Free-from diets, are they helpful or harmful?

By Victoria Woodhall



Why you should cut it out


You have coeliac disease This serious autoimmune condition is caused by a reaction to gluten, the protein found in wheat and some other grains.


You are sensitive to wheat Non-coeliac gluten sensitivity (NCGS) is caused by wheat proteins called amylase-trypsin inhibitors. Symptoms include diarrhoea, cramping and bloating.


You suffer from irritable bowel syndrome (IBS) Wheat, along with broccoli and milk, is high in naturally occurring sugars known as fermentable oligo-, di-, mono-saccharides and polyols (fodmaps). They can cause excessive gas leading to bloating, constipation and/or diarrhoea. Many dietitians recommend a (largely) wheat-free low-fodmap diet for IBS.


You have a leaky gut Compounds in wheat can cause intestinal hyper-permeability which, according to Dr Michael Mosley in his latest book The Clever Guts Diet, is now an evidence-based condition. Symptoms include food sensitivities, bloating, tiredness and general aches and pains.


You feel better without it Some people find that the skin condition rosacea – as well as headaches, stomach aches and brain fog – improve by cutting out gluten, which has been found to cause inflammation in the body.


Why you shouldn’t


You could be missing out on fibre Wholemeal bread is a primary source of dietary fibre. Wheat and gluten abstainers have been shown to eat less fibre, increasing their risk of cardiovascular disease and type 2 diabetes.


Wheat alternatives may be toxic Gluten-free people were found to have raised levels of mercury and arsenic from eating rice flour, a common wheat substitute. The toxins come from pollutants and pesticides used in rice growing. Gluten-free foods cost more and can be high in sugar.

You could be missing out on vitamins Commercial wheat breads and cereals are often fortified with vitamins and minerals, so if you’re gluten-free, ‘you may need to take a multivitamin to replace them,’ says Dr Mosley. Wholewheat itself is a good source of B vitamins, vitamin E and minerals such as calcium, phosphorous and zinc.


What’s the alternative?


Switch to sourdough If you are sensitive to wheat, artisan sourdough bread has a long fermentation which makes it easier to digest. It’s also rich in B vitamins, minerals and proteins. Sourdough is permitted on a low-fodmap diet.


Eat in moderation ‘It is easy to fall into the trap of eating wheat with every meal,’ says nutritionist and Healthspan ambassador Rob Hobson. ‘Stick to one portion a day and include other complex carbs in your diet such as brown rice.’


Cut out yeast temporarily ‘It could be yeast causing bloating,’ says Rob Hobson. ‘Keep a two-week food and symptoms diary to identify what you are reacting to. Our bodies naturally produce gases when we’re digesting food. It’s only chronic bloating that might indicate an issue.’




Why you should cut it out


You are lactose intolerant Humans need the enzyme lactase to break down lactose, the natural sugar in dairy, and many of us lose the ability to make it as we age. Symptoms include bloating, gas and abdominal pain.


You are prone to acne It’s thought that the natural hormones in milk (IGF-1) are inflammatory and cause breakouts. Also, dairy leads to increased sebum production, which may cause spots. Many acne sufferers report their skin improves by going dairy-free.

You have eczema Cow’s milk can be a trigger for eczema, according to the NHS.


You have a milk allergy Some people can have an allergic reaction to casein, a protein in milk that can cause itching, hives, sneezing, nasal congestion and facial swelling. (A severe milk allergy can cause fatal anaphylactic shock.)


You have IBS You could be one of the 20 per cent of IBS sufferers who are lactose intolerant.


Why you shouldn’t


You may have wrongly self-diagnosed ‘Patients come to us convinced that their digestive troubles are due to a lactose intolerance,’ says Dr Anthony Hobson, clinical director of The Functional Gut Clinic in London. Many patients discover that ‘issues with dairy may be specific to the A1 milk protein found in cow’s milk’, he says. Switching to milk without the A1 protein, such as A2 milk, often resolves the problem.


You miss out on important vitamins Dairy is rich in proteins, calcium and vitamin D, which are vital for bone health. Cutting back on dairy can put women at risk of osteoporosis in later life. ‘Most soy milks are fortified with calcium, B12 and vitamin D but many nut milks are not,’ says Rob Hobson.


You could be missing out on good bacteria A recent Danish study showed that eating cheese and milk resulted in higher levels of gut-friendly compounds. Some cheeses such as mozzarella, blue cheeses, cottage cheese and gouda contain ‘significant levels of good bacteria,’ says Dr Mosley, but check food labels for ‘active cultures’.


What’s the alternative?


Go lactose free If you are lactose intolerant, switch to Lactofree milk and look for cheeses labelled 0g sugar (lactose is a sugar), or take a lactase enzyme supplement. Some people tolerate sheep’s and goat’s milk better. The low-fodmap diet for IBS allows lactose-free milk and hard cheeses.


Eat yoghurt Yoghurt with active live cultures is a fermented food, a process that breaks down lactose. ‘Even if you are lactose intolerant you should be able to eat yoghurt,’ says Dr Mosley.


Go organic If you are concerned about ingesting hormones and antibiotics used in conventional milk farming, buy organic.


