If you are reading this article, it may be that you or a loved one has recently been diagnosed with celiac disease.  This is not rare, as 1 in 100 people have celiac disease worldwide (Celiac Disease Foundation, 2017).  For now, those diagnosed with celiac disease can maintain their short-term and long-term health by following a strict gluten-free diet.  This diet combats damage to the small intestine, which occurs when individuals with celiac disease ingest gluten.

Unfortunately, gluten can be in pretty much anything—from Twizzlers to salad dressing.  To ensure that you are not ingesting gluten, you have to become competent in reading food labels and avoiding foods containing gluten.

Below are 10 tips to help you determine which foods are celiac-safe and which are not.

1. Don’t just check food labels: personal care products may also contain gluten

Be sure to check the labels of not just your food, but also your skin products, medications, cosmetic products, and dental products.  If you have celiac disease, these products can contain gluten and pose a threat to your health.

2. Check the label even if packaged food is labeled as gluten free.

But, if food is labeled “gluten free,” doesn’t that mean that the FDA ensures that the product contains no gluten?  No! Food companies may have typos, so it is important to first check the ingredients label rather than just assuming the food is safe because it is labeled gluten free.  If you stumble upon wheat, rye, spelt, barley, malt, or triticale in the ingredients list, do not consume these foods because they contain gluten.

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3. Check labels of naturally gluten-free grain products for “may contain gluten” or “made on shared equipment with gluten” labels.

Why?  Because although a product may be made with gluten-free grains, such as rice or buckwheat, that doesn’t mean that the product is free of gluten completely.  In fact, when naturally gluten-free grain products do not have a “gluten free” label and “may contain gluten” or are “made on shared equipment with gluten,” this means that the product may have greater than 20 ppm of gluten—which is not safe for those with celiac disease.

4. Do not eat foods that contain the following ingredients in alphabetical order:

A: —

B: Barley, brewer’s yeast, bulgur

C: Couscous

D: Durum

E: Einkorn wheat and emmer

F: Farina, farro, and frumento

G: Graham flour

H: Hordeum vulgare (barley) and hulled barley

I: —

J: —

K: Kamut and khorasan wheat

L: —

M: malt, malted milk, malt extract, malt flavor, malt syrup, and malt vinegar, and matzo meal

N: —

O: oats (unless specified as not contaminated)

P: —

Q: —

R: Rye

S: Seitan, semolina, and spelt

T: Triticale

U: —

V: —

W: wheat, wheat berries, and wheat starch

X: —

Y: —

Z: —

5. Look out for modified food starch.

Why?  This can be any processed starch—and when not clarified in parentheses—could be a gluten-containing grain.  When this is in the label, it is best to check with the manufacturer for the presence of the gluten protein in the product before purchase and consumption, or simply go without that product.  Better safe than sorry, for even the smallest crumb of gluten can cause damage to the small intestines.

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For doctors, it would be helpful to include this useful information in an online training for parents of a child with celiac disease or for a patient with celiac disease themselves. Check out CertCentral CME solutions to get started creating your online training today.

References

Asaff, B. (n.d.). Gluten-free cosmetics. Retrieved from

http://gluten.lovetoknow.com/Gluten_Free_Cosmetics

Celiac Disease Foundation. (2017, July). Food label reading guide [Brochure]. Retrieved from

https://celiac.org/wp/wp-content/uploads/2017/07/Combined-Gluten-Free-Diet-and-Food-Label-Reading-Guide.pdf

Jenny. (2016, January 6). What does “may contain wheat” mean? [Blog]. Retrieved from

https://www.goodforyouglutenfree.com/what-does-may-contain-wheat-mean/

O’Connell, A. (2017, August 4). Is modified food starch gluten free? [Blog]. Retrieved from

https://www.livestrong.com/article/446555-is-food-starch-gluten-free/

What is celiac disease? (2017, June 12). [Blog]. Retrieved from

https://www.glutenfreeliving.com/gluten-free/celiac-disease/what-is-celiac-disease/