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Gluten Free Diet

Assortment of gluten free grains

Guideline for a Gluten Free Diet

What is the Gluten-free diet? The gluten-free diet is a diet that excludes all the food containing gluten. Gluten is a protein found in grains such as wheat, barley, rye and triticale (a cross between wheat and rye) in their derivatives and also in processed foods.

When individuals affected by celiac disease ingest gluten, an immune response is developed damaging the lining of the small intestine. Small quantities of gluten can cause problems too, although sometimes symptoms are not visible.

Initially the complete exclusion of gluten from diet is not easy to accomplish and this food restriction may be frustrating. However, with time, patience and creativity, you’ll find there are many foods that you already eat that are gluten-free and you will find substitutes for gluten-containing foods that you can enjoy.

This document aims to provide some basic guidelines for a gluten-free diet.


Picture of many different types of healthy gluten free food

Step 1: Identify the safer food

ALLOWED FOOD Many healthy and delicious foods are naturally gluten-free:

  • Rice
  • Buckwheat
  • Amaranth
  • Corn and cornmeal
  • Gluten-free flours (rice, soy, corn, potato, quinoa, bean, flax)
  • Hominy (corn)
  • Millet
  • Quinoa
  • Sorghum
  • Soy
  • Tapioca
  • Teff
  • Tubers (potato, sweet potato, mexican potato, manioc, topinambur, arrowroot)
  • Fresh meats, fish, seafood and poultry (not breaded, batter-coated or marinated)
  • Fresh eggs
  • Most dairy products (unless lactose intolerance)
  • Fruit
  • Vegetables
  • Legumes (chickpeas, beans, lentils, peas, soybeans), seeds and nuts in their natural, unprocessed form

NOT ALLOWED FOOD Avoid all food and drinks containing:

  • Barley (malt, malt flavoring and malt vinegar are usually made from barley)
  • Rye
  • Triticale (a cross between wheat and rye)
  • Wheat
  • Emmer
  • Einkorn
  • Bulgur
  • Durum flour
  • Farina
  • Graham flour
  • Kamut
  • Semolina
  • Spelt
  • Atta
  • Cous cous
  • Hydrolyzed wheat protein
  • Brewer’s yeast
Picture of a plump man holding on to a bowl of healthy salad

Picture of many different food alternatives for gluten free diet

FORBIDEN FOODS
Avoid unless labeled ‘gluten-free’
In general, avoid the following foods unless they’re labeled as gluten-free or made with corn, rice, soy or other gluten-free grain:

  • Beer
  • Breads
  • Cakes and pies
  • Candies
  • Cappuccinos or hot chocolate (chocolate drink powders may contain wheat starch)
  • Cereals
  • Cookies
  • Crackers and croutons
  • Food additives, such as malt flavoring, modified food starch and others
  • French fries
  • Gravies
  • Imitation meat or seafood
  • Matzo
  • Pasta and pizza
  • Processed luncheon meats
  • Salad dressings (including balsamic vinegar)
  • Sauces, including soy sauce
  • Seasoned rice mixes
  • Seasoned snack foods, such as potato and tortilla chips
  • Self-basting poultry
  • Soups and soup bases
  • Stock cubes or powder
  • Tempura
  • Vegetables in sauce
  • Medications and vitamins that use gluten as a binding agent
    Certain grains, such as oats, can be contaminated with wheat during growing and processing stages of production. For this reason, doctors and dietitians generally recommend avoiding oats unless they are specifically labeled gluten-free.

STEP 2: AVOID THE HIDDEN GLUTEN & REDUCE THE CONTAMINATION

HIDDEN GLUTEN
Sometimes you can find some products you think they are safe because made with the “allowed food” but they are not. Why? Because they also contain “not allowed food”. An example is made by rice cereals or corn flakes that are often added with malt as a sweetener that is a source of gluten.
To identify the hidden gluten please follow this simple rules when you check the ingredients and since they can change at any time, it’s important to read labels every time you shop.

Choose products with a short ingredients list, in this case it is easier to check if there are gluten-containing ingredients.
Avoid the product that contain ingredient like: wheat starch, modified wheat starch, wheaten corn flour, thickeners (1400-1450) (wheat), dextrin and maltodextrin (wheat), malt or malt extract (barley), malt vinegar, yeast extract (barley, malt), textured vegetable protein & hydrolyzed vegetable protein (wheat), icing sugar mixture (wheat starch), bran (wheat, oat, barley).
Avoid products that do not list the source of dextrin or starch on the product label.
Please, purchase naturally gluten-free foods because they are also healthier compare to the processed form and remember that all of those processed foods may have gluten-containing ingredients.
Products labeled “wheat-free” are not necessarily gluten free. Remember to read all the ingredients.

