Leena Watts
Celiac disease is a condition that affects the small intestine, causing damage to the villi, small finger-like projections that line the intestine and help the body absorb nutrients from food. The only treatment for celiac disease is a strict gluten-free diet, which must be followed for life. Gluten is a protein found in wheat, rye, and barley, and it is the immune system's reaction to this protein that causes the damage to the intestine. A gluten-free diet involves avoiding grains, pasta, cereals, and processed foods, as well as many other products that contain hidden gluten. Despite these restrictions, a gluten-free diet can include many healthy foods, such as meat, fish, fruits, vegetables, and gluten-free alternatives to common foods.
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What You'll Learn
Gluten-free alternatives
A gluten-free diet is the only treatment for celiac disease. It is important to always check the labels on the foods you buy, as gluten may be hidden in many foods. Gluten can be found in food items you might not suspect, such as condiments, dressings, gravy, and even medicines.
When following a gluten-free diet, it is important to base your diet around fruits, vegetables, meats, and other healthy food groups. Many foods are naturally gluten-free, such as meat, fish, rice, fruits, and vegetables. You can also eat potatoes, poultry, and some egg products. Dairy products such as cheese, butter, and milk are also gluten-free.
Many commercially available products are labelled “gluten-free,” and you can find gluten-free bread, pasta, and other products in most grocery stores. There are also gluten-free alternatives to common foods such as pizza bases available in supermarkets and health food shops. When eating out, you can ask the chef how the food was prepared and whether a gluten-free menu is available.
To replace wheat flour, you can use potato, rice, soy, amaranth, quinoa, buckwheat, nut, or bean flour. You can also use sorghum, chickpea, arrowroot, and corn flour. Tapioca starch extract is another option and can be used as a thickener.
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Reading labels
When reading labels, be aware of the many terms for hidden gluten. For example, gluten can be found in einkorn, emmer, spelt, wheat starch, wheat bran, wheat germ, hydrolyzed wheat protein, emulsifiers, dextrin, mono- and di-glycerides, seasonings, and caramel colours. Products that contain modified food starch, food starch, hydrolyzed vegetable protein, stabilizers, or fat replacers may also contain gluten. In addition, barley, rye, triticale (a cross between wheat and rye), farina, graham flour, semolina, and any other kind of flour contain gluten. This includes self-rising and durum unless they are labelled gluten-free. Be careful with corn and rice products, as they can sometimes be contaminated with wheat gluten during processing.
Oats are another food that requires careful consideration. Oats are naturally gluten-free, but they are often harvested and processed with the same equipment used for wheat, increasing the risk of contamination. If you can tolerate oats, only consume those specifically labelled gluten-free, including granolas and granola bars.
Soups, sauces, and condiments are some of the biggest sources of hidden gluten, as companies often use wheat as a thickener. Always read the labels of any pre-prepared or canned soups and sauces, paying special attention to cream-based options.
It is also important to remember that "wheat-free" does not necessarily mean "gluten-free". Many commercially available products are labelled "gluten-free", but some may not be, so proper label reading is crucial.
In addition to food labels, be mindful of non-food products that may contain gluten, such as prescription and over-the-counter medications, lipsticks, and lip balms. Always check with your pharmacist to ensure that any medications you are taking are gluten-free.
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Naturally gluten-free foods
Celiac disease is a condition that requires a strict gluten-free diet for life. Gluten is a protein found in wheat, rye, and barley, and it is the immune system's job to attack it when it enters the small intestine. This attack damages the villi, which are small, finger-like projections in the small intestine that help the body absorb nutrients from food.
A gluten-free diet can be challenging, as gluten is found in many food items, including bread, pasta, cookies, cakes, and processed foods. However, there are plenty of naturally gluten-free foods that can be enjoyed. These include:
Fruits and Vegetables
Fresh and frozen fruits and vegetables are naturally gluten-free. They form a crucial part of a healthy gluten-free diet, providing essential vitamins, minerals, and fibre.
Meats and Poultry
Meat and poultry products are naturally gluten-free. However, processed meats, such as canned soups, sour cream, and cold cuts, may contain gluten. It is important to read labels and opt for unprocessed or freshly prepared options.
Dairy
Most dairy products, such as cheese, butter, and milk, are naturally gluten-free. However, some dairy products, like flavoured milk and sour cream, may contain gluten, so checking labels is essential.
Grains and Starchy Foods
While many grains contain gluten, there are several naturally gluten-free options. These include rice, amaranth, quinoa, buckwheat, corn, sorghum, chickpeas, and potatoes. These can be used as alternatives to wheat-based products and provide variety in a gluten-free diet.
