Core Gluten-Containing Grains
For individuals with celiac disease, consuming gluten triggers an autoimmune response that damages the small intestine. Avoiding grains containing gluten is essential. These include wheat, barley, and rye, along with their various forms and derivatives.
Wheat and its many varieties
Wheat is a major source of gluten found in numerous products. Celiacs must avoid all wheat types such as durum, semolina (used in pasta), spelt, kamut, farro, einkorn, wheat berries, and graham flour.
Barley and its derivatives
Barley is another key gluten source, often present in less obvious forms. Celiacs should avoid barley, including barley malt, malt extract, syrup, flavoring, brewer's yeast, and most beers.
Rye and triticale
Rye is a gluten grain in breads, and triticale is a wheat-rye hybrid. Both are unsafe for those with celiac disease.
What about oats?
Naturally gluten-free, oats pose a high cross-contamination risk from processing with wheat, barley, or rye. Celiacs can only consume oats certified as gluten-free.
Unexpected and Hidden Sources of Gluten
Gluten is often used as a thickener, binder, or flavoring in processed foods. Careful label reading and avoiding certain prepared items is vital.
Processed foods and additives
Many processed items can contain hidden gluten, including soy sauce, teriyaki sauce, some condiments and salad dressings, sauces, gravies, canned soups (due to modified food starch), seasoning blends, processed meats, and certain candies or snacks.
Non-food items
Gluten can also be in non-edible products that might be ingested. Check with your pharmacist about medications and supplements, and be aware of gluten in lipstick and lip balm.
Avoiding Cross-Contamination
Cross-contamination, where gluten-free food contacts gluten, is a serious risk. Even minimal amounts (under 20 ppm) can cause symptoms and intestinal damage.
In the home kitchen
Prevent cross-contamination at home by having separate preparation areas, dedicated gluten-free utensils and equipment (like cutting boards and toasters), separate condiments, and properly storing gluten-free items above gluten-containing ones in sealed containers.
Dining out and food production
When dining out, inform staff about your medical condition. Avoid high-risk items like fried foods (cooked in shared oil), buffets, and shared utensils. Ask about dedicated cooking surfaces.
Comparing Celiac Disease and Gluten Intolerance
Celiac disease and non-celiac gluten sensitivity (NCGS) are distinct, though both involve avoiding gluten. Celiac is an autoimmune disease causing long-term intestinal damage and diagnosed by tests and biopsy, requiring a strict, lifelong gluten-free diet. NCGS is an intolerance that doesn't cause permanent damage and is diagnosed by exclusion. Untreated celiac disease carries risks like malnutrition and increased cancer risk, which are not associated with NCGS.
Conclusion
Effectively managing celiac disease hinges on understanding and avoiding all gluten sources, from grains like wheat, barley, and rye to hidden additives and processed foods. Diligent label reading and preventing cross-contamination are critical. Adopting a gluten-free lifestyle helps prevent intestinal damage, relieves symptoms, and lowers the risk of serious health issues. The Celiac Disease Foundation website offers resources for guidance.
What Things Can Celiacs Not Eat?
- Core Grains: Wheat (including spelt, kamut, farro, durum, semolina, and wheat berries), barley, rye, and triticale.
- Processed Foods: Many sauces, gravies, salad dressings, processed meats, and snack foods.
- Additives: Malt flavoring, modified food starch (unless explicitly specified as gluten-free), and some spice blends.
- Beverages: Most beers, ales, lagers, and malt beverages.
- Contaminated Oats: Only certified gluten-free oats are safe due to high cross-contamination risk.
- Cross-Contaminated Foods: Any food prepared with utensils or on surfaces that also handle gluten-containing products.
