09 May 2007, 12:42  

And once again about gluten-free diet.


How to survive the first year of living gluten free.

Just been diagnosed? Here are some tips to help you get through that first year of being gluten free...

Gluten Free Diet.


Purpose: This diet is designed to provide adequate nutrition while eliminating foods that contain gliadin, which is the alcohol-soluble extract of gluten, a protein found in barley, oats, rye, wheat, and wheat derivatives.

1. Be brave - and optimistic. It will be difficult, but you will feel better as your intestine heals.
2. Clear out some cupboard space, dedicated for your gluten free products. They can be very bulky, especially if, like me, you have to buy everything you see ‘to encourage them’ to keep making/stocking it. If you have gluten products in the house that nobody else in the house eats - bin them. Don’t eat it ‘to avoid waste’.


The dietary guidelines below are intended for people with celiac sprue (also known variously as "celiac disease," "celiac syndrome," "gluten-induced enteropathy," "gluten-induced sprue," "idiopathic steatorrhea," and "nontropical sprue") and/or dermatitis herpetiformis (DH or Duhring's disease), for whom a gluten-free diet will help to prevent such complications as abdominal cramping and bloating, diarrhea, fatigue, excess intestinal gas, and weight loss. People with celiac sprue and/or DH must follow a gluten-free diet for life.


3. Join the local support organisation, even if you’re not a natural joiner. Here in the UK, it is Coeliac UK. They will have advice, tips and other helpful material. CUK produces a list of manufactured foods that are acceptable for coeliacs to eat - with updates every month. If there are local meetings - go to them! And talk to people, no matter how shy you feel.
4. Read every label. On everything. If you’re not sure, don’t eat it - and contact the manufacturer to ask if it is OK. Working out what you can and can’t eat will become easier as you learn what can instantly be discarded, leaving you to concentrate on the things that might be OK.

General Guidelines for a Gluten-Free Diet.


If you are restricted to following a gluten-free diet, you must be careful in the selection of both the foods you prepare at home and the foods you buy and order when away from home. For preparing food at home you may find specialty cookbooks for a gluten-free diet helpful. DietSite recommends Against the Grain: The Slightly Eccentric Guide to Living Well Without Gluten or Wheat, by Jax Peters Lowell; Wheat-Free Recipes & Menus: Delicious Dining Without Wheat or Gluten, by Carol Fenster, PhD; and More from the Gluten-Free Gourmet: Delicious Dining Without Wheat, by Betty Hagman. Remember that gluten-free products do not contain preservatives; be sure to store all gluten-free foods in your refrigerator or freezer.

5. Learn as much as you can - even if you end up knowing more than the local doctor does. She, after all, has to know something about a lot of things. You can concentrate on what affects you. Then you’ll be able to assess whether you will be able to eat codex wheat, lactose, oats …
6. Find other people in the same situation. We went to local meetings but when there wasn’t a local support group for children, we set one up. It helped us a lot in the early years to talk to other parents in the same situation. If there isn’t a local group, then these days there is the internet. I’m always recommending the message board, because it is a great source of support.


For tips and information on reading food products' ingredient labels and on avoiding gluten when dining out, see the following sections.


For detailed information on foods that do and do not contain gluten, refer to Foods for a Gluten-Free Diet.


Reading Labels.


If you must avoid gluten, you can still eat a variety of foods In fact, by experimenting with a range of gluten-free products, you will be better able to provide your body with the nutrients it needs both safely and enjoyably.

7. Don’t ever be persuaded by people saying “just one [cream cake, doughnut, slice of quiche] won’t hurt”. It will, even if you can’t feel any difference. It will be eating away at your small intestine, and set your recovery back. Don’t do it.
8. Do be prepared to explain it often, and sometimes over and over again. No it is not a fad, yes it is a medical requirement.
9. Be prepared to be pushy - you will have to ask what is in dishes, and double-check if necessary. But do be polite. You don’t want them just to pick the croutons out of your portion of soup and give you the same bowl again!
10. Read every label again. Sometimes manufacturers change the recipes of your trusted favourites, so don’t assume it will be OK.
11. Do avoid cross-contamination. Some people set up dedicated ‘areas’ for gluten free preparation - with dedicated chopping boards, knives, pans etc. Even if you don’t go this far, do think about a dedicated toaster (or buy lots of foil for the grillpan), your own breadbin and even your own pots of butter, jam etc. It only takes someone to dip a knife with gluten crumbs into the butter for you to spend the night in the bathroom.
12. Do plan ahead for festivities and celebrations. From Valentines Day to Mothering Sunday, Thanksgiving to Christmas, conferences to an impromptu birthday cake at work, celebrations involve food and drink. Plan ahead - what will you eat?


