Be Gluten Free

Gluten is a protein found in wheat and a number of other cereals, including oats, rye and barley. People with Diagnose Celiac Disease will find that eating gluten can cause intestinal damage, resulting in the inability to absorb nutrients.[1] Some people who do not have celiac disease may nonetheless be gluten-intolerant. They may suffer any number of symptoms of illness without actually experiencing intestinal damage. In either case, a person may need to avoid foods made from grains containing gluten, including most types of bread, pasta, pizza, pastry and cakes. This article describes the steps you can take to become gluten-free.

Steps

Gluten Cheat Sheets

Doc:Gluten Substitution Chart,Gluten Free Foods,Foods That Contain Gluten

Making Gluten-Free Work for You

  1. Educate yourself. Because gluten is contained in many different foods, there is a lot to learn if you want to avoid it.
    • Don't confuse "wheat-free" with "gluten-free". A product labelled "wheat-free" may contain gluten in the form of grains such as rye, barley and oats, each of which contain gluten. In addition, a gluten-free product may contain proteins not suitable for someone who is allergic to wheat.
    • Understand what it means to be "gluten-free". There is no consistent definition of what "gluten-free" means. There is, however, an international standard for "gluten-free" products produced from cereals containing gluten. This is the Codex Alimentarius, and it permits products to be called "gluten-free" if there are less than 200 parts-per-million of gluten in the finished product.[2] Many manufacturers follow this standard.
      • A new standard has been proposed for gluten-free products made from foods that do not naturally contain gluten. This would allow a product to be called "gluten-free" if there are less than 20 parts-per-million of gluten in the finished product. It isn't always possible to make products absolutely free of gluten, because tiny amounts of food containing gluten could get into these products when they are being made or transported. However, 20 parts-per-million is a very low level.
  2. Be sure it's gluten-free. Read as much as you can about different foods. Processed foods can be a problem when it comes to hidden gluten. Even after many years of being gluten-free, you may still be discovering new products that contain gluten. Examples of such sources include some glucose syrups, smoked foods, ice cream and tomato ketchup.
    • Read the packaging. Since November 2005, pre-packaged foods sold in the EU are required to show clearly on the label if they (or any of their ingredients) contain sources of gluten. This applies even if the sources have been specially treated to remove gluten. Bear in mind that this EU regulation applies only to cereals and that other foods containing gluten--such as some glucose syrups--needn't be identified as gluten sources.
    • Research on the internet. You can check many processed foods and their individual ingredients by searching online.
    • Never eat anything without knowing what's in it. (No more secret ingredients in your aunt's special recipe!) Be politely persistent. Explain clearly why you need to know exactly what you're being served. Simply removing the croutons from your gluten-contaminated soup isn't enough. You're not being pushy, you're just protecting your health. Be nice about it, however, if you want to be invited back.
  3. Know that other household items and medications may also contain gluten. Just because it's not food doesn't mean it can't contain gluten. And products that you use to clean yourself and your home may be culprits. Again, remember to check the label and research online if you have any doubts about the product that you are using.
    • Check the ingredients of your medications. Some medicines contain gluten in the form of starches and fillers. If the packaging doesn't list the ingredients, check with your pharmacist, who may be able to suggest gluten-free alternatives.
    • Look for the ingredients in household products — particularly make-up, shampoo and skin lotions. You may also want to check on the contents of children's art supplies and also home building supplies. People vary in their sensitivity, but you may find that you absorb sufficient gluten from such products to cause a reaction.
  4. Find other gluten-sensitive people. You can get a lot of support — and a lot of information — from local organizations and internet groups. It's worth considering even if you're not usually a joiner. The internet makes it easy to feel like you're part of a community without doing that much work.
    • Be on the lookout for support groups offering help to those diagnosed with celiac disease. Forums, blogs, and other internet resources exist to make life for celiac sufferers a lot easier. Helpful hints, recipe tips, and coping mechanisms can motivate you to breathe easier and trust in your ability to push through.
  5. Be prepared. A little planning can really protect your health and make it easier to be gluten-free.
    • Have a separate cupboard for your gluten-free products in order to prevent contamination. If this isn't possible, at least reserve a top shelf for gluten-free items. Be especially wary of sharing jam, butter, toasters and other items regularly associated with bread or other gluten products.
    • Be sure to clean surfaces in the kitchen and have clean utensils before preparing any gluten-free food.
    • Think ahead to holidays, parties and other festivities. Plan your gluten-free food well in advance so you know what you'll be eating. If a party is at someone else's house, offer to bring some food to share — gluten-free, of course!
    • Plan your travels with food in mind. It can be handy to keep an emergency travel-pack of gluten-free snacks — such as popcorn — to take on trips.
  6. Don't assume you will never again eat some of your favorite foods. Now that many people are eating gluten-free by choice because they believe it is a healthier option, it is much easier to find gluten-free products in supermarkets and natural-food stores. There are also many gluten-free recipes available. If you are a confident cook, you could even adapt your favorite recipes to gluten-free versions yourself!
  7. Make sure family and friends understand how important it is that you completely avoid gluten. If you are celiac or gluten-intolerant, be sure to praise those who feed or share food with you when things go well. If mistakes are made and anyone takes it lightly, be sure to explain clearly the consequences you will suffer as a result of the mistake. If you don't speak up, others may not take your situation seriously enough to help prevent future problems.
  8. Focus on what you can eat. Although there are some things you can't eat, there are actually many more that you can. Having a positive outlook will go a long way in your ability to live a better life, even if you don't have celiac.