Oats
Oats are naturally gluten-free, but they are often contaminated with gluten during harvesting and processing. Pure, uncontaminated oats consumed in moderation (up to 1/2 cup dry rolled oats daily) are usually well-tolerated by people with celiac disease. However, some individuals may have an immune reaction to avenin, a protein in oats similar to gluten, and should avoid all oats.
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Oats and contamination
Oats are often harvested and processed using the same equipment as gluten-containing grains, such as wheat, making them highly susceptible to gluten contamination. This is particularly true for oats that are not specifically labelled as "gluten-free". Therefore, it is recommended that individuals with celiac disease only consume oats that are labelled as gluten-free to avoid the risk of contamination.
Even with gluten-free labelling, some people with celiac disease may still experience an immune reaction to the avenin in oats, a protein that is similar to gluten. For this reason, some individuals with celiac disease may need to avoid all oats, even those that are gluten-free, as avenin can trigger a response in those who are particularly sensitive.
Research suggests that consuming pure, uncontaminated oats in moderation (up to 1/2 cup of dry rolled oats daily) is generally well-tolerated by most people with celiac disease. However, it is important to note that even trace amounts of gluten can trigger a reaction in individuals with celiac disease, causing damage to the small intestine. Therefore, it is crucial to be vigilant about checking ingredient lists and labels to ensure that products are truly gluten-free and have not come into contact with gluten during processing or packaging.
Cross-contamination can occur at any stage of food production, from growing and processing to storage, preparation, and serving. It is important to be aware of this risk and take steps to prevent it, such as choosing products that are specifically labelled as gluten-free and avoiding bulk bins where cross-contamination is more likely. Additionally, it is recommended to separate kitchen items used for gluten-free and gluten-containing foods, including utensils, cutting boards, dishes, and cutlery.
In summary, while oats are naturally gluten-free, they are often contaminated during processing. Individuals with celiac disease should opt for gluten-free labelled oats and be mindful of their sensitivity to avenin. Cross-contamination is a significant concern, and steps should be taken to minimise this risk to avoid adverse health effects.
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Eating out
Firstly, it is advisable to research the restaurant's menu online in advance. Most restaurants have websites displaying their menus, allowing you to assess the gluten-free options available. Calling the restaurant beforehand to verify these options and inquire about any concerns is also a good idea. This proactive approach ensures a safe dining experience and can make the process less isolating and stressful.
When dining out, it is essential to be vigilant about the ingredients in your meal. Ask the chef or server about the ingredients and how the food is prepared if you are unsure. Many restaurants now offer gluten-free menus, but it is still crucial to be cautious as gluten can be hidden in various dishes. For example, condiments, dressings, and gravy may contain gluten, and even a small amount can trigger a reaction for those with celiac disease.
It is also important to remember that "wheat-free" does not always mean "gluten-free." Gluten is a protein found in wheat and other grains such as barley and rye, so be sure to check for these on ingredient lists. Additionally, watch out for potential cross-contamination, which can occur during the growing, processing, storing, preparing, or serving of food. Oats, for instance, are often processed with the same equipment as wheat and can be contaminated. While research suggests that moderate amounts of pure, uncontaminated oats are tolerated by most people with celiac disease, it is important to consult your healthcare provider first.
In social situations, such as weddings or parties, it is a good idea to inform your host about your celiac disease and inquire about gluten-free options. If you are unsure or if gluten-free options are unavailable, bring your own gluten-free food. This proactive approach ensures your dietary needs are met and allows you to enjoy the gathering without worry.
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Frequently asked questions
A celiac diet is a gluten-free diet. Gluten is a protein found in wheat, rye, and barley. People with celiac disease must follow a gluten-free diet for life to prevent intestinal damage and symptoms such as diarrhoea and stomach pain.
Many foods are naturally gluten-free, including meat, fish, rice, fruits, and vegetables. You can also find gluten-free alternatives to common foods like bread, pasta, and pizza bases in most grocery stores.
You should avoid all sources of gluten, including wheat, rye, and barley. This means avoiding most grains, pasta, cereals, baked goods, and processed foods. Be cautious with condiments, dressings, and gravy, as these may contain gluten.
It's important to read ingredient lists and labels carefully. Look for products marked "gluten-free." Be aware that “wheat-free” does not necessarily mean “gluten-free." Oats are naturally gluten-free, but processing increases the risk of contamination with gluten, so only consume oats labelled as gluten-free.
