Gluten free diet effects and benefits

Gluten-Free Diet

The objective of this study is to examine the importance and benefit of a gluten-free diet. Gluten is a protein found in wheat, rye and barley that results in intestinal damage including weight loss and nutrient deficiencies in those with gluten intolerance. Symptoms of gluten intolerance include: (1) diarrhea; (2) abdominal pain; (3) bloating; (4) fatigue; (5) forgetfulness; and (6) irritability. (Massachusetts General Hospital, 2013)

Products to Avoid

Products that should be avoided for those who are gluten-intolerant include the following food products:

(1) Wheat -- this is inclusive of food products made or processed with flour; various parts of the what kernel (to include the germ, bran, and endosperm [starch]); and grain species derived from prohibited grains;

(2) Barley -- this is inclusive of all parts of the rye grain generally found in food supply as rye flour and rye bread. Rye is generally not utilized as a food additive;

(3) Oats -- this is inclusive of all products containing oats (to include oat flour, oat bran and oat gums). There are various sources of uncontaminated oats available and a dietitian or gastroenterologist should be consulted on the safe introduction of oats. (Massachusetts Hospital, 2013, paraphrased)

II. Common Processed Foods that Contain Wheat, Barley or Rye

Reported as common processed foods containing wheat, barley, or rye include the following stated foods:

Bouillon cubes

Matzo

Sweeteners

Seasoned rice mixes

Candy Soy

sauce and marinades

Cold cuts, hot dogs sausages salami

Seasoned tortilla/potato chips

French fries

Self-basting turkey

Gravies and sauces

Soups and soup bases

Imitation fish and imitation bacon

Trail mixes

Malted Products

Panko (Japanese bread crumbs)

Cereals (including rice and soy varieties)

Energy bars and supplements

Meat and dairy substitutes

Flavored beverages (Massachusetts General Hospital, 2013)

III. Miscellaneous Ingredients on Food Labels

Miscellaneous ingredients on food labels include such as the following:

Wheat starch

Seasonings

Emulsifiers

Stabilizers

Starch

Caramel coloring

Natural and artificial flavorings

Hydrolyzed vegetable protein (HVP) (Massachusetts General Hospital, 2013)

IV. Celiac Disease

Celiac disease is a genetically determined disease. (Jackson, 2013) if an individuals' close relatives have a specific gene then there are more likely to get celiac disease at some point in their life. Jackson (2013) states that it is important that "nine out of ten people with celiac disease do not know they have it. A simple blood test can give the physician the first clue to this disease." For those who have celiac disease, gluten results in injuries to the lining of the small intestine. The elimination of gluten from the individuals' diet gives the lining of the intestine an opportunity to heal. (Jackson, 2013, paraphrased) the small bowel is the primary area of injury in celiac disease however, it is believed that a relationship exists between what occurs in the small bowel and the colon also known as the large bowel. Large numbers of bacteria are present in the colon and the majority of these are beneficial bacteria. The thriving of good bacteria suppresses the bad bacteria however, the celiac patient or anyone that adheres to a gluten free diet generally has an "altered makeup of bacteria in the colon which favors the unwanted bacteria." (Jackson, 2013)

V. Prebiotic Plant Fiber

Prebiotic bacteria are the plant fibers that contain oligofructose and insulin which are necessary plant fibers for the primary nourishment of the good bacteria residing in the small bowel. These fibers are reported to be found in "chicory root, Jerusalem artichoke, leeks, asparagus and others." (Jackson, 2013) These prebiotics are also found in gluten containing wheat and barley. Health benefits from prebiotic fibers include the following:

(1) Increased calcium absorption;

(2) Stronger bones and bone density;

(3) Enhanced immunity;

(4) Reduced allergies and asthma in infants and children;

(5) a lower triglyceride level;

(6) Appetite and weight control;

(7) Lower cancer factors in gut; and (8) Other benefits, including an increased sense of well-being. (Jackson, 2013)

VI. Avoiding Gluten

Steps that can be taken to avoid contact with gluten include the following stated steps:

(1) Buy two jars of jelly, peanut butter and mayonnaise since a knife with bread crumbs will leave gluten behind in jars that are shared. Label the jar that is gluten-free or buy squeeze bottles so that knives need not be used;

(2) Purchase a separate toaster for gluten-free breads or alternatively place clean aluminum foil on the toaster rack when used for gluten-free products.

(3) Purchase a separate colander or strainer for use with gluten-free past and color code with a permanent marker to keep utensils in the kitchen separate.

(4) Be sure to clean counter tops and cutting boards regularly to remove crumbs containing gluten;

(5) Store foods that are gluten-free above foods containing gluten in the refrigerator or pantry;

(6) Use pure spices rather than using blends;

(7) When baking with flours containing gluten, put foods away or cover gluten-free foods when baking as flour dust can float in the air and contaminate gluten-free products; and (8) Avoid purchasing staples from bulk bins. (Anderson and Roach, 2009)

VII. Proper Nutrition for Individuals With Celiac Disease

It is important that individuals with celiac disease get enough vitamin D, Iron, Calcium, and Vitamin B, as well as fiber while adhering to a gluten-free diet. The following list contains gluten-free products in those categories:

Calcium -- milk, yogurt, cheese, sardines and salmon with bone, broccoli, collard greens, almonds, calcium-fortified juice, amaranth, teff, quinoa.

