the diet.

Gluten is not only found in wheat, but also occurs in barley, rye and oats. Consequently, all foods containing any one of these cereals must be excluded from the diet for the rest of the person’s life.

Not all people with who are sensitive to gluten are sensitive to oats. So, although oats must be excluded initially from the diet after diagnosis, it can be reintroduced at a later stage to test if the person reacts. If none of the characteristic symptoms reoccur, oats can be eaten.

It’s vitally important to stick to a gluten-free diet for life, because failure to comply with the diet can predispose the affected person to an increased risk of lymphoma (cancer of the lymph glands) and osteoporosis (progressive loss of calcium from the skeleton leading to bone fractures).

Foods to avoid

Unfortunately, in our modern world with all its thousands of processed and convenience foods, someone with coeliac disease will encounter wheat at every turn.

If you’re sensitive to wheat, barley, rye and/or oats, you not only have to avoid the obvious sources of these cereals (breakfast porridges, ready-to-eat cereals, bread, pasta, cakes, pastry, biscuits and pies), but you also need to be on the lookout for wheat in packet soups, sausages, processed meat products, frozen meat, fish products that contain wheat flour as a binder or coating (crumbs), tinned foods that contain sauces thickened with wheat flour, condiments, sauces and confectionary.

This can be tough, but it’s important to stick to your diet and to steer absolutely clear of these foods. Read every food label to check if products contain one of the forbidden cereals. If in doubt, simply don’t buy the product.

Foods you can enjoy

Maize-meal porridge, corn flakes, rice cereals, puffed rice, milk, yoghurt, cheese, cream, butter, meat, poultry, fish, bacon, eggs, plant oils, margarine, fresh and dried fruit, fruit juices, fresh vegetables, nuts, seeds, rice, potatoes, homemade gravy made with cornflour, custard made with cornflour, soups made with meat and vegetables and thickened with cornflour, rice flour, peas, lentils, cooked dry beans, salad dressing thickened with cornflour, puddings made with jelly and fruit and milk thickened with maizena, rice flour, gelatine, rice cakes, gluten-free bread, Mexican tacos made with maize, jams, jelly, hard-boiled sweets, special gluten-free confectionary, and potato, rice and maize chips and snack foods can all be included in your diet.

Some good news

A few years ago, Australians with gluten sensitivity or coeliac disease had very few commercially manufactured food products to choose from. Fortunately, a number of local and international food companies now produce gluten-free foods.

Shop around and you’ll find a reasonable variety of gluten-free foods to make your diet more interesting.