Gluten Free Facts

The Basics

 

What is gluten?

Gluten is the protein found in wheat, barley, rye and related wheat species such as spelt and kamut.  It helps baked goods keep their form and chewy texture and is also added to other food items more and more, both for consistency and taste purposes.

Helpful Hint:  Buckwheat, contrary to its name, is not actually wheat and does not contain gluten.

 

What foods contain gluten?

The obvious foods that contain gluten include foods made from a flour base.  Wheat, barley, and rye based breads, cookies, pastries, and bagels all contain gluten.  However, hidden sources of gluten are abundant in many packaged goods from soy sauce to spice mixes, to breath mints.  More and more companies are voluntarily labeling their products as gluten free and some even go through a gluten free certification process.

Here is a short list of foods that can have hidden gluten:

  • Sausages
  • Luncheon meat
  • Blue cheese
  • Gravy and gravy powder
  • Baked beans
  • Self basting turkeys
  • Sauces
  • Soups
  • Seasoning Mixes
  • Mustards
  • Instant coffee
  • Brown rice syrup
  • Chocolate
  • Potato chips
  • Soy sauce
  • Hot Chocolate
  • Licorice
  • Pickles
  • Salad dressings
  • Curry powder
  • White pepper
  • Malt vinegar
  • Marinades
  • Candy
  • Breath mints
  • Oats (while naturally gluten free, there is a risk of contamination through harvesting, milling, and processing; Udi’s only uses certified gluten free oats) (1) (2)

 

For a full list of unsafe ingredients, click here:

http://www.the-gluten-free-chef.com/foods-containing-gluten.html

http://www.celiac.com/articles/182/1/Unsafe-Gluten-Free-Food-List-Unsafe-Ingredients/Page1.html

 

Who should eat a gluten free diet?

Some people must eat a gluten free diet because they’ve been diagnosed with Celiac Disease or Gluten Sensitivity, in which the only cure is a gluten free diet.  Others eat gluten free because they suspect gluten is causing them undesirable symptoms that they wish to avoid.  Still others have learned that gluten can cause inflammation and therefore they seek to eliminate it from their diet.  No matter what your situation, a gluten free lifestyle may be of benefit to you.

 

Who can get Celiac Disease or have a Gluten Sensitivity?

  • The short answer is: anyone.  Some are more predisposed to have this disease or intolerance than others, especially if a family member has been diagnosed.  It has been noted that northern European countries, specifically Nordic countries, as well as Italy and Ireland have a higher rate of Celiac Disease, and approximately 1 out of every 133 Americans have Celiac Disease.7

http://www.ajcn.org/content/69/3/354.full  

 

Avoiding Nutritional Deficiencies

 

Whether it’s due to celiac disease, non-celiac gluten sensitivity, other medical concerns, or for overall health and wellness, there are various reasons people consume a gluten free diet.  Your patients can easily meet their nutritional needs with education, menu planning, a balanced diet, and a daily multivitamin.

For patients diagnosed with Celiac’s Disease or gluten sensitivity, there is a possibility of damage to the finger-like projections (called villi) in the gastrointestinal tract, depending on the degree of gluten sensitivity and the length of time undiagnosed. This damage can cause essential vitamin and mineral deficiencies.  Even if they’ve been eating gluten free for an extended period of time and their gastrointestinal tract has returned to normal function, it is important that they eat a balanced diet and take a daily multivitamin to make sure they are consuming adequate nutrients.

In a Beth Israel Deaconess Medical Center study examining dietary habits of 109 people with celiac’s disease eating gluten free for an average of five years, a large percentage of people were not consuming the daily recommended intake levels for a variety of nutrients in the chart below.1  It is important to consume a variety of foods as part of a healthy diet.  Recommend food sources listed within each category to maximize nutrient stores:2-4

 

Vitamin or Mineral

% of People Not Meeting RDIsin / Minerale of villi havesumed. ultivitamin so that iteficiencies.e of five years and confirmed celiacs

Food Sources

Vitamin B12

29.4%

Oysters, Liver, Crab, Lobster, Beef, Lamb, Cheese, Eggs, Yogurt
Folate

85.3%

Peas, Beans, Spinach, Broccoli, Brussels Sprouts, Potato, Avocado, Peanuts, Bananas, Oranges, Strawberries
Riboflavin

