The gluten free diet - All you need to know about

The gluten free diet - All you need to know about. When you have celiac disease, wheat allergy, gluten sensitivity, you avoid consuming gluten. Why should gluten be eliminated, and how can this be achieved?
"gluten intolerance" covers three different disorders and diseases: celiac disease, wheat allergy and gluten sensitivity (non-celiac). People who suffer from these disorders exclude grain products from their diet, and this can also be the case for those who suffer from irritable bowel syndrome. How to implement this diet, what foods to avoid and replace them with, and prevent any risk of deficiency? Follow the leader.

Gluten-Free Diet Plan

Gluten-Free Diet Plan

What is gluten?

Wheat, rice and maize are the most consumed cereals in the world. These products are sources of starch, a staple food constituent of the human population since Neolithic times and the advent of agriculture. Wheat is one of the leading food crops in the world. The wheat kernel contains 8-15% protein, of which 10-15% is albumin/globulin and 85-90% gluten.

Gluten is a complex mixture of hundreds of related but distinct proteins, primarily gliadin and glutenin. The different wheat varieties vary in protein content and the composition and distribution of the proteins that make up gluten. The gliadin and glutenin proteins are collectively referred to as prolamins; they are characterized by high levels of glutamine (38%) and proline (20%).

Proteins similar to wheat gliadin exist as decalin in the rye, hordein in barley and avenins in oats. They are collectively called "gluten". Derivatives of these grains, such as triticale, malt and other ancient wheat varieties such as spelt, spelt, and Kamut, also contain gluten.

The gluten in these grain species triggers celiac disease. In 1953, a study confirmed the involvement of this protein in malabsorption disorders after consumption of wheat in patients with celiac disease.

Gliadin contains sequences (called epitopes ) that are significantly resistant to gastric, pancreatic, and intestinal digestion, thus escaping degradation in the intestine. This difficult digestion is due to the high gliadin content in proline and glutamine, two amino acids that our enzymes responsible for degrading proteins (proteases) fail to cut. These proline-rich residues create tight, compact structures that may promote adverse immune reactions in celiac disease.

The agglutinin contained in wheat germ is a lectin, a protein that binds to carbohydrates. In vitro, agglutinin has been shown to damage the gut lining and affect the immune system. This lectin could therefore contribute to disorders related to gluten consumption.

What are the signs of gluten intolerance?

Here are the main symptoms of gluten intolerance:
  1. Digestive symptoms: diarrhoea (but constipation is also possible!), abdominal pain, bloating, flatulence, weight loss
  2. Chronic fatigue
  3. Anaemia
  4. Infertility unexplained by other causes
  5. Skin problems
  6. Chronic canker sores
  7. A disease of the nerves of the limbs
  8. Growth retardation in children

What food contains gluten?

Wheat varieties (durum wheat, spelt, Kamut), barley, rye, hybrids of these cereals (for example, triticale, resulting from the cross between wheat and rye) contain gluten. Gluten is found in:
  • Bread, pastries, pastries
  • Pasta 
  • Cookies (savoury or sweet)
  • Most breakfast cereals
  • Foods that are breaded, floured or coated in batter
  • Meat and fish loaves containing flour or breadcrumbs
  • Canned or bagged soups, desserts and sauces bound with wheat flour
  • Beer
  • Seitan
In addition, gluten is often found in processed or ultra-processed foods; Read the labels carefully:
  • the mention "gluten-free" is said of food containing less than 20 mg of gluten per kilo of finished product;
  • The indication "very low gluten content" means that the full gluten content is between 21 and 100 mg/kg of the finished product.
How much gluten is there in our diet?

How much gluten is there in our diet?

It is estimated that the average daily gluten intake in a Western diet is between 5 and 20 g per day. A recent Danish survey found average information of 10.4 g/day among adults aged 20-75. Wheat-based bread is one of our primary sources of gluten: each slice of bread contains about 4g of gluten.
Modern practices have probably contributed to an increase in gluten consumption due to the acceleration of bread rising, the increased use of chemical agents and yeasts and the rise in nitrogen fertilizers and organic products. Phytosanitary products increase the yields of the proteins needed to
make bread. Added to this is bakers of "vital gluten", an ingredient that promotes bread-making.

How to eat gluten free?

Gluten exclusion diets eliminate all foods containing this protein:​

Foods to avoid What to replace them with
Wheat, wheat, kamut, spelled, barley, rye, oats (sometimes contaminated with cereal crops containing gluten) and their derivatives in the form of starch, flour, flakes, semolina, malt (barley).
Pastries, pastries, cakes of all kinds, cereal bars, confectionery, cereals, mueslis, pizzas, quiches, all unverified commercial preparations
Quinoa, buckwheat, millet, rice, amaranth, tapioca, cassava, sesame

Which bread has the least gluten?

