If you are diagnosed with coeliac disease you must follow a lifelong avoidance of gluten-containing foods. If diagnosed, ask your GP to refer you to see a dietitian. A dietitian will be able to help answer dietary questions and help you with where to begin on your gluten-free diet.
Why do I need to avoid gluten if I have coeliac disease?
Coeliac disease is a disease of the digestive tract in which a person reacts to a protein called gluten. Complete removal of gluten from the diet allows the small bowel to heal and prevent symptoms from recurring. People diagnosed with coeliac disease but who don't have any symptoms must also avoid gluten in their diet for life.
Which foods contain gluten?
Gluten-containing cereals include wheat, rye, barley, oats and hybrid strains of these cereals (e.g. triticale).
- Other names for wheat products: atta, bulghar, bran, couscous, dinkel, durum, emmer, farina, german wheat, graham flour, Kamat, polish wheat, semolina, spelt, triticale, wheat bean, wheat germ.
- Other names for barley products: malt (barley).
Watch out for hidden gluten
Some people with coeliac disease show no improvement on the gluten-free diet. The most common reason for poor response to the diet is that small amounts of gluten are still being consumed.
- Hidden sources of gluten include additives such as modified food starch, preservatives, and stabilisers made with wheat.
- Because many corn and rice products are produced in factories that also manufacture wheat products, they can be contaminated with wheat gluten.
People with coeliac disease remain sensitive to gluten throughout their life. If gluten remains in the diet, damage to the small bowel will still be happening, even if symptoms disappear.
Foods to avoids
Do not consume the following products unless they state ‘gluten free’ on packaging or do not contain gluten or anything derived from it in the ingredient list.
Foods containing gluten*
Hidden sources of gluten*
Breakfast cereals including oats
Ice cream cones/ wafers
Additive: Thickener 1400
Dry roasted nuts
Ice cream/ desserts
Imitation seafoods e.g. surimi
Lemon and barley cordial/ drinks
Pickles, relishes, chutneys
Stock cube/ liquids
* Note – these lists may not be complete. For more information, speak to a Registered Dietitian or visit: www.coeliac.org.nz
Thickeners to avoid
Thickeners (modified starches) made from wheat and raising agents made with wheat starch are not gluten free.
- Additive 1400, dextrin roasted starch, is made from wheat.
- Other thickeners, 1401 to 1450, made from maize, tapioca or potato starch are gluten free.
Highly processed sweeteners are OK
Sweeteners such as caramel, dextrose, glucose, glucose syrup and maltodextrin are such highly processed and purified ingredients that the source of the starch does not matter. Even when made from wheat they are always gluten free due to extensive processing.
Naturally gluten free foods
- Fresh fruit and vegetables
- Chickpeas, lentils and beans
- Fresh, unprocessed, unflavored meats
- Butter and oils
Be careful of cross contamination
Cross-contamination occurs when gluten-free foods come into contact with foods that contain gluten.
- It can happen during the manufacturing process, for example, if the same equipment is used to make a variety of products.
- Some food labels include a "may contain" statement if cross-contamination is likely. But be aware that this type of statement is voluntary. If you are unsure whether a food contains gluten, don’t buy it. Check with the manufacturer first.
- Cross-contamination can also occur at home if foods are prepared on common surfaces or with utensils that weren't thoroughly cleaned after being used to prepare gluten-containing foods, for example using a common toaster for gluten-free bread and regular bread is a major source of contamination
How to avoid contamination
Regular exposure to gluten, even in tiny amounts without symptoms, can cause damage to the gut surface and increase the risk of long-term complications of coeliac disease.
Reduce the risk by:
- Washing kitchen equipment, utensils and chopping boards after preparing foods containing gluten or use separate equipment
- Wiping surfaces after preparing foods containing gluten
- Keep wheat flours is a separate container or cupboard
- Using a washable silicon mat in cooking surfaces that may be contaminated with gluten e.g. barbeques
- Using toaster bags or a separate toaster for gluten-free bread
- Having a separate container of butter/margarine, spreads and chutneys for those on a gluten-free diet
- Be aware of the risk of cross-contamination in bulk bins and deli foods
For more information, contact Coeliac New Zealand which is a support group for adults and children with coeliac disease.
- Membership benefits include a regular magazine, along with telephone support and assistance.
- New members are provided with a manual containing information on the condition, the gluten free diet, where to shop, recipes and helpful advice to make the change from gluten to gluten free as easy as possible.