I have just read what is in my view a fairly ignorant piece by Merryn Somerset Webb, editor in chief of Moneyweek. It’s here.
Her view, also expressed on Twitter, is that coeliacs should no more get gluten-free food on prescription than diabetics should get sugar-free chocolate.
I would have posted comments to the blog but the terms and conditions of the site are to me as obnoxious as the piece itself. (I would strongly urge you to avoid it too – as it seems you agree to any legal liabilities arising from your comment whilst ceding copyright in it.)
I don’t have time to get too angry today, or for a long post, but I will say this: to compare diabetes / sugar-free food with coeliacs / gluten-free food is absurd. First, diabetics don’t need to avoid sugar, and second, bread is a staple, while chocolate is not.
Research shows prescription foods help coeliacs stick to their strict diet – preventing ill health in the long run. This is just one reason why it is so important.
The writer calls ‘free from’ food ‘generally pretty disgusting’ – but I suspect she hasn’t tasted much lately, as the quality has risen remarkably in recent years – so much so that the industry now has its own awards.
Insulting to ‘free from’ producers, then, and apparent lack of sympathy towards coeliacs, to boot. Way to go.
I have just read said blog post by Merryn, and I must say I'm angry and disappointed by her display of ignorance. I do think prescriptions should be monitored, and reviewed to ensure the individuals aren't taking more than they should.
For example, cake is a luxury item in my mind, but as we discussed on twitter Alex it can be useful for weight gain in long suffering Coeliacs newly diagnosed (a point I hadn't considered). So I'd say assess if they patient needs it for that reason, or to help them initially adjust to the diet change and look at removing it later. Also, consider quantities being prescribed and ensure its for the right items.
But in no way does bread, which in this country is a staple food, compare to chocolate! Her alternatives are rice cakes (which I personally think are disgusting) or potatoes. Neither are often practical options on a lunch time – whereas my gluten free Warbutons sandwiches are.
I've never had anything gluten free on prescription, nor been offered any by my GP, but I earn above the average wage and can afford it so I have never chased it. For those that earn less though the cost from shops vs the prescription cost can make a huge difference to their food budget. But at no point, despite her claims, does prescription automatically equal free. Whereas I think diabetics get all prescriptions free.
Certainly won't start reading her blog in the future!
Coeliacs can't eat gluten, which is unfortunate as bread is a major part of the UK diet. However gluten free bread is horrid, so why not use the fact of your condition to move away from using bread as a staple.
There's 101 ways of using potatoes or rice for lunch at work. The Japanese manage an entire cuisine (one of the best and healthiest in the world) without bread.
It is total nonsense that the government should subsidise coeliacs to buy gluten free bread. Merryn's article is spot on.
Some gluten free bread is horrid I agree, however, have you tried all of them? I happily eat it everyday as sandwiches.
There are some instances where NHS subsidies are ridiculous, but for those that need the support then it should be there. Not all Coeliacs will do, but some do and they should receive support.
True, re: Japanese diet.
But a dated view re: glutenfree bread – some of which is now excellent.
Thanks for all comments.
It's sad that she doesn't consider those who aren't fortunate enough to afford gluten free alternatives. Like many who favour these cuts, they always seem to target those who would benefit from the things they actually want to get rid of.
Before being diagnosed with coeliac disease, bread was my staple food. I would literally have it with every sitting – toast for breakfast, sandwiches for lunch, bread to accompany my main meals and also for snacks [students do love their toast]. The day I was told I had to go on a strict gluten free diet I was so scared, upset, overwhelmed that I didn't know where to even start. Getting my first gluten free bread allowed me to transition 'easily' to a gluten free diet and more importantly, stick to it.
Exactly, Saara: it's a very useful and supportive 'stepping stone' when you're bewildered at the start. And some families just couldn't manage without!
I have to say I ask my patients to avoid replacing bread and educate them into a much healthier less bread-centric diet. It can be useful to help transition but, in most cases, when you discourage bread in any form, the diet inevitably improves and so does health. Admittedly, this is a tougher approach, but ultimately do-able and hardly anyone ever goes back!
To be so dependent on a food that is simply not that nutritious is never a good idea. My advice is always not to have any for the first few weeks and then have a loaf, if you still want some by then – most actually don't even though they never believe me they will lose the need and taste for it – in the freezer and take a slice or two out as a treat for toast etc a couple of times a week max.
I am seeing too many patients with corn intolerance secondary to gluten problems to recommend regular use of normally corn-based bread alternatives.
Anyway, my two pennyworth for what it's worth!
And your two pennyworth is always thought-provoking, Micki! Certainly a tough approach, I agree.
