If you have been diagnosed with Celiac Disease, the only known treatment is sticking to a strictly gluten-free diet for the rest of your life. This can be extremely distressing to many people – how can one manage to go their whole life without eating pizza and birthday cake? The good news is that there is a wide variety of gluten-free products available these days, and you will feel much better once you are on a gluten-free diet. The trick is knowing what foods are safe for you to eat, and learning how to read labels in order to identify ingredients that contain gluten.
Even if you don’t have Celiac Disease, there are many other reasons to avoid gluten, which has been implicated in over 50 different diseases or conditions, according to the New England Journal of Medicine. Gluten sensitivity can cause inflammation that affects every part of your body. Some of the other conditions that gluten sensitivity can lead to include osteoporosis, Irritable Bowel Syndrome (IBS), anemia, rheumatoid arthritis, multiple sclerosis, dermatitis, asthma, and a wide range of psychological issues including depression, anxiety, and autism. Over 17 million Americans have a sensitivity to gluten that is not nearly as well understood as Celiac Disease. Unfortunately, there are no definitive diagnostic tests that can confirm that these individual’s symptoms are due to gluten. So, if you or a family member suffer from any of these conditions listed above, it makes sense to try a gluten free diet for a few months to see if this leads to any improvements.
What is Gluten?
So, let’s start with the basics. Gluten is a protein that is found in many grains, including wheat, barley, triticale, rye, and possibly oats. It is composed of hundreds of different types of proteins, including glutenin and gliadin, that are then combined with starch that is found in the endosperm of the grains. In many ways, gluten is a remarkable substance that makes flour stretchy and elastic when water or liquid is added to it, and also helps dough to rise. Gluten is found in nearly all traditional bread products found in bakeries and your local grocery store. Unless a bread product clearly states on the packaging that it is ‘gluten free’, you must assume it contains gluten. Common sources of gluten include all types of bread, cereal, pasta, cake, cookies, crackers, pretzels, and pizza, to name a few. To begin, you must avoid all of these common sources of gluten.
Basic Gluten-Free Foods
From now on, the main grains and starches that can be included in your diet are corn, rice, millet, arrowroot, quinoa, tapioca, amaranth, teff, and chia seeds. Starchy vegetables are also OK, such as potatoes, yam, and sweet potatoes. Beans are a good source of protein in a gluten-free diet, including kidney beans, pinto beans, black beans, cannellini beans, garbanzo beans, and navy beans, as well as split peas and all kind of lentils. Minimally processed meat, poultry, eggs, and fish are gluten free, as long as they do not have anything else on them (such as breading or seasonings). Fresh fruit and vegetables should be eaten every day, and if you are not lactose intolerant, be sure to include dairy products such as milk, plain yogurt, and cheese.
It would be fairly easy to stick to a gluten-free diet, if you only ate unprocessed and natural foods that you cooked in your own home. A typical whole food diet could include eggs and fruit for breakfast, a skinless chicken breast sliced over a spinach salad for lunch, and grilled steak and vegetables with corn tortillas and black beans for dinner.
Learning to Read Labels
Most of us, however, cannot prepare all of our meals at home, using whole foods. A typical grocery store has thousands of processed foods and a very high percentage of these have gluten in them. In order to incorporate other foods in your diet, and to increase the convenience of your life, you will have to learn to read labels. Individuals with celiac should meet with a registered dietitian or nutritionist shortly after diagnosis. These professionals are highly trained, and some specialize in gluten free diets. They can be extremely helpful in identifying which of your favorite foods must be avoided, and give you ideas on what replacement foods will be safe. They can also help you learn to read labels, and can provide follow-up care to ensure that gluten is not still sneaking into your diet.
Here is a list of food additives and processed ingredients that contain gluten. (This list is for informational purposes only, and may not be complete, so check with your doctor or dietitian if you see any ingredients on a label that you do not recognize.)
- Monosodium glutamate (MSG)
- Modified food starch
- Hydrolyzed plant protein
- Hydrolyzed vegetable protein
- Vegetable gum and proteins (xanthan gum)
- Various extenders and binders
- Various flavors, including natural flavors, smoke flavors, and artificial flavors
- Various coloring, including natural colors, artificial colors, and caramel color
- Soy sauce
- Chicken, beef, and vegetable stock cubes
- Non-dairy creamer
- Dip mixes and dry sauce mixes
- Instant tea and coffee products
- Gravy, and gravy sauce mixes
- Processed cheese products and spreads
- Baking powder
- Mustard and mayonnaise
- Roasted seasoned nuts, honey roasted nuts and snack products that contain them
- Vitamins and other supplements
These alcoholic drinks contain gluten
- Malted beverages
- Spirits that are grain-based
Other products that may contain gluten
- Various medications
- Dog and cat food
Cross contamination is when food with gluten comes in contact with gluten-free food, transferring the gluten over. This can happen in an astonishing number of ways, from crumbs on the toaster, to oil used for frying food, to flour on a cutting board. People with Celiac Disease can become quite ill from even one crumb of gluten, so cross contamination must be avoided whenever possible. The best way to accomplish this is by paying careful attention to your food preparation. Here are some suggestions to avoid cross contamination in your own home.
- Have your own butter dish and butter knife.
