Gluten free, dairy free, clean, raw and …why?

You shouldn’t deprive your body of the nutrients provided by a food group just because it’s the fashionable thing to do – only if your health requires it.

I was recently sitting at a local café doing some admin work when something caught my attention. It was similar to the sensation you get when someone scratches their nails down a blackboard.

As a couple of customers were paying for coffees they’d just enjoyed, the lady behind the counter asked them whether they’d like a ‘clean treat’ to take away. When asked what they were, she responded ‘They’re all really healthy – they’re raw, vegan, gluten free, dairy free and sugar free.’

Let’s just stop right there: how did this lady know they were vegan, had coeliac disease and had either a cow’s milk protein allergy or lactose intolerance? Did she check the docket? Obviously not, as they’d ordered lattes with cow’s milk. So they were clearly not vegan, didn’t have a dairy protein allergy and weren’t lactose intolerant. Had she been stalking them on Facebook or gone through their medical records to discover that they needed to follow a strict gluten free diet? Of course not. So why did she deem the treats she was touting to be heathier than the bircher muesli or the fruit salad and yoghurt they also had on display?

Nutrients from every food group

It seems that many people have forgotten the very basics of healthy eating: to eat from each of the five food groups to meet 100% of our nutrition requirements. Why are we now intentionally eliminating food groups? Each food group is characterised by providing different nutrients. For example, ‘dairy and/or alternatives’ is our richest and most available source of calcium, as well as a good source of protein, iodine, vitamin A, vitamin D, riboflavin, vitamin B12 and zinc. ‘Grains’ meanwhile, especially whole grains, are a rich source of carbohydrate, fibre, protein, B group vitamins and also a good source of iron, vitamin E, zinc, magnesium and phosphorus.

There are over 35 different nutrients, all with essential roles in the body. Different foods provide different nutrients. The amount of each nutrient we need is also unique and, depending on our gender and stage of life, that amount, or recommended dietary intake (RDI), changes. For example, 1000mg of calcium is recommended for adult males and females aged 19 to 50. Women over 50 years of age require 1300mg to compensate for the loss of oestrogen (a calcium transporter) produced post menopause. Children aged 14 to 18 also require 1300mg per day to support their growing bones. The recommended food group serves match our nutrition requirements across the lifespan.

The tools and energy to build your house

We must appreciate these nutrients are like our ‘tools’ to carry out vital functions of the body, and our ‘fuel’ comes from our macronutrients or ‘energy yielding’ nutrients (carbohydrate, protein and fat).

To put this into perspective, if you were to build a house you would need a huge variety of tools (nutrients) and hard labour (energy). If you lacked key tools it would be very difficult to build that house. Further, if you neglected some key tools and instead bought more of some you already had – 10 hammers when you need a welder – you are not going to build a better house. It often seems today that protein is like these hammers, with its requirements being overestimated and the other tools, such as calcium, iron and B group vitamins, being neglected.

Grains and dairy

Whole grains truly are little powerhouses, containing over 26 nutrients and phytonutrients which help nourish and maintain health. According to the Grains and Legumes Nutrition Council, eating whole grains daily is linked to a reduced risk of chronic disease, including cardiovascular disease, type 2 diabetes and certain cancers by 20 to 30 per cent. It is also linked to a lower waist circumference, a lower risk of being overweight and a lower risk of weight gain over time.

The Australian Dietary Guidelines, based on the highest quality studies, say that consumption of milk, cheese and yogurt is linked to a reduced risk of heart disease, stroke, hypertension, type 2 diabetes, metabolic syndrome and colorectal cancer. These are currently some of the biggest causes of death in Australia. Regular dairy consumption is also linked with a healthy weight and has been shown to play an important role in sport, development of lean muscle mass and exercise performance.

Who should avoid what?

So who should be avoiding dairy and gluten (found in wheat, barley, rye and oats)?

