What an honour to be asked to speak at the latest Free From Festival in Bristol, the UK’s first Gluten, Dairy and Refined Sugar-Free exhibition. Given that the title of the talk was "Unintended Consequences: Free From diet pitfalls and how to successfully overcome them" and I was surrounded by Free From food producers, I think we struck the right tone!
For many, changing their diet reduces unpleasant symptoms, but what are the unintended consequences of eliminating these foods and how can you alter your diet to ensure that your health and performance are actually improved, now and for the longer term? The answers (well, some of them) lie here. Bear in mind that covering Gluten, Dairy and Sugar Free in 45 minutes is a tall order, so I'm going to publish the key elements of the talk in 3 blogs, so this blog (Part 1 of 3) covers the Gluten Free element. Check back for Dairy Free and Sugar Free.
Gluten Free
10% of the UK population follow a Gluten Free (GF) diet because they have a diagnosed issue with gluten such as wheat allergy or coeliac disease; have self-diagnosed a gluten intolerance; or because they feel it's a healthier option (1). That's massive. Take the entire population of Bristol, times it by 13, and there are our gluten free peeps.
Luckily the supermarket aisles are full of GF foods these days. But wait ...
GF products are unlikely to provide health benefits unless you have a diagnosis (2)
•GF assumed to be healthier
•May overconsume nutrient-poor UPFs
•Less fibre
•Fewer vitamins and minerals (B vitamins, Iron, Calcium) (3, 4)
Fibre: the more fibre you eat, the less risk you have of dying from any disease (5). But in terms of a GF diet, we need to look at the link between inflammation in the gut (as seen in Coeliac disease, Crohn's, IBD, gluten intolerance etc), fibre and the gut microbiome (the collection of microbes in your colon which impact many areas of health as well as gut function and tolerance).
A key starting point is the disruption of the gut microbiome. This influences coeliac disease through the loss of gluten tolerance (6). But research tells us that:
•GF diet lowers diversity, increases unwanted strains (6)
•GF diet lowers Short Chain Fatty Acid (SCFA) production which feed our gut cells among other roles (6)
So we could nip out and buy expensive probiotics and try to blast the microbiome into success, or just eat more fibre which is shown to improve gut health (7, 8). Fibre increases the diversity of the microbiome to crowd out non-beneficial strains and increases the production of SCFAs (6). In turn this can reduce inflammation, leaky gut and immune response to gluten.
What to Eat to Increase Probiotic strains:
Vegetables, Fruit, Beans, Lentils, Chickpeas, Nuts, (GF) Oats, Nuts and Milk (the lactose acts as a probiotic) (7, 8)
What to Eat to Feed Probiotic strains: Onion, Leek, Garlic, Jerusalem Artichoke, just ripe Banana, Asparagus, Mushrooms and
Omega 3 rich Oily Fish (e.g. salmon, mackerel, sardines), Walnuts, Flax/Linseeds, Chia seeds (8, 9)
Deficiencies in B vitamins, Iron and Calcium (10, 11, 12)
Two reasons why those on a GF diet are likely to be low in these nutrients:
Diet restrictions means no flour or flour based goods, fortified by law in the UK with B vitamins, Iron and Calcium
Inflammatory gut disorders can lead to lower absorption levels of these nutrients (and others)
This can result in:
• Poor energy, fatigue, failure to thrive, heart palpitations
• Low Iron levels are problematic for children, teenagers, (pregnant) women
• Women in the UK are 25% down on their recommended daily intake
• Adverse effect on bone and tooth health
What to eat
B vitamins: Meat, Liver (not in pregnancy), Chickpeas, Beans, Leafy Greens and Broccoli (13)
Iron: Meat, Fish, Tofu, Leafy Greens, Chickpeas, Beans, Lentils, Brown Rice, Eggs, Dried Apricots (14)
Calcium: Dairy, Leafy greens, Oranges, Nuts, Sardines, Dried figs, Tofu, Beans, Lentils, Fortified milk substitutes (15)
But there's more. To absorb and lock Calcium into bones and teeth you need Vitamin D.
Known as the Sunshine vitamin, we don't get enough in the UK so the recommendation is to supplement with 10mcg/d from birth, October-May. Food is a poor source apart from Sardines & Tuna in oil (7mcg/100g) (16), Sunbathed mushrooms (10mcg/100g) (17)
The Expense
Does all of this sound expensive when the cost of living is rising so sharply?
Well, you have to think about how much highly processed GF foods cost as well, and their quality.
In fact, GF bread is the GF consumer's No.1 bug-bear in terms of taste and price (18), although shout-out to Hungry Scarecrow who exhibited at the Festival and sell great substitutes.
Sadly, budget supermarkets tend not to stock large ranges of GF goods.
And GF product prices are high - somewhere between 2 and 4 times more expensive than their non-GF equivalent (18, 19). That's a rip off. So being selective about your GF purchases, making sure you recognise what's on the ingredients list, and focusing on non-gluten whole foods could save you money.
Summary The pitfalls of a GF diet:
1.Increased likelihood of imbalanced gut microbiome which impacts sufferers/disease progression
2.Nutritional deficiencies
3.High Cost, Low Nutritional Value and Poor Taste Quality (sometimes!)
Benefits of adjusting the GF diet: “whole foods” reduce symptoms, promote gut health, improve overall health and wellbeing, and may save you money if you buy GF essentials for exactly that reason - they're essential.
Shopping List
As promised to many of you, here's the visual shopping list I put together for the talk - enjoy!
As ever, keep in touch for hints, tips and recipes via this blog or on Instagram, Twitter and Facebook - just use the handle @360FitFood
A full reference list for all 3 diets will be released with the Sugar Free diet blog but short citations are here, in order of use, for this Gluten Free piece:
(1) Coeliac.org.uk, 2023
(2) Wu et al., 2015
(3) Martin et al., 2013
(4) Kinsey, Burden and Bannerman, 2008
(5) McKeown et al., 2022
(6) Marasco et al., 2020)
(7) Guan, Yu and Feng, 2021
(8) Silva, Bernardi and Frozza, 2020
(9) Vijay et al., 2021
(10) Szaflarska-Popławska, Dolińska and Kuśmierek, 2022
(11) Taetzsch et al., 2018
(12) Niewinski, 2008
(13) NHS, 2020a
(14) NHS, 2020b
(15) NHS, 2020c
(16) Sahar et al., 2022
(17) Cardwell et al., 2018
(18) Vriesekoop et al., 2020
(19) Fry, Madden and Fallaize, 2018