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
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