Guide to avoiding foods containing Gluten

Gluten is present in many grains and starches, as shown in the following table:

Contains Gluten			Gluten-free
Wheat Wheat germ Wheat grass Rye Barley Bulgur Couscous Farina Graham flour	Kamut Matzo Seitan Semolina Spelt Triticale Oats* Oat bran* Oat fiber*		Amaranth Rice Corn Soy Potato Quinoa Tapioca Tef Beans	Flax Garfava Sorghum Millet Buckwheat Arrowroot Nut flours

* controversial due to contamination

Beer is made from grains and thereby contains gluten.  Most other alcohols such as scotch, rye, and vodkas while made from grains that are glutenous, are distilled, which removes the gluten thereby making them safe to consume.  Do keep in mind that alcohol when mixed with gluten in food seems to magnify the reaction and therefore should be avoided.  Further, many patients who have celiac disease or who are gluten intolerant have intestinal infections which creates a poor reaction to alcohol. 

The key to understanding the gluten-free diet is to become a good ingredient label reader.  Foods with labels that list the following ingredients are questionable and should NOT be consumed unless you can verify they do not contain or are not derived from prohibited grains.  Remember you need to be gluten-free, not just wheat-free.  Also, many products say that they are gluten-free while having ingredients such as oats, hemp, wheat grass, malt or starch which may contain gluten and cause intolerant persons to react negatively.  Don’t be fooled and compromise your health – always read the ingredient list carefully.  If in doubt, write to the company on-line.  Most companies are very forthcoming with such information.

• Bran
• Brown Rice Syrup (frequently made from barley)
• Caramel Color (infrequently made from barley)
• Dextrin (usually corn but may be derived from wheat)
• Dry roaster nuts - processing agents may contain wheat
• Flour or Cereal Products
• Hydrolyzed Vegetable Protein (HVP), Vegetable Protein, Hydrolyzed Plant Protein (HPP), Hydrolyzed Soy Protein or Textured Vegetable Protein (TVP)
• Malt or Malt Flavoring (usually made from barley)
• Malt Vinegar
• Modified Food Starch of Modified Starch from Unspecified or Forbidden Source
• Starch
• Soy Sauce or Soy Sauce Solids
• Ricola cough drops
• Emergen-C in raspberry and mixed berry flavors only, the other flavors are fine.

There are foods which do not contain gluten but may still trigger the same or similar symptoms.  How?  These foods contain lectins which are glycoproteins (proteins with carbohydrate attached to them) and are considered the major antinutrient of food.  They are identified in wheat, corn, rye, barley, oats and rice.  Lectins are also found in legumes such as peanuts, beans and peas.  Additionally, lectins are found in higher concentrations in whole grains as compared to refined grains and cooking doesn't break them down.

Lectins have the ability to bind and interact with every single cell in the body.  This means that they can interfere with the body's normal metabolism, hormonal balance and overall health if they are able to leave the intestine and enter the body's circulation.  Studies show that this does occur.

How permeable or leaky your gut is determines how much of an adverse effect these lectins may have.  Those who are gluten intolerant have a "leaky gut" which is why patients can observe that they are not tolerating any grains, legumes or beans well despite being vigilant about being gluten-free.  Further, lectins in themselves increase the permeability or leakiness of the gut.

Much like gluten, lectins in high concentrations damage cells in the intestinal lining, interfering with digestion and absorption and causing an imbalance of the good bacteria of the intestine.

Once they pass into the circulation, lectins may fool the immune system into reacting to proteins that it shouldn't normally react to.  This process is called molecular mimicry and it can lead to the initiation of autoimmune diseases such as rheumatoid arthritis, Hashimoto's thyroiditis, autoimmune liver disease, Crohn's disease, ulcerative colitis, Type 1 diabetes, lupus, multiple sclerosis, psoriasis, Sjogren's sydrome, celiac disease, dermatitis herpetiformis and possibly allergies, skin rashes and asthma.

Because gluten and lectins both cause damage to the intestine and resultant gut permeability, let's look at the probable scenario of how they create autoimmune diseases:

1. Increased gut permeability allow undegraded protein fragments from food, bacteria and viruses to pass into the bloodstream and travel throughout the body.
2. The protein fragments, while being foreign to the body, share certain characteristics of proteins which make up body structure.  The immune system may not be able to distinguish these foreign proteins from "self" proteins and ends up attacking itself due to the resemblance.

Phytates are mineral-binding antinutrients.  They are not classified as a fiber but are found with insoluble fiber in whole grains and legumes.  Studies support the finding that phytates combine with calcium, iron, zinc and magnesium and block their absorption to a significant degree.

Soy is considered an acceptable food for those who are gluten intolerant.  Traditional soy foods such as tofu, edamame, soy pods and some types of miso and tempeh are gluten-free.  Do read the label as grains or tamari can be added to miso and tempeh.

Unfortunately soy has some negative characteristics.  Soy foods are one of the most common sources of hidden gluten.  Seitan and most soy-based veggie burgers contain "vital wheat gluten" - the ingredient that gives these foods the texture and taste of meat.

Further, despite being gluten-free soy beans often provoke digestive bloating, gas and allergic symptoms.  This is understandable because as a bean they contain the same lectins that grains have.  Evaluate your tolerance to soy and if acceptable choose high-quality products and eat them in moderation.

Oats can be an area of confusion when trying to avoid gluten.  Many companies are advertising oats as gluten-free.   And there are some gluten free societies which will get quite impassioned when defending their ability to eat oats.  Others don’t recommend oats due to the problem of unacceptable levels of contamination.  Oat fields frequently have wheat or rye growing in them and therefore most oats, when assayed, show gluten contamination. And if the contamination doesn't happen in the fields then it occurs in transport or at the manufacturing facility.

While we all agree that oats has a different protein from wheat, rye and barley and is therefore not classically gluten, in practicality when a gluten intolerant person consumes "regular" oats they often react to them the same as if they were consuming gluten.  Whether this is from a contamination issue or the lectin content or both, the unhealthy reaction occurs and that is not acceptable.  So please be cautious when reading other materials or consulting other web sites which say that "regular" oats are fine.

Fortunately there are some companies which recently started offering certified gluten-free oats which are an excellent source for some patients who tolerate them well. Bob's Red Mill (bobsredmill.com), Creamhill Estates (creamhillestates.com) and Gluten-free Oats (glutenfreeoats.com) are all certified as gluten-free. Bob's Red Mill is found most easily in healthfood stores while the others are available on-line only at this time.