There is often confusion as to whether wheat and gluten are the same thing, with the names frequently being used interchangeably, particularly when people talk about intolerances.
What is wheat?
Wheat is a member of the cereal grass family and has been cultivated in the UK for thousands of years. In the present day, wheat is one of the most common food sources and wheat-based foods make up a significant portion of a modern-day diet. There are 3 main types of wheat used for culinary purposes:
- Common wheat; used for bread
- Durum wheat; used for pasta
- Club wheat mainly used to make cakes and pastries
Looking at food labels
As well as being found in staples such as bread and pasta, wheat can be found in many unexpected food products such as soups, sauces, dressings, soy sauces, stock cubes, seasonings and artificial flavourings and colourings. It may not be immediately obvious that wheat is contained in a product, as it may be labelled with an unfamiliar name such gelatinised starch, gluten, vital gluten, hydrolysed vegetable protein, modified starch and malt extract.
Wheat allergy or intolerance?
An allergy is, in simplistic terms, an over-reaction of the immune system to a harmless substance. A wheat allergy is a reaction which occur when eating a food containing wheat protein. It can arise immediately or even a few hours after ingesting a wheat containing food. Symptoms of an allergic reaction can be mild which include swelling, itching, hives or rash, irritation to the mouth and throat, vomiting and diarrhoea. However, wheat allergy can also be extremely serious, leading to anaphylaxis which is a life-threatening situation requiring immediate treatment. Symptoms of anaphylaxis include tightness of the throat and chest, difficulty breathing, pale, blue skin colour, difficulty swallowing and fainting.
Wheat ultimately is a carbohydrate and is broken down into a sugar. In some people it is not properly absorbed in the gut and it can trigger symptoms of intolerance in people with irritable bowel syndrome (IBS). The symptoms of IBS include bloating, flatulence, diarrhoea, constipation and nausea. People with IBS are often advised to strictly exclude wheat (and other types of foods) for a period by following a special diet called the FODMAP diet. Some people find relief from their symptoms and are able to reintroduce some wheat products back into their diet. An intolerance can ruled out by using this test.
What is gluten?
Gluten is a naturally occurring protein found in all wheat varieties including durum, spelt, farro, semolina, wheat berries, emmer, farina, KAMUT ®, graham, wheat bran, wheat germ, malt, bulgur, seitan and couscous. It is also found in barley, rye and their cross, triticale. It acts as a binding agent and lends strength and a stretchy quality to foods. Gluten can also be used as a thickening agent. Oats are naturally gluten free, however they are often contaminated by growing in close proximity to gluten-containing grains or being processed in the same factories as other grains which contain gluten. They also contain a very similar protein to gluten call avenin.
Coeliac disease is neither an allergy or intolerance but it is an autoimmune disease. Eating foods containing gluten results in the body attacking itself and causing damage to the lining of the intestines. This can ultimately lead to the prevention of the absorption of important nutrients in the intestines. It can cause vitamin and mineral deficiencies to develop as well as increase the risk of osteoporosis and some types of cancers. It is actually a relatively common disease affecting 1 in 100 people and symptoms can include nausea, bloating, diarrhoea, constipation, tiredness, mouth ulcers, anaemia and unexplained weight loss.
Currently the only way to manage coeliac disease is to strictly exclude gluten from the diet. Some people may also not be able to tolerate oats, either due to cross contamination or due to the similar proteins found in them.
There are a huge range of gluten-free products available in the supermarkets to help increase the variety in the diet if you need to exclude gluten. Remember, always check the labels, but often stores and supermarkets will have a ‘free-from’ section, and some even have a ‘gluten-free section, as this is one of the most common dietary reactions.
It may be difficult in some instance for a doctor to diagnose whether you have gluten intolerance or coeliac disease, as some of the symptoms are similar. In the case of coeliac disease however, there are more far-reaching symptoms.
Ultimately, both conditions are liveable with and can be controlled by dietary changes.
- Coeliac disease is an autoimmune condition, caused by gluten reaction, which can take some time to diagnose. It is also less common than gluten intolerance (about 1% of the population suffer from coeliac disease).
- Blood testing and elimination diets are usually doctors’ first point of call
- Coeliac disease is a lifetime illness, it cannot be cured, only controlled
- Sufferers with gluten intolerance, however, can still tolerate small amounts of gluten without reaction
- Dietary intake must be strict in the case of coeliac disease. Even a small deviation from your diet can cause long term complications.
If you are a sufferer of either of these conditions, do get tested and find out as soon as possible.