Gluten
Gluten – what you need to know!
May 6, 2012 | 
Author 
I’m sure that most of you have heard about gluten, or know someone who is gluten intolerant. But, what does ‘intolerant’ actually mean? Let’s start with the basics.
What is gluten?
Gluten is a protein found in grains and cereals such as wheat, barley, triticale, rye, etc. 
It provides elasticity to dough, allowing it to rise and take on its characteristic chewy, soft texture. It is also added as a thickener to many prepared foods such as imitation meats, sauces and gravies. Once you start looking for gluten – it’s everywhere!
Types gluten intolerance
1. Celiac Disease
- Celiac disease is an autoimmune condition, not an allergy or intolerance. The presence of gluten triggers the production of antibodies resulting in damage to the mucosa of the small intestine. This can result in loose stool (but not always), weight loss, fatigue and various nutrient deficiencies such as B12 and iron defeciency. Screening for celiac disease can be done through bloodwork, but can only be diagnosed with a biopsy of the small intestine.
- A new in-office/home test is now available, allowing for more convenient screening. The Biocard test can be purchased online, or at our office. During the month of May we will be offering the Biocard test at a reduced rate – $45.
- Gluten avoidance is mandatory for those with celiac disease, otherwise damage will continue to occur. Individuals with celiac disease must avoid all gluten-containing grains such as wheat, barley, rye, spelt and kamut.
2. Wheat allergy
- Wheat allergy is an IgE bound histamine reaction of the immune system.
- Unlike celiac disease, the reaction is usually only to wheat, so other grains (such as rye and barley) may be ok. Spelt and Kamut should also be avoided though as they are wheat relatives.
- Also unlike celiac diease, allergies are sometimes outgrown, so an allergic child may not become an allergic adult.
3. Wheat/Gluten Intolerance
- Symptoms of a wheat and/or gluten intolerance can vary quite a bit. Some people may experience digestive symptoms such as diarrhea, gas or constipation, but others may experience headaches, fatigue, anxiety or depression.
- Unlike celiac and wheat allergy, there is no reliable testing available to detect intolerance. The gold standard “test” is an elimination diet. By eliminating all wheat and/or gluten for a minimum of 3 weeks, intolerance can be ruled in or out based on the return of symptoms with a subsequent challenge. Often times, other foods are eliminated as well and the patient is put on a strict hypoallergenic diet. While not difficult per se, this diet does require a bit of planning and guidance, which an ND is qualified to provide.
More Information:
- Canadian Celiac Association
- http://www.celiac.com/
- About.Com – Info page on Celiac Disease/Wheat allergy
Posted in Celiac, Gluten, Gluten-Free, Naturopathic Medicine, Nutrition, Uncategorized, allergies | 
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Gluten-free resources
Gluten
Gluten is a protein found in wheat, barley, rye, triticale, and spelt. Because gluten binds ingredients together and helps baked goods to rise, it is commonly used in processed foods. Reactions to gluten vary from the extreme of celiac disease to mild digestive upset. While people with celiac disease or gluten allergies have to avoid all amounts of gluten including contamination from kitchen utensils and toasters, most people with gluten sensitivities can tolerate trace amounts up to about 1/8 tsp.
Common sources of gluten
bread
pasta
baked goods including cakes, biscuits, muffins, and cookies
cereal
crackers
pizza dough
tortilla wraps
breaded meats
beer
Gluten is often used as an additive in soups, broths, baking powder, spice mixes, soy sauce, gravy, sauces, marinades, and imitation seafood (especially crab).
What to look for on labels
If any of these ingredients are in a product, it contains gluten: flour, enriched flour, wheat, whole wheat, bran (unless from a gluten free source), barley, rye, triticale, spelt, bulgar, semolina, frumento, durum, kamut, graham, einkorn, farina, couscous, seitan, matzoh, matzah, matzo, malt (assume it is derived from barley unless otherwise specified) and gluten.