Gluten-free bread that you buy ready-made or at home is not always delicious, and they almost always have a high glycemic index (GI), and they raise blood sugar to a level incompatible with good health. Christine Calvet tested many combinations for her low GI gluten-free recipe book and came up with this recipe that respects your blood sugar while being very tasty.

Gluten-free products: which ones to choose?

Eating gluten-free has some pitfalls, especially when looking for alternatives to the diet section of supermarkets. Indeed, these gluten-free products are often ultra-processed with a high glycemic index.

Who should follow a gluten-free diet?

This regime is followed in particular by:
  • People with celiac disease
  • People with wheat allergy
  • people with gluten sensitivity
  • Followers of the Paleo diet
  • People with autoimmune disease who follow the Seignalet diet
  • Some families with autistic children
Celiac disease is caused by gluten in foods; it affects about 1% of the Western population. Toxic gliadin peptides trigger an immune response that causes inflammation of the mucosa, atrophy of the small intestine's villi, and increased intestinal pressure.
And it increased gut permeability. Damage to the small intestine can cause common gastrointestinal symptoms. The disease has a genetic disposition, and the only known treatment is a lifelong strict gluten-free diet.
Wheat allergy is an IgE-mediated reaction to insoluble wheat gliadins. Symptoms usually develop within minutes to hours after ingestion, with swelling, rash and even life-threatening anaphylaxis. Symptoms can range from asthma and baker's rhinitis (due to flour inhalation), atopic dermatitis (due to skin exposure), hives (after contact with wheat), or exercise-induced anaphylaxis (when cereal is eaten before strenuous physical activity). It is estimated that 0.4% of the world's population is allergic to wheat. The majority of cases involve children, and most of them will lose their wheat allergy as they grow up.
Gluten sensitivity covers a set of digestive and extra-digestive symptoms that cease or improve with the cessation of gluten consumption.

Is the gluten-free diet effective for weight loss?

A study published in the journal Digestive Diseases and Sciences investigated the health effects of a gluten-free diet. They analyzed data on 13,523 people, 155 of whom had a gluten-free diet.
Results: people following this type of diet have a lower BMI than others.

How to follow a gluten-free diet without the risk of deficiencies?

Vitamin D and iron deficiencies have been observed in celiac disease people. These deficits do not only affect these patients: the lack of vitamin D is widespread, and some women between the ages of 15 and 50 do not get enough iron. Patients may also lack vitamin B12 and calcium.

The gluten free diet - All you need to know about

Vitamin D

Exposure to sunlight provides most of the vitamin D we need, especially on sunny days. You can synthesize the vitamin D you need on sunny days by exposing your arms and torso for 10 to 15 minutes at midday at least two to three times a week, face protected. It is pretty tricky to find good sources of vitamin D in the diet. In general, fatty fish (salmon, mackerel, tuna, sardines) are the richest sources, with an average content of 400 IU per 100g of fish. One egg provides only 20 IU of vitamin D.
For these reasons, from October to April, supplements are essential. Indeed the vitamin D brought by the food is insufficient, and the wavelength of the solar radiation does not allow any more synthesis by the skin.
The amount of vitamin D to take depends on each individual, and it must make it possible to aim for a blood level of circulating vitamin D or 25(OH)D at least equal to 30 ng/ml. Every October, it is necessary to give between 400, 1000 IU of vitamin D3 to a child and 1000 to 5000 IU/d to an adult. LaNutrition.fr advises contacting the doctor to perform blood tests. He can then prescribe vitamin D3, which he can take daily or once a week.
A tablespoon of cod liver oil provides 1360 IU of vitamin D. Unfortunately we cannot recommend it because of its excessive vitamin A content. Several studies have also shown that vitamin A would reduce specific effects of vitamin D.

The iron

Iron is an essential nutrient for life. Due to malabsorption of dietary iron, iron deficiency anaemia is the most common type of anaemia in patients with celiac disease; it may be present in more than half of patients at the time of diagnosis of celiac disease. Other causes of anaemia include folate (vitamin B9) and vitamin B12 malabsorption, inflammation, blood loss.

Gluten-free diet benefits

Therefore, the gluten-free diet is not the cause of the lack of iron; it is a fact of not following this diet that leads to deficits. Thus, the initiation of the diet often improves the status of patients. But you usually have to prescribe supplements, at least initially. In children, the recommended dose of elemental iron is 2 to 6 mg/kg/day. In adolescents and adults, it is 40 to 80 mg per day, in the form of iron gluconate, in two doses, one of which after dinner.