Friday, January 27, 2012

Diets based on a grain of truth | Sidney Morning Herald - Erik Jensen

January 28, 2012 - 3:00AM

More than anyone else, Igor Cetojevic is the man credited with revolutionising the world No. 1's tennis

''He's done a great job in changing my diet after we established I am allergic to some food ingredients, like gluten,'' Djokovic said of the diagnosis that turned around his career two years ago. ''It means I can't eat stuff like pizza, pasta and bread. I have lost some weight but it's only helped me because my movement is

The improvements to Djokovic's form are not in contention. But the explanation for the Serbian's success

''There are a whole lot of people who believe they are gluten intolerant, who don't have coeliac disease,'' says Professor Peter Gibson, professor of gastroenterology at the Alfred Hospital in Melbourne. ''This is very controversial because there is a quite big percentage - even up to 10 per cent - of people who are avoiding gluten because they think gluten is their problem. Naturopaths have put them on a diet, or they have done it

As yet unpublished research from Monash University, co-written by Professor Gibson, found only 14 per cent of people on gluten-free diets were put on the regime by a doctor. Almost half had simply decided to cut wheat and grains from their diet because they assumed they were intolerant. More than 60 per cent had not been tested

''It's a very emotive area,'' Gibson said. ''Fortunately, now there is a lot of work going on around the world trying to

The issue is a question of medical distinction: coeliac disease is an immunological complaint in which gluten interferes with the body's ability to absorb nutrients, identifiable by a blood test; gluten intolerance has no diagnostic

Improvements to a person's health without gluten can be explained several ways, by placebo effect or by the fact a gluten-free diet removes other agents from the body - most importantly the poorly absorbed carbohydrates known as

An Australian study published last year in the American Journal of Gastroenterology showed for the first time that gluten could trigger symptoms of fatigue in people without coeliac disease - making the argument for what doctors

''Gluten intolerance in individuals without coeliac disease is a controversial issue and has recently been described as the 'no man's land of gluten sensitivity','' the authors wrote. ''The evidence base for such claims is unfortunately very

Finland has done more than any other nation to identify its coeliacs. It has the most reliable data on increased prevalence: a doubling, from 1 per cent to 2 per cent between 1979 and 2000. Fins have been eating gluten free

It is accepted that coeliac disease affects about one in every 100 Australians - although there is no local research to confirm the Finnish findings. Some academics argue perceived increases in coeliac disease are heightened by

The increase in people identifying with non-coeliac gluten intolerance is more conflicted. An editorial in the Medical Journal of Australia last year noted the distinction: ''The popularity of the 'fad' gluten-free diet might be peaking, but

Penny Dellsperger, a dietitian at Coeliac NSW, said there were significant medical risks to people adopting gluten free diets without first ascertaining whether they suffered coeliac disease. She said the symptoms could easily relate to

''Obviously there are a lot of people on gluten free diets who don't need to be and who haven't had the proper tests.

''I don't understand why you would [maintain a gluten free diet] if you didn't need to. It's been marketed a lot and

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