Do you remember making glue in primary school? What was it made from? Just wheat flour and water mixed together! Gluten really is the ‘glue’ found in many grains and is responsible for the elasticity of products that contain gluten.
So what is gluten? Gluten is a protein present in all forms of wheat (including durum, semolina, and spelt), rye, barley, triticale and kamut. It is present in smaller amounts in oats and is also found in many processed foods.
What is the difference between Coeliac Disease and Gluten Sensitivity
Coeliac Disease (CD), also known as gluten-induced enteropathy or sprue, is an autoimmune disease that leads to a permanent intestinal intolerance to gluten. Gluten causes inflammation of the intestinal wall and destruction of the villi, which are finger-like projections that line the interior surface of the intestines. If the villi are damaged and flatten, the surface area for absorption is greatly reduced and will often result in nutritional deficiencies. CD is relatively common with an estimated incidence of approximately 1 in 130, this increases significantly if you have a family history of CD to about 1 in 10.
Gluten Sensitivity is a condition that is characterized by a degree of gluten intolerance without the presence of immune markers associated with CD. The treatment approach is similar as the removal of gluten from the diet often results in clinical improvement and symptom relief. Those with gluten intolerance may be able to tolerate small amounts of gluten containing foods after the initial period of avoidance.
Symptoms of Coeliac Disease
The most common symptoms of CD affect the digestive system and include abdominal bloating or pain, diarrhoea, constipation, flatulence, heartburn, or nausea with or without vomiting.
Additional symptoms that may be present include sinusitis, asthma, skin disorders including eczema and dermatitis herpetiformis, fatigue, bone, joint and muscle pains, mouth ulcers, loss of tooth enamel, mood and behavioural problems, poor growth or development in children, weight loss, hair loss and menstrual problems.CD is associated with a higher risk of osteoporosis, iron deficiency anaemia, menstrual problems including amenorrhoea, miscarriage and infertility, and thyroid or other autoimmune diseases.
Helpful hints
Read all food labels carefully.
The Australian food standards code requires that foods labelled as ‘gluten free’ must not contain any detectable gluten. Food labelled as ‘low gluten’ must contain less than 0.02% gluten. Look for this symbol when shopping for gluten-free foods in Australia.
Lactose intolerance is a common accompanying problem to CD. Your practitioner may recommend the removal of dairy products as part of your treatment.
Avoid cross contamination in the kitchen by developing gluten-free kitchen habits, storage plans and procedures for mixing, cooking and baking.
Gluten-free breads taste better toasted and should be stored in the fridge or freezer.
When eating out select food without crumbing, ‘creaming’, coatings, gravies and sauces. When dining at restaurants, you may like to call ahead to notify the chef of your dietary requirements, most now offer gluten free options.
Obtain your dietary fibre from brown rice, buckwheat, unpeeled potatoes, fresh and dried beans & legumes, fresh fruit & vegetables.
Nutritional deficiencies are common, particularly of iron, zinc, vitamins B2, folate and B12.
Avoid skipping meals, eat slowly and chew all food thoroughly. Enjoy your food!
Plan your meals and carry snacks with you so you are prepared for all eventualities.
WHAT TO INCLUDE
Grains /Flours /Roots /Tubers and Legumes
Grains: Buckwheat, brown rice, basmati rice, wild rice, maize (corn), chia, quinoa, amaranth, millet, sorghum. (Some CD patients may have a secondary sensitivity to the grains quinoa, amaranth, buckwheat & millet)
Roots and Tubers: potato, tapioca, arrowroot, sweet potato, parsnip, jerusalem artichoke
Legumes: Beans, soy, lentils, peanut, pea, chickpea.
Flours: Any flours made from the above sources, chickpea flour.
Breads and Cereals
Breads: Gluten free breads based on buckwheat, corn, rice, chickpea flour and/or soya flour.
Cereals: Gluten free muesli, homemade muesli made from a combination of: Brown rice flakes, millet flakes, organic cornflakes, puffed corn, puffed rice, soy bran, soy grits, raw nuts & seeds, shredded coconut.
Pastas
Buckwheat noodles, rice noodles, vegetable, corn, spinach or quinoa pasta.
Crackers
Rice cakes, corn cakes, gluten free products.
Snacks and Desserts
Popcorn, dried fruit (limit), fresh fruit, carob, sesame snacks, fruit and nut bars, gluten free biscuits or other snack.
Stock, seasonings and thickeners
Bouillon stock powder, sesame salt, tamari (check label), mustard seeds, fresh dried herbs and spices, potato flour, apple cider vinegar, authentic balsamic vinegar, wine vinegar, maize corn flour, soy flour, arrowroot, kuzu & agar-agar.
Beverages
White wine, light rum, gin, tequila without dyes, potato vodka; Teas, coffee, soft drinks, mineral water, fresh fruit and vegetable juices.
WHAT TO AVOID
Grains /Flours /Roots /Tubers and Legumes
Grains: Wheat (including, durum, semolina, triticale), rye, barley, bulgur, couscous and possibly oats. (Spelt and kamut are ancient grains but may be well tolerated by people with gluten sensitivity or wheat intolerance.)
Roots and Tubers: French fries (check labels)
Legumes: Baked Beans unless gluten-free.
Flours: Wheat flour, wholemeal flour, bakers flour, semolina, barley, rye (avoid battered or crumbed food).
Breads and Cereals
Breads: Wheat breads – wholegrain or white, rye bread, oat bread, barley bread, burritos, pumpernickel bread. (Spelt may be suitable for some people with wheat intolerance)
Cereals: Commercial cereals (rice bubbles, weetbix, wheat containing muesli, coco pops etc) wheat germ, wheat bran, porridge oats, oat bran, oat germ. Any cereal containing malt.
Pastas
Durum wheat pasta (spaghetti, macaroni etc), egg noodles, hokkein noodles, barley pasta, spelt pasta.
Crackers
Wheat crackers, bran biscuits, ryvita, kavli, oatcakes.
Snacks and Desserts
Commercial biscuits, cookies, cakes, scones, pastries, liquorice, some lollies and ice creams, some commercial fruit pies, flavoured or frozen yoghurts, processed cheeses & creams.
Stock, seasonings and thickeners
Malt, malt vinegar, Vegemite, wheat starch, modified starch, mustard pickles, soy sauce, gravy mixes and seasoning ‘rubs’; Hydrolyzed vegetable protein (HVP), texturized vegetable protein (TVP); Some binders, fillers, excipients, extenders etc (It is best to contact the manufacturer or state Coeliac Society)
Beverages
Beers, ale and lager, cereal and malted beverages, malted or flavoured milk drinks, instant tea, coffee substitutes.
Other sources of gluten
Some medications use gluten as a binder. Contact your doctor or pharmacist for more information. If ingredients are not itemised, check with the manufacturer of the product or with your state Coeliac Society.
Adult Coeliacs, parents of Coeliac children and those with Dermatitis Herpetiformis have formed Coeliac Societies in all Australian States. These Societies provide information on the disease, gluten free diet, ingredients, where to buy, cooking and recipes, overseas travel, education material, etc. If you would like to become a member or would like more information, please contact your State Society. www.coeliac.org.au
For a list of gluten free publications please visit: http://www.coeliacsociety.com.au/downloads/Endorse%20-%20Endorsed%20Publications.pdf
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