Years ago, coeliac disease was thought to be a rarecondition, but in recent years the general consensusis that it's quite common, with many people not realisingthey have it.
In a nutshell, gluten (a protein found in wheat, rye,barley and oats) damages the gut, which prevents normaldigestion and absorption of food including nutrients,protein, fat, carbohydrate, vitamins and minerals.
If undetected, in the long term it can lead to healthissues such as anaemia, osteoporosis and a greater chanceof developing a cancer somewhere in the gastrointestinaltract, especially in the small intestine.
People with coeliac disease are born with the genes(there is an increased risk of 1 in 10 when coeliacdisease exists in a family) and the symptoms can betriggered at any time in their life. More women arediagnosed than men and the most common age of diagnosisis 50.
It's a strange disease, where symptoms can includefatigue, anaemia, stomach pains, bloating, vomitingand mouth ulcers - or none at all. It's diagnosed viaa simple blood test, then a gut biopsy (a tube witha camera passed down your throat into your stomach sodamage can be assessed) under sedation. If you suspectyou may have coeliac disease, never change your dietuntil you have a diagnosis as it can skew the result.
The good news is that it's relatively easy to treat- just eat a gluten free diet for life. At face value,this seems pretty easy. There are plenty of naturallygluten free foods including meat, fish, milk, butter,cheese, fruit, vegetables, legumes and seeds. However,considering our convenience packaged food culture, it'sa lot trickier in practice.
At present, food labels in Australia are difficultto decipher without a degree in nutrition - a fact thatis much discussed in NOVA articles. First, the uninitiatedmust understand that when you pick up a product froma supermarket shelf and read the ingredients list tosee if that product contains gluten, you are not justlooking for the word "gluten". Gluten comesin many forms, for example, thickeners, 1400-1450, numbers,colours, flavours, maltodextrin, malt, malt extract,hydrolysed vegetable protein - you get the picture.There are way too many for the average person to learn.
Unfortunately, many people with coeliac disease (andthe friends and family members who occasionally cookfor them) end up picking up a product, looking at thelabel and seeing a host of numbers, colours, thickenersand so on and have no idea whether those ingredientscontain gluten or not and end up putting it straightback on the shelf. With that in mind, it's not surprisingthat the "free from" ranges are the fastestgrowing supermarket products in terms of demand.
After moving to the UK recently, I discovered that,as a coeliac sufferer, shopping and eating is a hellof a lot easier than it is in Australia. Why? For starters,it's free to join Coeliac UK (www.coeliac.uk) - a charitythat is working to improve the lives of people withcoeliac disease through support, campaigning and research.Anyone with coeliac disease can join and so far thereare 70,000 members with 600 new members joining everymonth. There's a free dietetic and food helpline, leaflets,books and 96 voluntary groups you can elect to jointo get advice, support and meet people who understand- which is especially important if you're newly diagnosed.
Coeliac UK produces an excellent annual 350 page Foodand Drink Directory that lists around 11,000 foods fromtins of soup to ready meals under individual supermarketheadings so you know exactly where to buy it.
In addition to this, more and more UK food manufacturersare putting gluten free symbols on their foods and manysupermarkets, notably Tesco, have an entire "freefrom" range which offers gluten free food suchas pasta, biscuits, bread and so on.
The good news for coeliac sufferers in the UK (or overseasvisitors) is that all food packaging must now complywith the EU Regulations that came into force in November2005. This means that any packaged food that containsgluten now has to specify this on the pack, either inan allergen advice box or in the ingredients list.
Chief Executive of Coeliac UK, Sarah Sleet, agreesthat it's a "massive step forward". "Thebottom line is increased transparency for anyone shopping,"she explains. "Now gluten must be labelled as 'gluten'."
Quite rightly so. As consumers, we are entitled toknow exactly what we are eating - in clear, simple terminology.Tesco supermarket in the UK, for example, (the mostgluten free friendly supermarket according to CoeliacUK) has hit the nail right on the head in how they providethis information to the consumer.
Every Tesco product has a section on their labels called"allergens". Halleluiah! It makes eating glutenfree so simple - the allergen box either lists "gluten"under allergens or it doesn't. That way you - or anyoneelse who has invited you to dinner - can pick up anyitem and see at a glance whether it contains gluten.Blissfully easy!
Thanks to this new labelling law, living in the UKmeans that a whole new world of food has opened up tome. Take bacon and ham, for instance. In my local supermarketin Australia, most of the bacon and ham had a long complicatedingredient list with all manner of scary gluten infestedingredients and I had to buy a special brand of glutenfree ham and bacon that cost a fortune compared to "normal"versions. Over here, ham and bacon seem to have a lotless rubbish in them and refreshingly are, well, justplain old ham and bacon.
This can be partly attributed to the fact that CoeliacUK has been working with retailers to try and avoidgluten in their products in the first place. "Theidea is that they don't design it in to the productif at all possible," says Sleet. "Now majorretailers are thinking at the beginning of the productdevelopment process - does it contain an allergen andif so, does it have to? So the end result is that nowyou don't see the amount of rubbish you used to seein food."
Another interesting bonus the UK has over Australiais that if you are diagnosed with coeliac disease youcan get gluten free food on prescription from your doctor.A prescription (costing around £6) will get youa month's supply of gluten free pasta, bread, or biscuitsand so on which goes a long way to help. The cost ofgluten free food in my experience in Australia is generallya lot higher than ordinary food - a loaf of gluten freebread baked locally costs around $6. What's more, forthat money, the actual slice sizes are much smallerand the size of the loaf itself is almost half the sizeof a normal loaf. In addition, another pleasant surpriseis that the cost of gluten free food in the UK is prettymuch the same as ordinary food.
When it comes to eating out in restaurants - as everycoeliac sufferer will attest - it's a whole differentball game. Contamination is a huge issue, occurringvia using breadboards, utensils and foodstuffs likejam and butter that have come into contact with foodcontaining gluten. It's not uncommon to see in cafes,for example, gluten free cakes or muffins sitting sideby side - and often touching - cakes that aren't glutenfree. This is a huge no no. There's no point in cafowners ordering in gluten free food if it's contaminatedwith food that contains gluten and we can't eat it!
What hasn't helped the coeliac cause is that one ofthe latest fad diets to come out of the US is all abouteating gluten free - so there's the risk that some restaurantowners and staff may assume when you ask if somethingfrom the menu is gluten free that it's not a medicalcondition and, accordingly, don't take your requestseriously.
Another scenario coeliac disease sufferers may, unfortunately,be only too familiar with is when frazzled chefs aretoo busy to take the time to explain the ingredientsand insist you "trust them". Too many timesto mention, after insisting I be told the ingredients,it turns out that their knowledge of gluten is limitedand the meal is not gluten free as promised. Had I "trusted"those chefs, I would have been very sick.
Busy chefs and hectic kitchens are totally understandable.The easy answer is for restaurants and cafes to offera couple of gluten free items on their menu - just asthey would always include a vegetarian option. Mostof the time, they will probably already have a glutenfree option or two - so all they have to do is labelit clearly on the menu. That way, every time customersask for gluten free - or wheat free meals - it won'ttake up the chef's valuable time in a busy kitchen.
It's also interesting to note that although one personmight have coeliac disease, every time that person goesout for a meal with family and friends, the restaurantthey choose to eat in is invariably the one where thecoeliac sufferer can eat.
Some forward-thinking restaurants and cafes have alreadycaught onto the fact that the "free from"market is burgeoning world wide and that offering tastygluten free meals (not just a salad) - attracts a lotmore customers. "Bon appetit" to that!