Eating Gluten Free
A gluten-free diet is highly restrictive. 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 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 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 oats (up to 1/2 cup rolled oats) back into your diet. Even if you don’t feel any negative reactions to adding oats back into your diet, the lining to your small intestine could be suffering. Therefore, follow-up testing should be conducted by your gastroenterologist to ensure your celiac disease remains clinically controlled once you begin to eat oats.
As an editorial in the November 2004 New England Journal of Medicine revealed, the brand of oats you purchase is very important. Dietitian Tricia Thompson observed that the level of gluten can vary considerably in commercial brand oats. Therefore, when you do begin to add oats back into your repertoire, choose a manufacturer that analyzes their crop with an R5 ELISA gluten test to verify the level of gluten it contains.
Bob’s Red Mill is one such manufacturer and their new Gluten-Free Rolled Oats contains less than 20 parts per million of gluten (the level the FDA has proposed to use for identifying gluten-free products). Bob’s Red Mill Gluten-Free Rolled Oats can be found in the special gluten-free sections located in a handful of our Big Y World Class Markets.