Avoiding gluten

For those who suffer from celiac disease, or sensitivity to a protein in gluten, eliminating it is the only good treatment. Since there is no cure only a consistent commitment to a gluten-free diet can alleviate the symptoms.

Naturally, that's easier said than done. The number of processed food (and drink) products with gluten as an ingredient is simply astounding. That astonishment is the result of seeing a list that goes well beyond the expected villains: bread, pasta, pizza dough, and the like.

Those unexpected cohorts may include such things as: instant coffee, mustard, ice cream, luncheon meats, and many canned soups. Even lipstick balms of certain types contain gluten. Certain pills, both vitamins and medicine, contain it as well.

Avoiding all those can be a daunting task. Yet thousands of those who have celiac disease manage to lead active, healthy lives without undue constraints. As diseases go, while far from easy, for most it is possible to lead a full life and almost forget celiac entirely.

For some, substituting oat-based breads for wheat breads is an option. Care is necessary, though; some oats are 'contaminated' with gluten-containing grains. Many enjoy making their own bread with gluten-free flour, of which there are several brands on the market.

(Actually, fresh wheat flour itself doesn't contain gluten, but glutenin and gliaden. The latter is the major component in generating celiac symptoms and it is activated when wheat flour is blended with water, a necessary step for making dough.)

Regular beer and some other alcoholic drinks are also among the first to go in a gluten-free diet. Many celiac sufferers switch to wine or cider. As with bread, home-brewing beer from gluten-free ingredients like sorghum and buckwheat is another option. There are several commercially-made gluten-free beers on the market, too.

Barley and rye also contain the protein (gliaden) that destroys the lining of the small intestine. (It's that effect that creates the nutrient malabsorption at the bottom of so many celiac symptoms.) So, rye and barley-based whiskies should be avoided. Many malt whiskies are acceptable though, if no gluten has been added after distillation.

Sherry, port, and many liqueurs are completely gluten free. Since milk and cream don't naturally contain gliaden, Irish Cream and other popular types are ideal for those who don't want to give up alcohol entirely.

Coffee and tea are perfectly acceptable as well, even with milk and sugar, provided no gluten-containing additives are present. That's usually pretty easy to check.

These are just a few examples of how contracting celiac disease can require some lifestyle changes. Even so, there are invariably very healthy and tasty substitutes.

In fact, it's often the case that those who suffer from the condition don't suffer at all (apart from the annoyance of having to carefully monitor everything they consume). On the contrary, they're often much healthier as a result of such careful attention to diet.

That's truly a situation of being served lemons in life and making lemonade... which is another thing those with celiac disease can happily consume.

Your gluten free diet: What's allowed, what's not?

Anyone diagnosed with celiac disease knows the importance of maintaining a completely gluten-free diet. Not only the importance but the difficulty, too, of checking every single item of food and drink not allowed.

An exhaustive list would fill several articles, but here are some simple to follow guidelines and a few examples of gluten-containing foods and drinks to avoid.

First, be aware that food labels don't always specify gluten explicitly. Despite legislation requiring improved labeling, there are still loopholes. Barley and rye, for example, aren't even mentioned in the Federal law that requires listing any of the eight major allergens.

Instead, those labels more often list the actual gluten-bearing ingredient. That can run quite a wide gamut. Such esoteric grains as kamut, triticale, einkorn, emmer, and spelt have gluten protein in them. Even general categories like emulsifiers, flavor additives, and HVP (hydrolyzed vegetable protein) carry gluten. You'd never know that from looking at the package.

So, the best line of defense is simply to assume that every commercial food not explicitly labeled "gluten free" contains some. Tragically, even those that are so labeled sometimes contain trace amounts. It's not usually enough to bother celiac sufferers, but anything below about 20 ppm is legally allowed and the label is considered legally accurate.

The trick is how to take that approach without either starving, or becoming completely paranoid about food.

The solution is to take a "glass more than half-full" perspective. It is possible to do that without upping the odds of consuming gluten. Simply create a list of allowed foods and stick to them. Then, as time goes on, expand the list as you discover more safe foods (nd drinks.

Fortunately, while that list is in some ways much shorter it is also clearer and easier to develop.

