A coeliac's guide to going gluten-free

A gluten-free diet is essential for staying healthy if you’ve got coeliac disease. Follow our expert’s advice.

25 March 2015
by Carla Hüsselmann

Bread is your worst enemy if you suffer from coeliac disease – as well as any food or beverage containing gluten. Every time you eat gluten it leaves you writhing in pain and completely drained because it inflames your small intestine.

Fortunately embracing a lifelong, strict gluten-free diet will make all the difference. “Once gluten is eradicated from your diet completely, the small intestine can heal and nutrient absorption is optimised and symptoms gradually disappear,” explains Nicola Walters, a registered dietitian from Nutritional Solutions in Bryanston, Johannesburg.

“For true coeliac disease sufferers, the change to a gluten-free diet is actually a hugely rewarding experience despite its restrictive nature, because of the vast improvement in health and well-being that results,” says Walters.

Which foods should you avoid like the plague?

Avoiding wheat, rye, gluten-contaminated oats and barley products is a necessity but so is identifying hidden sources of gluten, advises Walters. “Many processed foods contain sources of gluten and label reading is imperative to identify potential sources,” she says. “Oats should be avoided unless it’s labelled ‘gluten-free’. Many oats products have become contaminated with wheat, barley or rye and thus may contain trace elements of gluten.”

Also, be aware that labels marked “wheat-free” don’t always mean “gluten-free”, as gluten-containing, non-wheat derived products could still be present in the product. “South African legislation specifies that a foodstuff is only eligible to bear a ‘gluten-free’ claim if it can be demonstrated that it contains no more than 20 mg/kg (ppm) gluten,” Walters explains.

Foods to avoid include:

  • Grains: Wheat, pearl wheat, barley, rye, gluten-contaminated oats, spelt, bulgur wheat, couscous and products made from these flours, such as pasta and breads. All other cereals containing wheat, rye, oats and barley, for example, All Bran, Pro-Nutro, etcetera. All crackers and crisp breads containing wheat, rye, oats or barley flour, for example, Matzo, Provitas, etcetera.
  • Dairy: Malted milk, commercial chocolate drinks, all processed cheeses containing any of the forbidden flours, certain non-dairy creamers and yoghurts with added toppings.
  • Meat: Prepared meats that contain wheat, rye, oats or barley such as some sausages, luncheon meats, sandwich spreads, bread-crumbed schnitzels, polony, viennas and crumbed fish portions.
  • Baked goods: All baked goods that include the use of wheat, rye, oats or barley, including pie fillings, which are often thickened with gluten-containing flour.
  • Dressings and sauces: Certain commercially-manufactured mayonnaise, marinades and sauces that contain malt.
  • Alcohol: Beer and drinks containing malted barley.

What are the “allowed” foods?

Fortunately there are plenty of foods that are naturally gluten-free.

This “safe” list includes:

  • All fresh fruits, vegetables and legumes
  • Meats, chicken, pork and fish
  • Dairy products that are plain and unseasoned
  • Replace gluten-containing grains with a wide variety of alternatives such as corn, potatoes, rice, soybean, tapioca, amaranth, quinoa, millet and buckwheat. The flours made from these options can be substituted successfully in baking and cooking.

“There are also a growing number of delicious gluten-free alternatives being developed by manufacturers, as well as a variety of gluten-free recipes to replace the ‘forbidden’ old-favourites,” says Walters.

Watch out for these hidden sources too...

Both over-the-counter and prescription drugs can be a hidden source of gluten. “The best way to avoid gluten in medication is to learn which ingredients to look for. Just as with food, it is often the inactive ingredients, that is, binders or fillers, that can be potential sources of gluten,” cautions Walters.

“Note anything with the word ‘starch’. Some examples of words to look out for include pregelatinized starch, sodium starch glycolate, dextrin or dextrate.”

Interestingly, gluten may also be found in everyday products, such as vitamins and lip balms, so read package inserts carefully.

Get the help you need

As this new diet can be rather intimidating, it’s best to consult a registered dietitian, as they can assist with the practicalities around planning for meals at home as well as when eating out. “Individuals on any avoidance diet are at risk of developing deficiencies of micro-nutrients such as thiamine, riboflavin, niacin, iron, selenium, chromium, magnesium, folacin, phosphorus and molybdenum, so it’s essential to optimise your micronutrient nutrient status, which is where a dietitian can assist,” says Walters. “They can also provide medical nutrition therapy to correct the adverse effects of symptoms such as diarrhoea and nausea.”

For more info, contact Nutritional Solutions on 011 463 5502 or visit www.nutritionalsolutions.co.za