Naturally gluten free
Most foods are naturally gluten free including vegetables, fruit, beans, nuts, seeds, seafood, and poultry. There are a number of gluten free grains and starches that can be eaten on their own or used to make pasta, cereal, bread, and baked goods including:
Amaranth
Arrowroot
Buckwheat/kasha
Chickpeas/garbanzo beans
Corn
Millet
Potato
Quinoa
Rice (any variety including glutinous rice)
Tapioca
Teff
Although naturally gluten free, oats are often contaminated with gluten and may be an issue for some people.
Gluten free products
Fortunately gluten free products can be easily found at your local supermarket in the health food section. Farmers’ markets, health food stores and the Bulk Barn are also great resources. There are a wide range of breads, pastas, cereals, baked goods, crackers, baking supplies, and even pizza! Just remember that gluten free does not necessarily mean healthy- many products are based on starches (such as potato) which lack nutrients and fiber, and are loaded with sugar. Try to choose products with either a whole grain or a bean flour base. For baking purposes, you can buy mixes for pizza dough, bread, and desserts or simply purchase a gluten free all purpose flour and use your favorite recipes. You may need to add some xanthum or guar gum to the mix to help it bind and rise- check the label for directions.
Alcohol
Avoid beer, malt beverages, and cider that contains barley.
Gluten free options include gluten free beer, gin, rum, schnapps, tequila, vodka, whisky, wine, and Champagne.
Eating Out
Many restaurants offer either a gluten free menu (you may have to ask for it) or have gluten free (GF) indicated beside some of the menu options. Even if they do not specifically advertise it, if you can tolerate trace amounts of gluten you should be ok with a main course of protein (non-breaded meat, fish, etc.) with some vegetables and rice or potatoes. Salads are usually fine too- minus the croutons.
Resources
celiac.ca A comprehensive guide to going gluten free.
glutenfreegoddess.blogspot.com Fantastic recipes, especially for desserts.
celiackids.com Information on celiac disease, tips for educating caregivers, and meal suggestions.
theceliacscene.com Search Halifax to find local restaurants that have gluten free options.
schoolhouseglutenfreegourmet.com A local gluten free bakery that provides a number of local restaurants with gluten free bread. Search the “where to buy” section for a list of places with gluten free sandwich options.
www.urbanspoon.com/tn/235/1/27000/Atlantic-Provinces/Gluten-Free-Friendly/Halifax-restaurants Another listing of local gluten free friendly restaurants.
Gluten-free living
May is Celiac Disease awareness month, so I thought a gluten-free living post would be timely. Approximately 1% of the population suffers from celiac disease, but that number may actually be higher because as many as 30% of people go undiagnosed. In fact, less than half of patients with celiac disease present with typical symptoms (such as diarrhea) so the diagnosis is often missed. And, there are also many people who do not have celiac disease, but are intolerant to gluten nonetheless.
In order to be diagnosed with celiac disease, your MD will need to order a blood test. If that test comes back positive, you will be referred for an intestinal biopsy to confirm the diagnosis.
Symptoms of celiac disease and/or gluten intolerance can include:
-diarrhea (sometimes constipation for people with intolerance to gluten)
-cramping
-bloating and gas
-skin rashes
-anemia
-infertility
So, where is gluten found, and how do you avoid it?
Gluten is found in wheat (semolina, spelt, kamut), barley, triticale and rye. Gluten-free flours include oats, buckwheat, rice, amaranth, arrowroot, quinoa, millet and teff. In the past, it was difficult to find gluten-free grains, let alone prepared gluten-free products such as breads and crackers. But, with the increased incidence of gluten sensitivity, these products are becoming much more easily found. A quick trip to the health food store, or health food section of your grocery store, and you will find crackers, breads, pasta and cereal. Keep in mind that many breads are frozen due to a shorter shelf life. And, don’t forget about Bulk Barn, which has long catered to the gluten-free community.
Here are a list of my favourite gluten-free websites:
Changing to a gluten-free diet can be daunting at the outset, but is very manageable in the long-term. Feel free to contact an ND if you need help managing symptoms, or making the change to a gluten-free diet.
Posted in Celiac, Gluten, Gluten-Free, Infertility, Naturopathic Medicine, Nutrition | Comments Closed