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Celiac Disease Nutrition Resources
Gluten-Free Diet Resources
What is gluten?
Common gluten containing foods include, but aren't limited to:
|Beer (even used in cooking)*||Modified food starch*|
|Bread*||Oats (products which aren't labeled gluten-free)|
|Brown rice syrup||Rye|
|Bulger||Seasoning and gravy mixes*|
|Cookies and cakes*||Semolina|
|Communion wafers*||Soy sauce*|
|Crackers*||Sprouted wheat or barley|
|Flour (usually from wheat)*||Udon|
|Kamut||Vinegar (if the type is not specified)|
|Malt (includes malt flavoring, malt extract)||Worcestershire sauce*|
*Unless labeled gluten-free
Safe foods include, but aren't limited to:
|Beans (dried beans, lentils, most baked beans)||Montina flour|
|Buckwheat (beware of buckwheat being combined with wheat flour)||Nut flour|
|Butter||Oats (only if labeled gluten-free)|
|Cheeses (caution on processed cheeses)||Rice|
|Chickpeas (garbanzo beans)||Rice crackers, rice cakes|
|Cream of tartar||Sorghum|
|Guar gum||Vegetables (plain)|
|Herbs||Vegetable oil, canola oil, olive oil|
|Manioc||Vinegar (apple cider, red wine, distilled, white, balsamic)|
Food Labeling Laws
The Food Allergen Labeling and Consumer Act:
- Requires companies to list in plain language the eight most common food allergens (milk, egg, peanuts, tree nuts, fish, shellfish, soy and wheat) that are in the product.
- Requires allergens to be listed even if used in small amounts (for example colorings, spices, and natural or artificial flavoring).
- The law does not include barley, rye, or oats.
- The allergen can be found on food labels in one of two places:
| In the ingredient list.
This list must state the common name, such as wheat. The common name may be in parentheses after the ingredient name.
|In the “contains” statement.
This always lists the common name, such as wheat.
The Gluten Free Labeling Rule:
- Allows for the voluntary use of the term “gluten free” for the labeling of foods
- “Gluten free” is defined as less than 20 parts per million (ppm) of gluten in foods
- Foods may be labeled “gluten free” if the food is either inherently gluten free or does NOT contain an ingredient that is:
- A gluten containing grain (e.g. spelt wheat)
- Derived from a gluten containing grain that has not been processed to remove gluten (e.g. wheat flour)
- Derived from a gluten containing grain that has been processed to remove gluten (e.g. wheat starch), if the use of that ingredient results in the presence of 20 ppm or more gluten in the food
Reading Food Labels
Reading labels is a way of life for those with celiac disease. Label reading will be discussed when you meet with your dietitian. Learn to read labels carefully, and try to memorize safe and unsafe ingredient names. If a product has a questionable ingredient you should avoid it. You must read labels every time you purchase food because ingredients in foods can change. Just because a product is gluten free today doesn't mean it will be the next time you buy it.
3 Key Places to Look on a Food Package
- Label/Logo indicating that product has been certified gluten free. If a product has this, no further label reading is required.
- Not certified, but bears “gluten free” claim. Also applies to “no gluten”, “free of gluten”, and “without gluten.” Product should be safe to consume.
- Ingredient list. For products neither certified nor labeled gluten free, it is essential to read ingredient list.
If you are unable to determine whether or not a product is gluten free you can call the manufacturer using the toll free number on the food package. Ask if the product contains wheat, barley or rye. Today, most customer service representatives understand the question and have reliable information about the gluten free status of their products. If the person you talk to doesn't appear to understand the question, be sure to ask to speak with a supervisor or quality control specialist.
Another source of hidden gluten can be from cross contamination. This occurs when a gluten free product comes in contact with a gluten containing product. As a result, the gluten free food will then contain a small amount of gluten that could cause a reaction in someone who is sensitive. Some examples of cross contamination are:
- A toaster that has been used to toast gluten containing products
- A knife used to spread peanut butter on gluten containing bread is dipped back into the peanut butter jar
- A deep fat fryer that has been used for breaded products such as chicken nuggets, fried fish, etc
- A conveyor belt in a manufacturing plant that has been used for gluten containing products
How to prevent Cross Contamination
- Teach others about cross contamination and ask appropriate questions when obtaining food outside the home
- Foods may have manufacturer advisory statements saying the product could have accidental inclusion of wheat by using manufacturer “advisory” warnings such as: “May contain wheat” or “Processed in a facility that also processes wheat.” These foods should be avoided.
