Over the last few weeks, I have been giving a lot of lectures and classes again. What I still hear is the term 'gluten intolerance' being misused by participants.
Gluten intolerance (celiac disease)
In fact, gluten intolerance is the same as Celiac disease, the autoimmune disease where you have to eat incredibly strict gluten-free to avoid physical complaints get.
- This means that for risky products that may contain gluten-containing ingredients and/or cross-contamination is possible, pay close attention to the gluten-free logo on the packaging.
- In addition, when preparing and cooking food, you have to be incredibly careful not to accidentally introduce traces of gluten into your meal.
Celiac disease occurs in about 1% of the Dutch population and special tests have been developed for it to help make a better diagnosis. If you have been eating gluten-free for a while, you will not be able to use these tests, so it is advisable to have them done when you are still eating gluten.
Wheat allergy
Besides Celiac disease or gluten intolerance, there is also wheat allergy and this is even more rare. This allergic reaction that occurs via IgE antibodies is very similar to gluten intolerance, but only occurs when eating wheat, while other grains containing gluten can be tolerated just fine. A doctor or allergist can help with the correct diagnosis, with a provocation test being the gold standard to see if reaction occurs and at what dosage.
- This allergy is common in children and sometimes they grow over it.
- Even small amounts of wheat can cause a reaction so wheat allergy also requires very close attention, just like Celiac disease.
Gluten sensitivity
However, there are many more people who do not go well on the Dutch diet where bread and pasta products are often on the menu. I experienced this in practice decades ago. I myself and many of my clients felt fitter, sharper and got rid of all kinds of inflammation-related complaints by greatly reducing the amount of gluten and wheat-containing foods and replacing them with healthy alternatives.
When I also wrote this in my books, besides applause from people who felt better, it also brought me a lot of criticism from fellow competitors, the Nutrition Centre and medics. It was unscientific and I was immediately framed as a 'nutrition guru' as a result.
Fortunately, I and others who also saw this did not give up and just continued with this harmless intervention. Science too eventually picked up on these practical experiences and this phenomenon was given the name 'non coeliac gluten sensitivity' or glutensensitivity and thus finally recognised.
Gluten sensitivity is much more common than gluten intolerance and wheat allergy, but it is also somewhat milder in nature. Also, you don't have to be super strict when it comes to smaller amounts of gluten or wheat. Often if you substitute large bread and pasta meals, you don't have to worry so much about the rest and feel better.
FODMAPS
However, what we do not yet know is whether this immune reaction is really due to gluten. It could also be due to another protein or even to certain fibres, the fructans which again fall under the FODMAPs (FODMAP diet in irritable bowel syndrome). What exactly is going on here and why this problem has arisen will have to be studied more closely. This is extra important because it affects a large group of people, namely about 6 per cent of the population in the Netherlands (1)
Gluten sensitivity is not easy to measure in a blood test, so only elimination and reintroduction in practice can make you wiser based on the symptoms. However, do not go gluten-free until you have ruled out Celiac disease, otherwise it cannot be measured immediately, but only after you have eaten gluten again for 6 weeks.
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