Knowing What Foods to Avoid

  1. Always avoid the big four. The big four gluten culprits are wheat, rye, barley, and triticale. Avoid these in all cases, whether you are only gluten-intolerant or have celiac.[3]
    • Wheat to avoid includes kamut and spelt.[4] Because wheat often goes by another name, here are varieties of wheat to also definitely avoid:
      • Bulgur
      • Durum flour
      • Farina
      • Graham flour
      • Kamut
      • Semolina
    • Rye contains a protein called secalin, which is a form of gluten.[5]
    • Triticale, a cross between rye and wheat, is actually a hybrid designed in laboratories in the late 19th century.[6]
    • Barley is the last big gluten cereal to avoid. It is commonly made into meals and used in alcohol production, among others.
  2. Watch out for oats and oatmeal. White oats themselves do not contain gluten, they are often cross-contaminated with wheat because both are commonly processed in the same facilities.[3] Avoid eating oats and oatmeal unless the packaging specifically designates the product as gluten-free.
  3. Enjoy distilled alcohols but avoid beers unless they are specifically gluten-free. In theory, the distillation process removes all gluten proteins if done properly, even if the alcohol was manufactured using a glutinous grain (such as wheat, barley, or rye).
    • You can safely drink alcohols such as vodka manufactured from wheat, but be wary of beer.[7] Look for beer that is specifically designated gluten-free.
    • In theory, the distillation process removes all glutinous proteins. But in reality, cross-contamination may occur. Not only this, but some distillers may add mash to alcohols after distillation as a filler. This may cast doubt on alcohol's ability to deliver truly safe results.
    • If you really want to be careful, stick with potato-based vodkas, tequilas and mescals, or rums.[8] These all contain non-gluten grain sources, so they should be fine to drink.
  4. Avoid the following foods unless labels specify they are gluten-free. Checking labels is important. While many of the following kinds of foods have been and are being made gluten-free, many of them aren't. It's better to be safe than sorry. Avoid:
    • Breads, croutons, cereals, and crackers
    • Cookies, cakes, and candies
    • Imitation meat, imitation seafood, processed lunch meats, and "self-basting" poultry
    • Salad dressings, gravies, sauces (such as soy sauce), and vegetables in sauces
    • Pastas and "seasoned" rice mixes
    • Soups, matzo, and processed snacks like chips (potato chips and tortilla chips)

