Gluten Restricted Diet

Gluten Restricted Diet 

Content

Gluten Restricted Diet
- Introduction
- Indication
- Relationship with
  Other Conditions
 

The Nature of Celiac Disease

- Genetic Properties

- Frequency and Occurrence

- Diagnosing Celiac Disease

- Treatment of CD

Gluten

- Wheat Flour Proteins

- Oats

- Gluten In Food Products

- Gluten Containing
  Grain Products

- Questionable Products

- Gluten Free Grains and
  Grain Substitutes

- Other Gluten Free Foods

- Nutritional Considerations

Autism and Gluten Free Diet

Gluten-Free Diet Sample Menu

Preparing Gluten-Free Food

Food Exchange Menu

Gluten Restricted Diet

Introduction¹

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.

Gluten Restricted Diet
                Indication²

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

•  Celiac Disease (CD).
•  Autism Spectrum Disorders (ASD).
•  Attention Deficit Hyperactivity Disorder (ADHD).
•  Some behavioural problems.

Relationship with Other Conditions

Gluten sensitivity correlates with other conditions such as³ :

•  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

Gluten⁹

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

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: 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

2 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 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 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.

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

• Bulgur
• Cereal Binding
• Chapatti flour (atta)       
• Couscous
• Dinkel (Spelt)
• Durum
• Einkorn                                
• Emmer
• Farina                   
• Farro
• Fu
• Gluten,  gluten flour
• Graham  flour
• Kamut
• Malt (extract, vinegar, syrup)
• Matzoh meal

                               

Oats (Controversial*, bran)

• Orzo     

Rye

• Seitan (wheat meat)     
• Semolina            
• Spelt (Dinkel)
• 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”

• Amaranth
• Cassava
• Flax
• Nuts
• Potatoes
• Sago
• Tapioca
• Teff
• Wild Rice
• Arrowroot

Fresh meat, poultry, fish and seafood.

Fresh vegetables and fruits.

Eggs.

Cheese and other dairy.

All products
made with
gluten-free
ingredients.

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