All meats are gluten free by nature. The only caveat is be cautious about any gluten-containing additives that might be present. That's generally only a concern with some lunch meats. Packaged beef, chicken, pork, etc. In the form, say, of the standard styrofoam-bottomed or plastic wrapped container, they are usually fine.

All fresh vegetables and fresh fruits are completely safe. Here again, the only challenge, and it's usually pretty minor, is to check for cross contamination. That's a phenomena in which gluten-containing foods are processed on the same equipment as gluten-free food. That's more common with cereals than other foods.

Most nuts are fine - Again, watch for cross contamination. Walnuts are especially healthy but peanuts, cashews, and others are gluten free. However, some celiac disease sufferers are also allergic to some nuts like peanuts. Consult your physician.

Those general categories could constitute much of a daily diet for anyone seeking a gluten-free lifestyle. Lets go a little beyond that and examine a short list of common ingredients that are also completely safe.

Those include: cellulose, canola oil, cheeses, cocoa butter, corn, corn meal, corn starch, and corn syrup, dextrose, disodium phosphate, eggs, folate, glucose, glutamine (note the similar name), gum arabic, lactose, mineral oil, oleic acid, paraffin, partially hydrogenated oil, peanuts, soy but not soy sauce, and sucrose.

There are many more, of course, but those are a couple dozen common foods and food ingredients in commercial packages about which you don't have to worry. They're all completely gluten free. Eat and enjoy!

Of course, there's nothing wrong with paying a little more for products explicitly labeled "gluten free" to really set your mind at ease.

How to read labels to avoid gluten

Seemingly, if your goal is to avoid gluten, nothing could be simpler than simply to read the label. Many times, it is just that straightforward. But sometimes manufacturers aren't as accommodating as they should be. Also, restaurants often don't offer complete ingredient lists and who wants to eat at home all the time?

The Food Allergen Labeling and Consumer Protection Act (FALCPA) was passed in 2006. It requires manufacturers to list on the label any of eight major allergens the food might contain.

Passing a law and implementing it are two different things, though. So, to maintain a gluten-free diet, it can be helpful to know a little bit about what goes in to common foods. It's also a good idea to know how gluten might be described in alternative ways.

First, it's common for food makers to not list gluten as a separate item at all. That's changing as public awareness expands and manufacturers respond to the law and market incentives. Fortunately, that response is usually in the direction of more information than less. Still, caveat emptor ("buyer beware") is the watchword always.

Instead, be aware of what ingredients include gluten as a natural component. The most common by far are the major grains: wheat, barley, and rye. Far from being found only in bread, cereal, and dough those are often part of a vast array of foods. Those include such surprising ones as: ice cream, salad dressing, cookies, and many candy bars. (Gluten is a great thickener and 'glue'.)

Sometimes you'll find foods with more exotic grains and think: "Great! A gluten-free substitute!" Often that's true. Sometimes you'll be mistaken. Kamut and spelt contain gluten. Durem, einkorn, emmer, farina, semolina, triticale, and bulgar are a few more.

Oats, which doesn't make the list outright, can be cross contaminated (the result of sharing equipment with wheat products during processing). Also, pay special attention to foods that contain wheat gluten where you wouldn't normally expect it: glucose syrup, soy sauce, and surimi, to name a few.

Keep in mind, too, that food labeling regulations don't cover every contingency. Rye and barley, for example, are not required to be listed under the FALCPA rules.

Beyond all that, there are several euphemisms or general additives that commonly contain gluten. The word "wheat" or any of the above may be nowhere in sight yet the product may still be hazardous to celiacs.

Those include such common categories as emulsifiers, flavorings, hydrolyzed plant protein, stabilizers, and starch. They are not all guaranteed to contain gluten, but it's always better to err on the side of caution. Some common foods or food components that often have one or more of those are: gravy, licorice, matzo, frozen french fries, condiments (like ketchup), and sausage.

It sounds pretty daunting to avoid gluten-containing foods – and it can be. But "challenging" need not mean "paranoia inducing." Those diagnosed with celiac disease who must maintain a gluten free diet quickly learn what to avoid. You can too.