Knowing Which Foods are Okay to Eat

  1. Start with your grains, cereals, and flours. Not all grains, cereals, and flours contain gluten. In fact, most don't. Here is a list of all the cereals, grain, and flours that are good to eat!
    • Cereals and grains: rice, maize, quinoa, tapioca, sago, buckwheat, and sorghum.
    • Flours: rice, corn, potato, maize, graham, soya, chickpea, sorghum, tapioca and chestnut flours are all okay — but check the label for possible contamination.
    • Breakfast cereal: this can be tricky. Check carefully and avoid brands containing wheat, oats, barley, rye, or malt extract. No Rice Krispies!! This contains barley malt extract. Gluten-free muesli is good, but boil thoroughly if it's made from crushed rice. Add fruit for flavor!
  2. Get full doses of your meat, fish and eggs. All are basically fine — just check any coatings, sauces and spices you add. Check wafer-thin meats, too. (Sometimes wheat flour is added to make them peel apart more easily).
    • When ordering fish in a restaurant, check with the chef — sometimes fish is fried with flour to stop it from sticking to the pan.
    • Again, avoid processed lunch meats, and all imitation meats or seafood, as they may contain gluten.
  3. Know that dairy products are good to go. Milk, cream, cheese and yogurt should be fine to eat. Check any added ingredients, and check ready-grated cheese. (Sometimes wheat flour is added to prevent the slivers of cheese from sticking together).
    • In some cases, celiacs are dairy-intolerant because of intestinal damage. This situation can improve over time, and it's important to keep eating dairy foods in moderation during recovery (perhaps a little cheese once in a while) to avoid permanent dairy-intolerance.
    • If you’re lactose-intolerant, or avoiding dairy for other reasons, try soya milk or rice milk (check label for contamination). You may be able to handle goat’s milk. If you find you are intolerant to soya, it may be intestine-related and should clear up over time.
  4. Get your full share of fruits and veggies. All fruits and vegetables are naturally gluten-free. Check ready-made pie fillings, coatings, sauces and spices though, as these can be thickened with flour.
  5. Know what kinds of fats are okay. You can eat butter, margarine, and oils, but avoid suet and check low-fat spreads.
  6. Be careful about desserts, although some can be fine. Check desserts every time. Meringue, jelly, and most ice creams and sorbets will be fine, but unless specifically labelled gluten-free, cheesecakes and pies will not be good for you.
  7. Get your snacks. Nuts, raisins and seeds are all naturally gluten-free, but check any added coatings and check all packets of crisps (chips) and other savory snacks. You can be fooled by these items, especially when the recipes change. Check every label, due to contamination issues.
  8. Check your spices and cooking ingredients. Pure salt, pepper, herbs, and vinegar should be fine. Check spices and mustard powder, however, for added flour.
    • As for cooking and baking ingredients, yeast, bicarbonate of soda and cream of tartar are all good, but check baking powder for added flour.
  9. Be mindful about what you drink. Of course, water is totally gluten-free and should make up the most of what you drink for health reasons. Here is a breakdown of what's okay and what's not for other drinks:
    • Soft drinks: coffee, tea, juices, cocoa, fizzy drinks and most squashes are fine. Check that they don’t contain barley or "cloud," and don’t drink beverages from vending machines.
    • Pure fruit juice contains no gluten, just flavor and vitamins.
    • Be careful about "smoothies." These are sometimes just fruit juice and yogurt but sometimes have other ingredients, so be sure to check.
    • Probiotic drinks are a new trend. Check them, but they should be fine if you can handle dairy products.
    • Plain tea is gluten-free, as are any milk or sugar that you add, but be wary of drinks from vending machines, as there may be cross-contact with other products. Herbal or fruit teas and infusions are probably gluten-free.
    • Plain coffee is gluten-free, but be careful of flavorings and other additions (e.g. some chocolate toppings to go on cappuccinos, lattes, etc). Again, be careful about using vending machines.
    • Wine should be gluten-free whether still, fizzy, sweet or dry, although there are reports that some Australian wines are treated with hydrolyzed wheat gluten as part of the fining process. Again, the level of gluten is not detectable in the final product, and it is considered to be gluten-free.

