Gluten-Free Diet
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Purpose
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 Gluten is the protein part of wheat, rye, barley, 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).
Celiac disease is now clearly known to be genetically determined. In other words, if you or your close relatives have a certain gene, then it is more likely that you will get celiac disease some time in your life. Of great concern and interest is the fact that 9 out of 10 people with celiac disease do not know they have it.
In patients with celiac disease, gluten injures the lining of the small intestine. 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.
So, the primary injury in celiac disease is in the small bowel but there may be a relationship between what happens in the small bowel and the colon or large bowel. There are very large numbers of bacteria in the colon. Most of these are beneficial and actually confer health benefits. When these good bacteria thrive, they suppress the bad bacteria, which are present in the colon. What has been found is that celiac patients have an altered make-up of bacteria in the colon and favor the unwanted bacteria.
Prebiotic plant fibers or supplements are the nourishment for the healthy growth of good bacteria. The fibers do not contain gluten and can be recommended for all celiac patients. So, eating generous amounts of gluten-free vegetables and fruits likely will push the bacterial colon balance in a favorable way.
Removing gluten from the diet is not easy. Grains are used in the preparation of many foods. It is often hard to tell by a food'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 the patient's condition. Since it is necessary to remain on the gluten-free diet throughout life, it will be helpful to review it with a registered dietitian.
Oats are a grain that merits special attention. Oats are believed to be safe for 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 methods. 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.
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Nutrition Facts
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Depending on the foods selected, the gluten-free diet can meet the Dietary Reference Intakes (DRI's) of the Institute of Medicine.
| Special Considerations |
The person who prepares the patient's food must fully understand the gluten-free diet. Read food labels carefully.
- Do not eat anything that contains the following grains: wheat, rye, and barley.
- The following can be eaten in any amount: corn, potato, rice, soybeans, tapioca, arrowroot, carob, buckwheat, millet, amaranth and quinoa.
- Distilled white vinegar does not contain gluten.
- Malt vinegar does contain gluten.
Grains are used in the processing of many ingredients, so it will be necessary to seek out hidden gluten. The following terms found on 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
Any of the following words on food labels usually means that a grain containing gluten has been used
- stabilizer
- starch
- flavoring
- emulsifier
- hydrolyzed
- plant protein
There are now several companies that produce gluten-free products, and several support groups to provide delicious recipes and help patients adapt to the gluten-free diet.
Organized Groups
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The Food Allergy Network
11781 Lee Jackson Hwy, Suite 160
Fairfax, VA 22033-3309
(800) 929-4040
American Celiac Society
P.O. Box 23455
New Orleans, LA 70183-0455
504-737-3293
Celiac Sprue
Association/USA, Inc.
P.O. Box 31700
Omaha, NE 68131-0700
(402) 558-0600
(877) CSA-4-CSA
Celiac Disease Foundation
13251 Ventura Blvd., Suite 1
Studio City, CA 91604-1838
(818) 990-2354
Gluten Intolerance Group
15110 10th Avenue SW, Suite A
Seattle, WA 98166-1820
(206) 246-6652
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Companies That Sell Gluten-Free Products
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Dietary Specialists, Inc.
P.O. Box 227
Rochester, NY 14601
(716) 263-2787
To place an order: 1-800-544-0099
Ener-G Foods, Inc.
5960 1st Avenue. S.
P.O. Box 84487
Seattle, WA 98124-5787
(206) 767-6660
Toll free: 1-800-331-5222
Gluten Free Pantry
P.O. Box 840
Glastonbury, CT 06033
860-633-3826
Glutino
3750 Francis Hughes
Laval, Quebec
Canada H7L5A9
1-(450) 629-7689
Toll free: 1-800-363-DIET (3438)
Fax: 1-(450)-629-4781
Website: www.glutino.com
email: info@glutino.com
The Really Great Food Company
P.O. Box 2239
St. James, NY 11780
Toll free: 1-800-593-5377
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Cookbooks
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The Gluten-free Gourmet
More from the Gluten-free Gourmet
Bette Hagma
Gluten Freeda Online Cooking Magazine
www.glutenfreeda.com
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| Do Not Contain Gluten |
May Contain Gluten |
Contain Gluten |
| 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 |
| 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 |
| 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 |
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 |
| butter,margarine, vegetable oil, shortening, lard |
salad dressings, non-dairy creamers, mayonnaise |
gravy and cream sauces thickened with flour |
| plain, fresh, frozen, canned, or dried fruit; all fruit juices |
pie fillings, thickened or prepared fruit, fruit fillings |
none |
| 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 |
| brown and white sugar, rennet, fruit whips, gelatin, jelly, jam, honey, molasses, pure cocoa, fruit ice, carob |
custards, puddings, ice cream, ices, sherbet, pie fillings, candies, chocolate, chewing gum, cocoa, potato chip, popcorn |
cakes, cookies, doughnuts, pastries, dumplings, ice cream cones, pies, prepared cake and cookie mixes, pretzels, bread pudding |
| 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
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| 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 |
| gelatin, arrowroot starch; corn flour, germ, or bran; potato flour; potato starch flour; rice bran and flour; rice polish; soy flour; tapioca, sago |
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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 |
| 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 |
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| 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 |
synthetic pepper, brewer's yeast (unless prepared with a sugar molasses base), yeast extract (contains barley) |
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all medicines: check with pharmacist or pharmaceutical company |
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| Sample Menu |
| Breakfast |
Lunch |
Dinner |
- cream of rice 1/2 cup
- skim milk 1 cup
- banana 1 med
- orange juice 1/2 cup
- sugar 1 tsp
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- baked chicken 3 oz
- rice 1/2 cup
- green beans 1/2 cup
- apple juice 1/2 cup
- ice cream (made with-out wheat stabilizers ) 1/2 cup
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- sirloin steak 3 oz
- baked potato 1 med
- peas 1/2 cup
- fruited gelatin 1/2 cup
- butter 1 Tbsp
- tea 1 cup
- sugar 1 tsp
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| This Sample Diet Provides the Following |
| Calories |
1748 |
Fat |
62 gm |
| Protein |
77 gm |
Sodium |
1577 mg |
| Carbohydrates |
225 gm |
Potassium |
2934 mg |
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