Picture of a cheerful lady preparing gluten free meal

An illustration of the sources of gluten cross-contamination

Contamination

Contamination can occur when gluten comes into contact with gluten free food. Usually it can happen during the preparation of food either in the kitchen at home, in a restaurant or during manufacturing, where companies produce both products with and without gluten (usually they states on the label that the naturally gluten free product may be contaminated “May contain gluten” or “May contain traces of wheat or gluten”). In this case, in order to reduce the contamination risk, you should purchase the products labelled “gluten-free” or safer alternatives.
The U.S. Food and Drug Administration (FDA) has defined the term “gluten-free” in the labelling of different foods and products. When a product is labeled “gluten-free” means that it meet the requirements of the agency’s gluten-free labelling rule and it contain less that 20 ppm.
Furthermore there are some tips and rules you can follow at home in order to prepare safe meal:

Carefully clean common surface, work tools and utensils before starting to cook.
Do not use hard to clean equipment for both gluten-free and gluten-containing foods.
Toasters, strainers and flour sifters should not be shared.
Wash your hands thoroughly before handling gluten-free ingredients
If you can prepare gluten free and gluten-containing foods at different times, give the priority to gluten-free ones.
Deep-fried foods cooked in oil also used to cook breaded products should be avoided. (in any case don’t use too much fried food).
If you are using spreadable condiment in shared containers, don’t use the same knife or teaspoon for both products with and without gluten because the risk is that you can contaminate the sauce.
Wheat flour can stay airborne for long time contaminating food, surface and utensils, so please clean everything before starting to cook and store your gluten-free product in a safe area.
Use two different pack of salt while you are cooking because most of the time you take a pinch of salt for both gluten free and non gluten free product and in this way you may have a contamination.
When you put bread with gluten on the table, do not place it on the tablecloth, but in a basket or plate.
Use baking paper for baking trays, grills and pans where contamination may be present and clean at the end removing all crumbs and residuals.
Store gluten-free products (pasta, flour, etc.) in a box in a different place from the gluten-containing foods.


Step 3: MENU PLANNING

HEALTHY BALANCED DIET

HEALTHY BALANCED DIET
A balanced diet is a diet consisting of a variety of food, providing adequate intake of energy and amounts of nutrients necessary to prevent nutritional deficiencies.
This diet is the combination of different foods that contains carbohydrates, fat, protein, minerals, vitamins, fiber and water required by your body to work properly.
Please follow these simple tips:
Divide the daily food intake into 5 meals (breakfast, lunch, dinner and 2 snacks).
Eat following the healthy plate

Eat more than 5 servings of fruit and vegetables every day, preferring vegetables instead of fruit.
Fill a quarter of your plate with the allowed carbohydrates preferring naturally gluten-free cereals.
Fill a quarter of your plate with protein using fresh meat and poultry, fish, eggs, cheese and legumes.
Increase the amount of monounsaturated and polyunsaturated fatty acid using: seeds (sesame, flax, chia, pumpkin, sunflower..), dried fruits (walnuts, hazelnuts, almonds, cashews..), good oils (olive oil or extra virgin olive oil), fish (tuna, sardine, salmon, mackerel) and avocado.
Drink 2 liter of water per day and remove the sugary drink from your diet because they contain sugar and artificial sweeteners that may cause bacterial imbalance in gut, bloating and fermentation.
Avoid GMO products like soy and corn.
Avoid non fat products because they are full of additives, thickeners, gums and gelatin.
Control the daily salt intake avoiding the process food and reduce the amount of salt in your meal. Use herbs, spices and lemon juice instead to give more flavor!

After diagnosis of celiac disease, people sometime start getting very nervous and frustating about the diet management although it represents a great opportunity to make you feeling better and remain healthy. In order to incorporate your new diet regime into day to day life, create your weekly menu to facilitate planning for a balanced and safe diet. Look at your gluten-free diet as an opportunity to discover new gluten-free foods and delights and get inspired also by different cuisine using their herbs and spices to create a tasty and gluten free recipes. Use also your weekly menu to create your own shopping list and facilitate your gluten-free purchaises.


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