Monday, October 5, 2009

Gluten Free Show (highlights)

After a couple of false starts, I made it to the Gluten Free Show at Jeff's Shed (aka the Melbourne Exhibition Centre).

Once there, I b-lined to the first information session which was a talk by Sue Shepherd about how to identify gluten free foods when they aren't clearly labelled.

Sue has celiac disease so for her the avoidance of gluten is paramount to maintaining good health. She noted, however, that in the audience were more than just people with diagnosed celiac disease. There were those who had not yet been tested, those who had been tested and found not to have the condition but for whom the reduction in gluten containing food assisted them in maintaining good health and those whom had been diagnosed with IBS and had been advised to limit (or remove) certain foods from their diet, including gluten containing grains and others.

Australian food labelling laws require that wheat, rye, oats and barley must be listed as an ingredient. She explained that 'no news is good news'. If the label doesn't mention any of those foods and doesn't say it contains gluten, then it doesn't. They don't have to say it doesn't, just if it does.

The main alternative flours for gluten free use are: rice, corn, potato, tapioca and soy. Some of these can be bought for a fraction of the price from Asian grocers. This is not a comprehensive list, others include quinoa, millet, sorghum, amaranth and more. As I sat there listening to her talk and picking up on her infectious enthusiasm, I realised that it's not people who live gluten free who are restricted in choice, it's those who aren't. Western society's diet is moulded around wheat. Wheat bread, wheat pasta, wheat thickeners, wheat fillers, wheat additives to flavourings, wheat snacks, wheat cakes... the list is endless. Take out wheat, and yeah, the choice of packaged goods narrows, but the diversity of wholefood options widens. I realised that I suddenly had a whole world of dietary options available to me, an exciting, delicious world, one I had never even considered because of my one-eyed devotion to wheat. Maybe this is a gift, not a curse.

Sue's talk was interesting, informative and rich with enthusiasm for a dietary lifestyle that many who do not need to live it would view as restrictive and boring. Sue is glowing evidence that this is not the case. Her recipe books are filled with examples of delicious, nutrient rich and diverse foods. I left her talk feeling inspired.

Fortunately I don't need to be as careful with my food as someone who has celiac disease, but limiting gluten is still important. The second talk, by Jaci Barrett, a dietician and researcher based at Box Hill Hospital, discussed the similarities between IBS and celiac disease and confirmed what I'd already discovered through experimentation and a food diary.

Unlike in celiac disease, IBS does not result in damage to the intestinal villi or bowel lining, just in embarassing and distressing symptoms. Nutrient malabsorption is rare in IBS and symptoms can fluctuate. Stress is also a factor, though not necessarily the cause. Gluten intolerance in IBS does exist but the mechanism is unknown and the instances of it are rare.

Jaci introduced FODMAPS (Fermentable Oligo-, Di-, and Mono-saccharides, And Polyols), aka short chain carbohydrates. Much of what she explained I already knew, in theory, from research I had done on the internet. But the following, I didn't know:

The FODMAPS are made up of: Fructans, Galactans, Polyols, Fructose and Lactose. In over simplified terms: Lactose is dairy; Fructose is fruit; Fructans are wheat and onions and Galactans are beans and legumes. Polyols are spread throughout various foods.

  • are poorly absorbed by everyone
  • move quickly through the intestine to create wind (e.g. baked beans)
  • in healthy people, these carbohydrates may just cause wind. In people with gastrointestinal disorders (such as celiac, IBS, Crohns disease, etc), these carbohydrates cause abdominal bloating, pain, gas, and constipation and/or diarrhea. Ah yes, I know those symptoms well.  ;-)
  • no diagnostic test to confirm these are problematic. No-one can absorb them well, but most can tolerate.
  • only a portion of these are absorbed
  • same as fructans/galactans, everyone is unable to properly absorb these
  • will acerbate symptoms of IBS
  • again, no diagnostic test to confirm these are problematic
  • these are in beer as mannitol (puts on droopy sad face)
  • spirits though, are fine (perks up)
  • usually well absorbed in intestine
  • some people will malabsorb
  • a test is available to identify if these carbohydrate is malabsorbed
  • usually absorbed but requires an enzyme to break it down
  • a test is available to identify if this is an issue.
Fructans, Galactans and Polyols are ALWAYS to be avoided in patients who present with gastrointestinal symptoms. A trial may be all that's required to identify if the removal of these carbohyrates will help. If symptoms abate, then a low FODMAP diet is recommended.

In hearing this, the final puzzle piece in my search for a solution to my dietary dramas slipped into place.

I won't list all the foods that are known to contain these three carbohydrate combinations, but the main ones that I now avoid are: wheat, rye and onions. Mushrooms may also be a problem, as are a list of about another 20 fruits and vegetables.

I wandered through the rest of the show, stopped by the cooking display to see a television chef making a delicious looking fish dish while the cameraman stuck a great hulking camera so close that it almost disappeared inside the pot he was working over. I guess the chef is used to it, but me, I'd swat the damn thing out of the way.

From this day I took away the secret to recovering my health. It's simple: no wheat; no rye; no onion. The other problem foods I can try in moderation, but I have enough experience with wheat, rye and onion to know that they are not my friend, not matter how enticing and tasty they may seem.

I bought a recipe book, Irrestistibles for the Irritable, some delicious low fodmap sweets and a brimming urgency to unleash a new way of cooking and eating -- one that doesn't make me sick, miserable and deplete my iron stores so I have to live on iron tablets and multi-vitamins... oh, and doesn't leave me achy, tired and depressed. It goes without saying that I have no sadness at losing those other IBS symptoms that are best not mentioned in polite company. ;-)

Gluten free ain't all that bad. Compared to the alternative, it's heaven!

1 comment:

  1. Wow, what a lot of great information. Thanks for taking such great notes! It really helps to see the FODMAPS stuff written out. Christy's little boy has celiac and is diabetic, so she's always montioring these things for him--but I never thought to ask about the science behind it.
    And that's why it works, isn't it--because this is science and not just some smooth-talker who thinks they've invented the next Great Diet. Our nation (and others) have gotten so lost when it comes to food. We no longer know or care what we eat. How did price become more important than healthy eating?? Doesn't that 99 cent burger cost us more in the long run?
    Food is something to be cherished. The act of cooking is theraputic and using fresh foods is good for the mind and body. And as you're discovering, there's a whole world of forgotten foods out there, each one special and unique. It's time we start celebrating!