Coeliac disease & gluten free diets


In this episode, I interview Dietitian Sally MarchiniShe is an active member of the Australian Diabetes Council and Coeliac Australia. She shares her personal experience with Coeliac disease and Type 1 Diabetes mixed in with her professional recommendations on how to manage Coeliac disease.

Coeliac disease is an autoimmune genetic condition that can only be treated with the exclusion of gluten from the diet. Sally explains the difference between this and irritable bowel syndrome cause by fermentable sugars (FODMAP).

Having a healthy diet is easy to do gluten free if you understand where gluten comes from.  Sally has shared with us the link to her blog post Following the Australian Dietary Guidelines Gluten Free and also explains how to make healthier choices amongst the gluten free grains so you can keep your diet low GI.

 Sally was kind enough to send through links to some of the useful websites she shared during the talk which include: Be Well Gluten Free closed Facebook group and The Yum Gluten Free e-magazine and the Coeliac Australia website.

 Want to know more? Listen to the podcast and make sure to SHARE it on Facebook and Twitter! If you’re looking for more detailed information on Coeliac disease or gluten free diets contact an Accredited Practising Dietitian, such as myself, to make an appointment.

Check out this episode!


Gluten free fads

With Gabrielle Maston

  • There’s a huge push in the dieting industry to follow a gluten free diet for weight loss. People follow gluten free diets for coeliac disease or as part of a low-FODMAP diet; they’re medical conditions.
  • Gluten is not the root of all evil in our food chain. Some research to suggest some people might have a problem with gluten it’s a far cry from the whole population needing to be gluten free.
  • Gluten is safe!
  • Gluten= protein found in grains (wheat, rye, barley and in some oats). Its not a nutrient itself but the sticky stuff that binds bread together. When you cut out gluten- exclude large majority of low GI wholegrain options available- high fibre grains that are slow releasing. On a whole some gluten-free carbohydrate foods such as rice or corn are faster releasing and lower in fibre.
  • While on the fad diet (gluten free) people tend to go for corn and rice-based products: fast-releasing high GI grains so they’re not great you’re your health in large quantities.
  • When people avoid gluten they automatically think all gluten-free products are free reign which they’re not! If want to lose weight its about quality AND quantity of food that you’re eating. Don’t get bogged down with highly processed, high energy and high fat gluten free packaged products such as cakes and pastries- they’re not healthier for you, in fact they can be higher in calories/fats/sugars.
  • Gluten-free options generally higher in energy and lower in fibre due to the flours they’re made from e.g. rice flour, coconut flour= higher fat.
  • If you’re trying to lose weight- need to cut our calories to achieve energy restriction. Cutting out gluten is not a magical pill.
  • If you have gut symptoms: get a blood test to see if you have antibodies for coeliac disease. Bloating: see a dietitian to go on a low FODMAP diet- elimination to find out what foods are causing the problem- get to issue of gut issue.
  • If you do need to go low GI: Choose whole food, low-GI options (buckwheat, quinoa, amaranth, wild rice). Legumes, lentils for high fibre, low GI carbs and they’re vegetarian protein sources.


Managing Coeliac Disease 

With Sally Marchini

  • She has Type 1 Diabetes and Coeliac Disease herself.
  • Sally aims to empower people to make the most out of life and learn about the foods they can eat rather than feeling like they’re missing out.
  • Discovered she had coeliac disease 13 years ago. 10% of people with Type 1 diabetes are diagnosed with coeliac disease. Genetic condition triggered by environment. Close to half population have the genes but not everyone gets it. Associated autoimmune condition to Type 1 diabetes.
  • Very hard to deal with when diagnosed with both conditions. All about education so it’s not as daunting.
  • For newly diagnosed people with coeliac disease:
  • 5 food groups in dietary guidelines: the only food group need to consider is cereals/grains group. There are more gluten free grains than gluten-containing grains. Learning how to swap these for gluten-containing grains. Learning to read food labels. Have to think before you eat. Takes 1-2 years to get use to a gluten free diet.
  • Facebook group ‘be well gluten free’- contains 12-15 dietitian’s, a GP and a pharmacist.
  • Following a gluten-free diet when you don’t have an intolerance/allergy: potentially dangerous! Eating fewer processed foods will make you feel better; not just because they contain gluten. Gluten is a protein found in wheat, barley, rye and some oats and it’s becoming better known. If people decide to go gluten-free:
  1. They’re potentially missing out on nutrients they don’t need to miss out on
  2. Putting themselves at risk of not being diagnosed with coeliac disease. Symptoms in coeliac disease aren’t the problem it’s the internal long-term damage that’s the problem.
  • Other things in wheat, barley and rye that may cause symptoms (such as fructans) that are not related to gluten intake. May need low FODMAP diet but seek advice from a dietitian first.
  • The Sista code: understanding of the difference between gluten and FODMAPS and importance of a medical diagnosis before putting yourself on a gluten free diet.
  • People with coeliac disease can have a FODMAP intolerance as well.
  • Eating out: chefs and restaurants knowing importance of avoiding cross-contamination of gluten.
  • Speak to chef yourself and explain how important it is. Be polite and thankful.
  • Can’t guarantee there will be no gluten: don’t go back to that place! You won’t die from accidental occasional gluten consumption- just go back to gluten free diet and get back on track. Body recovers quickly so there’s no long-term damage if you’re avoiding gluten most of the time.
  • Takes up to 12 months for damage to heal from internal damage after first diagnosed with coeliac disease.
  • Invasive diagnosis. Looking at easier methods of diagnosis and using simpler methods such as blood tests but they’re still working on it.
  • New range of bread products (Alpine bread)- FODMAP friendly but contain gluten. Only available in Victoria at the moment but delivering across Australia. Can minimise symptoms for gluten challenge people need to do for diagnosis.
  • Recipes: not too hard to swap ordinary recipes for gluten free recipes e.g. swapping flours.
  •– type in gluten free recipes
  • Australian healthy food guide- indicates when recipes are gluten free and they’re dietitian approved.
  • – good place for information.
  • Get a proper diagnosis! Don’t diagnosis yourself with coeliac disease- run the risk of missing things. Even a breadcrumb can cause problems let alone slipping up and eating a sandwich when eating out.
  • It doesn’t have to be complicated! A lot of foods are gluten free. Don’t have to go for packaged foods that have gluten free on the label. Legumes, fruit, meat, veggies are all gluten-free so pick from those instead of processed products.
  • Eating out: talk to chef at restaurant or at someone’s house make sure they understand there’s a huge difference between coeliac disease and following a fat diet of gluten free. Even minimal amounts can cause problems in some people. Ring the restaurant before you go or take your own dish at a friend’s house to avoid cross-contamination.




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