Navigating the Risks of Gluten-Free

  1. Be sure that you are getting enough essential vitamins. Talk with your dietician about maintain a healthy intake of essential vitamins, like iron, fiber, calcium, niacin, thiamin, riboflavin, and folate.[3] These vitamins are often added to grain products in order to enrich them. Cutting grain-products out of your diet completely may put you at risk for vitamin deficiency.
  2. Navigate the fallout after you accidentally eat gluten. We've all done it. Accidentally eating gluten is just something that happens, although with time and patience, it becomes a much less frequent occurrence.
    • If you do accidentally eat gluten, you may experience stomach cramps, abdominal pain, and even diarrhea. This is not uncommon, and usually it's nothing to be worried about.
    • If you accidentally eat gluten and you seem to be experiencing no discomfort or symptoms, don't necessarily take that as a sign that you can begin eating gluten again. Gluten can still damage your small intestines, even if you aren't aware of the symptoms.[3]
  3. Get comfortable with some of the things that make going gluten-free difficult. Going gluten-free is a boon to many, many people. Still, it takes a while to get used to, and it doesn't happen overnight. Here are some small and big things that you'll need to get comfortable with as you live your new, gluten-free life.
    • It can get expensive. Gone are the days of getting $1 loaves of bread and $2 cupcakes. More like $8 loves of bread and $5 cupcakes.
    • It can be inconvenient. Because of the dearth of gluten-free food, and especially fast food, it's hard to grab food on the run. You'll definitely spend more time cooking up a storm in your kitchen, which is the plus to balance out this minus.
    • People will think you're high-maintenance, or an a fad diet. Most of your friends will be understanding, but some people who don't understand that you may have a disease will write you off. Don't worry. They aren't worth it. Go about your life as you please and kindly educate people that falling off the gluten wagon isn't exactly the same as falling off the diet wagon.



Tips

  • It may be difficult adjusting to a gluten-free diet, but keep in mind how much better you will feel someday--especially if you have celiac disease. The healing process may seem to take forever (some cases can last two years or more). Your intestines will heal eventually. You will feel better. All your efforts will be worth it.
  • In the early stages of adopting a gluten-free diet, it may be best to focus on eating non-processed foods like fresh meat and fish, rice and fresh fruit and vegetables that will help you avoid gluten contamination. You can then gradually identify processed foods you believe to be gluten-free. Searching the internet can help identify such foods. You can add them to your diet one by one, giving you the opportunity to see if you react to them or if they are a safe food for you.
  • It's best to read the labels every time you buy a food product. You never know when the manufacturer may change ingredients.
  • Be prepared to explain your gluten diet often and sometimes over and over again. No, it's not a fad. Yes, it's a medical requirement. No, it will not go away.
  • Don't forget that beverages can contain gluten - whether they are alcoholic or not.
  • Many people who are gluten-intolerant or celiac find that they also have problems with non-glutenous foodstuffs such as soy. If your symptoms remain despite having completely removed gluten-containing products from your diet for some time, then you may wish to explore that possibility.

Warnings

  • Don’t ever be persuaded by people saying “just one cream cake/doughnut/slice of quiche won’t hurt”. It will, even if you can’t feel any difference. Consuming any gluten at all can eat away at your small intestine and delay your recovery. Don’t do it!
  • Just because some people have adopted gluten-free diets for health reasons, don't assume that simply avoiding gluten will lead to great health. The quality of the foods you eat is as important as avoiding gluten. Gluten-free junk food isn't any better for you than regular junk food.
  • Several types of "alternative" grains often found in breads and other products from health-food stores are actually varieties or hybrids of wheat plants. These include teff, spelt, bulgur, couscous, durum, semolina, kamut, and triticale. Some of these grains may contain gluten.
  • Some nutritionists believe that a gluten-free diet is not advisable for those who do not have celiac disease or who are not gluten-sensitive. In other words, most people may benefit from consuming gluten.

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Sources and Citations

  1. ↑ http://www.mayoclinic.com/health/celiac-disease/DS00319
  2. ↑ http://www.codexalimentarius.org/
  3. ↑ 3.0 3.1 3.2 3.3 http://www.mayoclinic.com/health/gluten-free-diet/my01140
  4. ↑ http://www.celiac.com/gluten-free/topic/40898-is-kamut-gluten-free/
  5. ↑ http://www.ncbi.nlm.nih.gov/pubmed/11260160
  6. ↑ http://www.hort.purdue.edu/newcrop/afcm/triticale.html
  7. ↑ http://celiac.nih.gov/GlutenFreeHoliday.aspx
  8. ↑ http://www.csaceliacs.info/
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