Suppose you are diagnosed with a wheat-related health condition such as coeliac disease, wheat allergy, or non-coeliac gluten sensitivity. You will have to cut out or cut down on gluten-containing grains. However, when transitioning to a gluten-free or low-gluten diet, you need to be aware of some pitfalls. 

Going gluten-free can be daunting because gluten is in almost everything! And what makes things worse is that many gluten-free products you find in the supermarket or even the health food shop are not healthy choices. They will leave you short on micronutrients (e.g., minerals and vitamins) and dietary fibre, a worry if you will be on a gluten-free diet for some time.  

A lifelong change for some, but not others

People with coeliac disease will need to follow a strict gluten-free diet for their whole life. If they continue to eat gluten they will develop further health complications. On the other hand, people with non-coeliac gluten sensitivity can benefit from a gluten-free diet to improve symptoms, and they may be able to tolerate gluten later in their healing journey.

Interestingly, some studies suggest that other substances like amylase, trypsin inhibitors, and FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) found in wheat can also trigger similar symptoms in sensitive people. 

Understanding these differences in gluten-related disorders can help you make informed decisions about your diet and seek appropriate guidance from qualified health professionals.

Not all gluten-free foods are equal

Walk into any supermarket, and you will find a dedicated gluten-free section. Unfortunately, the bulk of what you will find on the shelf is highly processed, loaded with sugar, fat, and salt; and lower in protein, minerals and vitamins than wheat-based processed foods.

Salt, fat, and sugar are added to gluten-free processed foods to make them taste better. Unfortunately, like all highly processed foods, they have been linked to increased disease risk. They also have the potential to alter the types of microbes that live in your gut, which in turn can predispose you to inflammatory and functional gastrointestinal diseases. 

A diet abundant in fibrous and colourful natural whole foods is essential for maintaining healthy populations of microbes that live in your gut (your gut microbiome). These microbes are also intimately involved in maintaining physical health beyond the gut and psychological well-being.

The main problems that can arise from eating highly processed gluten-free foods are:

• Nutrient insufficiency: lower than average protein, especially gluten-free bread and pasta. Lower fibre and inadequate micronutrients such as B vitamins, calcium, zinc, iron, and magnesium
• Contamination: in some studies, up to a third of samples of products labelled “gluten-free” were contaminated with gluten. 
• Expectation: gluten-free bakery products, especially bread, will always disappoint because gluten gives bread its elasticity. Gluten-free breads tend to be crumbly.
• Cost: it is not uncommon for many manufactured gluten-free products to be at least double the price of their wheat-containing counterparts. 

Moving forward and mindset

Thankfully there are many wheat alternatives including sorghum, millet, teff, buckwheat, rice, and quinoa. There are numerous ways to enjoy these grains; the simplest is to use them as a bed for other parts of a meal as you would use rice. Fermented grains and legumes can also be made into flatbreads and pancakes like injera or dosa. 

Use your transition to a gluten-free diet to get out of your comfort zone and explore all the wonderful ways other cultures use non-gluten grains and legumes. You will find some great options to please your palate. So treat the journey as an adventure for your taste buds!

Be aware that making changes to your diet can affect your psychological well-being. Keep this in mind and touch base with your healthcare professional if you feel changing your diet is challenging and affecting your mood. 

One last thing

Before making any significant dietary changes, speaking with a healthcare professional is essential. They will guide the best way to transition to a gluten-free diet while ensuring that your body is still receiving all the nutrients it needs to get you back to optimal health.

References: 

Campaniello, D., Corbo, M.R., Sinigaglia, M., Speranza, B., Racioppo, A., Altieri, C., Bevilacqua, A., 2022. How Diet and Physical Activity Modulate Gut Microbiota: Evidence, and Perspectives. Nutrients 14, 2456. 

Wieser, H., Koehler, P., Scherf, K.A., 2020. The Two Faces of Wheat. Frontiers in Nutrition 7. 

Aguiar, E.V., Santos, F.G., Krupa-Kozak, U., Capriles, V.D., 2021. Nutritional facts regarding commercially available gluten-free bread worldwide: Recent advances and future challenges. Critical Reviews in Food Science and Nutrition 63, 693–705. 

Khairuddin, M.A.N., Lasekan, O., 2021. Gluten-Free Cereal Products and Beverages: A Review of Their Health Benefits in the Last Five Years. Foods 10, 2523. 

Cenni, S., Sesenna, V., Boiardi, G., Casertano, M., Russo, G., Reginelli, A., Esposito, S., Strisciuglio, C., 2023. The Role of Gluten in Gastrointestinal Disorders: A Review. Nutrients 15, 1615.

Abdi, F., Zuberi, S., Blom, J.-J., Armstrong, D., Pinto-Sanchez, M.I., 2023. Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. Nutrients 15, 1475.