How can I tell which wheat is safe to eat?

Q AFTER two years of discomfort, I have discovered by trial and error that I have an intolerance to wheat. However, I can eat pasta, which I believe is made with wheat flour. So my question is, can I have a test that can confirm which types of wheat are good and bad for me to eat? A INTOLERANCE to food is a far more widely seen now than it once was. There are various explanations for this: our over-processing of foods, a heightened awareness of the possibility, or simply a faddishness for certain dispositions. Whatever the case, many people now adopt a wheat-free diet because it simply makes them feel better – and I would always support that attitude.

An intolerance is different from an allergy, which is a more severe reaction. An intolerance to a certain food may cause abdominal pain, bowel changes, skin changes and even headaches.

But one of the key differences between an intolerance and an allergy is that sufferers can accept a certain amount of the food before getting symptoms. So, in the case of wheat, whatever is causing the intolerance will exist in different quantities in the different wheats, making some more acceptable than others.

Gluten, the protein compound that occurs in wheat, barley and rye, is now a common culprit in food intolerances. It occurs in different amounts in different flours, and lower-gluten flours may cause fewer symptoms.

Gluten is the major irritant in people with coeliac disease, which is a full-blown allergy that damages the bowel, causing a great deal of pain and increasing the risk of cancer. Sufferers have to avoid gluten completely.

But the short answer to your question is no – there is no reliable, valid test to flag up which foods an intolerant person should avoid. Instead, keep a food diary. It will help identify the triggers of symptoms pretty quickly. If no specific food is identified, speak to a doctor. Other issues that can mimic the symptoms would be IBS, bowel diseases and endometriosis, all of which warrant medical attention.

Q MY HUSBAND, who is in his 80s, was diagnosed with atrial fibrillation six years ago and put on warfarin after a mini-stroke 18 months ago. He has also been on bloodpressure drugs for 20 years, and diabetes medication. Before the stroke he was fit and strong, but now gets very tired and dizzy. Is he on the right treatment? A ANYONE on blood-pressure medication should have a review with their GP at least once a year. At this review, the blood pressure will be measured and the GP gets a chance to evaluate any new symptoms, changes in other medication and, importantly, kidney function.

This is certainly the time to discuss side effects, especially if these symptoms have started suddenly. Tiredness and dizziness could be a side effect of medication but equally can be due to age, other medicine or indeed other conditions. Either way, they need to be addressed. In someone with multiple medical problems, all the problems need to be looked at holistically as they interlink and it would be normal for a patient with heart conditions, diabetes and high blood pressure to be on the appropriate blood-pressure medication to match those other conditions. Blood pressure varies throughout our lives and this can account for the need to change blood-pressure pills over the years. It is closely linked to kidney function and it is important to monitor this. Pills taken for diabetes can affect kidney function and these are always closely supervised. IT’S OFFICIAL: health MoTs are a waste of time. It’s something I have said before, and now a report from the London School of Economics has agreed. The NHS Health Checks scheme, introduced by Labour in 2009, was hailed as a way to identify high-risk heart-disease patients between 40 and 74.

In fact, for every three million people assessed, as few as 1,000 deaths are actually prevented. I know these screenings seem like a good idea. But the reality is full of pitfalls like false positives, anxiety and overmedicalisation. The money spent on the tests would be better spent on drives tackling obesity and smoking – evidence-based ways to prevent deaths from heart disease.