Gluten-Free Diet

The Gluten-Free (GF) Diet: The GF diet is the prescribed medical treatment for gluten intolerance diseases such as celiac disease (CD) and dermatitis herpetiformis (DH). An immune system response to eating gluten (storage proteins gliadin and prolamine) results in damage to the small intestine of people with gluten intolerance. The GF diet is a life long commitment and should not be started before being properly diagnosed with CD/DH. Starting the diet without complete testing is not recommended and makes diagnosis later more difficult. Tests to confirm CD could be negative if a person were on the GF diet for very long. A valid test would require reintroducing gluten (a gluten challenge) before testing. Celiac disease is an inherited autoimmune disease and confirmation of CD will help future generations be aware of the risk of CD within the family.

Dietitians developed the following dietary guidelines, for the Gluten Intolerance Group® and Celiac Disease Foundation. These are in agreement with the Gluten Free Diet guidelines published by the American Dietetic Association, October 2000. The American Dietetic Association Guidelines were written through a cooperative effort of dietitian experts in celiac disease in Canada and the United States.

The following grains & starches are allowed:

  • Rice
  • Corn
  • Soy
  • Potato
  • Tapioca
  • Beans
  • Garfava
  • Sorghum
  • Quinoa
  • Millet
  • Buckwheat
  • Arrowroot
  • Amaranth
  • Tef
  • Montina®
  • Nut Flours

The following grains contain gluten and are not allowed:

  • Wheat (durum, semolina, kamut, spelt)
  • Rye
  • Barley
  • Triticale

The following ingredients should not be consumed. They are derived from prohibited grains:

  • Barley
  • Malt or malt flavoring (can be made from barley)
  • Malt vinegar (made from barley)
  • Rye
  • Triticale
  • Wheat (durum, graham, semolina, kamut, spelt)

Additional components frequently overlooked that often contain gluten:

  • Breading, Coating mixes, Panko
  • Broth, Soup bases
  • Brown rice syrup
  • Candy – ex: Licorice, some Chocolates
  • Croutons
  • Flour or cereal products
  • Imitation bacon
  • Imitation seafood
  • Marinades
  • Pastas
  • Processed luncheon meats
  • Sauces, Gravies
  • Self-basting poultry
  • Soy sauce or soy sauce solids
  • Stuffing, Dressing
  • Thickeners (Roux)
  • Communion wafers
  • Herbal supplements
  • Drugs & Over-the-Counter Medications
  • Nutritional Supplements Vitamins & Mineral Supplements
  • Playdough: A potential problem if hands are put on or in the mouth while playing with playdough or are not washed after use

Can I Use Oats?

GIG Position on Oats in the Gluten-Free Diet

Research suggests that pure, uncontaminated oats in moderation (1 cup cooked) daily are safe for most persons with celiac disease.  There is concern by health professionals that most oats are cross-contaminated with glutenous grains.

Oats add soluble fiber and added nutrients to the GFD that are otherwise lacking or have limited availability. Some studies indicate that compliance with the GFD is increased when oats are included.

Some persons using oats may notice increased abdominal discomfort, gas and stool changes. This may be due to the increased fiber from oats. Introducing oats slowly may decrease this discomfort. Rarely, some persons with celiac disease may have a hypersensitivity to oats. There is insufficient research to suggest this is related to a gluten-like reaction, or an allergic reaction.

The GIG Medical Advisory Board suggests you work closely with your health care team before deciding to introduce oats in your diet, and that you have your antibody levels reviewed periodically.

This position has been approved by the GIG Medical Advisory Board.

0ct 2005.