What does gluten-free mean?

DR FAITH B YISRAEL

I’m sure that many of you have been as confused as I have been about this “gluten-free” diet. In fact, I have a few friends who frequently post about trying to find gluten-free products in Tobago and I always wondered why that’s necessary and what it really means. In this article I share what I’ve learned.

What is gluten?

The term “gluten” refers to a family of storage proteins formally known as “prolamins”, naturally found in wheat, barley, rye, oats (in some cases) and triticale (a cross between wheat and rye). While oats are naturally gluten-free, they may be contaminated during production with wheat, barley or rye. Oats and oat-products labelled gluten-free have not been cross-contaminated. Some people with celiac disease, however, cannot tolerate the gluten-free-labelled oats.

Gluten offers a variety of functional culinary benefits and is responsible for the soft, chewy texture that is characteristic of many gluten-containing, grain-based foods. When heated, gluten proteins form an elastic network that can stretch and trap gas, allowing for optimal leavening or rising and maintenance of moisture in breads, pasta, and other similar products. Because of these unique physical properties, gluten is also frequently used as an additive to improve texture and promote moisture retention in a variety of processed foods.

Since so many foods include these products, the list of processed foods that include gluten is very long: Beer, ale, porter, stout (usually contain barley); breads; cakes and pies; candies; cereals; communion wafers; cookies and crackers; croutons; French fries; gravies; imitation meat or seafood; malt, malt flavouring and other malt products (barley); pastas; hot dogs and processed lunchmeats; salad dressings; sauces, including soy sauce (wheat); seasoned snack foods, such as potato and tortilla chips; soups, bouillon or soup mixes; and vegetables in sauce.

Prescription and over-the-counter medications may use wheat gluten as a binding agent. Therefore individuals who can’t use gluten, may also need to chat with their health care provider before taking common medications.

Is gluten bad?

For most people, having a diet with gluten is not a problem, but for others, it is associated with several disease and conditions. According to the Mayo Clinic website, there are four main conditions of concern:

*“Celiac disease is a condition in which gluten triggers immune system activity that damages the lining of the small intestine. Over time this damage prevents the absorption of nutrients from food. Celiac disease is an autoimmune disorder.

*Non-celiac gluten sensitivity causes some signs and symptoms associated with celiac disease – including abdominal pain, bloating, diarrhoea, constipation, "foggy brain," rash or headache – even though there is no damage to the tissues of the small intestine. Studies show that the immune system plays a role, but the process isn't well understood.

*Gluten ataxia, an autoimmune disorder, affects certain nerve tissues and causes problems with muscle control and voluntary muscle movement.

*Wheat allergy, like other food allergies, is the result of the immune system mistaking gluten or some other protein found in wheat as a disease-causing agent, such as a virus or bacterium. The immune system creates an antibody to the protein, prompting an immune system response that may result in congestion, breathing difficulties and other symptoms.”

Gluten-free diets

A gluten-free diet is therefore a diet that does not include gluten. A gluten-free diet includes foods like fruits and vegetables; beans, seeds, legumes and nuts in their natural, unprocessed forms; eggs; lean, non-processed meats, fish and poultry; and most low-fat dairy products. Grains, starches or flours that can be part of a gluten-free diet include: arrowroot; buckwheat; corn – cornmeal, grits and polenta labelled gluten-free; flaxseed; gluten-free flours – rice, soy, corn, potato and bean flours; millet; quinoa; rice, including wild rice; sorghum; soy and tapioca (cassava root).

Gluten-free labels

Since gluten is naturally occurring, or is found in so many foods, governments have implemented gluten-free food labelling regulations. While these labels can make gluten elimination much easier, they don’t necessarily mean that gluten is completely absent from the item.

In the US, the European Union, and Canada a product can carry a gluten-free label as long as gluten makes up fewer than 20 parts per million (ppm) of the product. That means that for every million parts of the food, up to 20 of them can be gluten. Foods with these labels may include:

· Naturally gluten-free food

· A prepared food that doesn't have a gluten-containing ingredient

· Food that has not been cross-contaminated with gluten-containing ingredients during production

· Food with a gluten-containing ingredient that has been processed to remove gluten

Alcoholic beverages made from natural gluten-free ingredients, such as grapes or juniper berries, can be labelled gluten-free. An alcoholic beverage made from a gluten-containing grain (wheat, barley, rye and hybrid grains such as triticale) can carry a label stating the beverage was "processed," "treated" or "crafted" to remove gluten. However, the label must state that gluten content cannot be determined and the beverage may contain some gluten. These beverages may not be labelled gluten-free.

If you have celiac disease or fall into any of the other categories of individuals who should not consume gluten, it is important that you maintain a gluten-free diet. This means paying very special attention when preparing your own foods, or eating out. Here are a few tips from the Mayo Clinic:

· Store gluten-free and gluten-containing foods in different places.

· Keep cooking surfaces and food storage areas clean.

· Wash dishes and cooking equipment thoroughly.

· Toast bread in the oven – or consider separate toasters – to avoid cross-contamination.

· Read restaurant menus online ahead of time if possible to be sure there are options for you.

· Eat out early or late when a restaurant is less busy and better able to address your needs.

D
r Faith B Yisrael is a health educator, social scientist, public health specialist and politician.

Email address: Imani.Consulting.Tobago@gmail.com

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