Gluten free diet: How to go gluten free
 
Getting on a gluten free diet isn't easy, but it's essential if you have celiac disease. Following are tips to help you on your way to safe and healthy eating.

A gluten free diet excludes the protein gluten, which is found in grains such as wheat, barley or rye. If you or your child has celiac disease, a gluten free diet is essential, because gluten causes a problematic immune reaction in the small intestine. This reaction results in damage to the inner surface of the small intestine and an inability to absorb certain nutrients from food.

If you think you may have celiac disease, wait until you've been diagnosed to start a gluten free diet. That's because it may be more difficult for your doctor to make a diagnosis if you've begun the diet before being tested.

Initially, following a gluten free diet may be frustrating. But with time, patience and creativity, you'll find there are many foods that you can eat and enjoy.

Avoid these foods in a gluten free diet
To manage celiac disease and prevent complications, it's crucial that you avoid all foods that contain gluten.

Avoid these gluten-containing grains - Avoid all foods or food ingredients made from many grains, including:

• Wheat

• Barley

• Rye

• Farina

• Graham flour

• Semolina

• Durham

• Bulgur

• Kamut

• Kasha

• Matzo meal

• Spelt (a form of wheat)

• Triticale

Oats may not be harmful for most people with celiac disease, but oat products are frequently contaminated with wheat, so it's best to avoid oats as well. The question of whether people eating a gluten free diet can consume pure oat products remains a subject of scientific debate. Difficulties in identifying the precise components of grains responsible for the immune response and the chemical differences between wheat and oats have contributed to the controversy.

Avoid these products unless labeled 'gluten free' - The following grains are gluten free as grown, but may be contaminated by other grains during harvesting and processing. Verify that these are processed in a gluten free facility before consuming them:

• Amaranth

• Buckwheat

• Quinoa

Most foods made from grains contain gluten. Avoid these foods unless they're labeled as gluten free or made with corn, rice, soy or other gluten free grain. It's also important that they're processed in a facility that is free of wheat or other contaminating products:

• Breads

• Cereals

• Crackers

• Croutons

• Pasta

• Cookies

• Cakes and pies

• Soups

• Gravies

• Sauces (including soy sauce)

• Salad dressings

• Beer

• Candy

• Imitation meat or seafood

• Processed luncheon meats

• Self-basting poultry

Many other products that you may consume or that may touch your mouth have ingredients that contain gluten. These include:

• Food additives, such as malt flavoring, modified food starch and others

• Medications and vitamins that use gluten as a binding agent

• Lipstick and lip balms

• Toothpaste

• Postage stamps

• Play dough

Cross-contamination also may occur anywhere ingredients come together, such as on a cutting board or a grill surface. You may be exposed to gluten by using the same utensils as others, such as a bread knife, or by sharing the same condiment containers — the condiment bottle may touch the bun, or a knife with bread crumbs may contaminate a margarine stick or mayonnaise jar.

Safe foods in a gluten free diet
Foods allowed in a gluten free diet There are still many basic foods allowed in a gluten free diet. These include:

• Fresh meats, fish and poultry (not breaded, batter-coated or marinated)

• Most dairy products

• Fruits

• Vegetables

• Rice

• Potatoes

• Gluten free flours (rice, soy, corn, potato)

• Wine and distilled liquors, ciders and spirits

• Products labeled 'gluten free' also safe

Fortunately for bread and pasta lovers with celiac disease, there are an increasing number of gluten free products on the market. If you can't find them at your local bakery or grocery store, check with a celiac support group or the Internet. In fact, there are gluten free substitutes for many gluten-containing foods, from brownies to beer. Many specialty grocery stores sell gluten free foods.

Note that "wheat-free" doesn't necessarily mean gluten free. The product may still contain rye, barley or spelt ingredients that contain gluten.

How to tell what's OK
Read food labels every time - Read the label before you purchase any food product. Some foods that may appear acceptable, such as rice or corn cereals, may contain gluten. What's more, a manufacturer may change a product's ingredients at any time. A food that was once gluten free no longer may be. Unless you read the label every time you shop, you won't know for sure.

The Food and Drug Administration (FDA) requires products containing wheat, milk, soy, peanuts, tree nuts, fish, shellfish or eggs to say so in plain English on the product's label. By August 2008, the FDA is expected to issue a standard definition of "gluten free" to make it easier for shoppers with celiac disease to identify products.

Call the manufacturer
If you can't tell by the label if a food contains gluten, don't eat it until you check with the product's manufacturer. Some support groups produce a gluten free shopper's guide that can save you time at the market, although it may not be as current as that obtained from the manufacturer.

Tips for cooking at home
For thickening, use cornstarch, potato starch, arrowroot or tapioca flour in place of wheat flour. And in baked products, substitute rice, potato, corn, soy or a blend of these or other gluten free flours. Amounts and other ingredients in recipes may need to be adjusted. Gluten free cookbooks are available that can give you a good start at adjusting recipes.

You can still eat out
Though preparing your own meals is the easiest way to monitor your diet, this doesn't mean you can't dine out. For an enjoyable experience, remember the following advice:

Select places that specialize in the kinds of foods you can eat. You may want to call the restaurant in advance and discuss the menu options and your dietary needs.

Be a repeat customer. Visit the same restaurants so that you become familiar with their menus and the staff gets to know your needs.

Seek and share ideas. Ask members of your support group for suggestions on restaurants that serve gluten free food. If there are enough gluten-sensitive people in your community, it's likely that restaurant owners will try to satisfy your needs. Continue to share with the support group the names of restaurants that add gluten free foods to their menus.

Follow the same practices you do at home. Select simply prepared or fresh foods and avoid all breaded or batter-coated foods, gravies and other foods with obvious or questionable ingredients. Avoid cross-contamination, such as grills that have had buns or bread on them, which can contaminate your meat, or deep fat fryers that have had batter-fried fish in them, which can contaminate your french fries.

What if you eat gluten?
If you accidentally eat a product that contains gluten, you may experience abdominal pain and diarrhea. Some people experience no signs or symptoms after eating gluten, but this doesn't mean it's not damaging their small intestine. Even trace amounts of gluten in your diet may be damaging, whether or not they cause signs or symptoms. Going on and off a gluten free diet could lead to serious complications such as bone loss, anemia, vitamin deficiencies or gastrointestinal cancer, especially lymphoma.

Ask for help
Identifying gluten free foods can be difficult. Because a gluten free diet needs to be strictly followed, you may wish to consult a registered dietitian who teaches the gluten free diet. A dietitian can advise you on how to best maintain the nutritional quality of your diet and help you with gluten free alternatives. Your dietitian can also help you identify your need for vitamin, calcium and mineral supplements. Meeting with the dietitian regularly will help keep you up to date on newer food products as well as answer your questions.

sourced: Mayo Clinic