If you've ever tried -- or need to follow -- a gluten-free diet, you will know how difficult it is.
Going to cafes or restaurants can be a nightmare (hello, boring salads), you miss crusty pizza and fluffy bread and you have to watch your friends and family enjoying gluten-laden foods.
While avoiding gluten can be helpful for people with digestive problems, many people could be misdiagnosing the problem. Also, for people who aren't coeliac or don't have gluten sensitivities, following a gluten-free diet can have potential risks for your health -- and your wallet.
"I do believe there is a proportionate part of the population that actually does suffer from food intolerances," Kelly Lambert, accredited practising dietitian and researcher from the University of Wollongong, told The Huffington Post Australia.
"For example, irritable bowel syndrome is a very common condition. I think it’s something people can have control of, so if they are symptomatic at least they can give gluten-free a go themselves and see if it helps, rather than having to rely on doctors.
"But there’s a danger in that, too, and that is you’re not an expert and you might be going down the wrong path and assuming things that actually aren’t the case.
"It’s just like any other food fad. People are going to give it a try but, unfortunately, they may come to the wrong conclusion and self-diagnose it as a gluten sensitivity."
For those who don't have coeliac or gluten sensitivities, there is no need to avoid wheat and gluten-containing products.
"Yes, please, go and have a regular diet and include the beautiful range of breads and cereals we’ve got available to use," Lambert said. "The evidence is overwhelmingly positive that eating high-fibre breads and cereals is good for your health, but not for those that have a diagnosed problem with it.
"I can guarantee that anyone who does have to follow a gluten-free diet would love to be in their shoes and have the range of foods available."
Aside from possibly being unnecessary, there are potential risks associated with eating a gluten-free diet.
"Often the gluten-free choices people are making are foods much higher in calories," Lambert said.
"For example, a lot of gluten-free cakes will have nut flour as their bases. It is nutritious at times, but it’s also very high in calories, so if you’re someone who has a weight problem, that’s potentially adding a lot more extra calories than you might need."
Lack of Nutrients
The other disadvantage of a gluten-free diet might be that you limit the range of foods you eat and, therefore, the range of nutrients you are able to get.
"That can be quite difficult if you’re pregnant, breastfeeding or a young man who has very high nutritional requirements. It is much easier to get those nutrients from a wider range of foods," Lambert told HuffPost Australia.
These important nutrients, including B vitamins and folate, are found in some gluten-free products, however to a lesser extent as they are often supplemented.
"The main important one is fibre, and you get a different type of fibre in some gluten-free products. You get a lot of B vitamins from wheat-containing foods, which is really important. And also folate, which is an important mineral you need for growth and development, especially if you’re pregnant," Lambert said.
"If you didn’t choose fortified products you would be missing out on those nutrients."
In a new study published in the Dietitians Association of Australia’s journal Nutrition and Dietetics, Lambert and fellow researcher Catilin Ficken found families could be paying up to 17 percent more for a gluten-free diet and for some single gluten-free products as much as 500 percent more.
"In all cases, gluten-free flour, muesli, wraps and bread were more expensive. For example, gluten-free items were between 316 percent (for wraps) and 574 percent (for flour) more expensive per 100 grams," Lambert said.
"Why go down that road if you don’t need to?"
Higher Glycemic Index
Gluten-free foods can often have a higher glycemic index, meaning your body breaks the product down more quickly.
"The GI can be lower in some gluten-free products," Lambert said. "For example, some gluten-free breads have a much higher GI and that's especially difficult if you’re diabetic. You’re actually substituting something that’s worse in that sense.
"When we have patients who are diabetic that develop coeliac disease it can be really problematic because they’ve lost all those beautiful whole grain products that are low in GI."
If you do suspect you have a gluten sensitivity or intolerance, Lambert advises to seek help from a medical professional, rather than quickly diagnosing the problem yourself.
"One in 30 Australians have the genetics that put them at risk of developing coeliac disease, but not that many people develop it," Lambert said.
"Sometimes it’s really difficult to tell, you may not even have any of the traditional symptoms, for example, a bloated belly, diarrhoea and a history of abdominal discomfort. Often it’s accidental pick-ups, so perhaps you have a history of iron-deficiency or it's picked up when you’ve been diagnosed with osteoporosis."
According the Lambert, one way to find out if you have coeliac is to have a gene test, which is a blood test.
"If you have the gene then you may potentially need to have further investigations," Lambert said.
"If you don’t have the gene you’re not likely to have coeliac disease, but you could have another medical disorder that might respond to a change in diet and that’s where we can go down a different route of investigation.
"I would really encourage people to come along to a dietitian and discuss issues they might be having, because it’s really possible for us to tease out and have a trial of several different types of diets to figure out what it is in the chemicals of foods that might be causing the problem.
"That’s where a trial of a special elimination diet to get rid if those FODMAPs can be really helpful."