Mind your micronutrients ‘Aim to buy a fortified nut or soy milk and include other sources of dietary calcium from greens – especially kale – almonds, dried fruit and tofu,’ says Rob Hobson. The Department of Health advises everyone to take a vitamin D supplement in winter.




Why you should cut it out


It makes you hungry A blood sugar spike followed by a crash increases your appetite.


It raises your risk of type 2 diabetes The insulin spikes and weight gain caused by sugar lead to increased visceral fat, which is associated with a higher risk of major health conditions such as type 2 diabetes, heart disease, breast cancer, colorectal cancers and Alzheimer’s.


It’s addictive Like cocaine, sugar increases levels of the ‘reward’ neurotransmitter dopamine. Researchers from Queensland University of Technology found that people need higher levels of sugar to reach the same reward levels and to avoid mild depression. Sugar is especially addictive combined with fat.


It can increase cholesterol Simple carbs such as sugar can increase triglycerides, blood fats that contribute to hardening of the arteries and blood cholesterol.


It rots your teeth Particularly in fizzy-drink form – tooth extraction is the leading cause of child hospital admissions.


It raises insulin levels This can be dangerous. ‘Insulin is not only a fat-storage hormone but a cell-growth accelerator strongly linked with a number of cancers,’ explains Dr Mosley.


It gives you wrinkles Collagen and elastin in the skin help your face defy gravity and are susceptible to being attacked by sugar in a process called glycation.


Why you shouldn’t


Artificial sweeteners are worse than sugar Dr Mosley points to research showing that artificial sweeteners lead to changes in the area of the brain that regulates appetite, resulting in 30 per cent more calories being consumed afterwards. In mice, saccharin can lead to glucose intolerance – a precursor to diabetes – more quickly than sugar.


Natural sugars aren’t always better Agave nectar, a popular ‘natural’ sugar alternative, has high levels of fructose, which is converted by the liver to fat, upping our chances of developing insulin resistance, the precursor to diabetes. It also suppresses the fullness hormone leptin. Maple syrup and honey contain a small amount of minerals ‘but you’d have to eat an unhealthy amount to get anything close to be useful,’ says Rob Hobson.


It is on the Eatwell Guide Sugary foods such as ketchup, chocolate and ice cream feature on government healthy eating guidelines – albeit in small amounts, which is probably a realistic approach.


What’s the alternative?


Eat sugar as natural food ‘We should be eating ten servings of fruit and veg a day and most of us are getting only four. Of those ten, most should be vegetables, which contain less sugar than fruit but more vitamins, minerals and antioxidants,’ says Rob Hobson.


Limit sugar to meals To protect teeth the British Dental Association advises keeping sugary foods to a minimum and eating them at mealtimes only. Every sweet snack creates a new assault on teeth.


Try stevia A natural sweetener from a leaf that the body doesn’t recognise as sugar. It has a metallic taste so it’s hard to overdo.




Why you should cut it out


It could cause cancer Diets high in red and processed meat are linked to heart disease, cancer and diabetes. The World Health Organisation has classified processed meat as a carcinogen and red meat as a possible carcinogen. Cooking meat at high temperatures, especially on a chargrill, generates carcinogenic chemicals. The nitrites used as preservatives in processed meat are strongly linked with colorectal cancer.


It’s bad for animals and the environment Intensive meat farming has obvious animal welfare issues and methane generated from cow ‘emissions’ is one of the most damaging greenhouse gases.


It could lead to antibiotic resistance There is concern that antibiotics given to animals to prevent disease are causing antibiotic resistance in humans, leading to drug-resistant superbugs. Untreated waste products containing active ingredients can end up in the water supply. A 2015 UK government report called for antibiotics to be limited.


It could get worse post-Brexit Friends of the Earth warns that hormone-treated beef and chlorine-washed chicken could find their way on to UK shelves if Britain doesn’t uphold EU food and farming standards.


Why you shouldn’t


Studies may be skewed ‘Most meat eaters who participate in studies that show harm from eating meat are also eating a boat-load of sugar and refined carbs alongside a processed, inflammatory diet,’ says Dr Mark Hyman, respected clinician and author of Eat Fat Get Thin. ‘They aren’t eating small-to-moderate amounts of grass-fed or organic meat along with a pile of colourful fruits and veggies.’


Saturated fat isn’t the enemy The saturated fat/cholesterol/heart disease argument is often used to demonise meat. ‘The types of saturated fats that cause heart disease – stearic and palmitic acid – don’t come from meat. Your liver produces these fatty acids when you eat sugar and carbs. In other words, your liver produces saturated fat from sugar and carbs and that causes heart disease,’ says Dr Hyman.


It’s a complete protein Meat contains all nine essential amino acids for optimum health.


It’s an important source of iron Vegetarians require 1.8 times more iron than meat eaters, because iron from plant sources is less well absorbed than iron found in meat and fish.


What’s the alternative?


EAT less red meat The NHS recommends that people eat no more than 500g per week of red meat, ingest processed meats as little as possible and avoid the chargrill. ‘Start with meat-free Monday,’ says Rob Hobson.


Switch to other complete proteins For example eggs, tofu, dairy or quinoa, or combine ‘incomplete’ plant proteins such as grains and legumes. Peanut butter on wholemeal toast counts.


Avoid nasties Go organic and look for nitrite-free bacon and ham.