EATING GLUTEN-FREE

What is gluten and why are people avoiding it?

Gluten-free diets have become popular in recent years and are often promoted for their health benefits. But what is gluten? Gluten is a term for proteins found in certain grains like wheat, barley, rye and triticale (a hybrid of wheat and rye). When mixed with liquid and manipulated, the proteins form an elastic substance that gives structure to flour mixtures, such as bread. For most people, eating gluten-free is a choice. For people with celiac disease it is a necessity. When a person with celiac disease eats gluten, their immune system responds by attacking the lining of the small intestine. The small, finger-like growths in the intestine, called villi, are damaged in the process and are not able to absorb the important nutrients needed for health. This increases the risk for nutrient-deficiency diseases like bone disease and anemia.

It is estimated that around 1% of the U.S. population has celiac disease. Another 5-10% of the population may have some degree of gluten intolerance or sensitivity. Nonceliac gluten sensitivity does not result in damage to the digestive tract, but it can cause a range of uncomfortable symptoms similar to those of celiac disease.

What are the symptoms of celiac disease?

Symptoms of celiac disease include stomach pain, gas, diarrhea, extreme tiredness, change in mood, slowed growth, itchy skin rash with blisters, and weight loss.

The only treatment for celiac disease is a gluten-free diet. Avoiding gluten will allow the small intestine to heal. Eating foods that contain gluten will continue to harm the small intestine.

Will a gluten-free diet help you lose weight?

For people who do not have celiac disease, gluten intolerance or gluten sensitivity, a gluten-free diet doesn’t provide any health benefit. The whole grains that contain gluten are a good source of fiber, vitamins and minerals. People following gluten-free diets may not get enough fiber, iron, folate, niacin, thiamine, calcium, vitamin B12, phosphorus or zinc, and may need to take supplements.

People who do not have celiac disease but follow a gluten-free diet may lose weight and feel better because they have cut out foods made with refined grains like desserts, snack foods and other processed foods.

If you eliminate wheat and other glutencontaining foods from your diet, make sure to replace them with naturally gluten-free whole grains, such as rice, quinoa or buckwheat. Balance your diet with lots of fruits, vegetables, lean meat and low-fat dairy products.

The FDA recently issued its final rule defining “gluten-free.” A food may be labeled gluten-free if it contains less than 20 parts per million (ppm) gluten. The less than 20 ppm standard is based in part on the lowest level at which currently available test methods can reliably detect gluten and is consistent with the 20 ppm standard adopted by the European Union.

Naturally Gluten-free Foods

The following list provides examples of naturally gluten-free foods. This is not a complete list.

• Legumes

• Buckwheat

• Beans, plain

• Nuts

• Oils

• Corn

• Quinoa

• Dairy, plain

• Seeds

• Flax

• Sorghum

• Fresh eggs

• Soy

• Fresh fruits

• Fresh meats, poultry, fish

• Herbs

• Vegetables

Foods That Contain Gluten

• Wheat, including einkorn, emmer, spelt, kamut, wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein

• Triticale

• Barley

• Rye

Ingredients That Contain Gluten

For people with celiac disease and gluten intolerance, it is important to pay attention to ingredients in foods. Many packaged foods can contain gluten in ingredients added during processing. Reading food labels can help you identify gluten-containing foods. Look for the following in the ingredients list:

• Bromated flour

• Phosphated flour

• Durum flour

• Enriched flour

• Plain flour

• Farina

• Self-rising flour

• Graham flour

• Semolina

• Malt • White flour

• Modified food starch

Processed Foods That May Contain Gluten

• Bouillon cubes

• Imitation fish

• Brown rice syrup

• Matzo

• Rice mixes

• Chips/potato chips

• Sauces

• Seasoned tortilla chips

• Candy

• Cold cuts, hot dogs, sausage

• Self-basting turkey

• Communion wafer

• Soups

• Soy sauce

• French fries

• Vegetables in sauce

• Gravy

Certain grains, such as oats, can be contaminated with wheat during growing and processing.

Doctors and dietitians generally recommend that people with celiac disease avoid oats unless they are specifically labeled gluten-free.

For people with celiac disease, fortunately there are gluten-free options available in the marketplace. These products often cost more and may be higher in calories, carbohydrates, fat and sodium, and lower in fiber than the regular products, but they can help with management of the disease.

Many grocery and health food stores sell gluten-free products. If you do not see them on the shelf, talk to the manager to see if they might be willing to carry these items. Lots of restaurants are now making glutenfree options available to their customers and labeling their menus accordingly.

Resources

There are multiple resources available for those with gluten sensitivity or celiac disease. These websites may be helpful in adapting to a glutenfree diet.

• www.celiac.nih.gov

• www.americanceliacsociety.org

• www.celiac.org

• www.csaceliacs.info

• www.gluten.net Additionally, The Gluten Detective is a mobile app that can be used to identify gluten-containing ingredients in food items at the grocery store.