24.8%

Liver, Eggs, Milk, Yogurt, Soybeans, Peas, Almonds, Broccoli, Collard Greens
Thiamin

58.7%

Sesame & Sunflower Seeds, Pork Chops, Pine Nuts, Pistachios, Fish, Pecans, Macadamia Nuts
Niacin

29.4%

Tuna, Brown Rice, Liver, Peanuts, Chicken, Veal, Bacon
Vitamin B6

34.9%

Tuna, Beef, Chicken, Turkey, Potatoes, Cod, Sunflower Seeds, Spinach
Iron

41.3%

Beef, Chicken, Fish, Clams, Liver, Turkey, Eggs, Tofu, Pumpkin Seeds, Beans, Lentils, Chickpeas
Fiber

74.3%

Fresh Fruits and Vegetables, Potatoes, Brown Rice, Millet, Teff, Nuts & Seeds, Beans & Legumes
Calcium

81.7%

Dairy or Non-Dairy Milk, Yogurt, Cheese, Salmon, Tofu, Spinach, Almonds, Peas, Broccoli
Vitamin D

92.7%

Mushrooms, Salmon, Tuna, Eggs

 

Scientific research continues to focus on gluten free diets and potential alleviation of symptoms in a variety of disease states.

  • Arthritis – Researchers at Karolinska University Hospital in Solna, Sweden found that people consuming a well-balanced gluten free, vegan diet had increased levels of antibodies that could protect against inflammation associated with heart disease and rheumatoid arthritis.5
  • Diabetes - At approximately 10 % of the population, the American Diabetes Association indicates that the prevalence of celiac disease is higher in people with Type 1 diabetes compared to the US population (approx 1%).6
  • Autism – Some parents and autism groups believe that when maintaining a gluten free, casein free diet, autistic individuals show positive developmental outcomes and improvements in behavior.
  • Crohn’s, Colitis, or IBS – People with disorders of the gastrointestinal tract, such as Crohn’s disease, exhibit symptoms such as upset stomach and nausea, and may be unable to adequately absorb essential nutrients.  Due to the irritation of the gastrointestinal tract that results from the above conditions, a gluten free diet may help to reduce symptoms.9

As with people with diagnosed celiac disease or other non-celiac gluten sensitivities, it is important to focus treatment on a balanced diet to make sure adequate nutrients are being consumed.

 

Sources:

  1. http://celiacdisease.about.com/b/2009/06/01/research-supports-the-recommendation-for-a-daily-multivitamin-for-people-with-celiac-disease.htm
  2. http://www.health.gov/dietaryguidelines/dga2005/document/html/appendixb.htm
  3. http://ndb.nal.usda.gov/
  4. http://www.webmd.com/diet/guide/vitamins-and-minerals-good-food-sources
  5. http://www.arthritis.org/meatless-gluten-free-meals.php
  6. http://www.diabetes.org/food-and-fitness/food/planning-meals/gluten-free-diets/
  7. http://www.ingentaconnect.com/content/maney/nns/2010/00000013/00000002/art00004
  8. http://people.emich.edu/jtodd/whiteley_et_al_1999.pdf
  9. http://www.livestrong.com/article/255195-crohns-gluten-free-diet/

Patient Recipes:

Link to general recipes page, including filter for Dietitans/HCPs (with recipe suggestions featured below)

 

Breakfast Gluten Free Fabulous Baked Eggs
Breakfast Pumpkin Pie Oatmeal Muffins
Breakfast Egg in a Basket Breakfast Burger
Breakfast Peanut Butter & Banana Stuffed French Toast
Breakfast Granola-crusted Fresh Toast with Apple-Cinnamon Syrup
Breakfast Mama’s Breakfast Casserole
Breakfast The Kitchen Sink Breakfast Sandwich
Breakfast Udi’s Superstar Breakfast Casserole
Lunch / Dinner GF Mediterranean Sandwich
Lunch / Dinner Philly Cheese Steak Pizza
Lunch / Dinner Chicken Salad
Lunch / Dinner Italian Style Mini Chicken Meatloaf
Lunch / Dinner Prosciutto & Ricotta Panini
Lunch / Dinner Mushroom Soup with Chicken & Stuffing
Lunch / Dinner Delicious Lasagna
Lunch / Dinner Baked Macaroni & Cheese