Gluten -Free Diet

Gluten -Free Diet

A gluten-free diet is a diet that is completely free of gluten, which is a generic term for storage proteins found in grains.

A gluten-free diet as followed in the United States does not contain protein from wheat, barley, rye, or hybrids of these grains.

All other grain foods, with the possible exception of oats, are considered safe to include in a gluten-free diet.

The gluten-free diet is the prescribed medical treatment for gluten intolerance diseases, including:

o   Celiac Disease (CD).

o   Autism Spectrum Disorders (ASD).

o   Attention Deficit Hyperactivity Disorder (ADHD).

o   Some behavioural problems.

 

Relationship with Other Conditions

Gluten sensitivity correlates with other conditions such as :

Osteoporosis

Chronic Fatigue Syndrome

Irritable Bowel Syndrome

Peripheral Neuropathy

Some autoimmune disorders includes:

Dermatitis Herpetiformis (DH)

Multiple sclerosis.

Sjogren’s Syndrome

Fibromyalgia

Eczema

Type 1 Diabetes

Thyroid Disease

Gluten Includes several different grain storage proteins:

Wheat: Gliadin

Rye: Secalin

Barley: Hordein

Functions:

Provides structure of dough- holding ingredients together, retaining leavening gas as it is formed

In contrast…gluten-free flours:

Mainly starches and non-sticky proteins

Cannot produce same results unless adaptations are made

 

Gluten Structure and Properties

Gluten: 80% protein

High molecular weight (glutenin average MW = 3 million)

Substantial hydrogen bonding due to amino acid side chains

Intertwined network filled with water in inner spaces

Chemical structure binds water, helps in holding moisture

Gliadin and glutenin absorb about twice their weight in water

Also effective in binding lipids

main gluten proteins (prolamin + glutelin)

Gliadin (prolamin): sticky, extensible, low in elasticity

Glutenin (glutelin): rubbery, low extensibility, high in elasticity

Gluten controls baking quality of bread wheat flours

Oats

¢      Oats are often  avoided-although storage protein in oats called avenin does not illicit same response as gluten.

¢      Commercial oats have risk of cross-contamination from harvesting or processing

— Pure oats in moderation: not a problem for most

¢      ½ cup dry rolled oats or ¼ c dry steel-cut oats per day¹

— Expensive

— Proposed FDA rule: Oats can be labeled GF if < 20 ppm gluten

Availability:

       Specialty markets
or order online

 

The Nature of Celiac Disease

The onset of CD can occur at any age.

All people diagnosed with CD will have intestinal damage.

The villi become inflamed, flattened and disappear.

Nutrients, including carbohydrates, proteins, fats, vitamins and minerals, can no longer be absorbed.

This leads to malnutrition and other serious health problems.

Genetic Properties

Celiac Disease is a true autoimmune disease

The genetic predisposition (HLA), the exogenous trigger (Gluten) and the autoantigen (tTG) are all known

CD is currently the only autoimmune disease for which all three factors are known

Unlike many other autoimmune diseases, the cause of the disease has been identified

¢      CD occurs in almost 1% of the population.

¢      CD occurs in 1 in 22 first degree relatives. Canadian Research 12-15 per cent

¢      CD occurs in 1 in 39 second degree relatives.  Canadian Research 5-12 percent

¢      CD occurs in 1 in 56 people with gastro-intestinal symptoms.

¢      CD occurs in 1 in 133 of the ‘not at risk population.

¢      A series of serologic tests can assist in the preliminary screening for CD

¢      An intestinal biopsy must be performed to confirm the diagnosis of CD

¢      The Gluten-Free Diet should never be started without an accurate diagnosis of Celiac Disease

The only treatment for Celiac Disease is

STRICT GLUTEN-FREE DIET FOR LIFE

  

       Even small amounts of gluten can be harmful to people with Celiac Disease and can cause continued small bowel damage.

¢      Digestive damage from
 antibiotic use, intestinal
bacterial imbalance,
yeast overgrowth, or
food sensitivities.

¢       Impaired digestion of gluten and casein into morphine, explains the symptoms of drowsiness, impaired pain intolerance.

¢       Removal of gluten and casein can help a damaged intestine heal itself – can be very

       difficult due to addictive nature, chemical dependency for pain management.

¢      Gluten often added at bakery to strengthen dough

— Often 20% of flour weight

— Hamburger and hot dog buns

— Used to increase protein content (breakfast cereals)

— Vital Gluten used as meat analog (vegetarian products, pet foods)

— Binder in sausage products

Barley

o  Bulgur

o  Cereal Binding

o  Chapatti flour (atta)

o  Couscous

o  Dinkel (Spelt)

o  Durum

o  Einkorn              

o  Emmer

o  Farina         

o  Farro

o  Fu

o  Gluten,  gluten flour

o  Graham  flour

o  Kamut

o  Malt (extract, vinegar, syrup)

o  Matzoh meal

             

Oats (Controversial*, bran)

o  Orzo     

Rye

o  Seitan (wheat meat)      

o  Semolina    

o  Spelt (Dinkel)

o  Triticale      

Wheat (bran, germ, starch)

¢      Blue cheese (crumbles)

¢      Beer  (GF-Greenes, Redbridge)

¢      Broth or bouillon

¢      Candy

¢      Caramel color/flavor

¢      Chocolates

¢      Communion wafers

¢      French fries

¢      Glucose syrup

¢      Herbal teas

¢      Ice cream

¢      Licorice

¢      Malt vinegar

¢      Maltodextrin

¢      Medications

¢      Nuts

¢      Puddings

¢      Salad dressings

¢      Rice mixes

¢      Sauces

¢      Seasonings

¢      Soy sauce

¢      Vegetarian “burgers”

Gluten Free Grains and Grain Substitutes

o  Amaranth

o  Cassava

o  Flax

o  Nuts

o  Potatoes

o  Sago

o  Tapioca

o  Teff

o  Wild Rice

o  Arrowroot

Other Gluten Free Foods

¢      Fresh meat, poultry, fish and seafood.

¢      Fresh vegetables and fruits.

¢      Eggs.

¢      Cheese and other dairy.

All products made with gluten-free ingredients

Nutritional Considerations

Due to decreased absorption of nutrients
(damage to intestinal lining),
and Lack of nutrient-fortified gluten-free products.

Fiber

— Look for “whole grain” versions that contain the bran layer (i.e. Rice bran, “whole grain” brown rice pasta, sprouted grains)

Nutrient density

— Choose more nutritious ingredients such as
brown rice flour, buckwheat and legume flours

— Variety is key-to maximize protein, fiber and nutrients

Nutrients of concern (focus on foods high in the following):

— Calcium

— Iron

— Folate and Vitamin B-12