My teenage daughter wants to eat gluten-free foods, is it safe for her?

It is commonly reported that coeliac disease affects one in every 100 people worldwide, and the prevalence is increasing. The incidence is 1.5%-2 % of the population in Norway and Finland, representing a 50% increase.

Gluten is a protein found in wheat, barley and rye. For some people, consuming gluten-containing foods triggers an auto-immune
response that damages the small intestine’s lining. The small intestine has folds called villi, which help to absorb food. With coeliac disease, these villi are damaged by gluten, reducing the absorption of some essential nutrients, particularly calcium and iron. While many coeliacs will experience gut symptoms (bloating, irregular bowel movements, etc) if they consume gluten, 40% of those with coeliac disease will not and instead experience symptoms outside of the gut (such as ataxia and neuropathy).

A blood test, checking the tTg (tissue transglutaminase) and EMA (endomysial antibody) levels in the blood, is used as an initial screen for coeliac disease. Diagnosing coeliac disease is done by a gut biopsy to analyze mucosal damage in the small intestine. It is essential that gluten is consumed daily (at each meal) for six weeks before these tests are taken. If gluten has already been excluded from the diet before a blood test/gut biopsy, the gut may look normal and coeliac disease may be ruled out falsely.

Undiagnosed coeliac disease can increase the risk of osteoporosis, iron deficiency anaemia, poor growth, migraine, infertility and miscarriage. It must be diagnosed and treated appropriately with support from medical professionals and registered dietitians.

There is no benefit for people who do not have coeliac disease to cut out gluten. Many whole foods, such as meat, poultry, vegetables, fruit, dairy, and potatoes, are naturally gluten-free, forming a sound foundation for eating well with coeliac disease.

A wide range of manufactured gluten-free products are on the market, but many of these foods are low in fibre and high in fat.

I advise your daughter to eat foods containing gluten and get appropriate screening with a general practitioner to help determine if gluten is the problem.

After that, support from a registered dietitian (coru.ie) will help identify if there are any problem foods that need to be either reduced or eliminated from her diet to help ease bloating symptoms of bloating.

If you have a question for dietitian Aoife Hearne, send it to [email protected]