Dr Cindy Pan Coeliac Awareness Interview

Research released has revealed a worrying number of Australians have self-prescribed themselves a gluten free lifestyle in the mistaken belief that diets containing wheat are -unhealthier', unwittingly putting themselves at risk of a nutritional deficiency.

Findings from the research by leading health retailer Amcal showed that more than one in 10 has adopted a gluten-free lifestyle - almost ten times the number of Australians who suffer from medically-diagnosed coeliac disease and have no choice but to eliminate gluten from their diet.

Further findings suggest that a high number of people have self-diagnosed themselves as gluten-intolerant without undergoing proper medical testing. In addition, more than a quarter (27%) admitted they had no idea what coeliac disease was.

When questioned about the reasons behind voluntarily following a gluten-free lifestyle, a quarter (25%) claimed they were doing so to improve their overall health while almost one in seven (13%) said it was to lose weight.

Close to a third (29%) who claimed to be coeliac or gluten sensitive had not been officially diagnosed by a health professional – rather, they had simply assumed they had an intolerance, self-diagnosed through Google or spoken with a friend or relative who shares the same symptoms.

Furthermore, the research findings indicate that the majority of wheat-avoiders did not know that going gluten-free unnecessarily could be putting them at risk of a nutritional deficiency. Almost two-thirds (65%) were unaware that their diet may lack essential nutrients such as iron, calcium and zinc with a quarter wrongly believing a gluten-free diet was more nutritious.

Dr. Cindy Pan said these figures highlighted the need for further education around the nutritional risks associated with an elimination diet.

'Many people perceive gluten-free diets to be a healthier option, however for those who don't have coeliac disease, this is simply not the case," she said.

'Gluten-free foods are often higher in sugar and fats and low in fibre, meaning that people who strictly follow this regimen may put themselves at risk of developing vitamin deficiencies.

'It is possible to follow a healthy and sustainable gluten-free diet but it's important to seek expert advice to ensure you are meeting your nutritional needs."

With almost a quarter (24%) of Aussies admitting to regularly using Dr Google to self-diagnose, Amcal Senior Pharmacist James Neville said it was important to consult a health professional before jumping to the wrong conclusion about conditions such as Coeliac disease.

'If you are experiencing sensitivity to gluten and consistently suffer symptoms such as digestive issues, lethargy, irritability or headaches, a definitive diagnosis to rule out coeliac disease is recommended," he said.

"As a first step, you may wish to do a blood test to screen for any obvious indicators that you might be at risk. This can be done by your GP or at an Amcal pharmacy, and you may be referred to a specialist for further assessment.

'Eliminating gluten from your diet is not a trivial undertaking and should only be overseen by a medical professional such as a GP or pharmacist to ensure the most accurate results."

Anyone concerned about gluten sensitivities may wish to consider a coeliac disease screening available exclusively at selected Amcal, Amcal Max and Guardian Pharmacy stores nationwide for $44.99.

Interview with Dr Cindy Pan

Question: Why are many people adopting a gluten-free lifestyle when they don't have coeliac disease?

Dr Cindy Pan: There are a variety of reasons some people might adopt a gluten-free diet including thinking it is healthier, believing it will help them lose weight and suspecting that perhaps they might have coeliac disease or gluten sensitivity. Some people might also try it if they have friends or family members who are on a gluten-free diet.


Question: Will cutting our gluten result in weight loss?

Dr Cindy Pan: Cutting out gluten will not necessarily result in weight change; it really depends on what is substituted for the previously eaten foods.


Question: Is gluten unhealthy?

Dr Cindy Pan: Gluten is not unhealthy for the majority of people however for those with coeliac disease consumption of even small amounts of gluten causes damage to the lining of the small intestine with serious potential health consequences.


Question: How will this put them at risk of a nutritional deficiency?

Dr Cindy Pan: Any diet involving stringent restrictions has the potential to result in nutritional deficiencies so it is important to determine that there is a medically valid rationale for the stringent restrictions in the first place. Seeking advice and support from your GP, dietitian and gastroenterologist is ideal to optimise your nutrition and ensure you maintain and can sustain a balanced, varied, nourishing and appetising dietary intake.


Question: What is coeliac disease?
Dr Cindy Pan: Coeliac disease is an autoimmune disorder in which consumption of gluten causes your immune system to attack and damage the lining of your small intestine. This can cause numerous symptoms, as well potentially serious permanent damage to the intestine, malnutrition (and its numerous health consequences) as well as other associated complications.


Question: What are the symptoms of coeliac disease?

Dr Cindy Pan: Typical symptoms of coeliac disease may include: bloating
diarrhoea
constipation
flatulence
pale, foul-smelling bowel motions
abdominal pain
nausea and vomiting
tiredness

Other possible symptoms might include:
depression and anxiety
joint pain
headaches
mouth ulcers
infertility or frequent miscarriages
menstrual irregularity
tingling in the hands and feet


Question: What is the difference between gluten intolerance and coeliac disease?
Dr Cindy Pan: Coeliac disease is a well recognised, long established and fairly well understood autoimmune disease that is definitively diagnosed by seeing characteristic changes on biopsy of the small bowel mucosa (taken by a gastroenterologist during endoscopic examination). It is managed by lifelong, strict adherence to a gluten-free diet.

Non-coeliac gluten sensitivity is a relatively less well understood condition in which people - who are tested and are found not to have coeliac disease or wheat allergy - nonetheless react adversely to eating gluten when challenged in an elimination diet.


Question: How are Australians diagnosed with coeliac disease?

Dr Cindy Pan: There are blood tests that can be used for screening but definitive diagnosis is based on biopsy findings.


Question: Can you share your practical tips for those who suspect they may have a gluten intolerance or coeliac disease?

Dr Cindy Pan: One of the most important things to be aware of is that prior to any test for coeliac disease - be it a blood test or endoscopic bowel biopsy - you need to have consumed a gluten-containing diet for at least six weeks prior to the test or else the results will be invalid. This means eating the equivalent of four slices of wheat-based bread daily for six weeks.


Interview by Brooke Hunter