Iron -- meat, fish, chicken, beans, nuts, seeds, eggs, amaranth, quinoa, teff

Vitamin B -- eggs, milk, meat, fish, orange juice, beans, nuts, seeds, gluten-free whole grains

Vitamin D -- Vitamin D fortified milk and yogurt, egg yolks, salmon, sardines, and tuna.

Fiber -- vegetables, fruits, beans, amaranth, quinoa, millet, buckwheat, sorghum, teff, flax. (Anderson and Roach, 2009)

The following list is a partial list of gluten containing foods, which the individual with Celiac Disease should avoid.

Figure 2 -- Gluten Containing Foods

le

Durum

Lager

Seitan

Atta

Einkorn

Malt

Semolina

Autolyzed yeast

Emmer

Malt extract, malt syrup, malt flavoring, malt vinegar

Soy sauce

Barley (pearl, flakes, flour)

Farina

Malted milk

Spelt

Beer (gluten-free beer is available)

Faro/Farro

Matzoh

Triticale

Brewer's yeast

Fu

Modified food starch

Wheat

Bulgur

Gluten, gluten flour

Oats*

Wheat bran

Chapatti

Graham flour

Orzo

Wheat flour

Couscous

Hydrolyzed vegetable/plant protein

Rye

Wheat germ

Dinkel

Kamut

Seasoning

Wheat starch

*Those labeled gluten-free are fine. Oats do not contain gluten, but have the risk of cross-contact during harvesting or processing.

Common Sources of Hidden Gluten (This is not a complete list.)

Baked beans

Flavoring

Marinades

Seasonings

Blue cheese crumbles

French fries

Meat loaf

Self-basting poultry

Breading

Gravy

Nuts

Soups, soup bases

Broth, bouillon

Herbal Teas

Processed meat

Soy sauce

Candy

Ice cream

Puddings

Stuffing

Cereal binding

Icing/frosting

Rice mixes

Thickeners

Chocolates

Imitation seafood

Roux

Vegetarian "burgers"

Color (artificial, caramel)

Imitation bacon

Salad dressings

Communion wafers

Licorice

Sauces

Dry roasted nuts

Maltodextrin

Sausage

Sample Gluten-Free Shopping List

Vegetables

Lettuce

Tomatoes

Cabbage

Carrots

Broccoli

Potatoes

Celery

Fruits

Apples

Oranges

Bananas

Grapes

Meat, Proteins

Beef

Chicken

Fish

Eggs

Pork

Turkey

Shrimp

Dairy

Milk*

Cheddar cheese

Cream cheese*

Butter

Yogurt*

Cottage cheese*

Sour cream

Binders (for baking)

Xanthan gum

Guar gum

Tapioca

Frozen Foods

Berries

Corn

Sorbet

Gluten-free waffles

Mangoes

Peas

Canned and Packaged Foods

Peaches

Pears

Green beans

Dried beans

Gluten-free Grains

Rice* (all forms, even glutinous)

Amaranth

Buckwheat

Soy

Quinoa

Arrowroot

Potato flour, starch

Teff

Millet

Bean flours (garbanzo, fava)

Sorghum

Tapioca (manioc, cassava)

Corn

Snacks

Popcorn*

Corn chips*

Nuts and seeds*

Jello

Rice cakes, rice crackers*

Potato chips*

Condiments

Honey

Jams, jellies, marmalade

Herbs

Pickles

Ketchup

Corn and maple syrup

Salt

Vinegars

Mustard

Sugar

Pepper

Regular mayonnaise and salad dressings*

Peanut butter

Spices

Olives

Vegetable oils

Drinks

Fruit juice

Coffee

Tea

*With no gluten-containing additives.

Shopping Guide: Sources of Gulten (This is not a complete list. If in doubt, choose another brand.) Read labels every time you buy! Ingredients can change at any time.

Foods to Avoid

Ale

Dinkel

Lagar

Seasonings

Atta

Dry roasted nuts

Licorice

Seitan

Autolyzed yeast

Durum

Malt

Self-basting poultry

Baked beans

Einkorn

Malt extract, malt syrup, malt flavoring

Semolina

Barley (pearl, flakes, flour)

Emmer

Malted milk

Soups, soup bases

Beer (gluten-free beer is available)

Farina

Marinades

Soy sauce

Breading

Faro

Matzoh

Spelt

Brewer's yeast

Flavoring

Meat loaf

Stuffing

Broth, bouillon

Fu

Modified food starch

Textured vegetable protein (TVP)

Brown rice syrup

Gelantized starch

Mono- and di-glycerides

Thickeners

Bulgur

Graham flour

Oats (not labeled gluten-free)

Triticale

Cereal binding

Gravy

Processed meat

Wheat

Chocolate bars

Hydrolyzed vegetable/plant protein

Roux

Wheat bran

Color (artificial, caramel)

Icing/frosting

Rye

Wheat flour

Communion wafers

Imitation seafood

Salad dressings

Wheat germ

Couscous

Imitation bacon

Sauces

Wheat starch

Dextrin

Kamut

Sausage

(Source: Anderson and Roach, 2009)

VIII. Research on Gluten