How to be gluten free
March 10th, 2009
The treatment of coeliac disease is exclusively dietary and requires the complete exclusion of gluten. This means avoidance of all sources of wheat, rye and barley. Oats are controversial and may be tolerated in moderate amounts.
The aim of medical advisors is to give first line dietary advice on a gluten-free diet for patients with confirmed coeliac disease or dermatitis herpetiformis. People who are allergic/intolerant to wheat will require different dietary advice.
Practical dietary advice is often given such as: -
The exclusion of gluten means avoiding a wide range of manufactured and processed foods, which imposes considerable constraints on food choice and variety. Food labeling is not always helpful because although ingredient lists on food products can confirm the presence of gluten, they cannot confirm that they are gluten-free.
Gluten may be present via constituents which do not have to be declared or through cross-contamination during processing. Any food in a can, packet or jar or food that has been coated or modified in any way has therefore to be suspected of containing gluten.
Many manufacturers and supermarkets are voluntarily identifying gluten-free products by providing information or a logo on the label. In the UK, the Coeliac Society maintains a continually up-dated database of manufactured foods free from gluten.
Proprietary gluten-free foods such as breads, crackers, biscuits, pasta, flour and flour mixes are prescribabled for people medically diagnosed with coeliac disease or dermatitis herpetiformis. Their use should be encouraged to reduce the risk of dietary imbalance or non-compliance. Luxury items such as gluten-free cakes, chocolate and fancy biscuits are also available but not prescribable to reduce the costs on the NHS.