Choosing a gluten-free diet is something many people opt for and have done for many years now as they feel they have better digestive health without gluten and want to reduce the amount of carbohydrate they eat. Many also choose gluten-free bread in the belief that it is better than normal bread and that gluten-free is the same but healthier. The foods that most people choose to cut out of their diet tend to be pasta, bread and foods baked with wheat flour. But there is obviously an abundance of gluten-free products on the market for people who have a real gluten intolerance, coeliac disease. This article is not for people with coeliac disease – the fact that they have to cut out gluten for health reasons is clear. It is more for those who experience discomfort from gluten but have not established why.
As more and more people report that they have an adverse reaction to gluten, in recent years a number of studies have been done on the subject. The studies have looked at patients who have not been diagnosed to have coeliac disease, and who are not allergic to wheat. A series of tests has been carried out to try to find the cause of their problems. These tests are difficult to carry out as there is no indicator to measure against, and the problems are often only self-reported. The group is referred to as having Non-Coeliac Gluten Sensitivity, i.e. they do not have coeliac disease but experience sensitivity to gluten.
In summary, the result of these studies is the discovery that the considerably more common functional disorder of the gastrointestinal tract IBS (irritable bowel syndrome) is probably the cause. This is the most common disorder in the world …
What is what?
-Gluten intolerance is indeterminate, and many people do not actually feel any discomfort, i.e. they do not always know that they suffer from it. So, it is something hidden, which produces many other more substantial health problems. If people do suffer noticeable symptoms, these may include diarrhoea, feeling bloated, constipation, joint pain, headache and stomach pain. Approximately 2% of the population has coeliac disease.
-If a person suspects they may have gluten sensitivity because bread and pasta cause them problems, it may well be IBS that they are suffering from. With IBS it is only certain carbohydrates that cause discomfort – carbohydrates that are fermentable in the intestine, to be precise. These types of carbohydrates increase the absorption of liquid in the digestive tract and result in IBS problems. So, it is possible to get rid of digestive problems without cutting out a large food group (all cereals). To help you establish which types of food that may cause you discomfort and digestive problems you could use FODMAP.
FODMAP is not a low carbohydrate diet, but rather a complete list of the carbohydrates that cause discomfort to those who have IBS and which carbohydrates they should avoid. The most common ones are onions, cabbage and legumes. IBS is a far more common condition to suffer from, close to 15–20% of the population experience digestive discomfort from IBS.
If you choose to eat a gluten-free diet, even though you are not gluten-intolerant, you are adopting a strict and often more expensive diet than you need. Avoiding gluten to cut down on the amount of carbohydrates you eat is the wrong approach.
There are carbohydrates left in gluten-free bread – what has been removed is the gluten protein as it is this protein that people do not tolerate if they have gluten intolerance.
Gluten-free food does not contain the same amount of fibre, nutrients or protein as you get in the cereals. It is often higher in sugar content and the minerals that are naturally present in cereals such as zinc, phosphorus and magnesium – all minerals that many of us need more of. There are also foods that are rich in fibre and are naturally free from gluten, such as brown rice, quinoa and sweet potatoes. But choosing gluten-free pasta instead of ordinary pasta or gluten-free bread instead of ordinary bread does not have any health benefits. What would make people feel better would be to reduce those foods that are worse for the digestion, those that are baked with wheat such as pizza, cakes, other pastries, buns and hamburgers. If you exclude these foods from your diet, there is no doubt that you will feel the benefit of doing so.
I have written about bread in the past, and how people should read the ingredients to understand how to compare products with one another. If you compare gluten-free bread with ordinary bread and you choose it even though you do not suffer from coeliac disease, it would be a good idea to check whether you have really improved your diet.
The biggest noticeable difference between the ingredients in gluten-free bread and those in ordinary bread is the length of the list of ingredients.
Here are two examples:
Store-bought gluten-free sourdough bread:
Ingredients
Water, tapioca starch, sunflower seeds (11%), corn starch, chia seeds (7%), syrup, dried sourdough culture (buckwheat and quinoa) (4%), yeast, thickening agent (cellulose gum, guar gum, xanthan gum), sugar beet fibre, rapeseed oil, apple extract, salt, maltodextrine (corn), emulsifiers (lecithin [rapeseed], mono- and diglycerides of fatty acids [veg.], psyllium husks, acidity regulators (malic acid), aromas. May contain traces of egg.
Wholegrain Gluten-free bread
Ingredients
Gluten-free wheat starch, water, syrup, thickening agent (cellulose gum, guar gum, xanthan gum), yeast, rapeseed oil, sugar beet fibre, linseeds (1.2%), maltodextrine (corn), salt, emulsifiers (lecithin [rapeseed], mono- and diglycerides of fatty acids [veg.], psyllium husks, aromas, caraway seeds. May contain traces of egg.
Store bought rye bread (contain gluten):
Flour (wholegrain of rye,wheat, wholegrain of wheat, water, sourdough culture (wholegrain rye flour) 16%, rye fibre, yeast, salt, malt of corn.
Store bought white bread (contain gluten):
Wheat, water, wholegrain flour 20%, wheat bran, yeast, sugar (1%), sea salt (1%), sourdough culture (wheat) (3%), rapeseed oil, wholegrain rye flour* and wheat gluten.
A shorter list of ingredients is preferable; bread with more fibre has more health benefits; and ideally you should choose bread that does not contain syrup or any other form of sugar. So, from a health point of view, there is nothing to be gained from choosing the gluten-free breads above.
Knowledge and effort are required to learn which foods can replace the vitamins and fibres that are lost in a gluten-free diet. It is therefore an unnecessarily complicated way to go if it is not something you need to do. As a side note, I should mention that genuine sourdough bread that contains at least 8% sourdough and has risen for at least 12 hours (as you will find in a sourdough bakery), contains all the nutrients you need from the cereal, and they will seldom produce the discomfort that people with IBS or another gluten sensitivity experience from ordinary bread. The wholegrain we find in bread has several health benefits, provides diet fibre and keeps the digestive tract in good shape. But if you still choose to eat gluten-free and experience a more settled stomach as a result of that, you should obviously continue to do that. However, do consider cutting out the FODMAP carbohydrates first. Seek help from a dietitian if you feel unsure about the process.
Sources: Swedish Food Agency, Gluten-free and low-FODMAP sourdoughs for patients with coeliac disease and irritable bowel syndrome: A clinical perspective. Vårdguiden