Getting Started on a Gluten Free Diet

The Gluten File

Getting Started Internet Resources


 STOP BEFORE YOU START!

DO NOT start making dietary changes prior to diagnostic testing. You must be eating gluten for blood tests and biopsy to be accurate. Testing after the fact becomes difficult, as you must reintroduce gluten to your diet and wait for damage to recur, which may take anywhere from weeks to many months to happen. If you think you will ever want to pursue testing, do it now BEFORE changing your diet.

Having said that, you don't need a doctor's prescription or permission to make dietary changes. Just know that going backwards to do testing after altering your diet is complex and perhaps counterproductive.  I personally suggest having at least the blood work done before proceeding with dietary changes whenever possible and affordable. Talk to your doctor about it. Then, even if your test results are negative, a gluten free diet trial is a worthy experiment.  Many people who "test negative' find great benefit from a gluten free diet.


WHAT IS GLUTEN?

A very simple answer that will work for practical purposes is: Gluten is a protein fraction contained in wheat, barley, and rye grains.

Technically, gliadin is the protein found in wheat, hordein is the protein found in barley, and secalin is the protein found in rye. But, all of these protein molecules are considered 'gluten' .


LET'S START WITH....

WHAT YOU CAN EAT!

Lots of things! While it is true that a lot of food will now be off limits, it is also true that there is a lot of food in the world~ and many things are still perfectly safe to eat! Getting back to basics is a good way to start.

You can still eat:

Fruits
Berries
Nuts
Vegetables
Meat
Poultry
Fish
Eggs
Milk, Cheese, and Yogurt (if not casein or lactose intolerant)
Potatoes
Rice

Please rest assured that you can buy or make your own gluten free baked goods~ bread, cakes, cookies, muffins, and more!

There are several brands of gluten free beer on the market now, and an endless supply of gluten free snack foods like popcorn, peanuts, gf pretzels, gf crackers, corn chips, etc.  Many restaurants offer gluten free menus.

It really is easiest to begin with a basic whole foods diet, though, for many reasons. It is also important to focus on what you CAN HAVE rather than dwell on what you can't have. It's that whole positive thinking thing.

Whole grains like quinoa, buckwheat, and amaranth are acceptable on the diet. It can be fun to explore new foods, and you may find with the new focus on food you will actually increase the variety of healthy foods in your diet; most of us do!

“Back to basics” eating is just easier while on the gluten free diet learning curve. Reading labels at the grocery store can be daunting in the beginning. That gets easier over time as you eventually learn which foods and ingredients are acceptable.

You will eventually get back to a regular shopping list~ it will just be a little different than it was before. Eating unadulterated whole foods over processed foods really cuts down on label reading.... a big help when beginning this overwhelming task of re-evaluating everything you eat! 

Whole foods, unprocessed foods, are just healthier for you all the way around, and may be easier on your intestinal system while its healing. You will be reducing the risk of inadvertent gluten errors by avoiding processed foods, and giving your body a better chance to heal quickly.

It is not uncommon for those with gluten sensitivity or celiac disease to suffer from other food intolerances as well. In fact, studies tell us up to 50% of those with celiac disease or gluten sensitivity also have problems with cow's milk. Corn and soy sensitivity are commonly a problem as well.

Sticking to whole foods, and keeping a food and symptom journal, can help to identify additional sensitivities if you continue to have symptoms.  Many people find they do much better without any grains at all in their diet.

If everything goes well, no problem~ you will be in good shape to slowly start adding some gluten free processed foods back if you wish.


DO I HAVE TO BUY EXPENSIVE SPECIALTY FOODS?

No! In fact, you can live quite nicely and healthfully without any of the specialty food products.  Many opt to eat only naturally gluten free whole foods and find this simple way of eating very satisfying.

There are also many mainstream processed foods that are gluten free and safe for you to eat.  Some mainstream products are even beginning to clearly label products as gluten free... which makes our job of label reading a lot easier.

Allergy and Contains Statements on products are also very helpful, but beware because they won't necessarily include barley or rye ingredients. Wheat is one of the eight major allergens covered under labeling laws. When you see wheat in a Contains: statement, or highlighted in the ingredient list, it shortens the label reading task as you quickly return the product to its store shelf.


 SPECIALTY FOODS GALORE IF YOU WANT THEM!

There are many specialty gluten free foods on the market and the market is growing like wild fire. More products are making their way to your very own local grocery store... be sure to check the health and specialty aisles! Most health food stores will carry a wide variety of gluten free products.

The GF Mall is a one stop directory of websites offering foods in the gluten free specialty market.

There is a searchable data base of GF products at GF Overflow

One caution about specialty foods... though. They are not necessarily all HEALTHY foods. Once you begin to read labels of everything you eat, out of necessity, you will gain an acute awareness of exactly what you are eating. Many of us end up cleaning up our diets overall and doing without much of the processed foods, but for some of us who still like to splurge on occasion with a little junk food... it is still all available! No shortages there....   

