Motivations for avoiding wheat consumption in Australia: results from a population survey

Abstract

Objective: To assess the prevalence of and explanations for wheat avoidance, including reported symptoms, diagnoses and information sources influencing the decision to avoid wheat, and to investigate potential psychological predictors of this behaviour. Design: Cross-sectional population survey. Setting: The study was conducted in Australia, using a nationwide postal omnibus survey. Subjects: Adults aged 18 years and over (n 1184; 52·9 % female) selected at random from the Australian Electoral Roll. Results: With cases of stated and suspected coeliac disease (1·2 %) excluded, 7·3 % of the sample reported adverse physiological effects, predominantly gastrointestinal, that they associated with wheat consumption. Few among this group (5·7 %) claimed a formally diagnosed intolerance or allergy requiring avoidance of wheatbased foods. Symptomatic wheat avoidance was highly correlated with dairy avoidance and predicted by gender (female), lesser receptiveness to conventional medicine and greater receptiveness to complementary medicine, but not by neuroticism, reasoning style or tendency to worry about illness. Conclusions:The data indicate that many adult Australians are consciously avoiding consumption of wheat foods, predominantly without any formal diagnosis. Reported symptoms suggest a physiological but not allergenic basis to this behaviour. Questions to be answered concern whether symptoms are attributed correctly to wheat, the agents (wheat components, dietary factors or additives) and physiological mechanism(s) involved, the nutritional adequacy of avoiders' diets, and the clinical and psychosocial processes that lead a substantial number of adults to avoid consuming wheat (or any other dietary factor) apparently independently of a medical diagnosis.

Food avoidance in an Australian adult population sample: the case of dairy products

“…Principally, these components are a disaccharide (lactose) and protein (gluten), respectively, and the intolerances that they trigger are diagnosed clinically. However, the avoidance of dairy foods for symptom control, as found previously for wheat (5) , appeared to rely substantially on a nonmedically diagnosed connection between ingestion and symptoms. Reports of a diagnosed allergy or intolerance mandating the avoidance were similarly infrequent at 6·2 % (0·7 % of the sample).…”

“…Strengths, limitations and public health implications As discussed previously (5) , the strengths of these survey data lie in the use of probability sampling from the national adult population and the potential contributions of response anonymity and structure of the omnibus survey to limiting of response biases. Conversely, weaknesses include the inability to substantiate participants' reports, to examine possible differences in dairy avoidance by race or ethnicity, or to quantify any possible sampling bias associated with interest in food or health.…”

“…This is the same set of measures as used in the wheat avoidance study (5) . The psychological characteristics considered thus include neuroticism, tendency to worry about illness, propensity for a less analytical and/or more intuitive reasoning style, and receptiveness to each of conventional and complementary medicine.…”

Are Gluten-Free Foods Just for Patients with a Gluten-Related Disease?

“…The boundaries of each wheat-related disease are not always clear, inducing confusion regarding diagnosis [6] and dilemma on which diet and treatment should be applied [14]. In that way, it is not surprising that many people in developed countries decide by themselves to follow a gluten-free diet; only 15-16% of such diet followers have a medical diagnosis and prescribed treatment of gluten or wheat exclusion [16].…”

“…This can generate beneits in the short term in those cases where the symptoms decrease. Golley et al [16] published a study of 1184 Australians surveyed from the general population, where 10.6% were already on a gluten-free diet, while just 1.2% of them had formal diagnosis of celiac disease. However, 80% of the followers do to relieve symptoms such as bloating, abdominal discomfort, asthenia and adynamia.…”