Gluten & Wheat
Gluten-free is becoming a well known term. It's practically trendy. But the truth is 'gluten-free' is not a health trend, nor should it be considered the latest diet. If you have sensitivities or allergies to gluten, it's an element of your diet that must be eliminated. Many of the symptoms and conditions discussed in the digestion portion of this website can be contributed to or caused by a food sensitivity or allergy, and gluten seems to be a repeat offender. Everyday new research is proving that gluten allergies are far more common than once thought. It was once believed celiac disease affected approximately 1 in 1,000 people. Today that number is thought to be closer to 1 in 100, with an alarmingly low 3% diagnosis rate. A reminder, this is only an estimate of people with a true celiac diagnosis; gluten IgG sensitivities (which cause many symptoms) may be much higher, affecting a much larger population. There may be some confusion about living wheat-free vs gluten-free. Essentially, everything that contains wheat has gluten in it, but everything that contains gluten doesn't necessarily have wheat in it. This page will dive further into that, as well as provide tips for living wheat-free or gluten-free.
The topic of gluten has been know to cause confusion. If you have celiac disease you have a gluten allergy, but if you have a sensitivity to gluten, you don't necessarily have celiac disease. Confusing. Having celiac disease means you have an autoimmune reaction triggered by gliadin, a type of protein found in gluten, which is the stretchy protein found in wheat, rye, triticale and barley. Your reaction will cause the villi in your small intestine to atrophy, leading to a host of problems, including dermatitis herpitiformis, gastrointestinal issues, migraines and more. If you have celiac disease and continue to eat gluten, you drastically increase your risk of associated conditions, as well as the risk of early death. Health Perch created a really awesome article and graphic tool to help those with celiac understand what they need to eliminate from their diet - more on that below.
Some people have a sensitivity to gluten, as opposed to an allergy. I go into more detail on that topic towards the bottom of this page. People sensitive to gluten will have negative results in a celiac test, but that doesn't necessarily mean gluten isn't causing their problems. They are having a different type of reaction, and it may only show up in food sensitivity panels (IgG), or perhaps determined through an elimination diet. It can be difficult to pinpoint a gluten sensitivity, but once you do it's important you eliminate it from your diet. Most people will need to be gluten-free for life to avoid symptomatic flare-ups, but some may be able to ingest gluten products in small amounts after an extended period of abstention and healing. Determining if you're gluten sensitive is just as important as determining if you have celiac disease, as over time your health will deteriorate if nothing is done.
Much research has been done on the opiate effect of gluten peptides and it's link to autism. Many parents of autistic children report beneficial results by putting their children on a gluten-free/casein-free diet. Many people eliminate gluten from their diets and feel better, but not fantastic. There seems to be a growing population that need to eliminate both gluten and casein (milk protein), as these proteins have similar effects on those who can't metabolize them correctly. Check out my dairy page for further information.
Gluten is found in barley, rye, triticale, wheat (durum, graham, kamut, semolina, spelt) and all products containing them. There are a number of hidden sources which must be avoided and are listed at the bottom of this page. Even small amounts of gluten, in places like soy sauce, can cause symptoms. Celiac.org developed a great 'quick start guide' which will be helpful for both celiacs and those with gluten-sensitivities.
True wheat allergies are common in children, and they often do grow out of them, but adults may have them as well. Wheat is one type of grain that contains gluten - a general term used to describe the protein found in certain grains. If you have a wheat allergy, you can be allergic to different proteins within wheat, including the pollen of the plant. A wheat allergy can have symptoms typical of other food allergies, including: eczema, hay fever, hives, asthma, swelling, gastrointestinal problems, headaches, nausea and although rare, anaphylactic shock. If you have a specific wheat allergy that means you may be able to consume other grains that do have gluten, such as rye, non-contaminated oats and barley. You must avoid all types of wheat and wheat products, which includes semolina, durum, spelt, triticale, farina and kamut. It will be safe to eat anything labeled wheat-free, but just realize that wheat-free does not equal gluten-free. The Food Allergy & Anaphylaxis Network has created an extremely useful guide for avoiding wheat (second page).