- Buy an extra toaster, and only put gluten free products in it. The same is true of a toaster oven. Never us a toaster oven that has been used for gluten foods, unless the tray and everything around it have been washed in the dishwasher. If it is not reasonable to have two toasters, then consider purchasing toaster bags that are made out of silicon and will toast the bread right in the bag.
- Make sure to thoroughly wash down all surfaces before preparing gluten free food.
- Prepare gluten-free food first, before you prepare any gluten based food. Then wrap the food well and put it away before you start using ingredients like flour, soy sauce, or breading. (This advice is for a family where some members are gluten free, and others can eat gluten. Though it may be optimal for all members of the family to eat gluten free, this is not always practical.)
- Be careful not to breathe in any flour, as some celiacs are very sensitive to airborne gluten.
- Do not ‘double-dip’ and instruct family and friends that they should not either. Even a speck of a pretzel in the sour cream dip can cause a problem with cross contamination. The same is true for silverware. Do not use a spoon for cereal, and then dip it into the sugar bowl. This can contaminate the sugar.
- Thoroughly scrub all pots, pans, and cooking sheets after using.
- Purchase a separate set of wooden utensils for gluten free cooking. Gluten particles can easily stick in the surface of wood utensils.
And here are some tips to avoid cross contamination when you are away from home:
- Do not buy products that are in large bins, and require a scooper. There is a very high likelihood of cross contamination with this method of food distribution. The bins are probably not regularly cleaned, and different products can move from bin to bin. You can’t be sure if gluten-based food was in the bin a week ago.
- Be careful at sandwich shops or delis, where the sliced meat can come in contact with bread crumbs or processed meat that has gluten in it. Even shops that advertise gluten free bread may not be aware of the problems caused by cross-contamination, so you should be alert to this issue, and ask the staff to prepare your meal on a clean sheet of paper or paper towel.
- Avoid fried foods, because most restaurants use the same fryer for all foods, included breaded products like chicken nuggets. When french fries are immersed in the same oil, they are exposed to gluten.
- Avoid grilled meat because if the grill has not been scrubbed, there is a high likelihood that previous meats have seasonings or soy that contain gluten.
- Do not go to buffets, where the same spoon may be used to place the food in the buffet line, or where people may inadvertently cross contaminate the food by dropping bits of food while serving themselves.
Advice for Gluten-Free Shopping
There are many things you can’t eat while on a gluten free diet. Fortunately, the available of certified gluten free food has soared, and many of these items can be purchased from your local grocery store, a specialty gluten-free store, or directly on the internet. Amazon.com has many products available from reputable gluten-free manufacturers.
Here is a list of some of our favorite manufacturers that use dedicated facilities or equipment to manufacture their gluten free foods, and test their food using the ELISA scale. They also clearly label their products as ‘gluten-free’.
- Arrowhead Mills
- Bob’s Red Mill
- Food for Life
- Gluten Free Essentials
- Gluten Free Pantry
- Health Valley
- Kay’s Naturals
- Nature’s Path
- Pacific Organic
- Thai Kitchen
And, when you want to go out or are traveling, here are some restaurants that have gluten-free menus:
- BJ’s Restaurant and Brewhouse
- Buffalo Wild Wings
- Claim Jumper
- Dickey’s Barbecue Pit
- Duffy’s Sports Grill
- Quaker Steak and Lube
- Red Robin
- Redstone American Grill
- Ted’s Montana Grill
- The Melting Pot
- Uno’s Chicago Grill
- Village Tavern
Special care must be taken if your children needs to eat a gluten-free diet. Children are not going to read labels, but they will definitely have issues if they inadvertently eat an item with gluten in it. So, you must be very careful, and will probably have to prepare and supervise most of your child’s meals until they are at least 10 years old. It’s best if you can make your house entirely gluten free, so that your child is not tempted by food items that may make them sick.
Stock up on healthy gluten-free options. Variety is essential in a gluten free diet, so serve different fruits and vegetable each day. Purchase a lot of gluten free snacks, because kids are hungry all the time, and you can’t always stop to prepare them a meal. Good examples include cheese sticks, gluten-free pretzels, raisins, hard-boiled eggs, apples, plain or raw nuts, and organic juice boxes.
You’ll also need to stock up on gluten-free lunch supplies. Most school cafeterias do not serve gluten free lunches, so you will most likely have to prepare all of your child’s lunches, until they can make one themselves. Purchase gluten-free bread, and keep it in the freezer. Make sandwiches on the frozen bread, and it will thaw by lunchtime. Add a piece of fruit, baby carrots, and include several snacks. Schools also have many parties throughout the year, and you should learn how to make delicious gluten-free cookies or have some packaged cookies on hand, to bring for your child to eat.
Hopefully, you have learned a lot about gluten free eating today. There is still a lot to learn, so consider signing up for a gluten free cooking class, and subscribe to a gluten-free cooking magazine, like Gluten-Free Living, Simply Gluten Free, Delight, or Living Without’s Gluten Free and More. Keep snacks on hand for yourself so you won’t feel deprived when others are eating donuts or birthday cake at the office. Health is the most important thing in your life, so understand that eating gluten-free is a lifestyle choice for you that will keep you active and healthy for many years to come.