Is it really corn intolerance, do you think, or could it be a reaction to high GI corn flour? I was under the impression corn sensitivity was rare in the UK, albeit common in North America.
My husband rarely has GF bread. We get 5 boxes of glutafin bread mix on prescription about every 2 months and we buy DS brown ciabattas, maybe 1 or 2 packs a week. Our meals are generally bread free.
Prescriptions for gluten free food are not free unless you have a co-existing disease like thyroid disease or Diabetes which entitle you to free prescriptions. I pay annually for my prescriptions and I do not use my full monthly quota of 14 units either, on average only eating 2 small slices of bread a day for my lunchtime sandwich that millions of people who are not coeliacs take for granted every day. I am not aware of being able to get cake on prescription so I am not sure why this has been mentioned giving the impression that coeliacs are stuffing their faces on unhealthy free cake, getting fat and therefore developing Diabetes etc. You can only get staples of plain biscuits, bread and pasta on prescription. gluten free cake is available to buy at supermarket inflated prices or you can bake it yourself as I do if I occasionally want a treat like other people. I work full time for the NHS, pay my national insurance, taxes(which go towards paying for treatments/prescriptions for others too) do not smoke or drink and stick to my gluten free diet to keep myself healthy so I am in no way a drain on the NHS therefore I do not think getting a few subsidised loaves of bread or packs of pasta to help me keep on a lifelong strict gluten free diet is too much to ask given the fact coeliac disease is not self inflicted.If the gluten free diet is not adhered to this brings the risk of cancer, osteoporosis, anaemia all of which would cost the NHS far more in the long run. No I dont have to eat bread, pasta, plain biscuits etc but I wonder how those who take eating whatever they like for granted would cope without even these basics. My guess is not very well in the long run and they would cave in, an option not open to the coeliac who would suffer pain, diarrhoea, body ache etc. Coeliac Disease is not a lifestyle choice like vegetarianism it is a chronic auto-immune disease caused by gluten in not only staples like bread,and pasta but millions of other food products where it is used as thickeners etc. Treatment for CD is life long gluten free diet only. As a coeliac herself Merryn should be supporting not attacking other coeliacs and the provision of gluten free staple foods on prescription for those who need them to keep to their diet, not holding herself up as some sort of gluten free saint.
Thanks for such a detailed post, EP, and the insight into the realities of living with coeliac.
Just in regard to your point re: cake – I think very occasionally it is prescribable to a severely underweight newly diagnosed coeliac, in order to help them gain weight very quickly.
Thanks Eleanor for your comment, too.
This article does make me very cross on many levels. Who is this Merryn woman anyway? The comments also had me seething. People who have absolutely no idea how impossibly hard it can be to avoid a staple food all diving in and joining the coeliac bashing. One commenter says eat Corn Flakes instead of weetabix. If they actually knew what they were talking about they'd know that corn flakes actually contain barley – which contain gluten. One might assume that Rice Krispies are also Gluten Free – well they aren't, unless you live in the US where gluten free Rice Krispies are available.
I'm not a coeliac but I do need prescriptions for various conditions. Some of these I cannot avoid but often because I can afford to, I will buy other products which are far nicer on the high street. I'm sure this equally applies to coeliacs. Not everyone can afford to buy tasty M&S, Warburtons or Genius bread. They're small loaves which don't last long, but taste really pretty good. For those closer to the bread line (no pun intended) these things should be available on prescription, otherwise parents may not be able to afford to feed their child. More education is needed also though so that newly diagnosed coeliacs have the knowledge and confidence to experiment with other GF grains.
It can be devastating to be faced with a larder full of stuff you know you can't eat because every ingredients list contains something you're now allergic to. I've been there, and trust me, a bag of rice and a pack or rice cakes doesn't really cut it. I cried! But after years of experimenting and discoving new things that I can eat I now eat a very varied, more healthy and interesting diet.
I bet Merryn doesn't have any allergies or intolerances and has never had to avoid any foods for any reason. I bet she hasn't tried any of the amazing new breads and cakes in the shops now and she certainly hasn't spoken to many people to find out what they really think. Next time you write a piece Merryn – do some proper research and don't just bash the Coeliacs. Diabetics don't have to avoid sugar – they have to monitor their insulin levels. Not a relevant comparison whatsoever. Get your facts straight! Stupid woman.
She's the editor in Chief of Moneyweek, and has been diagnosed coeliac for twenty years. Her argument is we can't afford to keep paying for coeliac prescriptions, and that coeliacs should eat naturally GF food. Her argument is financially and economically driven, and she is challenging what she sees as a sense of entitlement to prescription GF.
In total agreement about the diabetic/sugar argument – a weak comparison, based on a common misconception.