Gluten is a protein found in wheat, rye and barley. It gives elasticity to baked goods and the ‘chewy' texture of many breads and products. Cereals containing gluten include wheat, rye, barley, oats, kamut, spelt. Wheat is a major component of our western diet. A few years ago, anyone who needed to avoid gluten faced a difficult task trying to find alternatives, but thankfully nowadays there’s much more awareness and consideration for those who require gluten free foods and there are whole areas in supermarkets now dedicated to gluten free, and other allergen free foods.
Coeliac disease is a lifelong autoimmune disease caused by a reaction to gluten. About 1 in 100 people have coeliac disease and once diagnosed it is managed by a gluten free diet for the rest of the individuals life. If someone with coeliac disease consumes gluten they will have an immune response which causes damage to the lining of the small intestine. This can impact on nutrient absorption as the small projections that line the small intestine, called villi, are flattened causing reduced nutrient absorption. Therefore it is important that coeliac disease is identified.
Symptoms of coeliac disease vary considerably from person to person, and include:
• stomach pain, abdominal cramps, nausea and bloating
• altered bowel habit: often diarrhoea but sometimes constipation
• low energy and tiredness
• mouth ulcers
• a severe type of skin rash, called dermatitis herpetiformis
• poor weight gain in children; weight loss in some adults
• joint and bone pain, with or without osteoporosis
• infertility and repeated miscarriages
• nerve symptoms (such as pins-and-needles) which are thought to be due to the inflammation causing vitamin deficiencies
There are a number of blood tests which can be used to help diagnose coeliac disease. Skin tests cannot be used to look for the antibody in coeliac disease.
It can be challenging to manage coeliac disease once you are first diagnosed but once you become familiar with gluten free foods - those naturally gluten free and those that are specially produced products, it will become easier. More and more cafes and restaurants are serving gluten free dishes which also allows coeliac sufferers to carry on enjoying social occasions with friends and families.
Wheat intolerance differs from coeliac disease in that it is a poorly defined set of symptoms which vary considerably from one affected person to another. Symptoms tend to include abdominal discomfort, nausea, tiredness, bloating and altered bowel habit. It is not caused by an immune reaction, and while the symptoms can be very unpleasant, it cannot cause life-threatening reactions or consequences unlike true wheat allergies.
People with wheat intolerance will still experience adverse symptoms from gluten free products, as the remaining part of the wheat will be affecting them. They may, or may not, be able to eat rye, barley and oats, that are part of the wheat family and, as with many other food intolerance's, may be able to reintroduce wheat back into the diet after a period of elimination.
Sensitivity to wheat (and gluten) can also produce symptoms in some individuals which means they have to avoid these substances. For a wheat free diet, you will need to make sure you check all ingredient labels (be aware of hidden wheat which can be found in many convenience products such as ready meals, sauces, etc.) Due to customer demand and increased need, there are many ranges available in supermarkets and health food shops which include wheat free flours /cakes /biscuits/frozen foods. This has made a valuable contribution and extended many peoples' choices enabling them to adapt recipes and use alternative flours and products. Wheat free cooking is a challenge. However with practice and trial and error, it can become easier!
Foods containing wheat:
Bread and baked foods
All loaves, including pumpernickel, and rolls unless specifically stated; many "rye" and "corn" loaves contain some wheat; pitta, crumpets, muffins, tortillas, and tacos (should be corn but mostly wheat in UK), doughnuts, cakes, cookies, biscuits, crackers, croutons, packet snacks, rusks, waffles, pancakes, crepes, pizzas, pretzels, breadsticks, communion wafers, pasta, pastry, Yorkshire pudding, suet pudding, and many other puddings.
Most cereals will contain some wheat. The exceptions are porridge oats, corn flakes, Rice Krispies and granola. Make sure you always read the labels though.
Flour and pasta
All of these will contain some wheat unless stated to be wheat free or buckwheat, which is not from the wheat family.
Meat and Fish
Burgers, rissoles, salami, sausages, corned beef, luncheon meat, liver-sausage, continental sausages, pates, meat and fish pastes and spreads, ham, fish and scotch eggs coated with breadcrumbs.
Vegetable pates and spreads, vegetables coated in breadcrumbs, e.g. onion rings, vegetables tempura, tinned beans, (also tinned spaghetti, often grouped with vegetables), soups and tinned and packet snack or ready prepared foods.
Sauces and condiments
Gravy, packet and jar and bottled sauces, casserole and "ready-meal" mixes, stock cubes and granules, ready prepared and powdered mustard, stuffing, baking powder, monosodium glutamate, some spice mixes (check label).
Most puddings, pastry, yogurts containing cereal, ice cream, pancakes, cheesecakes and others with a biscuit base.
Malted milk, chocolate, Ovaltine and other powered drinks. Beer, ale, stout, lager, Pils lager, whisky, malt whisky, gin, most spirits and many wines.
Liquorice, chocolate, chocolate bars and most wrapped bars. Other sweets (check labels).
Many prescribed and over the counter drugs contain wheat. Check with your pharmacist. Do not stop prescribed medication without discussing with your doctor.
Glue on labels and postage stamps.
Sometimes, a food label may not specify wheat but another form of wheat product:
• Durum wheat, spelt (triticum spelta), kamut (triticum poloncium)
• Bran, wheat bran, wheat germ, wheat gluten
• Semolina, durum wheat semolina
• Flour, wholewheat flour, wheat flour, wheat starch
• Starch, modified starch, hydrolysed starch, food starch, edible starch
• Vegetable starch, vegetable gum, vegetable protein
• Cereal filler, cereal binder, cereal protein.