I’m not following a fad — gluten could actually kill me
IN 2019, we have well and truly heard all the dietary trends and fads you could imagine.
From Keto, Atkins, intermittent fasting, and flexitarianism, to the blood type diet, and everything in between. There is a diet trend for everyone, and 20 accompanying articles singing its praises, telling you why you should adopt it.
So many of us are encouraged to try these new trends, especially going 'gluten-free'. As an Accredited Practicing Dietitian who has a special interest in this area, it is an issue I deal with and research daily.
For those affected by coeliac disease, following a strict gluten-free diet is not an attempt to adapt to the latest diet trend, it's a legitimate medical condition that requires the proper treatment and consideration. The health concerns facing coeliacs surrounding risk of cross contamination when eating out are amplified by these trends as dietary requirements are, unfortunately for the most part, seen as a choice rather than a necessary action.
Up front we have coeliac disease (CD). CD is an auto-immune medical condition that in Australia effects about 1 in 70 people, and around 80 per cent of those go undiagnosed. The diagnosis of CD can be incredibly overwhelming, but it is critical for long-term health that people with CD follow a strict lifelong gluten free diet.
Unless it is medically necessary, going 'gluten-free' is not a healthier option. If it means that you cut out processed and "junk" foods from your diet, then you can see that it may be beneficial in encouraging more fresh food intake, which will ultimately make you feel better. However, many of the 'gluten-free' options for the processed foods contain less fibre, more fat, more salt, fewer nutrients and are more expensive.
While having gluten-free options on menus is important, there is still a lot of education to be done around mitigating the risks of cross contamination, and it is a slow process. Whether there is a chance of contamination in the toaster, deep fryer, cooking benches, or any other surface where there is a risk, it is of paramount importance that this is communicated to the customer. For those of us affected by coeliac disease, it is not enough to be "semi" gluten-free - hence the need for it to be a strict diet. This is because it is the protein gluten that causes an inflammatory response in these people, which can lead to various ongoing health issues. Even a small amount of gluten that's not enough to cause symptoms will cause the inflammatory response.
As someone who is personally affected by CD, I have developed a routine to protect myself before eating out at a new restaurant or cafe, and I encourage my patients to as-well;
Unfortunately, you do have to call ahead and ask the difficult questions.
EG: Is a different strainer used for the gluten-free pasta than the normal pasta?
Double check when you order that the dish is gluten-free and make sure the waitstaff are aware of your dietary needs.
Don't assume that it is gluten-free when it is placed in front of you. Ask again.
If all else fails, and you are concerned by the risk, you can purchase certain products, which break down gluten protein for people who are symptomatic where there is a risk of contamination. But it's important that people with CD don't see this as giving them the opportunity to eat gluten-containing foods. It's really just to be used to address accidental glutenings from a symptom perspective.
For food and beverage establishments, the trendy diet market is an extremely attractive market to provide options for. Generally, the people purchasing these options are somewhat health conscious, and are willing to pay extra to satisfy their wants. It's exceptionally easy to place "GF" next to a menu item and charge an extra $2, but it's difficult to ensure that there is no cross-contamination in the preparation process. We'd like to see more eating establishments training their staff about the difference required for people with CD, and of course we love the ones that are careful and provide us delicious gluten free food without the extra charge. This of course would encourage us to visit again and tell our coeliac friends - a win-win for everyone!
Sally Marchini, who runs Marchini Nutrition, is an Accredited Practising Dietitian (APD).
The Sydney Gluten Free Expo is on August 3 & 4 at the Rosehill Racecourse, Sydney, NSW. Sally will speak at 10.30am on Saturday, August 3 on 'Dietary considerations in coeliac disease and pregnancy'.