Going on a gluten-free diet is hard work. Find out whether you’re genuinely gluten sensitive – or simply think you are.

Most health professionals know that diseases and conditions that start out as fads often end up being recognised as serious health threats.

For example, a few years ago, “yuppie flu” trended as a new disease. While it was originally treated with scepticism by doctors around the world, this debilitating condition was subsequently renamed “chronic fatigue syndrome”, and was recently identified as another one of the growing list of diseases and conditions attributed to autoimmune reactions.

In a similar fashion, a number of digestive conditions like Crohn’s disease and ulcerative colitis have also been classed as autoimmune diseases.

Around the world, thousands of people believe they suffer from gluten allergy or gluten sensitivity, and avoid gluten as a result. Are you one of them? Then a proper diagnosis is important. If you’re not really sensitive to gluten, your health may be at risk.

Allergy vs. sensitivity
If you have a genuine gluten allergy (a condition called coeliac disease), gluten makes you really ill and you have to studiously avoid all foods that contain gluten. Coeliac disease will show up on a blood test, so it’s important to consult your doctor for a proper diagnosis.

If you don't have coeliac disease, but suffer from symptoms related to gluten sensitivity, you may have “non-coeliac gluten sensitivity”. This means you may have symptoms similar to people who cannot tolerate gluten, but that you don't have the same antibodies and intestinal damage as seen in coeliac disease. Once again, a proper diagnosis is necessary.

According to Mayo Clinic, most physical reactions to foods are caused by a food intolerance rather than a food allergy. Unfortunately, the two are often confused.

“A true food allergy causes an immune system reaction that affects numerous organs in the body. It can cause a range of symptoms,” reads an article on the Mayo Clinic website. “In some cases, an allergic reaction to a food can be severe or life-threatening. In contrast, food intolerance symptoms are generally less serious and often limited to digestive problems.”

If you have a food intolerance, you may be able to eat small amounts of the offending food without experiencing symptoms. You may also be able to prevent a reaction: for example, if you have lactose intolerance, you may be able to drink lactose-free milk or take lactase enzyme pills to aid digestion.

If you who don’t have coeliac disease or aren’t gluten sensitive or intolerant, it’s best to go back to following a balanced, varied diet. If you unnecessarily cut out foods that contain gluten, you may develop nutrient deficiencies or chronic constipation, or you may struggle to achieve your energy-intake requirements. This can be a major problem in young children, teenagers, and pregnant and breastfeeding women.

Who needs to cut out gluten?
If you have diagnosed coeliac disease, it’s vital to avoid gluten and all foods containing gluten.
This not only means avoiding wheat bread, rolls and cakes, but also all products that may contain wheat or derivatives of wheat (e.g. thickeners in soups, drinks, sweets, sauces, gravies etc.) and all rye and barley. For coeliac patients, life can become a struggle, particularly in a modern world where most processed foods contain some wheat, rye or barley.

The good news is that a variety of gluten-free grains and starchy foods are available. These include:

- Maize products – including maize meal, maize grits, fresh and canned maize kernels, and corn on the cob
- Buckwheat, which despite its name, does not contain any wheat or gluten. It’s made from the seeds of a plant related to knotweed or sorrel.
- Ancient staples such as millet and sorghum
- Quinoa, the “queen of seeds”. This is a high-protein starchy food that is free of gluten.
- Flours made from starchy crops such as potatoes, rice, soya, chickpeas, lentils and other pulses
- Sago and tapioca. Experiment using these in both sweet and savoury dishes.
- Specific gluten-free baked goods produced from some of the non-gluten seeds, flours and starches mentioned above.

Survival rules
If you have coeliac disease, it’s important to read every food label thoroughly. When in doubt, avoid buying a food that could contain wheat, rye, barley or some form of gluten. Even if there’s no “list of allergens” on the label, you need to be on the lookout for potential sources of gluten when shopping by carefully checking the list of ingredients.

Take note that “gluten-free” baked goods will probably cost more, because they’re produced for a much smaller market than standard cakes, biscuits and breads.

When eating out, you also need to be vigilant. If none of the staff can tell you what ingredients went into the soup or other mixed dishes, be careful and rather order grilled meat or fish with baked potatoes, chips, rice, sweet potatoes, corn on the cob or fresh salad. Ask for olive oil and freshly squeezed lemon juice to dress your salad and eat fresh fruit for dessert (minus the custard or ice cream).

Lastly, remember to consult a dietician to help you with your gluten-free diet. The reality is that you may find it difficult to meet your nutrient needs without some professional assistance.