Purpose
Gluten is the protein part of wheat, Rye, Barley, Einkorn, Durum, Faro, Graham, Kamut, Semolina, Spelt, Tirticale and other related grains. Some people cannot tolerate gluten when it comes in contact with the small intestine. This condition is known as celiac disease (sometimes called non-tropical sprue or gluten sensitive enteropathy). There is also evidence that a skin disorder called dermatitis herpetiformis is associated with gluten intolerance.
In people with celiac disease and gluten sensitivity, gluten injures the lining of the small intestine even without the presence of symptoms. This injury results in weight loss, bloating, diarrhea, gas, abdominal cramps, or vitamin and mineral deficiencies. When patients totally eliminate gluten from the diet, the lining of the intestine has a chance to heal.
Removing gluten from the diet is not easy. Grains are used in the preparation of many foods. It is often hard to tell by an ingredient’s name what may be in it, so it is easy to eat gluten without even knowing it. However, staying on a strict gluten-free diet can dramatically improve their condition. We have put together helpful hints and food lists to make your transition to a gluten free diet as easy as possible.
Oats is a grain that merits special attention. Oats are believed safe in patients with celiac disease although this was not always the case. The problem with oat products is not the grain but rather the manufacturing process. When oats are processed in the same facilities as wheat, contamination can occur even with the best cleaning protocol. Oat products can now be found that are not cross contaminated. These can be tried after an initial period of 6 months to see if they can be tolerated. Most, but not all patients can tolerate pure oat products.
Special Considerations
DO NOT EAT anything that contains the following grains: wheat, Rye, Barley, Einkorn, Durum, Faro, Graham, Kamut, Semolina, Spelt, or Tirticale.
The following CAN BE EATEN in any amount: corn, potato, rice, soybeans, tapioca, arrowroot, carob, buckwheat, millet, amaranth, quinoa, beans, garfava, sorghum, teff, montina, flax and nut flours.
It will also be necessary to seek out HIDDEN GLUTEN since grains are used in the processing of many ingredients. The following terms found in food labels may mean that there is gluten in the product.
Hydrolyzed Vegetable Protein (HVP) – unless made from soy or corn
Flour or Cereal products – unless made with pure rice flour, corn flour, potato flour, or soy flour
Vegetable Protein – unless made from soy or corn
Malt or Malt Flavoring – unless derived from corn
Modified Starch or Modified Food Starch – unless arrowroot, corn, potato, tapioca, waxy maize, or maize is used
Vegetable Gum – unless vegetable gums are carob bean gum, locust bean gum, cellulose gum, guar gum, gum Arabic, gum aracia, gum tragacanth, xanthan gum, or vegetable starch
Soy Sauce or Soy sauce solids – unless you know they do not contain wheat
Malt vinegar – does contain gluten
DISTILLED WHITE VINEGAR does contain gluten.
Any of the following words on food labels usually means that a grain containing gluten has been used: Stabilizer, Starch, Flavoring, Emulsifier, or Hydrolyzed plant protein
Be a food detective
Call First – You can verify ingredients by calling or writing a food manufacturer and specifying the ingredient and the lot number of the food in question. State your needs clearly – be patient, persistent and polite.
If in Doubt, Go Without – Don’t eat a food if you are unable to verify the ingredients or if the ingredients list in unavailable. Regardless of the amount eaten, if you have celiac disease, damage to the small intestine occurs every time gluten is consumes, whether symptoms are present or not.
Add One New Food at a Time – When adding a food item to your diet, introduce only one new food at a time. Listen to your body for adverse reactions before trying a second new food item.
Wheat Free is NOT Gluten Free – Products labeled wheat free are not necessarily gluten free. They may still contain spelt, rye or barley-based ingredients that are not gluten free. Spelt is a form of wheat.
