This fact sheet addresses the various confusions and questions that arise around intolerances. 

What is gluten?

Gluten is a protein that is found in three types of cereal:

· Wheat

· Barley

· Rye

· Oats are often heavily contaminated with wheat flour

What is gluten intolerance?

Gluten intolerance develops over a prolonged period causing symptoms such as gas, constipation, diarrhea, fatigue and headaches. Gluten allergy is when an allergic reaction such as swelling of the face, eyes and mouth, shortness of breath, hives or even an anaphylaxis reaction occur minutes after eating foods containing gluten.

What is Lactose?

Lactose is the sugar found in milk.

What is lactose intolerance?

When someone is said to be lactose intolerant this is because the digestive system of this individual is not able to break down completely the sugar called LACTOSE found in milk. This inability results from a shortage of the enzyme lactase, which is produced by the cells that line the small intestine.

In a normal digestive system all the food we eat is broken down into smaller and simpler ‘bits and pieces'. This helps the body to absorb the food and take out the proteins and whatever is needed to maintain itself. Lactase breaks down milk sugar (lactose) into the simpler form of sugar called glucose and galactose that can then be absorbed into the bloodstream.

When lactose is missing or there is not enough of it to digest the lactose consumed, the results may be very distressing for the person. While not all persons deficient in lactase have the same symptoms if at all, those who do are considered to be lactose intolerant.

Some tips by Dietician Sian Porter to surviving Christmas with a lactose or gluten intolerance:

* Take a little extra time to read food labels while doing your Christmas shopping. Many festive foods contain lactose and gluten which can be easily avoided by checking the ingredients. Look for words like milk, lactose and gluten.

* If you’re lucky enough to have Christmas lunch made for you, make sure that the cook knows in plenty of time what foods might contain lactose or gluten as well or suggest that you will bring an alternative for everyone to try

* Generally, Christmas is a time in which we all indulge. Remember that however careful you are to avoid foods that cause your symptoms to flare you also take care to help prevent yourself feeling uncomfortable from over indulgence;

* Chew your food thoroughly so your digestive system is presented with food prepared for it to work on. Remember, digestion starts in the mouth. Gobbling can lead to indigestion. Savour the flavour!

* Eat little and often. It is better to eat 3 light meals and a couple of healthy snacks a day rather than overloading your system. Avoid a pattern of eating little all day and then having a large meal late at night

* Avoid wearing tight clothes, particularly if you know you are going to be eating a large meal

*Smoking can have an adverse effect on many stages of digestion

*Eat slowly with your mouth closed, to avoid gulping down air along with your food

* Drink plenty of water, but avoid carbonated drinks and excess alcohol

* Sit up straight at the table to help improve digestion (your mum was right!)

* Good table manners such as putting your knife and fork down in between mouthfuls and not talking with your mouth full can also have a positive impact on your digestion and food intake

* Be physically active – a brisk walk will get everyone out of the house or have a family disco in the sitting room

 Lactose allergy vs. intolerance

Milk protein allergy is when the immune system overreacts to one or more of the proteins found in milk. Milk allergy can be severe and in some cases can cause an extreme and severe reaction known as anaphylaxis (the whole body is affected, often within minutes of exposure to the allergen). When someone has an allergy to milk they can experience symptoms in addition to digestive discomfort, such as skin rashes, eczema, nasal congestions and coughing and the swelling of the lips, mouth and tongue.

In the past these were sometimes called ‘milk intolerances’, but an intolerance doesn’t involve the immune system so it is important to distinguish between them. While lactose intolerance can cause a great deal of discomfort, it won’t usually produce a sudden or dangerous reaction.

Stats

(Base 21,000 respondents, the research conducted in December 2010 by TNS on behalf of Lactofree. Published in May 2011)

· Up to 15% of people in the UK are estimated to be lactose intolerant, but due to the similarity of symptoms and the relatively low awareness of lactose intolerance, sufferers could easily be misdiagnosed as having IBS

· 38% of people who think they suffer from IBS might in fact be lactose intolerant due to confusion surrounding diagnosis and management of both conditions

· The research found that 1 in 5 have been suffering with symptoms** such as bloating, diarrhoea, sickness and cramps for over a decade

· 30% of these sufferers may have been taking medication unnecessarily due to treating IBS and not lactose intolerance

Elimination Diet

Advising on or undertaking an appropriate elimination diet can be an effective way to determine the cause of symptoms. The diet involves eliminating all the lactose from your system by ensuring that your daily food intake does not include any lactose for two weeks – if your symptoms improve during this lactose free period then you may be lactose intolerant. Lactose is then gradually reintroduced to discover a person’s tolerance levels. Most people can successfully undertake an elimination diet without the help of a doctor. However if you have any concerns whatsoever, other symptoms or medical problems or your symptoms do not improve, you should consult your GP or a health care professional. This elimination diet can be carried out in the same way but eliminating gluten.

Benefits of eating gluten-free for non-coeliacs:

Many people who are not coeliacs but have a minor or medium intolerance to gluten can benefit from cutting gluten out of their diets. Although scientists are still testing exactly what it is that makes gluten cause some people to feel bloated, there are thousands of people who do not have coeliac disease but feel better, healthier and have more energy when following a gluten-free diet.

Who suffers from coeliac disease?

Coeliac disease is now known to be a common condition that affects approximately 1 in every 100 people in the UK. Women are two to three times more likely to develop coeliac disease than men. Cases of coeliac disease have been diagnosed in people of all ages. In some cases, coeliac disease does not cause any noticeable symptoms, or it causes very mild symptoms. As a result, it is thought that at least 50% or possibly as many as 90% of cases are either undiagnosed or misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS). 


Recipes for Christmas

Lucinda Bruce-Gardyne, Chef, founder of Genius Foods and author of ‘How to Cook for Food Allergies’ has devised some tasty alternatives for traditional Christmas recipes that do not include gluten or lactose including:

- Bread Sauce

- Apricot, orange and chestnut stuffing

- Aunt Libby’s Genius bread and butter pudding

- Gluten Free Christmas pudding

For recipes: www.geniusglutenfree.com

More info on gluten intolerance: www.coeliac.org.uk

More info on lactose intolerance: www.lactoseintolerant.co.uk