gluten-free foods

want to know more about a gluten-free diet?

This information has been compiled by dietitians to help answer some of the questions you may have about what a gluten-free diet involves.

Who needs a gluten-free diet?

A gluten-free diet is the recognised treatment for coeliac disease - a lifelong intolerance to gluten, which affects the lining of the bowel - and dermatitis herpetiformis - a serious skin condition. A gluten-free diet is different to a wheat-free diet.

What is a gluten-free diet?

A gluten-free diet requires the exclusion of all sources of gluten in the diet. Gluten is the protein found in wheat, rye, barley and possibly in oats. It is possible to follow a gluten-free diet by simply avoiding all foods
containing gluten (Please check out the list of naturally gluten-free foods mentioned later). Products labelled just “wheat-free” could still contain gluten from rye and barley.

There are a number of specially manufactured gluten-free products available to make a gluten-free diet more varied, less restrictive and easier to comply with. Many of these products contain Codex Wheat Starch. This is a special wheat starch that has had the gluten removed to a very low level and is known as gluten-free wheat starch. It is safe for most coeliacs and helps compliance to the diet as it improves the taste and texture of gluten-free food, making it taste more like gluten-containing food.

What is the difference between a gluten-free diet and a gluten-free/wheat-free diet?

Most people with coeliac disease are able to follow a gluten-free diet containing Codex Wheat Starch, but there are a small group of coeliacs who are highly sensitive to even tiny amounts of gluten and their diet needs to be wheat-free as well as gluten-free. Always check with your dietitian first to see if you require a gluten-free, wheat-free diet, as this will affect the choice of foods available to you.

What foods are naturally gluten-free?

The good news is that there are many foods that are naturally gluten free including potatoes, meat, poultry, fish and nuts, as well as fruit and vegetables. Flours, pastas, crackers and breakfast cereals made from rice or
corn provide natural alternatives to specially manufactured versions. Dairy foods and fats such as milk, eggs, plain yoghurt, cheese, cooking oil, margarine and butter are also gluten free. For naturally gluten free drinks and beverages choose wine, spirits, cider, tea, coffee and fruit juices.

What foods should be avoided?

All foods made from wheat, barley, rye and their flours must be avoided. That means cutting out many of the everyday staple foods most of us take for granted, such as bread, cakes, biscuits and pasta. Most breakfast cereals are made from these grains and must be excluded too.

Many manufactured and processed foods contain gluten. The main examples here are fish fingers, chicken nuggets and all breaded and battered fish and meat. Pastry, scotch eggs and yogurt with muesli should also be avoided. Some drinks and beverages contain gluten including malted milk drinks and barley water. Beer, lager and stout are made from barley and must also be eliminated from your diet.

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What foods should be checked carefully?

Many manufactured and processed foods contain hidden gluten. Suspect ingredients to watch out for include rusk, thickener and modified starch.

Malt and malt extract sourced from barley and wheat is not gluten-free, but there are many other sources of malt that are safe for coelaics. New regulations require that the source of these ingredients must be stated on the label, so it is much easier to see which varieties contain gluten as a mixer or filler ingredient, and which are gluten-free.

The golden rule is to check the food label carefully, particularly when choosing sausages and burgers, ready meals, soups, sauces, crisps and snacks. Some drinks to watch out for include, carbonated drinks and milkshakes.

One important area is medication, including vitamins, minerals and supplements. Always check with the pharmacist that the medicine you have been prescribed is gluten-free.

How can I check what foods are safe to eat?

It is important to remember to check that the information you refer to is up to date, as the ingredients for some manufactured foods change from time to time. The Gluten-Free Food & Drink Directory is an annual food list available from Coeliac UK which is updated monthly on their website. All supermarkets are now legally required to label all foods that contain gluten and wheat. To help coeliacs many now clearly label which of their products are “gluten-free”.

What about oats?

Although recent studies suggest that 'pure' oats may be tolerated by some people with coeliac disease, it is extremely difficult to source oats that are not contaminated. Do not include oats in your diet unless you have discussed this with your gastroenterologist or dietitian. Oats are still not recommended for children with coeliac disease.

What special gluten-free foods are available?

In order to make the gluten-free diet more adaptable and easier to comply with, a number of specially manufactured gluten-free products have been developed. These include bread, biscuits, flour mixes, breakfast cereals, pizza bases and pasta.

How do I obtain gluten-free foods?

Many staple gluten-free products are available on prescription5 for people medically diagnosed with coeliac disease. If you pay for prescriptions you might consider buying a prescription season ticket. Ask your pharmacist for details. Gluten-free food items are also now readily available from supermarkets, health foods shops, and via the internet and mail order.

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Smart thinking

After diagnosis is confirmed by a gastroenterologist, you should be referred to a dietitian who will give you detailed and practical advice on how to set about following a gluten-free diet for the first time.

A gluten-free diet does involve adopting a new attitude to food. You will have to plan your meals and think carefully before you eat anything away from home. Here are just a few suggestions and tips to help you get started.

Planning Ahead

When eating away from home always check in advance the availability of gluten-free food, or take along a suitable gluten-free meal or snack.

Shopping

Always remember to take an up to date copy of The Gluten-Free Food & Drink Directory with you when you go food shopping. If you are unsure always check the label carefully for guidance.

Eating Out

More and more restaurant chains are considering the needs of people on special diets and now provide or label glutenfree dishes. If unsure, notify the restaurant in advance of your special requirements, and always confirm again when ordering your meal.

Holidays

If choosing a full-board holiday check to see if the hotel provides gluten-free meals. Many airlines and other transport operators now offer gluten-free meals which must be requested at the time of booking.

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Enjoying a varied gluten-free diet

A gluten-free diet can be both varied and interesting. There are plenty of recipe ideas from the websites and publications of the gluten-free manufacturers, as well as Coeliac UK, through its website, on-line magazine eXG, and regular publication Crossed Grain. So why not experiment with gluten-free cooking and discover your own favourite gluten-free dishes and recipes.

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