Taking the Mystery Out of Gluten-Free

Gluten is a protein found in certain grains, namely, wheat, barley, and rye grains. One of the most common grains found in the typical American diet is wheat. Everyday foods such as bagels, cereal, bread, crackers, donuts, pasta, pizza, and many more contain gluten.

Wheat allergy is most commonly diagnosed in childhood and is usually outgrown before adulthood. An allergy to wheat is not the same as celiac disease. Children and adults with celiac disease, which is an autoimmune, inflammatory disease affecting the gastrointestinal tract, need to avoid gluten-containing products because consuming them will cause distress and damage to the small intestine and inhibit absorption of nutrients over time.

Gluten-free replacements for cereals and baking mixes are often made up of a combination of cornstarch, potato starch, tapioca starch, and/or white rice flour. See the baking substitution recipe towards the end of this article for baking with wheat-free flours.

Symptoms of celiac disease may include one or more of the following: *

• Recurring abdominal bloating and pain

• Chronic diarrhea/constipation

• Vomiting

• Unexplained weight loss

• Pale, foul-smelling stool

• Iron-deficiency anemia that does not respond to iron supplementation

• Fatigue

• Growth failure

• Joint and muscle pain

• Leg or arm numbness

*The items listed are not meant to diagnose but instead to make one aware of some of the common symptoms. If you have concerns about any of the above, see your physician.

Nutrition Therapy for Gluten Intolerance

It is challenging enough to prepare gluten-free meals at home, let alone send a child to school or daycare where trigger foods abound. There are many food items that may contain gluten but are “hidden” in unexpected ways. Less obvious foods such as broth, salad dressings, some varieties of hot dogs, sauces and gravies, coating mixes (such as on chicken nuggets or corn dogs), and certain candies can all contain gluten.

Tips on How to Read a Label for a WheatFree Diet

All FDA-regulated manufactured food products that contain wheat as an ingredient are re- quired by U.S. law to list the word “wheat” on the product label.

Wheat can be “hidden” in the following ingredients:

Breadcrumbs, bulgur, cereal extract, club wheat, couscous, cracker meal, durum, einkorn, emmer, farina, flour, hydrolyzed wheat protein, Kamut, matzoh or matzoh meal, pasta, seitan, semolina, spelt, sprouted wheat, triticale, vital wheat gluten, wheat, wheat bran hydrolysate, wheat germ oil, wheat grass, wheat protein isolate, and whole wheat berries.

Gluten can also be sometimes found in the following additives/foods, so it is best to check with the product manufacturer if it is unclear by the label: Soy sauce, starch, including gelatinized starch, modified starch, modified food starch, or vegetable starch.

Here is a quick list of some common foods that may contain gluten. Check the labels or ask the restaurant before ordering.

• Energy bars/granola bars – check for wheat or oat ingredients (the oats might not be gluten-free)

• French fries – the batter may contain wheat flour or be cross-contaminated from fryers

• Potato chips – some potato chip seasonings may contain malt vinegar or wheat starch

• Processed lunch meats

• Candy and candy bars

• Soup – cream-based soups may contain flour as a thickener

• Multi-grain tortilla chips or tortillas – if they are not entirely corn-based, they may contain wheat

• Salad dressings and marinades – check for malt vinegar, soy sauce, or flour on the ingredient list

• Starch or dextrin – could be from any grain, including wheat

• Brown rice syrup – may be made with barley enzymes

• Meat alternatives – such as vegetarian burgers, vegetarian sausage, imitation bacon, and imitation seafood may all contain wheat gluten

• Soy sauce

• Pre-seasoned meats

• Cheesecake filling – some recipes may contain wheat flour

• Eggs served at restaurants – some restaurants put pancake batter in their scrambled eggs and omelets, but on their

own, eggs are naturally gluten-free

So, what can I send my child for lunch at school/daycare?

Remember, ask your children to help in preparing meals. Incorporate their preferences when making lunches to encourage compliance with the diet. Many parents choose to send food from home, rather than trust the school to provide a gluten-free diet.

There are gluten-free foods that can always be kept on hand

Remember that this is just a general list. Some foods may themselves be gluten-free but may risk cross-contamination if not processed in a dedicated facility. Bottom-line: check with the product manufacturer if unclear by reading the label.

• All fruits

• All vegetables

• Beans, fresh (not all baked beans are safe)

• Beef, not mixed with anything else, unless you know it’s safe (for example, meatloaf may have breadcrumbs in it)

• Cheese: American, cheddar, swiss, and cottage cheese

• Chicken, fresh, unbreaded

• Chocolate

• Cocoa (make your own hot chocolate, mixes often contain gluten)

• Cold cereals: puffed rice, Rice Chex, Fruity Pebbles, Cocoa Pebbles, Cream of Rice, Gluten-Free Rice Krispies go to www. kelloggs.com for more information

• Eggs

• Fish, fresh, unbreaded

• Hummus

• Ice cream marked as natural (check label,

• Marshmallows

• Milk

• Nuts

• Peanut butter

• Popcorn

• Pork, unbreaded

• Potatoes (but not necessarily potato chips)

• Quinoa

• Rice

• Rice cakes and crackers

• Sesame seeds

• Sour cream

• Tapioca pudding

• Turkey, not mixed with anything else unless you know it is safe

• Tortillas, made from corn

• Yogurt

Baking

When baking with wheat-free flours, a combination of flours usually works best. Experiment with different blends to find one that will give you the texture you are trying to achieve.

Try substituting 1-cup wheat flour with one of the following:

• 7/8 cup rice flour

• 5/8 cup potato starch flour

• 1 cup soy flour plus 1/4 cup potato starch flour

• 1 cup corn flour

Here are additional resources to help you navigate through meal planning and enhance your understanding of gluten-free/wheat allergy. As always, if you have questions, ask your pediatrician and registered dietitian for help.

• Celiac Disease Foundation: www.celiac.org

• Gluten Intolerance Group: www.gluten.org

• Beyond Celiac: www.beyondceliac.org

• FARE: www.foodallergy.org j