Non Food Sources of Gluten
When you think of a dietary restriction, it's obvious to examine the foods you eat. But it's important to consider whether or not a product is gluten free, even if it's not typically thought of as food. If you can ingest it, you need to check it. This applies to chapstick/lipstick, medications, vitamins and mineral supplements, toothpaste, mouthwash, Play-DohTM and other products that curious kids may be tempted to put in their mouth.
Tips for Getting started on the gluten-free diet
Even if you feel overwhelmed, frustrated, deprived or confused about the diet, it's important to jump in with both feet and try to achieve and maintain a 100 percent gluten free diet, right from the beginning. It's OK to make mistakes. You and others will make them, especially in the first six months. But forget the notion of "easing into" the gluten free lifestyle. It's best to strive for a strict, gluten free diet right off the bat.
The gluten-free diet is difficult – at first
It's easy to get caught up in the challenges of this diet. Realize that it's OK to be angry, scared, frustrated and confused. Deal with those emotions in whatever way you find most therapeutic – confide in close friends, seek counseling or find other emotional outlets. When first diagnosed, many people with celiac disease never imagine that the diet will come easily; but before they know it, studying labels and ingredients becomes second nature.
There's no need to feel deprived on the gluten-free diet. Many commercial products, including candies and candy bars, chips, ice cream, pretzels, crackers, cookies, brownies, cakes and pudding (many of which are available at any grocery store) are gluten-free (read labels to be sure).
Talking to friends and family about celiac disease
Everyone you talk to about this condition is likely to react differently. Some will understand and put forth a lot of effort to learn about the diet; others will have a hard time accepting the diagnosis and may not be receptive to information about the condition. Loan books to people, refer them to websites, and encourage them to learn more. The better they understand it, the more support they can provide.
Frequently Asked Questions
Are oats safe for those on a gluten free diet?
Are there risks to a gluten free diet?
But it's my birthday – isn't just a little bit of cake OK?
Can my whole family switch to a gluten free diet if just one of my children has celiac disease?
How do I eat when I'm away from home?
This can be difficult at first but do not stay home for fear of making a mistake on the gluten free diet. Dining out is a part of life, so with a little planning and patience you can continue to enjoy eating away from home. Here are a few basic tips that will make eating out easier:
- Before going out, do some research on local restaurants. Many restaurants have gluten free menus posted on their websites. Check to see if there are enough options for you.
- Call the restaurant ahead of time and talk to the manager or chef. Do not be afraid to ask how foods are prepared. Ask how they prevent cross contamination in their kitchen.
- Dine early or late, not during peak hours.
- Explain your dietary restrictions by using words like “severe reaction” or “allergy”.
- Be pleasant and informative, but not demanding.
How do I know if I accidentally eat gluten and what should I do if I do?
How do I send my child with celiac disease to school without worrying?
There are a few strategies we recommend:
- Empower your child- Involve your child in his or her condition, no matter how young he or she is; read labels with him or her, encourage him or her to make food choices with your help, and allow your child to help with food preparation. Teach your child to politely decline well-meaning friends and family who offer gluten-containing foods.
- Educate teachers-Provide your child's teachers with as much information as they will accept about your child’s condition and the gluten free diet. Make the teacher a list of safe and unsafe ingredients/foods to have on file. If they are interested in reading books or information on the topic, offer to buy or lend them a copy of your favorite gluten free guide. Make sure they understand your child's symptoms, so that if he or she accidentally ingests gluten, the teacher will be aware of the consequences.
- Pack a lunch- It is possible to let your child buy lunch at school, but it takes planning, coordination and cooperation between you and your lunch provider. In the beginning, it is best to send a gluten free lunch and gluten free snacks to be safe.
- Provide the teacher with treats- A large bag of small candies works well to leave with the teacher, in case there are surprise birthdays or unplanned events involving snacks or treats. If you know of a party or birthday in advance, bring your child a special treat – or better yet, bring gluten free treats for the entire class.