Here is a list of some of my favorite specialty foods:
http://www.glutenfreeandbeyond.org/forum/viewtopic.php?p=1418#1418

This list geared with children in mind:
http://www.glutenfreeandbeyond.org/forum/viewtopic.php?p=24700#24700




Can I make my own baked goods?

Yes, you can!

It is simple to purchase various gluten free flours and make your own baked goods.  You can buy pre-blended gluten free flours, or blend your own... usually a combination of rice flour, tapioca flour, and potato starch flour. There are many gluten free recipe books on the market if you look for them.  According to Amazon.com there are 276 of them, and counting!
 
Online and local support groups are also very helpful in supplying gluten free recipes and baking tips. I won't try to recreate that here when there are so many helpful places already in existence. You can check the Favorite Links page for links to various cooking blogs and recipes sites.

We also have a recipe section at Gluten Free and Beyond Forums, as do many other forums. Please take a browse, and add your own favorites! 

And don't throw away your old cook books either! It is very simple to convert most recipes, especially when cooking, but even when baking.  You can make a mean Toll House cookie right off the Nestle package, with a simple substitution of gluten free flour, and an added teaspoon of xanthan gum or guar gum. 

And... 

WHAT YOU CAN'T EAT

Bread, cakes, pies, cookies, pasta, candy, or any other product that uses wheat, rye, or barley needs to be avoided. Don't be fooled... white bread is indeed made with wheat flour!

Avoid anything made with:

Wheat - including einkorn, emmer, spelt, kamut, wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein

Bromated flour
Durum flour
Enriched flour
Farina Graham flour
Phosphated flour
Plain flour Self-rising flour
Semolina
White flour
Barley
Rye
Triticale - a cross between wheat and rye

Gluten may also be found in other processed foods you might not suspect, so it is important to read labels carefully. You'll need to ask questions when eating at restaurants, and at the homes of family and friends. It is generally possible to find gluten free brands of many of these items, but you must be especially cautious about the following items~ and verify!

Bouillon cubes
Brown rice syrup
Chips/potato chips
Candy (including licorice!)
Cold cuts, hot dogs, salami, sausage
Communion wafer
French fries
Glazed Hams
Gravy
Imitation fish
Marinated Meats
Matzo
Rice mixes
Sauces
Seasonings
Seasoned tortilla chips, french fries, potato chips
Self-basting turkey
Soups
Soy sauce


 Important: 

READING LABELS


Reading labels must become a new part of every day life unless you remove all processed foods from your diet.  We need to read labels at the grocery store, and reread them again before opening a can, box or package at home. And because ingredients often change~ we must read labels over and over and over again, even when purchasing products we think we “know” are safe.  

Being a member of a gluten sensitivity or celiac disease community, locally or online,  can be immensely helpful when starting out on a gluten free diet. There are a lot “tricks to the trade”... and generally, others who have been doing this for years can tell you exactly which brands are currently safe. Local support groups are also very helpful, and will be able to tell you the best gluten free shopping spots, and gluten free restaurants in the area.

www.childrenshospital.org/.../GIP_20120515_GoingGlutenFree.pdf



 What about oats?

Some oats may be contaminated with gluten because of cross contamination in the fields or during processing. Consequently, whether or not oats are safe to eat remains a controversial subject. The majority of research on the subject indicates that oats are safe for people with gluten sensitivity or celiac disease, but it remains in question.

Some people may also have a separate sensitivity to oats.

If you do choose to include oats in your diet, look for a brand which has gluten free certification.  It may be wise to eliminate them completely from your diet for the first several months, and add them back only if all is well, and then do so with caution.

Bob's Red Mill GLUTEN FREE Oats, Glutenfreeoats.com
Creamhill Estates 
Only Oats


HOW STRICT DO I NEED TO BE?

You need to be very strict~ 100% diligent about removing all gluten from your diet. A tiny little bit, even in the form of cross contamination, can do damage if it occurs often enough~ preventing your intestines from healing, and keeping your immune system producing destructive antibodies.

One of the best analogies I've heard is of comparing damaged intestinal villi to a skinned knee. If you skin your knee, and then keep falling down every couple of days and re-scraping it, it will never heal. Cross contamination and gluten errors are like falling down and re-scraping your knee. You'll never get better if you keep falling.

Some people may not react symptomatically to gluten errors, but that doesn't mean the infractions aren't doing any damage. Repeated errors will keep those antibodies in production and working against you, even if you aren't noticing any symptoms on the 'outside'.


CROSS CONTAMINATION

Beyond checking lables for safe ingredients, those on a gluten free diet have to worry about cross contamination that can occur in the home, school, workplace, manufacturing environments, etc.  Rather than reinvent the wheel, here are some links to things you need to think about. 

Cross Contamination Concerns by Anne
http://www.glutenfreeandbeyond.org/forum/viewtopic.php?p=14508#14508 

Cross Contamination Potential Issues by Mireille http://forums.delphiforums.com/n/mb/message.asp?webtag=celiac&msg=32462.1  (may enter as guest)

How to Make Your Home Gluten Free
by Children's Hospital Boston














 Other Helpful Internet Resources for Those Just Getting Started