In addition to shopping for gluten-free products at your local supermarket or health-food store, you can order foods directly from the manufacturer or through the Gluten-Free Food Vendor Directory. However you choose to do your shopping, you will need to be very careful not only about reading food labels but also about verifying the ingredients of any medications you purchase. The tips and information below may be helpful:

  • In addition to avoiding all foods that list barley, oats, rye, wheat, or wheat derivatives in the ingredients, avoid products containing gluten stabilizers, hydrolyzed vegetable protein (HVP), and texturized vegetable protein (TVP).

  • Ingredients marked as additives, cereals and cereal grains, colorings, emulsifiers, excipients, flavorings, hydrolized plant protein (HPP), malts, preservatives, starches (including modified starch or modified food starch), vegetable gum, and vinegar may be derivatives of gluten-containing grains.

  • If an ingredient list does not appear on a food product's label, contact the manufacturer for detailed information (the manufacturer's name and address must appear on the label). There are no laws requiring that a product label indicate the inclusion of food sources that contain gluten, and food manufacturers and processors may change a product's formula without announcement. When in doubt about the contents of any commercial product, do not use the product until you have obtained the necessary ingredient information from the manufacturer. Most food manufacturers will provide information about their products upon request.

  • Before you take any medication, check with your pharmacist or the product manufacturer to make sure that the medication is gluten-free. All medications have fillers or dispersing agents, some of which may include wheat starch.


13. Consider travelling and days out - an emergency travel pack of gluten free snacks can be invaluable, especially if it is a gluten free child you are travelling with!
14. Don’t forget drinks - these can contain gluten too, whether they are alcoholic or soft drinks. Be careful.
15. And at the end of the year - celebrate! (With something gluten free, obviously)... [read more]

Dining Out.


Restaurant menus almost never provide explicit information about the inclusion of gluten in dishes If you must avoid gluten, order very carefully Always ask your waiter to list the ingredients in dishes, and follow these guidelines:

  • Ask your waiter specifically whether the dishes that you are interested in contain any of the following ingredients: barley, bran, bulgur, cereal additives or products, durham, emulsifiers, flour, graham, HVP or TVP, malt or malt flavoring, millet, oats, rye, starch (modified starch or modified food starch), wheat, wheat germ, vegetable gum.

  • Inquire about the methods of preparation as well as about the foods themselves. Flour and cereal products that contain gluten are often used in the preparation of dishes. Order meat, poultry, or fish, for example, only if the dish is prepared without breading, gravy, or sauce.

  • Beware of food that is grilled; a restaurant's grill may be contaminated with gluten from other foods.

  • Beware of fried foods; the grease in which a restaurant fries food may be contaminated with gluten from other foods.


Foods for a Gluten-Free Diet.


The table below provides detailed dietary guidelines for following a gluten-free diet.


Food Groups. Gluten-Free Foods. Foods Containing Gluten.
Breads & Grains.

6-11 servings daily.		 Breads or bread products (bread crumbs, dressings, etc) made from the following flours: amaranth, bean, buckwheat, carob, chickpea (gram), corn, Indian Rice Grass (Montina ™), flax, kasha, maize or waxy-maize, masa, millet, finger millet (Ragi), pea, potato, quinoa, rice, sago, soba (made from pure buckwheat), sorghum (milo), soy, sweet, chestnut, teff, yam;

Breads or bread products (bread crumbs, dressings, etc) made from the following starches: arrowroot, corn, potato, tapioca;

Breads or bread products (bread crumbs, dressings, etc) made from "gluten-free" mixe;

Note: Gluten-free bread products taste better when warmed or toasted;

Corn or rice cereals containing malt flavoring derived from: corn, cornmeal, grits, hominy, kasha (buckwheat), cream of rice, puffed rice;