Gluten and coeliac disease

Coeliac disease is an inherited medical condition in which the lining of the small intestine becomes damaged when it is exposed to even small amounts of gluten, a protein found in wheat, barley, rye and possibly oats. Coeliac disease is estimated to affect 1 in 60 women and 1 in 80 men in Australia. A strict, lifelong gluten free diet is currently the only recognised medical treatment. By eliminating the cause of the disease, a gluten free diet supports the small bowel lining to repair and the symptoms to resolve. Individuals with coeliac disease will have been born with the genetic predisposition. The major genes linked with susceptibility to coeliac disease are HLA DQ2 and HLA DQ8. Both, or just one, of these genes are present in most people with coeliac disease. While 30 per cent of the population carries the gene or genes, only 1 in an estimated 30 of these people will develop coeliac disease.

A simple blood test can confirm whether you carry the gene, and therefore may be susceptible to coeliac disease. The gene can be triggered by environmental factors at different stages of life. A second blood test (coeliac serology) can be used to screen for the disease itself. Coeliac serology measures antibody levels in the blood which are usually elevated in people with untreated coeliac disease, due to the body’s response to gluten. A diagnosis of coeliac disease should not, however, be made on the basis of a blood test alone. A positive blood test always needs to be followed by a small bowel biopsy (small sample) to confirm the diagnosis. It is important also to note that gluten must be consumed in the diet for the antibody and biopsy tests to be accurate. The gastroscopy (for biopsy) is a simple day procedure done under light anaesthetic sedation that takes about 10 minutes.

Cow’s milk allergy and lactose intolerance

Cow’s milk is a common cause of food allergy in infants (and is completely unrelated to being lactose intolerant, which we’ll touch on in a moment). According to The Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body of clinical immunology/allergy specialists in Australasia, in Australia and New Zealand around two per cent of infants are allergic to cow’s milk and other dairy products. Ongoing symptoms in adults are very rare, however, with around 80 per cent of babies growing out of their allergy by the age of 3 to 5 years. Treatment for cow’s milk allergy involves removal of cow’s milk and other dairy products from the diet and substitution with an appropriate formula for infants.

Lactose intolerance is caused by a lack in the body of the lactase enzyme, which helps to break down lactose, the carbohydrate or sugar found in cow’s milk. Symptoms include diarrhoea, vomiting, stomach pain and gas, which are similar to some of the symptoms of cow’s milk allergy. Although this condition causes discomfort and sometimes embarrassment, it is not dangerous and does not cause rashes or anaphylaxis like the cow’s protein allergy. Small amounts of cow’s milk are usually tolerated, and yoghurts and hard cheeses, containing less lactose, are usually tolerated more than cow’s milk.

Skin or blood allergy tests are required for a cow’s milk allergy diagnosis, but are negative for lactose intolerance. The diagnosis for lactose intolerance can be confirmed by a hydrogen breath test. For lactose intolerance, treatment may involve reducing or avoiding consumption of dairy products containing lactose and substituting them with lactose free dairy products or alternatives.

You’ve probably heard it said that ‘We are the only species to drink the milk of another species’. True, but humans are the first and only to do lots of things, including nurturing plants, cooking food, drinking coffee, fermenting grapes to make wine, exercising for fitness... Does that mean that they’re all bad?

Different people, same nutrient needs

We must appreciate we are all individuals with different health and ethnic beliefs, religions, food habits, experiences and taste preferences. Due to lifestyle factors, food preferences, availability, health status, activity levels and health and fitness goals, there is no ‘one size fits all’ for a diet or way of eating. However, we must not ignore that we are all the same species with the same basic requirements.

Develop an understanding of your body’s requirements and appreciate the foods that will meet these. Consuming your food groups in the recommended amounts is a great framework for you to build on and personalise. For more information on this visit eatforhealth.gov.au

Don’t deprive your body of the nutrients provided by a food group because it’s the fashionable thing to do – only do so if your health requires it.


Amy Giannotti is a dietitian, personal trainer, running coach and passionate foodie. Check out her e-book Fit Fabulous Foodie at eatingfit.com.au