Today we are increasingly hearing terms such as gluten intolerance, wheat allergy and coeliac disease. On top of this, the words wheat and gluten are often used interchangeably too, even though there is a very clear difference between the two substances. So what do they actually mean and how are they different?
Gluten is a component of wheat and is also a protein that is found in some other grains too, including spelt, barley and rye. It’s also what gives yeast-based dough its elasticity. Because gluten is found in a variety of grains, people who react to gluten (including those with coeliac disease, which is actually an autoimmune response triggered by gluten, as we’ll see below) need to avoid not only wheat, but also other gluten-containing grains and any foods that contain them.
A reaction to wheat can be completely different from a reaction to gluten. In fact, those with a true allergy to wheat are often not reacting to the gluten, but to some other part of the plant. Researchers have actually identified 27 different potential wheat allergens (1), of which gluten is one type. Albumin and globulin proteins may be particularly common triggers (2).
Let’s look more closely at the difference between wheat allergy, coeliac disease and gluten intolerance.
A true wheat allergy should not be confused with gluten intolerance or coeliac disease. A food allergy is caused by the immune system producing IgE antibodies to a specific food protein or proteins. Symptoms tend to occur fairly soon after eating the food, from seconds up to two hours. When the food protein is ingested, it can trigger a range of allergy symptoms from mild (such as a rash, itching, or sneezing) to severe (trouble breathing, wheezing, anaphylaxis). Wheat allergy symptoms may also include abdominal pain, diarrhoea and other digestive disturbances. A true food allergy such as this can be potentially fatal.
Allergy to wheat is thought to be more common in children, who may ‘grow out of’ it before reaching adulthood. But it can also develop in adults.
Those with a wheat allergy may still be able to consume other gluten-containing grains; although in some cases these will need to be avoided too.
According to the Coeliac Society (www.coeliac.org.uk), coeliac disease is a well-defined, serious illness where the immune system attacks the body’s own tissue, when gluten is eaten. This causes damage to the lining of the small intestine and means that the body cannot properly absorb nutrients from ingested food. Usually diagnosed by a gastroenterologist, it is a digestive disease that can cause serious complications, including malnutrition and intestinal damage, if left untreated. Coeliac disease is not a food allergy or intolerance; it is an autoimmune disease where the sufferer must completely avoid gluten from all grains – not just wheat.
The Coeliac Society states that one in 100 people in the UK is thought to have coeliac disease, but only 24 per cent of these people are diagnosed. This leaves nearly half a million people in the UK who could have coeliac disease but aren’t yet diagnosed (www.coeliac.org.uk/coeliac-disease/myths-about-coeliac-disease).
Many people who do not have coeliac disease can still experience uncomfortable symptoms when they consume gluten. This is known as non-coeliac gluten sensitivity or gluten intolerance. Researchers continue to debate just how many people are truly sensitive to gluten, but the number has been estimated to be approximately 6% of the population.
As some of the symptoms of coeliac disease, gluten intolerance and even wheat allergy can overlap, it is important to be tested by your doctor to determine which of these may be causing your symptoms.
A gluten-free diet may also be beneficial for other conditions. These include inflammatory bowel diseases such as Crohn's disease and other digestive conditions or symptoms such as irritable bowel syndrome or excessive bloating and gas. There’s increasing evidence that following a gluten-free diet may be beneficial for some people with other types of autoimmune disease too.
Now let’s look at why understanding the difference between these two terms is important, depending on which of the above conditions/symptoms you may have.
‘Wheat-free’ foods are free from any components of wheat, including other proteins that people with a wheat allergy can react to. But foods that are just labelled ‘wheat-free’ may still contain other gluten-containing grains or substances derived from them, and are not necessarily gluten-free.
‘Gluten-free’ foods have to be free of gluten from any of the gluten-containing grains (more accurately, they have to contain less than 20 parts per million of gluten – a very tiny amount). Once again, these grains include rye, barley and spelt as well as wheat. Oats can also contain small amounts of gluten via contamination from other grains. Therefore oats also need to be avoided on a gluten-free diet, unless they are specifically labelled ‘gluten-free’, indicating that the oats have been processed in facilities that eliminate risk of contamination with gluten.
However, ‘gluten-free’ doesn’t necessarily mean the food is free from other wheat components. So if you have a wheat allergy and you’re buying packaged or processed foods, it can be wise to look specifically for ‘wheat-free’ and not just gluten-free – or thoroughly check the ingredients list to make sure the food you’re buying doesn’t contain other wheat components.
If a label on a packaged food doesn’t explicitly state ‘gluten-free’ or ‘wheat-free’ then you may need to look through the ingredients to check. But it’s not enough to avoid anything that lists the word ‘wheat’ (or when looking for gluten-free products, the words ‘wheat’, ‘barley’, ‘rye’ or ‘spelt’). Products such as gravies, soya sauce, salad dressings and casseroles can contain derivatives of wheat or other gluten grains that are harder to identify and can also be listed under different names. The following should all be avoided: durum wheat, spelt, kamut, couscous, bran, wheat bran, wheat germ, farina, rusk, semolina, wheat starch, vegetable starch, vegetable gum, malt extracts, vegetable protein, cereal filler, cereal binder and cereal protein.
The following are alternatives that are both wheat and gluten-free: maize (corn), corn flour, potato, potato flour, rice flour, soya beans, soya flour, buckwheat, millet, tapioca, quinoa, amaranth, sorghum, arrowroot, chickpea (gram) flour and lentil flour.
Chickpeas, beans and lentils are good fillers and can be added to soups and gravies, while wheat-free pasta and rice noodles are a great alternative to standard wheat pasta.
Understanding the difference between wheat and gluten can help avoid any unnecessary symptoms that may be brought on by ingesting the wrong foods. Confusing wheat and gluten may have less of an impact on people with non-coeliac gluten sensitivity/intolerance, or wheat sensitivity/intolerance, but it can have more serious consequences for those with a true wheat allergy and coeliac disease.
Clearspring’s Range of Gluten-Free Products
The Clearspring promise is to provide great-tasting, delicious foods that support good health and provide optimum nutrition. We want to give our customers who need to avoid gluten or wheat the opportunity to have great-tasting food and to be able to cook with confidence. This has inspired us to launch a range of gluten-free ingredients, from meal staples such as soya protein, rice and vegetable pastas to seasonings, sauces and garnishes. These are tasty, nutritious alternatives perfect for those on a gluten-free diet but equally delicious for the whole family.
1. Sotkovský P et al. A new approach to the isolation and characterization of wheat flour allergens. Clin Exp Allergy. 2011 Jul;41(7):1031-43.
2. Mittag D et al. Immunoglobulin E-reactivity of wheat-allergic subjects (baker's asthma, food allergy, wheat-dependent, exercise-induced anaphylaxis) to wheat protein fractions with different solubility and digestibility. Mol Nutr Food Res. 2004 Oct;48(5):380-9.
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