WHEN I went for a medical last October and mentioned that my Mum was a coeliac, my GP suggested that I be tested for the antibodies that indicate the presence of the disease, as there is a stronger predisposition to it if a family member is already affected.
Two weeks later she confirmed there was a likelihood that I might be a coeliac and recommended that I go for a biopsy.
Two weeks later again I was having a tube inserted to remove a tiny piece of mucosa from my small intestine and praying that I wouldn’t receive a positive diagnosis.
Having observed my Mum’s adoption of a gluten-free diet I was aware of how stringent the regime was and had also witnessed her illness when she inadvertently consumed gluten. Another fortnight later I had confirmation that had I inherited more from my mother than just my looks — I too was a coeliac.
Now, after six months on a gluten-free diet by necessity, not by choice, I find myself in the ironic position of watching celebrities increasingly giving up gluten voluntarily, including Gwyneth Paltrow, Rachel Weisz, Victoria Beckham, Miley Cyrus and Novak Djokovic.
All of these have purged gluten from their diets, Cyrus most notably tweeting: “Gluten is cr@pp anyway! Everybody should try gluten-free for a week. The change in your skin, physical and mental health is amazing.”
Some of these have adopted gluten avoidance because of an allergy or intolerance while others believe that it reduces bloating, increases energy and promotes a positive mood. There also seems to be a misconception amongst some celebrity-smitten dieters that adopting a gluten-free diet automatically leads to instant and dramatic weight loss — regardless of the fact that many gluten-free foods have a higher fat and sugar content.
As Emma Clarke Conway of the Irish Coeliac Society observes: “The assumption that it’s a healthier diet is a worrying factor as your nutritional requirements are suffering.”
Being a coeliac and adhering to a gluten-free diet is not a fad — it’s a necessary dietary regime that must be followed to ensure that my health in general and that of my gut in particular aren’t compromised. As a coeliac I have a profound gastro-intestinal intolerance for gluten, a protein found in wheat, rye and barley, which also puts me at increased risk of osteoporosis and anaemia.
For coeliacs, gluten damages the small finger-like projections called villi in the small intestine — when these are damaged in response to gluten in the diet, they don’t absorb the nutrients from food correctly. Symptoms can include cramps, fatigue, vomiting, diarrhoea and weight loss: although in my case I was asymptomatic which meant that I was unaware of the damage gluten was doing to my intestine.
Gluten means glue in Latin and wasn’t identified as the trigger for the disease until after World War II when a Dutch paediatrician, Dr Willem Karel Dicke noticed that the death rate for kids with the disorder had dropped from over 35% to almost 0% during the war when there was a shortage of bread in the Netherlands. He also reported that once wheat was available after the conflict, the mortality rate soared to previous levels.
In Ireland the incidence of coeliac disease is about 1 in a 100 with a higher occurrence in the west of Ireland. Celebrity Irish coeliacs include Bill O’Herlihy and Jim Sheridan, and many adults can go undiagnosed for decades, (up to five out of six sufferers remain undiagnosed) particularly if they don’t have pronounced symptoms.
Continued consumption of gluten has serious health implications for coeliacs. Absorption of nutrients including iron, folate and calcium can be severely impaired, leading to anaemia and premature osteoporosis while continuous inflammation of the gut can increase the risk of several cancers of the intestine.
As my inability to tolerate gluten is permanent, I must stick to my gluten-free diet for the rest of my natural life, not until the next dietary fad takes my fancy. I do therefore feel slightly aggrieved that the media has focused so much on celebrities pursuing a gluten-free diet as it can trivialise the regime making it seem like a fashionable lifestyle choice rather than a medical imperative.
On the plus side, the increased awareness of gluten intolerance, has made a wider range of gluten-free foods available.
Emma Clarke Conway of the Irish Coeliac Society enthuses: “There are so many more products — with an increased market share for gluten-free products.”
When my Mum was diagnosed, gluten-free alternatives were very limited and I remember watching her chewing on unappetising long-life gluten-free bread with sympathy. Now there is an array of gluten-free breads, cakes, biscuits, pastas, cereals, and beers so that pursuing the diet is far easier. Once you are sourcing and preparing your own food you have total control over what you consume and can adopt ordinary recipes to suit the condition.
However trying to find suitable food when eating out is problematic: coeliacs can still encounter a limited choice of dishes or even ignorance of cross-contamination whereby gluten and gluten-free foods can end up being cooked or prepared using the same utensils, oils or cooking water.
An Bord Bia found in 2011 that 22% of consumers bought ‘free-from’ foods (including gluten-free, wheat-free, dairy-free and yeast-free varieties) with almost 200,000 choosing them because of health problems and a further 600,000 selecting them as a lifestyle choice. It’s estimated that this market will be worth €21m by 2015, so it’s not surprising so many companies and supermarkets are developing “free from” ranges.
Personally the most confusing aspect of adapting a gluten-free diet, hasn’t been finding gluten-free varieties of the traditional wheat staples such as bread, pasta and cereals but rather trying to avoid gluten in so many other foodstuffs. Sauces, corn and rice breakfast cereals, confectionery, crisps, soups, oat flakes, baking powder, suet, sausages, yoghurts, chocolates, cheeses and mustards can all contain gluten as an ingredient or can suffer from cross-contamination with other foodstuffs containing gluten.
The Coeliac Society of Ireland’s Food List has been an invaluable tool in helping me to identify “safe” foods and to avoid innocuous foods I would never have suspected of being potentially dangerous.
Having to be selective about food purchases is frustrating, but has made me far more aware of the bewildering amount of ingredients and additives in many pre-packaged foods.
As a rule, if in doubt, I leave the item aside as the potential complications aren’t worth the risk. I have never been a huge fan of processed foods so becoming a coeliac has intensified my belief that we are all far better off consuming simple food prepared from fresh ingredients with a bias towards lots of fresh fruit and vegetables, lean meat, chicken and fish, dairy products, seeds and nuts.
I have a lot to learn about managing a gluten-free diet and about staying healthy as a coeliac but am determined to integrate gluten-free into my daily existence, not to the extent that I become obsessive, but rather so that I can continue enjoying my food. Along with annual blood tests to monitor any potential deficiency in minerals or iron, etc., my diet is my best tool to manage the condition.
As Julia Childs said: “People who love to eat are always the best people” and I am determined to keep loving my food, despite its now gluten-free nature.
The Irish Coeliac Society is currently running an advocacy campaign to promote the introduction of a national policy for coeliacs to put guidelines in place for medical professionals who deal with coeliacs or newly diagnosed coeliacs. For more information or assistance contact the Irish Coeliac Society on 01-8721471 or log on to www.coeliac.ie
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