Rice of all types (including wild & flaked rice), rice crackers, rice noodles, rice spaghetti, rice wafer;

Note: Enriched converted rice may contain a barley additive;

Pastas made with the following flours: corn, maize or waxy maize, potato, rice, so;

Oriental bean noodles;

Pure-cornmeal chips & tortillas;

Polenta;

Popcorn (air-popped or popped in oil);

Yeast;

Brand-name recommendations;

Aproten hot cereal, Rusk, past;

Soya crackers.		 Bread or bread products (bread crumbs, dressings, etc) made from: bread flour, brown flour, "low-gluten" flour, flour, white flour, plain flour, bromated flour, enriched flour, phosphated flour, self-rising flour, dorum, farin;

Breads or bread products (bread crumbs, dressings, etc) containing or made from flours containing any of the following grains: barley couscous, durum, far, graham, granary, kamut, oats mir, rye, semolina, spelt, triticale (a cross between wheat and rye),wheat or wheat starch, wholemeal, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein;

Cereals containing malt or malt flavoring derived from: barley, barley malt, barley-malt syrup;

Any foods containing: bran, bulgur, einkorn wheat, emme;

Malt (including malt extract, flavoring, syrup, or vinegar;

Vegetable or wheat starc;

Most crackers, Rusk, Zwieback, & pretzels;

Matzo;

Biscuits, cornbread, muffins, pancakes, & waffles made form commercial mixes;

Dumplings, macaroni, noodles, & spaghetti made from wheat flour;

Udon (wheat noodles);

Farina;

Tabbouleh.
Frui.

2-4 servings daily.		 All fruits (dried, fresh, frozen);

Pure fruit juices;

Olive.		 Canned fruit in heavy syrup;

Ocean Spray Cranberry Juice;

Thickened fruit sauces;

Some commercial fruit-pie fillings.
Vegetable.

3-5 servings daily.		 All fresh vegetables (including pickles);

All canned or frozen vegetables not containing ingredients made with gluten.		 Most breaded or creamed vegetables;

Most commercially prepared vegetables.
Milk & Dair.

2-3 servings daily.		 All milk (including condensed, dry, & evaporated);

Homemade chocolate milk made with cocoa powde;

All aged cheeses, such as Cheddar, Edam , Parmesan, & Swiss;

Pasteurized cottage & cream cheeses that do not contain preservatives or vegetable gum;

Yogurt not containing cereal.		 Malted & instant milk drinks;

Commercial chocolate milk or chocolate drinks containing cereal additives;

Blue & Roquefort cheese;

Processed cheeses, cheese foods, & cheese spreads containing gluten stabilizers;

Ice crea;

Note: Some ice creams contain wheat flour; contact the manufacturer for complete ingredient information.
Meat & Other Protein Sources.

2-3 servings or 6 oz dail.		 Fresh fish & shellfish, meat, poultry;

Pure-meat cold cuts;

Meat products (canned meats, hot dogs, sausages) made without fillers;

Alfalfa;

Eggs;

Lentils;

Tofu-soya curd;

Beans (dried or fresh) of the following kinds: adzuki, carob, fava, garbonzo, hyacinth, mung, Romano, soya, tepary, urad;

Nuts of the following kinds: acorns almonds, chestnuts, hazelnuts, peanuts (peanut butter),walnut;

Peas (dried or fresh) of the following kinds: cowpeas, pigeon, sweet, urad dal;

Seeds of the following kinds: flax, mustard, poppy, safflower, sesame, sunflower.		 Any meat prepared with barley, oats, rye, wheat, or gluten stabilizers;

Breaded meat, fish, shellfish, poultry (croquettes, patties, loaves);

Any canned meats, cold cuts, hot dogs, sandwich spreads, & sausages that contain fillers;

Meat with added HVP (as in some turkey bastings);

Freeze-dried meals;

Canned baked beans.
Soups. Homemade soups not containing barley, oats, rye, or wheat in any form. Soups containing barley, oats, rye, or wheat in any for;

Note: Most canned soups and soup mixes contain gluten;

Stews containing noodles;

Bouillon or broth containing HVP;

Miso.
Fats & Oils. Butter, lard, margarine, & salad dressings not containing emulsifiers, gluten stabilizers, or HV;

