Have you ever realized how many foods have gluten? For such a little protein, it seems to show up in a wide variety of places. My last blog highlighted oats, spices, nuts, seeds, alcohol, and coffee - - be sure to view that if you haven’t already.
There are many other hidden sources of gluten, and some of them may surprise you! Let’s walk through increasing your chances of avoiding them.
First, be sure to recognize all the grains and pastas that are actually WHEAT, including bulgur, semolina, durum, spelt, kamut, graham, einkorn, farina, couscous, orzo, seitan, matzah (or matzoh or matzo) and cake flour to name a few. I had a client tell me she eats spelt because she read somewhere that it isn’t really wheat. It is!
Second, my ongoing recommendation is to read all INGREDIENTS on food labels. Some food packages make it easy for us by stating “gluten-free”; this is a voluntary claim that can be used by food manufacturers on food labels if they meet all the requirements of the regulations. A symbol is not required. If the food package does not say “gluten-free”, then we need to look at the list of Ingredients. Food manufacturers are required to list all ingredients in order from highest to lowest amount. Here are a few ingredients to avoid:
Unfortunately some ingredients can be listed as “flavors” or “spices” without naming each one, making your symptoms journal all the more important. For example, I had a client who was symptom-free and doing well, so he purchased a new type of rice, a flavored mix to add variety to his diet. It turned out to cause him quite a bit of bloating and pain, and he realized the source of the problem was the spice mix it contained.
Food labels do have to list wheat, thanks to the federal Food Allergen Labeling and Consumer Protection Act (FALCPA). Any packaged food regulated by the FDA must state that it contains wheat; furthermore, it may also have the statements “may contain wheat” or “made in a facility with wheat”, which are voluntary statements. These come in very handy for me when I am choosing nuts.
My third suggestion is to take a second look at the MEAT, FISH and POULTRY you are eating, as processed versions may contain gluten. Starting with meat and poultry, it is good to know that plain beef, chicken, turkey and pork do not naturally contain gluten. But when they are packaged or processed in any way, they may contain additional ingredients, or if they are sliced in the deli they may come into contact with gluten from other foods. The more the meat or poultry strays from its origin, say into the form of bologna or salami, the more likely it is to have outside ingredients. Your safest approach is to look for those clearly labeled “gluten-free”. These are helpful lists of brands of gluten-free deli meat and gluten-free sausages.
In addition to deli meat, beware of hot dogs, self-basting turkey or seasoned chicken breast. Even rotisserie chicken may have gluten; when roasted in the store, flour is often added to the skin to make it crisper, and there are also many spices and sauces that are used that may contain gluten. Also, as if that isn’t all worrisome enough, the rotisserie chicken may be exposed to gluten when it is packaged, since fired chicken is usually prepared right next to it. Look for “gluten-free” rotisserie chicken.
Meat substitutes are not necessarily a safe replacement, as there may be gluten in veggie burgers and other meat alternatives products (veggie bacon, sausage, burritos, etc.). Seitan is a common meat substitute, but is almost completely wheat gluten. Soy and bean products may have gluten-containing ingredients added. As always, read labels or call the manufacturer if you are not sure.
As for fish, seafood itself is naturally gluten-free and a wonderful source of nutrients, but processed fish such as imitation crabmeat usually contains wheat. Also, seafood that has been pre-seasoned, breaded, or packaged with a sauce are risky. I recommend you stick to plain fish that you can season and prepare yourself. This is a good overview of choosing safe seafood.
Another popular food is PIZZA. I know it seems obvious that pizza with a wheat crust has gluten and should be avoided. But also be careful with other pizzas, as sometimes they have a gluten-free crust but contain gluten in the cheese (shredded cheese may be mixed with a gluten-containing starch to prevent sticking and clumping) or the toppings (such as pepperoni). Read, call, ask, become informed. Whether you are buying a pizza from a grocery store or ordering pizza from a restaurant, use the same rules.
SAUCES, GRAVIES AND SPICE mixes may contain gluten from wheat or other culprits because they provide thickening (think roast beef gravy made from a roux) or stability (e.g. a package of fajita seasoning may have wheat added to prevent caking). Or they may be made of wheat; for example, soy sauce is a mixture of soy and wheat fermented together.
SOUPS from a manufacturer (premade) often contain pasta, barley, or spices that potentially contain gluten. Some brands are great about using the “gluten-free” designation on the label, but others just provide the list of ingredients, so you have to read carefully. If in doubt, don’t buy it; if you already bought it, call the manufacturer to check.
SALADS can be a nutrition dream of a variety of colorful greens and other fresh vegetables like tomatoes, cucumbers, peppers, carrots and mushrooms. As is, these are all naturally gluten-free ingredients. Make your own dressing or simply toss with vinegar, oil, salt and pepper for one of my favorite lunches and side dishes. Be careful, though, with store bought and restaurant salad dressing as well as croutons and other toppings that may have gluten containing elements.
Between meals, SNACK BARS can give you a boost but could also make you sick, so be sure to know what you are getting. With over 100 different brands and even more flavors, they also come with a variety of names: protein bars, energy bars, granola bars, health bars, and cereal bars. Start by eliminating those with wheat, rye and barley, then study the ingredient list. Avoid any that say “may contain” or “processed in a facility with” wheat. Bars often contain oats that are not gluten-free, wheat starch, rice syrup, yeast extract, and natural flavors. Some also contain dextrin and maltodextrin, which may or may not be made from wheat. If the bar is labeled “gluten-free”, of course, you do not need to worry, but if it is not, you should probably avoid or call the manufacturer to check.
SWEETS such as cookies and cake are probably obvious to you has potential sources of gluten. But what about ice cream, candy, candy bars and even cheesecake filling? All potential sources of gluten due to wheat and other gluten containing ingredients that are added. For example, vanilla ice cream is gluten-free while cookies and cream flavor is not; plain M&M’s are gluten-free but pretzel and crispy M&M’s are not; cheesecake is sometimes thickened with wheat. Other times, the product comes into contact aith gluten during processing. If you have celiac disease, you must carefully avoid all of these. If you have non-celiac gluten sensitivity, you may tolerate a product that has only slight exposure to gluten. Your symptom journal will help you. And fortunately for us, the most trusted celiac and nonceliac gluten sensitivity expert sites list gluten-free candy sources every Halloween and Easter; start with this one: Gluten and Candy.
That is a lot of information and there is so much more out there! I don’t attempt to list all the brand names of what does and does not contain gluten because there are other sites that serve that purpose. My favorites are www.celiac.org and www.beyondceliac.org.
If you are doing your elimination diet, you can start to add them back foods in just a few weeks to identify which are bothersome to you. Until then, continue to keep a symptoms journal, read food labels and watch for those gluten sources.
What does a dietitian, nutritionist, and health professional do when she discovers she has to avoid gluten? I mean, avoid it to prevent painful symptoms, not to follow a trend!