Most people who need to avoid gluten have celiac disease, a chronic digestive disorder in which individuals who ingest gluten experience a toxic immune response. (Gluten is defined as the mixture of protein fragments, called peptide chains or polypeptides.) There is no cure for celiac, though people who have it can manage the disease by following a gluten-free diet. (Learn more about the causes, symptoms and diagnosis of celiac disease by visiting the Celiac Disease Foundation, WebMD’s Celiac Disease Center or the Mayo Clinic’s Celiac Disease pages.)

There are also many people who do not have celiac disease but subscribe to a gluten-free diet, due to gluten sensitivity or by choice. Whatever your reason for following a gluten-free diet, the best way to avoid it is to know where it hides.

Primary Sources of Gluten:
  • Wheat (including semolina, durum, spelt, triticale, and KAMUT® khorasan wheat)
  • Rye
  • Barley
  • Oats (oats don’t naturally contain gluten, but are often subject to contamination with small amounts of it, so many gluten-intolerant people avoid them.)
Hidden Sources of Gluten:

These ingredients and additives can include gluten, but sources must be carefully scrutinized. For example, modified food starch from corn is considered gluten-free, so long as no wheat starch is included. Apple cider vinegar is acceptable, but distilled vinegars contain gluten. If you’re unsure, check the labels or contact the manufacturer for detailed production information.
  • Binders
  • Blue cheese
  • Brown rice syrup (if barley malt enzyme is used)
  • Buckwheat flour and soba noodles (if combined with wheat)
  • Caramel coloring (made from barley malt enzymes)
  • Coatings
  • Colorings
  • Dextrins
  • Dispersing agents (i.e., cellulose, citric acid)
  • Emulsifiers
  • Excipients (added to prescription medications to achieve desired consistency)
  • Extracts (in grain alcohol)
  • Fillers
  • Flavorings (in grain alcohol)
  • Flours, breads, cereals, crackers, pasta, sauces and condiments made with the primary gluten source grains or their derivatives
  • Grain alcohol (beer, ale, rye, scotch, bourbon, grain vodka)
  • Homeopathic remedies
  • Hydrolyzed protein, hydrolyzed plant protein (HPP), hydrolyzed vegetable protein (HVP)
  • Malt or malt flavoring (barley malt)
  • Modified starch, modified food starch (when derived from wheat)
  • Mono-and diglycerides (made using a wheat-starch carrier)
  • Oils (wheat germ oil and any oil with gluten additives)
  • Preservatives
  • Soy sauce (when fermented using wheat)
  • Spices (if contain anti-caking ingredients)
  • Starch (made from primary gluten source grains)
  • Vegetable gum (when made from oats)
  • Vegetable protein
  • Vinegars (distilled clear and white or with a mash starter)
  • Vitamin E oil

If you’re living with celiac, you know that constant vigilance is a must. Many gluten-free grains can be contaminated by being processed on the same machinery as a grain with gluten. Some over-the-counter and prescription medications can contain gluten – pills may be dusted with flour during manufacturing, for example. Even cosmetics aren’t safe: Toothpaste and lipstick can contain gluten!

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