Allergy to wheat gluten is quite common. One way to determine if gluten is causing problems is to avoid it strictly for several weeks to see if any change occurs. Another method is to have a blood sample taken and tested for gluten antibodies. While a blood test for wheat allergy could be negative, there may be reactivity to digestive by-products of wheat.
The gluten-free diet requires a completely new approach to eating. With practice, screening for gluten becomes second nature and people learn to recognize which foods are safe and which are not.
A gluten-free diet means avoiding foods that contain wheat (including spelt, triticale, and kamut), rye, barley, and possibly oats or, in other words, most grain, pasta, cereal, and many processed foods. Despite these restrictions, people with celiac disease can eat a varied, well-balanced diet, including bread and pasta. Instead of wheat flour, for example, people can use potato, rice, soy, or bean flour. Gluten-free bread, pasta and other products are available from specialty food companies.
Some celiacs are able to eat oats without having a reaction but others are not. Plain meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat as much of these foods as they like. Examples of foods that are safe to eat and those that are not are provided below.
EXAMPLES OF A GLUTEN-FREE DIET
The following list shows examples of many foods that are allowed or avoided, but it is not a complete list. It is important to read all food ingredient lists carefully to make sure that the food does not contain gluten.
Allowed: Coffee, tea, carbonated drinks, wine made in U.S., rum, some root beer.
Avoid: Ovaltine, malted milk, ale, beer, gin, whiskey, flavored coffee, herbal tea with malted barley.
Allowed: Fresh, dry, evaporated, or condensed milk; cream; sour cream; whipping cream; yogurt.
Avoid: Malted milk, some commercial chocolate milk, some nondairy creamers.
MEAT, FISH, POULTRY
Allowed: Fresh meats, fish, other seafood, and poultry; fish in canned oil, brine, or water; some hot dogs and lunch meats.
Avoid: Prepared meat containing wheat, rye, oats, or barley; tuna canned in vegetable broth.
Allowed: All aged cheese, such as cheddar, Swiss, edam, parmesan; cottage cheese; cream cheese; pasteurized processed cheese; cheese spreads.
Avoid: Any cheese product containing oat gum, some veined cheeses (bleu, stilton, Roquefort, gorgonzola).
POTATO OR OTHER STARCH
Allowed: White and sweet potatoes, yams, hominy, rice, wild rice, gluten-free noodles, some oriental rice and bean thread noodles.
Avoid: Regular noodles, spaghetti, macaroni, most packaged rice mixes, semolina, spinach noodles, frozen potato products with wheat flour added.
Allowed: Hot cereals made from cornmeal or other corn-based cereal, Cream of Rice, hominy, rice; Puffed Rice, cereals made without malt.
Avoid: All cereals containing wheat, rye, oats, or barley; bran; graham; wheat germ; durum; kasha; bulgur; buckwheat*; millet*; triticale; amaranth*; spelt; teff; quinoa*; kamut.
Allowed: Specially prepared breads using only allowed flours.
Avoid: All breads containing wheat, rye, oat, or barley flours and grains listed above.
FLOURS AND THICKENING AGENTS
Allowed: Arrowroot starch, corn bran, corn flour, corn germ, cornmeal, corn starch, potato flour, potato starch flour, rice bran, rice flour, rice polish, rice starch, soy flour, tapioca starch, bean and lentil flours, nut flours.
Avoid: Amaranth*, wheat germ, bran, wheat starch; all flours containing wheat, rye, oats, or barley; buckwheat*; spelt; quinoa*; teff; kamut; millet*.
Allowed: All plain, fresh, frozen, or canned vegetables; dried peas and beans; lentils; some commercially prepared vegetables.
Avoid: Creamed vegetables, vegetables canned in sauce, some canned baked beans, commercially prepared vegetables and salads.
Allowed: All fresh, frozen, canned, or dried fruits; all fruit juices; some canned pie fillings.
Avoid: Thickened or prepared fruits; some pie fillings; raisins and dried dates that have been dusted with flour.
Allowed: Butter, margarine, vegetable oil, nuts, peanut butter, hydrogenated vegetable oils, some salad dressings, mayonnaise, nonstick cooking sprays.
Avoid: Some commercial salad dressings, wheat germ oil, nondairy cream substitutes, most commercial gravies and sauces.
Allowed: Homemade broth and soups made with allowed ingredients, some commercially canned soups, specialty dry soup mixes.
Avoid: Most canned soups and soup mixes, bouillon and bouillon cubes with hydrolyzed vegetable protein.
Allowed: Cakes, quick breads, pastries, and puddings made with allowed ingredients; cornstarch, tapioca, and rice puddings; some pudding mixes; custard; ice cream with few, simple ingredients; sorbet; meringues; mousse; sherbets; frozen yogurt.
Avoid: Commercial cakes, cookies; pies made with wheat, rye, oats, or barley; millet*, amaranth*, buckwheat*, spelt, teff, quinoa*, kamut; prepared mixes; puddings; ice cream cones; Jell-O instant pudding; cream fillings; products made with brown rice syrup.
Allowed: Jelly, jam, honey, brown and white sugar, molasses, most syrups, some candy, chocolate, pure cocoa, coconut, marshmallows.
Avoid: Commercial candies dusted with wheat flour, butterscotch chips; flavored syrups; sweets containing malt/malt flavorings; some brown rice syrup; some corn syrup.
Allowed: Salt, pepper, herbs, herb extracts, food coloring, cloves, allspice, ginger, nutmeg, cinnamon, chili powder, tomato puree and paste, olives, active dry yeast, bicarbonate of soda, baking powder, cream of tartar, dry mustard, some condiments, apple cider, rice or wine vinegar.
Avoid: Curry powder, dry seasonings mixes, gravy extracts, meat sauces, catsup, mustard, horseradish, chip dips, most soy sauce, some distilled white vinegar, instant dry baking yeast, some cinnamon, condiments made with wheat-derived distilled vinegars, communion wafers/bread, some alcohol-based flavoring extracts.
[Source: Gluten Restricted, Gliadin Free Diet. Iowa City, IA: The University of Iowa Hospitals and Clinics, 1996]
* Note: Celiac.com disagrees that amaranth, buckwheat, millet, or quinoa need to be avoided.
An interesting book to read on the subject of carbohydrate digestion and a diet to treat several digestive disorders is Breaking The Vicious Cycle: Intestinal Health Through Diet, or by its old name, The Specific Carbohydrate Diet by Elaine Gottschall, B.A., M.Sc.
The only treatment for celiac disease is to follow a gluten-free diet. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet, and the small intestine is usually completely healed in 3 to 6 months. Healing may take up to 2 years for older adults.
Some doctors have found that a higher than normal percentage of patients with autoimmune disorders are allergic to gluten/gliadin and dairy products. Complete avoidance should be tried for at least one month to see if benefits will occur.
A one-month trial period of avoiding dairy products and foods containing gluten/gliadin should indicate whether there is going to be any change in symptoms or lab values in individual patients. If there are improvements then these foods will need to be avoided on a permanent basis.
Some doctors recommend the complete avoidance of gluten/gliadin and dairy products when this allergy is suspected in cases of thyroiditis or other autoimmune disease.
Autoimmune diseases in general have a higher prevalence of gluten intolerance. A one-month trial period of avoiding dairy products and foods containing gluten/gliadin should indicate whether there is going to be any change in symptoms or lab values in individual patients. If there are improvements then these foods will need to be avoided on a permanent basis.
Strict adherence to a gluten-free diet has enabled many women who were previously unable to conceive to become pregnant.
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