Gluten-free 'lifestyle fad' a kick in the guts for coeliac sufferers

She also has coeliac disease, which causes gluten (a protein found in wheat, barley, oats and rye) to strip away the tiny, finger-like villi in her gut. Villi enable us to absorb nutrients. If Mayhew eats even the slightest amount of gluten she suffers acute abdominal pain. "Slightest amount" means 50 milligrams; less than one-hundredth of a slice of bread.

Mayhew is a friend of mine. I have seen the debilitating effects of the disease myself. One night we dined on sushi together. She gave the kitchen advice about her disease well in advance. She told the staff about her disease and double-checked there was no gluten in the food. Before the end of the meal her happy demeanour had changed. Her arm went around her stomach. By the time she was in the car she was slumped in pain. The soy sauce had been fermented with wheat. Less than half a teaspoon had turned her into a limp doll.

For sufferers of coeliac disease, it's not just the acute symptoms that are concerning. Continued exposure to gluten will destroy the villi in their bowels. This leads to a dramatic increase in the risk of developing other diseases such as bowel cancer and liver disease. For them, the term "gluten-free" is not a lifestyle choice. It is literally a matter of life and death.

The problem is that non-coeliacs following the "gluten-free" fad, who do not suffer an allergy or intolerance, are weakening the restaurant and cafe industry's support for true "gluten-free" labelling. Fairfax Media has collected many complaints from restaurateurs about diners who insist on a gluten-free meal, then proceed to eat a wheat-based food when they arrive.

"I know gluten-free food is essential for coeliacs," said Rosa Mitchell from Melbourne restaurant Rosa's Kitchen.

"We have people who insist on a 'gluten-free' meal when they book. The kitchen goes to a lot of trouble to look after them.

"We use separate utensils, separate pots to cook our meals. We wash our hands before touching any food. Then they order a pastry for dessert. I don't think people know how much effort we go to.

"It's quite frustrating when people who do not have a genuine gluten allergy eat the bread or order a pastry. It's like the boy who cried wolf.

"The effort in delivering completely gluten-free food by restaurants and cafes has been eroded by gluten-free lifestylers," says Jane Davies from Coeliac Victoria and Tasmania.

"For us, this is a real problem," said Davies, for whom a breadcrumb will cause nausea and vomiting.

"Even for the coeliacs who don't have symptoms after eating gluten, it will still affect their long-term health."

She says that it is harder now to get true gluten-free food than it was 10 years ago.

Mayhew is painfully aware of the problem.

"I now get dirty looks from waiters when I ask about 'gluten-free'. Yes, I am openly concerned for the poor people with gluten intolerance but I cannot tell you how much it pisses me off when someone comes into a restaurant saying they are gluten-free because they think it is going to help them lose weight. It's not right."

Over the past few years there has been an attitudinal change among chefs, cooks and front-of-house staff, leading to a loss of vigilance in eliminating gluten entirely from foods labelled "gluten-free".

A program of continuing testing by the City of Melbourne has food samples from cafes and restaurants labelled "gluten-free" sent to a laboratory for testing. Alarmingly, some of the foods have been found to contain gluten. The City of Melbourne has then informed the businesses and educated them on how to make sure dishes are truly gluten free.

A recent survey of coeliacs shows that while 90 per cent of them rely on "gluten-free" labels on menus, more than 40 per cent felt they had been exposed to gluten in a cafe or restaurant in the previous three months.

Coeliac Australia is calling on restaurants, cafes and other food businesses to take "gluten-free" seriously again, and have developed a standard that can be followed to create dishes that won't injure the insides of coeliacs.

This involves the proper "sourcing, segregation and service" to make sure that simple things, such as the same toasters and grillers that could contaminate gluten-free dishes, are not being used. Even crumbs in frying oil can make coeliac sufferers ill.

"There is no drug for coeliac disease," Davies says.

"Avoiding gluten is the only medical treatment we have. Real 'gluten-free' status is essential for our health."