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