The
Gluten-Free Diet
A gluten-free diet is essential for people
who have coeliac disease or dermatitis herpetiformis (a gluten
induced skin sensitivity). Some people may choose to follow a gluten-free
diet for other reasons, although these two diseases are the only
ones where a gluten-free diet is considered medically imperative.
Gluten is a mixture of proteins
found in some cereals, particularly wheat. It is the gliadin component
of gluten which is responsible for coeliac disease. A gluten-free diet
is not the same as a wheat-free diet, and some gluten-free foods are
not wheat free. Despite a good deal of research, it is unknown how
or exactly why gluten harms the gut. It is now considered likely that
coeliac disease involves an abnormal immunologic response, rather than
an enzyme deficiency as was suggested in the past.
The Vegetarian Society believes
that a gluten-free diet is compatible with vegetarianism. Some doctors
and The Coeliac Society advise against a vegetarian or vegan diet for
coeliacs because they believe it may make your diet too complicated
and this could mean it is difficult to comply with. There are no known
medical or nutritional reasons why you should not be a vegetarian or
vegan coeliac, although the gluten-free aspects of your diet must be
the priority for your own health and well-being.
It is possible to follow a gluten-free
vegan diet, although you must be extra careful to ensure that your
diet is nutritionally adequate. It is essential that you seek the advice
of a sympathetic dietitian if you want to follow a vegan gluten-free
diet.
Vegetarians may initially find
it difficult to establish what foods they can and cannot have. This
Information Sheet is designed to help.
A gluten-free diet involves
the complete avoidance of all foods made from or containing wheat,
rye, barley and usually, oats. Some doctors say oats may be permitted,
although The Coeliac Society advise against the inclusion of oats in
a gluten-free diet. (see the Cereals Information
Sheet for more details of cereals.)
The Coeliac Society publishes
a list of gluten-free manufactured products in a booklet which is updated
every year. You can check with The Vegetarian Society if you are unsure
whether any particular foods on this list are suitable for vegetarians
or vegans. Some manufacturers use the gluten-free symbol on their label.
A wide range
of specially manufactured gluten-free foods such as, bread, bread
mix, pasta, biscuits, cakes,
crispbread and flour are prescribable under the NHS. Some groups
of people are exempt from prescription charges, children, pregnant
women
and pensioners in particular. If you are not exempt, it works out
economical to buy a "season ticket" type prescription. Some gluten-free
products, such as chocolate biscuits, are considered luxuries and
are not prescribable,
although they can be bought from the chemist.
Nutritional Advice
Coeliac
disease leads to severe damage of the gut surface, which can be completely
reversed by following a gluten-free diet. Shortly after the diagnosis
of coeliac disease, you need to be extra careful to ensure you have a
nutritionally adequate diet, as you may have been suffering from malabsorption
of nutrients.
 Protein
Some gluten-free
flours are low in protein, because they have had the gluten removed,
which is
itself a protein. Specially manufactured, prescribed gluten-free
flours usually have milk protein added. Vegetarians can get protein
from nuts & seeds,
pulses, the non-gluten containing cereals, soya products, milk, cheese
and free range eggs. Make sure some protein is included in each meal,
and practice protein complementation with the vegetable proteins,
for example, combine a nut or pulse dish with a suitable cereal.
Protein is especially important
to a growing child, it is essential to seek the advice of your dietitian
if you are bringing up a child on a gluten-free vegetarian or vegan
diet.
Anaemia
Following diagnosis, many coeliacs
sufferers are anaemic. This is usually due to iron deficiency, although
it could also be due to folic acid or vitamin B12 deficiency. Your
doctor may prescribe an iron supplement for you until your digestive
system is back to normal and can absorb iron again.
To ensure a good intake of iron
include pulses, lentils, nuts and green vegetables daily in your diet.
Avoid drinking tea with meals and instead have fruit juice, which helps
the absorption of iron because it contains vitamin C.
Going
vegetarian
If you are already a vegetarian
or vegan and are advised to follow a gluten-free diet, you do not need
to abandon your vegetarianism. If you are recently diagnosed and would
like to become vegetarian or vegan, do give your digestive system time
to recover before making major changes to your diet, after all, you
have a lot to think about in getting used to a gluten-free diet. When
you have stabilised, you can gradually change to a vegetarian diet.
Do contact
The Vegetarian Society if you have any problems, when making the change to a vegetarian way
of living. Also, do contact us if you have any difficulties with health
professionals, who are sceptical about your following a vegetarian
diet.
Once coeliac disease has been
diagnosed, it is recommended that you follow a gluten-free diet for
life.
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