Food Group Contents
Food Group | Does Not Contain Gluten | May Contain | Contains |
| Milk & milk products (2 or more cups daily) | Whole, low fat, skim, dry, evaporated, or condensed milk, buttermilk, cream, whipping cream, Velveeta cheese food; American cheese, all aged cheeses, such as Cheddar, Swiss, Edam, and Parmesan | Sour cream, commercial chocolate milk and drinks, non-dairy creamers, all other cheese products, yogurt | Malted drinks |
| Meat or meat substitutes (5 to 6 oz. daily) | 100% meat (no grain additives), seafood, poultry (breaded with pure cornmeal, potato flour, or rice flour), peanut butter, eggs, dried beans or peas, pork | Meat patties, canned meat; sausages, cold cuts; bologna, hot dogs, stew, hamburger, chili, commercial omelets, soufflés, fondue, soy protein meat substitutes | Croquettes, breaded fish, chicken loaves made with bread or bread crumbs, breaded or floured meats, meatloaf, meatballs, pizza, ravioli, any meat or meat substitute, rye, barley, oats, gluten stabilizers |
| Breads & grains (4 or more servings daily) | Cream of rice, cornmeal, hominy, rice, wild rice, gluten-free noodles, rice wafers, pure corn tortillas, specially prepared breads made with corn, rice, potato, soybean, tapioca arrowroot, carob, buckwheat, millet, amaranth and quinoa flour, puffed rice | Packaged rice mixes, cornbread, ready-to-eat cereals containing malt flavoring | Breads, buns, rolls, biscuits, muffins, crackers, and cereals containing wheat, wheat germ, oats, barley, rye, bran, graham flour, malt, kasha, bulgur, Melba toast, matzo, bread crumbs, pastry, pizza dough, regular noodles, spaghetti, macaroni, and other pasta, rusks, dumplings, zwieback, pretzels, prepared mixes for waffles and pancakes, bread stuffing or filling |
| Fats & oils (servings depend on caloric needs) | Butter, margarine, vegetable oil, shortening, lard | Salad dressings, non-dairy creamers, mayonnaise | Gravy and cream sauces thickened with flour |
| Fruits (2 or more servings daily) | Plain, fresh, frozen, canned, or dried fruit, all fruit juices | Pie fillings, thickened or prepared fruit, fruit fillings | None |
| Vegetables (3 or more servings daily) | Fresh, frozen, or canned vegetables, white and sweet potatoes, yams | Vegetables with sauces, commercially prepared vegetables and salads, canned baked beans, pickles, marinated vegetables, commercially seasoned vegetables | Creamed or breaded vegetables, those prepared with wheat, rye, oats, barley, or gluten stabilizers |
| Snacks & desserts (servings depend on caloric needs) | Brown and white sugar, rennet, fruit whips, gelatin, jelly, jam, honey, molasses, pure cocoa, fruit ice, popcorn, carob | Custards, puddings, ice cream, ices, sherbet, pie fillings, candies, chocolate, chewing gum, cocoa, potato chips | Cakes, cookies, doughnuts, pastries, dumplings, ice cream cones, pies, prepared cake and cookie mixes, pretzels, bread pudding |
| Beverages (4 to 6 cups or more daily) | Tea, carbonated beverages (except root beer), fruit juices, mineral and carbonated waters, wines, instant or ground coffee | Cocoa mixes, root beer, chocolate drinks, nutritional supplements, beverage mixes | Postum™, Ovaltine ™, malt-containing drinks, cocomalt, beer, ale, gin, whiskey, rye |
| Soups | Those made with allowed ingredients | Commercially prepared soups, broths, soup mixes, bouillon cubes | Soups thickened with wheat flour or gluten-containing grains, soup containing barley, pasta, or noodles |
| Thickening agents | Gelatin, arrowroot starch; corn flour, germ, or bran; potato flour, potato starch flour, rice bran and flour, rice polish, soy flour, tapioca, sago | Wheat starch, all flours containing wheat, oats, rye, malt, barley, or graham flour; all-purpose flour, white flour, wheat flour, bran, cracker meal, durham flour, wheat germ | |
| Condiments | Gluten-free soy sauce, distilled white vinegar, olives, pickles, relish, ketchup | Flavoring syrups(for pancakes or ice cream), mayonnaise, horseradish, salad dressings, tomato sauces, meat sauce, mustard, taco sauce, soy sauce, chip dips | |
| Seasonings | Salt, pepper, herbs, flavored extracts, food coloring, cloves, ginger, nutmeg, cinnamon, bicarbonate of soda, baking powder, cream of tartar, monosodium glutamate | Curry powder, seasoning mixes, meat extracts | Yeast (unless prepared with a sugar molasses base), yeast extract (contains barley) |
| Prescription products | All medicines: check with a pharmacist or pharmaceutical company |