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Celiac Disease (CD) is a life-long digestive disorder found in individuals who are genetically susceptible. Damage to the small intestine is caused by an immunologically toxic reaction to the ingestion of gluten. This does not allow food to be properly absorbed. Even small amounts of gluten in foods may affect those with celiac disease and cause health problems. Damage can occur to the small bowel even in the absence of symptoms.

This is a simple overview of the Gluten-Free (GF) diet. Not all areas of the diet are as clear-cut as portrayed by this Guide. This is intended to be used as a safe and temporary survival tool until the newly diagnosed celiac obtains additional information. Understanding these dietary requirements will enable the newly diagnosed to read labels of food products and determine if a product is GF.

Gluten is the generic name for certain types of proteins contained in the common cereal grains wheat, barley, rye and their derivatives.

ALLOWED Grains/Flours

Rice, corn (maize), soy, potato, tapioca, beans, garfava, sorghum, quinoa, millet, buckwheat, arrowroot, amaranth, teff, Montina®, flax, and nut flours.

NOT ALLOWED in any form

Wheat (enkorn, durum, faro, graham, kamut, semolina, spelt), rye, barley and triticale.

Frequently overlooked foods that may contain gluten and need to be verified:

Breading, Coating mixes, Panko Brown rice syrup
Croutons Energy Bars
Flour or cereal products Imitation bacon
Imitation seafood Marinades
Pastas Processed Luncheon Meats
Sauces, gravies Self-basting poultry
Soy Sauce or soy sauce solids Soup bases
Stuffings, Dressing Thickeners (Roux)
Communion wafers Herbal supplements
Nutritional supplements Vitamins & mineral supplements
Prespcription Drugs Over-the-counter medications

Play-doh: a potential problem if hands are put on or in the mouth while playing with play-doh. Hands should be washed immediately after use.

Distilled alcoholic beverages and vinegars are gluten-free. Distilled products do not contain any harmful gluten peptides. Research indicates that the gluten peptide is too large to carry over in the distillation process. This leaves the resultant liquid gluten-free. Wines are gluten-free. Beers, ales, lagers, and malt vinegar are made from gluten-containing grains and are not distilled, therefore they are not gluten-free.

IF IN DOUBT — GO WITHOUT!

When unable to verify ingredients or the ingredient list is unavailable DO NOT EAT IT. Regardless of the amount eaten, it is not worth triggering your immune system and the damage to the small intestine that occurs every time gluten is consumed, whether symptoms are present or not. A person with celiac disease may have additional food sensitivity not related to gluten.

WHEAT FREE IS NOT GLUTEN-FREE

Products labeled Wheat-Free are not necessarily gluten-free. They may still contain rye or barley-based ingredients that are not GF. Spelt is a form of wheat and is not acceptable on a gluten-free diet.

Contamination in Food Preparation

When preparing gluten-free foods they must not come in contact with food containing gluten. Contamination can occur if foods are prepared on common surfaces, or with utensils that are not thoroughly cleaned after preparing gluten-containing foods. Using a common toaster for GF bread and regular bread is a major source of contamination. Flour sifters should not be shared with gluten-containing flours. Deep fried foods cooked in oil shared with breaded products should not be consumed. Spreadable condiments in shared containers may also be a source of contamination. When a person dips into a condiment a second time, with the knife (used for spreading), the condiment becomes contaminated with crumbs (e.g. mustard, mayonnaise, jam, peanut butter, and margarine).

Wheat flour can stay airborne for many hours in a bakery (or at home) and contaminate exposed preparation surfaces and utensils or uncovered gluten-free products. Likewise, foods not produced in a gluten-free environment have the potential to be contaminated with gluten. This may occur when machinery or equipment is inadequately cleaned after producing gluten-containing foods. Food manufacturers are required to abide by Good Manufacturing Practices outlined in the FDA’s Code of Federal Regulations, to reduce the risk of contamination in manufacturing. Let common sense be your guide.

Not All Adverse Reactions Are Due to Celiac Disease

Lactose intolerance, food sensitivities or allergies to soy, corn, other foods or even the stomach flu, are common causes of symptoms similar to celiac disease. Newly diagnosed celiacs may have trouble digesting certain foods, especially fatty ones, until the small intestine has had a chance to heal and start absorbing normally. If necessary, keep a diary of foods eaten. Read labels, remember what you ate, and listen to your body.

Attitude is Everything
Like anything new, it takes time to adjust to the GF diet. It is natural to mourn old food habits for a short time. Stay focused on all the foods you CAN eat. Fresh fruits and vegetables are delicious and healthy. Fresh poultry, fish, meat and legumes provide protein and are naturally GF. Most dairy foods can also be enjoyed providing you are not lactose intolerant. GF substitutes for foods commonly made with wheat are available at health food stores and from GF food manufacturers. Try GF waffles for breakfast; a sandwich on GF bread for lunch; and rice, corn or quinoa pasta for dinner. Your new way of eating is very satisfying!

The GF diet is a life-long commitment and should not be started before being properly diagnosed with CD/DH. Starting the diet without complete testing is not recommended and makes diagnosis difficult. Tests to confirm CD could be inaccurate if a person were on a GF diet for a long period of time. For a valid diagnosis gluten needs to be reintroduced. Celiac Disease is an inherited autoimmune disease. Screening of family members is recommended. Consult your doctor for testing.