Eating Gluten Free
A gluten-free diet can feel highly restrictive at first. But with a bit of practice, this new meal plan will get easier to follow over time. To eat truly gluten free, one must cut out all sources of gluten from their food intake. This includes wheat, rye, barley, any food that contains gluten from these sources, and sometimes oats. An example of a gluten-containing food is corn flakes. Although made with corn, this cereal often contains barley malt, which contains gluten.
Before beginning a gluten-free diet, it is imperative to verify the legitimacy of following such a diet. Eating gluten free will prohibit many, if not most, of the foods you already consume. Due to this, only follow a gluten-free diet if you are diagnosed with celiac disease, dermatitis herpetiformis or non-celiac gluten intolerance. A casein-free, gluten-free diet is often recommended for autism. At this time, following a casein-free, gluten-free diet for treating autism remains experimental.
Note on gluten "allergy": An allergy is an immune system response when body cells attack suspected protein "invaders." Symptoms of an allergic reaction may include temporary hives, swelling, congestion and tightening in the chest. In rare cases, anaphylaxis can occur. That said, gluten allergies don’t typically exist. Rather, individuals may have a reaction to wheat but not rye and barley. Therefore, their allergy is due to wheat rather than gluten.
Since the only treatment for celiac disease is diet, working with a registered dietitian who specializes in gluten-free meal planning is a necessity.
Living gluten free entails a lifetime commitment, proper education and trial and error. Successful execution of a gluten-free diet is the difference between feeling better and remaining sick. With that said, nutrition counseling will need to occur more than once until individuals feel comfortable with their new diet.
Foods to Avoid with Celiac Disease
- Bulgur Wheat
- Spelt (or Dinkel, Farro, Faro)
- Graham Flour
- Hydrolized Wheat Protein
- Matzoh, Matzoh Meal (unless designated as gluten free)
- Modified Wheat Starch
- Wheat—Bran, Flour, Germ and Starch
- Barley (Flakes, Flour, Pearl)
- Beer (unless designated as gluten free)
- Brewer’s Yeast
- Malt—Extract, Syrup and Flavoring
- Malt Vinegar
- Malted Milk
- Rye Bread
- Oatmeal, Oat Bran, Oat Flour and Oats (unless verified through R5 ELISA testing as gluten free)
To Oat or not to Oat?
As long as you take great care in choosing an appropriate oat manufacturer, there may not be a need to keep them on your "avoid" list. The symptoms individuals with celiac disease experience when eating oats appears to have more to do with the cross contamination of wheat, rye and barley rather than the oats themselves. This doesn’t make recommendations to be wary of oats less significant, because cross contamination has just as much impact on the small intestine as directly ingesting wheat, rye and barley.
Only after your celiac disease clinically appears to be controlled, and you receive the okay from your gastroenterologist, should you begin adding a moderate amount of pure, uncontaminated oats (up to 1/2 cup dry oats per day for adults or ¼ cup dry oats per day for children) back into your meal plan. When purchasing oats, only choose those labeled as “gluten free.”
Even if you don’t feel any negative reactions to adding uncontaminated oats back into your diet, the lining to your small intestine could be suffering, since a small subset of individuals may not be able to tolerate oats, even when they are gluten free. Therefore, follow-up testing should be conducted by your gastroenterologist to ensure your celiac disease remains clinically controlled once you begin to eat oats.