Frequently Asked Questions About Gluten

Gluten is a collection of proteins (namely the long-chain amino acids called gliadins and glutenins) found in foods made from wheat, barley or rye.  Gluten helps to make bread rise and gives a chewy, elastic texture to baked goods and many processed foods. Wheat consists mostly of gluten, is about 10-15 % protein and the remainder is starch. The more similar in structure a grain is to wheat, the greater the content of gluten.  Gluten may also be found in some medicines, supplements, hair products and lotions.

Gluten is found in any food or beverage that is made with an ingredient derived from grains that contain gluten (wheat, barley, rye).  It may be obvious to spot (like pasta or a bagel) or may be harder to discover (like flour in gravy or wheat in soy sauce).  You have to become quite a diligent detective to uncover all the gluten you may be exposed to.  Over time you will become more and more familiar with ingredients and become an expert in finding gluten.

Gluten containing grains:  Atta Flour, barley, bulgur, bran, chilton, couscous, dinkle, durum, einkorn, emmer, farina, farro, fu, gliadin, glutenin, graham flour, groats, kamut, matza, mir, orzo pasta, rye, seitan, semolina, spelt, sprouted wheat, tabouleh, triticale, and wheat.  (See Hidden Sources of Gluten)

Gluten-free grains and flours: Acorn, almond, amaranth, arrowroot, artichoke, buckwheat/kasha, cassava, carrrageen(an), chestnut, corn (maize), corn meal, coconut, dal, flax, hominy, manioc, millet, montina, peas, beans, lentils, popcorn, potato and potato flour, quinoa, rice (all varieties), risotto, sago, sesame, sorghum, sunflower, tapioca, taro, teff, water chestnut.

Surprise Sources of Hidden Gluten:  Glue used on stamps, envelopes, and labels that you lick.  Medications, vitamins, cosmetics, playdough (some kids will eat this), and tea bag packaging.  You can call the manufacturer, talk to your pharmacist or visit:  www.glutenfreedrugs.com for a list of gluten-free medications and cosmetics.

A few common hidden sources:  Beer, Caramel color, Dressings, Soy sauce, Tamari (shoyu contains gluten), Grain vinegar (apple cider and wine vinegars are fine), Ketchup, MSG, Natural flavors, Brown rice syrup (fermented with barley malt), some Yeast.  Click here for a complete list of hidden sources of gluten

Surprise Sources of Hidden Gluten:  Glue used on stamps, envelopes, and labels that you lick.  Medications, vitamins, cosmetics, playdough (some kids will eat this), and tea bag packaging.  You can call the manufacturer, talk to your pharmacist or visit:  www.glutenfreedrugs.com for a list of gluten-free medications and cosmetics.

Oats do not contain gluten. The protein in oats is called avenin which has been shown in several research studies in the U.S. and Europe that it is not toxic to people with celiac disease or the gluten intolerant.  Gluten has a specific sequence of amino acids that cause damage to the small intestine.  Oats or avenin, the protein in oats, has a different amino acid sequence than gluten, which many people with CD are able to tolerate.

It has also been suggested that oats should be consumed in moderation: 1/2 cup per day for adults or 1/4 C per day or less for children, seems to be generally safe. As long as oats are produced in facilities that do not process gluten containing grains (wheat, rye or barely), there should be no problem with eating pure, uncontaminated oats.  Problems with consuming oats seem to stem from the growth (farming practices), storage and/or the transportation process.

Some recommend eliminating oats from your diet for six to twelve months to see if they are a potentially sensitive food for you. When reintroducing them in your diet, it is recommended that you do so under the the care of your physician or healthcare provider who will monitor your intestinal healing or deterioration during follow-up visits.

The Celiac Sprue Association states that oats are not yet a risk free choice for all people with celiac disease. They also caution that “most physicians advise people newly diagnosed with celiac disease to wait until their health is restored before ingesting oats”.

Gluten Intolerance

Gluten Intolerance is an umbrella term including any negative reaction to gluten ingestion that includes an immune response. It includes: celiac disease (CD), wheat allergy and gluten sensitivity. If you have celiac disease, you are gluten intolerant, however, you may be gluten intolerant, but not have celiac disease.

Celiac Disease (CD)

CD is not a food allergy. It is an autoimmune disease where your body attacks itself resulting in intestinal damage, malabsorption of nutrients, and nutritional deficiencies. CD increases your risk of other autoimmune diseases, increases risk of malignancies or cancers, may cause neurological conditions, and is hereditary. It is treated with a gluten-free diet.

Gluten Sensitivity (GS) or Non-Celiac Gluten Sensitivity

Gluten Sensitivity or as most doctors refer to it as Non-Celiac Gluten Sensitivity (NCGS), is considered a non-autoimmune reactions to gluten ingestion. Typically, sensitivity refers to lacking an enzyme to digest that nutrient or eating too much of that nutrient.  People with GS do not have a wheat allergy or CD, but still present with adverse symptoms after the ingestion of gluten. The small intestine of GS patients is usually normal. As of yet, there are no screening tests, blood markers or defined set of symptoms for gluten sensitivity. The most common symptoms are abdominal pain, bloating, diarrhea, constipation, anemia, headaches, numbness and depression, but more than 100 symptoms have been loosely linked to gluten intake. A gluten-free diet is the only recommendation for GS, although some may be able to tolerate small amounts of gluten without a deleterious effect.   NCGS is only diagnosed by excluding both celiac disease, and an IgE-mediated allergy to wheat, and by the presence of adverse symptoms from gluten consumption.

Wheat Allergy (WA)

Wheat Allergy is an allergic reaction to wheat where the body produces antibodies in response to wheat ingestion. Unlike CD which is characterized by a delayed immune reaction, WA produces an allergic response that is immediate — within seconds or up to several hours. The immune system recognizes wheat as an antigen, causing the release of chemicals or histamines that are responsible for the allergy symptoms. Like other food allergies, the symptoms of WA may include hives, itching, nasal congestion, nausea, vomiting, throat tightening, swelling and anaphylaxis. WA is not an autoimmune disease. If you have a wheat allergy you need to avoid wheat products.

The answer is far from it. It is estimated that 1/3 of the US population is predisposed to a gluten sensitivity. A large-scale multi-year study published in the 2003 edition of Archives of Internal Medicine, concluded that 1 in 133, Americans have celiac disease.  Findings from a Mayo Clinic study published in the journal Gastroenterology in July, 2009 found that gluten intolerance is at least four times as common today as it was 50 years ago.  According to physician and author, Mark Hyman, MD, an estimated 99 percent of people who have a problem with eating gluten don’t even know it.