Gluten is the protein found in wheat. Similar
proteins which are harmful to Coeliacs are present in rye, barley and
possibly oats. Wheat, rye and barley are therefore excluded from the
gluten-free diet. Oats may be allowed for some patients, under careful
medical and dietetic supervision.
COELIAC DISEASE
Coeliac Disease is a life-long inflammatory
condition of the gastro-intestinal tract that affects the small intestine
in genetically susceptible individuals.
Gluten damages the lining of the small intestine,
reducing its ability to absorb adequate nutrients from food, resulting in
illness which may resemble malnutrition, The treatment for Coeliac Disease
is a strict gluten-free diet for life. For more informaation on Coeliac
Disease click here.
DERMATITIS HERPETIFORMIS
Dermatitis Herpetiformis is an itchy blistering
skin eruption, due to gluten sensitivity. This sensitivity also affects
the small intestine in the majority of patients, giving rise to a mild
form of Coeliac Disease. The gluten-free diet eventually cures the skin
rash as well as being the treatment for Coeliac Disease - ft should
therefore be continued for life. For more information on Dermatitis
Herpetiformis click here
WHAT IS NATURALLY GLUTEN-FREE?
Many foods are naturally gluten-free as they do
not contain any wheat, rye, barley or oats. For example, all fresh meat,
fish, cheese, eggs, milk, fruit and vegetables are gluten-free. However,
once such foods are processed or used as ingredients in other foods, great
care must be taken to ensure that wheat or other gluten-containing cereals
have not been added in the manufacture.
OBVIOUS DIETARY SOURCES OF GLUTEN
Wheat is usually milled into flour and therefore
any food made from four, such as ordinary bread, biscuits, cakes,
pastries, puddings and pies, will contain gluten.
HIDDEN SOURCES OF GLUTEN
Gluten is also contained in manufactured and
processed foods where wheat flour is commonly used as a processing aid, a
binder, a filler or as a carrier for favourings and spices. Contamination
with wheat or wheat flour can also occur during cereal production,
storage, processing or manufacture.
WHAT IS WHEAT STARCH
Wheat starch is produced from wheat four by
removing the proteins including gluten. Years ago it was believed that all
the protein could be removed, It is now recognised that it is technically
impossible to remove all traces of protein and a small amount remains.
There are two types of wheat starch:
Commercial wheat starch which is not pure enough
to be suitable for Coeliacs.
Specially-manufactured wheat starch which
complies with the lntemational Gluten-free Standard (Codex Ahmentarius)
and can safely be included in the gluten-free diet.
Wheat starch of this purity is expensive and it
is most commonly used in products specially-manufactured for Coeliacs, to
provide palatable and acceptable bread and flour substitutes.
WHEAT FREE, GLUTEN-FREE DIETS
These may be preferable for a few Coeliacs who
appear to be intolerant to wheat starch. This diet contains breads and
flours made from naturally gluten-free foods such as maize, potato, rice
and soya rather than wheat starch.
SUPER-SENSITIVITY
There are a few super-sensitive Coeliacs who do
not respond fully to a strict traditional gluten-free diet, Such people
may therefore be advised to limit their diets further - not only by
omitting wheat starch on the gluten-free, wheat free diet, but also by
restricting malt extract and malt extract flavorings. Sensitive Coeliacs
should additionally avoid oats and oat products. However, further
restrictions should not be undertaken lightly and the Society therefore
recommends that highly sensitive Coeliacs should discuss their diets
carefully with their Consultant Gastroenterologist and Dietitian.
SPECIALLY-MANUFACTURED GLUTEN-FREE FOODS
Many specially-manufactured branded gluten-free
and wheat free products are now produced. For people medically-diagnosed
as having Coeliac Disease or Dermatitis Herpetiformis, basic foods such
as breads, flours, mixes, biscuits, crackers and
pasta are available on a doctor’s prescription, A complete up to date
list of Prescribable Items is always available from the Coeliac
Society Office. Gluten-free luxury items such as cakes, chocolate and
fancy biscuits and seasonal foods like mince pies are not prescribable,
but can be bought over the counter, at pharmacies and some health food
stores. They may have to be specially ordered and they can be expensive.