Why do I miss it so much?
For most people, living gluten-free can initially prove difficult. For others, they feel like it's next to impossible. We develop addictions to foods like bread, baked goods and pizza not only because they taste good, but also because of what they do to our brain. The sugar included in most items certainly makes it addictive, but maybe even more powerful is the opioid peptides found in gluten (as well as casein) that some people cannot metabolize. These peptides can have an opiate like effect on our brain, making the food incredibly difficult to give up, just like any other addiction. After the first few weeks of a diet without gluten, life tends to gets much easier. Perhaps it just takes getting used to, or perhaps you're experiencing a detox. Either way, you must persevere for your health. When you're feeling frustrated, utilize these words of wisdom, and go to a support group if needed.
What You Can Eat
- Grains: Rice, corn (maize), soy, potato, tapioca, beans, garfava, sorghum, quinoa, millet, buckwheat, arrowroot, amaranth, teff, flax, and nut flours. * Oats are grown in fields rotated with or nearby rye and wheat, so contamination is extremely common. This makes their consumption controversial, however research is showing celiac patients can tolerate pure, uncontaminated oats (which you can buy, certified GF oats). Some still believe there is not enough evidence to show they are safe for celiacs.
- Vegetables and Fruit: All, just be careful of how they're cooked/what they're cooked in
- Meat & Fish: All, assuming it's not processed meat (lunch meat and hot dogs common sources of gluten)
- Dairy: All (although research is showing many people who have a sensitivity to gluten may have a sensitivity to the protein in milk, casein)
- Alcoholic Beverages: Wine, distilled alcohol, gluten-free beer
For those of you who love to bake and cook, I've compiled an extensive list of gluten-free flours, instructions on how to substitute. and some recipes in my blog. Check them out: gluten-free substitution, flour by weight, whole grain flours, starches, binding agents, recipes & blog.
What You Can't Eat
Grains you cannot have: wheat (includes semolina, durum, kamut, spelt, graham, farrina), rye, triticale, and barley. When looking at products, if something is labeled 'gluten-free' it means it is wheat-free as well, however if something is labeled 'wheat-free,' it is not necessarily (and often not) gluten-free. It is imperative you learn to read ingredient labels, as packaged and prepared products often include gluten, many items not obvious to the consumer. This is of particular importance if you're dealing with a child who has a true wheat allergy or celiac disease, as they are relying on you. At first eating out will be challenging, but once you are familiar with what you can and cannot eat, hidden sources, and being comfortable speaking with the restaurant staff, it will become second nature. Remember, when in doubt, just go without! It's simply not worth it.
Obvious products containing wheat and gluten include cereal, bread, baked goods, pasta, pancakes, biscuits, cornbread and pretzels. Some common hidden sources of wheat and gluten are listed below, but for a more extensive list please reference this guide and this GF quick start guide:
- Coffee substitutes & creamer
- Beer, ale, some root beers
- Breading / coating
- Broth / stock
- Anything with malt, including malt vinegar
- Sherbet or ice cream (check labels)
- Salad dressing, store bought
- Items containing "modified starch"
- Lunch meats
- Hot dogs & Sausage
- Gravy & sauces
- Soy sauce
- Supplements/Medications (gluten/wheat may be used in fillers)
Certainly not all of these items always contain gluten, only certain brands incorporate glutinous substances in their ingredients. This is when reading labels comes in handy. Many of these items you can make at home and avoid any problems: salad dressing, ice cream, gravy, soup, stock, frosting, etc. Remember to check out all my cooking/baking resources to the right for helpful tools in the kitchen. Maybe going gluten-free will make you cook you've always wanted to be! The chart below presented by Health Perch is an awesome visual to print out or bookmark so you can feel like you always have a great reference.