Note: Some margarines contain flour as an additive;

Cream, sour cream, & whipping cream made with gluten-free flours (see list above) or cornstarch;

Cooking oils of the following kinds: corn, hydrogenated, olive, peanut, safflower, sunflower, vegetable.		 Most commercial salad dressings;

Nondairy cream substitutes & some nondairy creamers;

Fat substitutes (Olestra, Oatrim, Replace);

Canola oil & vegetable oils that do not list the full ingredients & sources;

Cooking sprays that contain grain alcohol;

Suet (in packets);

Note: May contain wheat flour.
Snacks & Desserts. Desserts not containing barley, oats, rye, or wheat in any form, such as;

Fruit ice;

Gelati;

Most ice cream;

Junke;

Most sherbet;

Homemade puddings: custard, rice, tapioc;

Note: Homemade puddings may be thickened with cornstarch, which does not contain gluten;

Puddings made from mixes not containing gluten stabilizers or wheat flour;

Chocolate, chocolate syrup, cocoa, coconut, hard candy, honey, jam, jelly, marshmallows, pure molasses, meringue, sugar;

Some chewing gum.		 Cakes, cookies, donuts, pastries, & pies prepared with barley, oat, rye, or wheat in any form;

Cakes, cookies, & puddings made from commercial mixes;

Chocolate products made with gluten stabilizers;

Homemade puddings thickened with wheat flour;

Ice cream or sherbet containing gluten stabilizers;

Ice cream cones;

Jell-O Brand pudding;

Some commercial candie;

Note: Almond Roca , for example, is dusted with wheat flour.
Beverages. Pure tea, hot cocoa, or coffee (instant & decaffeinated;

Note: For flavored coffees, contact the manufacturer for complete ingredient information;

Carbonated beverages (except some root beers);

Pure fruit juices (including apple cider);

Drink mixers, and alcohol of the following kinds: brandy, champagne, cognac, grappa, mead (honey wine), ouzo, potato vodka, most rums (light rums are recommended), sake, tequila not containing dyes or additives, white wine made in the United State;

Note: Alcohol manufacturers may change their ingredients; be sure to read the label and check with the manufacturer for a full list of ingredients.		 Coffee, tea, or coffee substitutes containing gluten additives;

Herbal teas containing malted barley;

Hot cocoa or hot chocolate made from commercial mixes;

Ovaltine;

Postum;

Lemon or orange barley water;

Hawaiian Punch;

Most root beers;

Some ginger beers & cloudy lemonades;

Alcohol of the following kinds;

Beer (ale, lager, porter, stout;

Gi;

Vodka made from grai;

Corn whiskey (made with a grain mash;

Whiskey (including bourbon, Scotch, & Canadian blends.
Baking Products, Condiments, & Seasonings. Black pepper, salt;

All herbs;

Pure spices;

Balsamic, rice, & wine vinegars;

Baking powde;

Note: Must not contain wheat flour; check ingredient list;

Bicarbonate of soda;

Cornstarch;

Corn syrup;

Food coloring;

Gravies & sauces made with gluten-free flours (see "Breads & Grains") or cornstarch;

Some ketchups & mustards;

Pure mayonnaise;

Monosodium glutamate (MSG;

Note: Avoid completely if you are sensitive to MSG;

Soy sauces that do not contain wheat or barley (try Lachoy or Chun King brands;

Cream of tarta;

Flavorings not containing alcohol.		 Most white pepper;

Ground spice;

Note: Wheat flour is commonly included to prevent clumping;

Vinegar distilled from grain (white vinegar);

Some curry powders & mixes;

Mustard powde;

Note: May contain wheat flour;

Some dry seasonings, gravy & stock cubes, & extracts;

Gravies & sauces prepared with flour containing gluten (see "Breads & Grains");

Mayonnaise containing gluten stabilizers or wheat flour;

Sauces of the following kind: fish, some meat sauces, most soy sauces (shoyhu), steak, teriyaki, Worcestershir;

Most dips;

Vanilla & other flavorings containing alcohol.


Note: For specific information on serving sizes for the foods listed in the table above, refer to the US FDA food pyramid (US Food and Drug Administration). To substitute ethnic foods, see the ethnic food pyramids.


Source: www.dietsite.com


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