Overview

Coeliac disease, gluten sensitivity & a gluten-free diet

Gluten causes discomfort in people suffering from coeliac disease or gluten sensitivity. We will explain the difference between the two clinical symptoms and tell you what you need to consider in case of a gluten-free diet.

Gluten is a protein and is found in various different types of grain such as wheat, spelt or rye. All glutinous foods cause discomfort in people with coeliac disease or gluten sensitivity.

What is coeliac disease?

Coeliac disease, a form of gluten intolerance, is a hereditary autoimmune disease. If there is a genetic predisposition, the immune system releases substances, which trigger a reaction in the small intestine. The body of anyone with coeliac disease produces antibodies after consuming glutinous foods. These antibodies are detectable in the blood and damage the intestinal mucosa. This results in the intestine no longer being able to properly absorb the nutrients from food. These nutrients include, for example, fats, proteins, carbohydrates or vitamins. The symptoms of coeliac disease can vary greatly. Here are some examples:

  • Digestive problems like stomach ache, diarrhoea or constipation
  • Fatigue or exhaustion
  • Iron deficiency
  • Depressive moods
  • Infertility in women

In small children, a lack of growth and developmental delays can be an indication of coeliac disease. Further information on coeliac disease is available here (only available in German).

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What is gluten sensitivity?

In case of gluten sensitivity, no antibodies are present in the blood and the mucosa of the small intestine is not damaged. In spite of this, patients suffer from various complaints such as:

  • Stomach ache
  • Eczema
  • Headache
  • Fatigue
  • Diarrhoea

The symptoms subside if the affected people remove gluten from their diet. The background of this clinical picture isn’t entirely clear yet.

A gluten-free diet

A gluten-free diet is sensible for people who suffer from a form of gluten intolerance such as coeliac disease or gluten sensitivity. The only treatment option for coeliac disease and gluten sensitivity is to avoid gluten and traces of gluten. Gluten naturally occurs in various varieties of grain:

  • Wheat
  • Spelt
  • Rye
  • Barley
  • Unripe spelt grains
  • Einkorn
  • Emmer
  • Kamut
  • Triticale

All products made from it, e.g. flour, pasta or bread, also contain gluten. Gluten is also contained in many products, where you wouldn’t expect it, at first glance. Convenience products, packaged soups or sausage products may contain glutinous ingredients. The list of ingredients provides information on this. In accordance with the Foodstuffs Act, allergenic ingredients, even glutinous ingredients, have to be specially marked. They are highlighted in the list of ingredients:

Many other starchy products like potatoes, rice, corn, buckwheat, legumes, quinoa or amaranth do not contain any gluten. Other gluten-free foods include, for example, fruit, vegetables, dairy products, meat, fish, eggs or tofu. However, this only applies as long as they are not contaminated with gluten during preparation.

In addition to choosing exclusively gluten-free foods, it is important that no contamination occurs in the kitchen. Use a separate board and knife for gluten-free bread. By doing so, you will prevent contamination with glutinous foods. It is also essential not to use the same serving utensils for gluten-free pasta and normal pasta.

A gluten-free diet for everyone?

A gluten-free diet doesn't provide any benefits to healthy people. On the contrary: glutinous grains provide important nutrients as part of a balanced diet. These include, for example, nutrients like B-group vitamins, magnesium, zinc or iron. Unnecessarily removing glutinous foods from your diet without substituting them appropriately may result in a reduced supply of important nutrients.
If you suspect that you are affected by coeliac disease or gluten sensitivity, discuss it with your general practitioner. It is very important to seek medical advice. Please note: if you switch to a gluten-free diet without undergoing any preliminary medical tests, it will make it more difficult to provide a correct diagnosis.

Author: Stéphanie Bieler BSc, Swiss Society for Nutrition SSN
Publication: 26 July 2019

Dietitian Stéphanie Bieler

Ernährungsberaterin Stéphanie Bieler Stéphanie Bieler (BSc Dietitian, Bern University of Applied Sciences) works at the Swiss Society for Nutrition SSN in Bern. She primarily focuses on maintaining a balanced diet across various age and target groups. Stéphanie Bieler writes articles for Helsana on the topic of nutrition.

www.sge-ssn.ch

 

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