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    The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free


    Scott Adams
    The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free
    Image Caption: Photo: CC--Michael Coghlan

    Celiac.com 04/09/2010 - Receiving a celiac disease diagnosis or being told you need to be on a gluten-free diet can be an overwhelming experience, and it is certainly not for the faint of heart. Most people get frustrated with the transition, and many don't know where to begin. While eating gluten-free can improve your health, I must emphasize that it is not recommended to attempt a gluten-free diet without a doctors supervision, as there are many potential health risks involved with making drastic changes to your diet, which can be avoided with assistance of a qualified doctor and/or nutritionist. If you suspect gluten-intolerance to be the culprit for your health problems, get examined by a doctor and get tested for celiac disease before initiating a gluten-free diet. It is very important to continually consume gluten while you are undergoing testing for celiac disease because many of the tests require you to be consuming gluten to get accurate results.

    Prescription: A Gluten-Free Diet

    Now that you have your diagnosis and need to eliminate gluten, you can make the transition to a gluten-free diet with confidence. The following information is a guideline of what you will need to know to get started. I must emphasize that this is only a guideline, and you will need to do your own research and consult with your doctor for more detailed information on a gluten-free diet. It is also a great idea to get involved in local support groups. Support groups will have members that understand what you are going through and they can help direct you to beneficial resources:

    Create New Habits
    To begin, if you are accustomed to doing things your own way, you will have to throw out many of your old habits. To avoid gluten poisoning you must keep all gluten away from your mouth. You will need to evaluate everything you ingest very carefully. Gluten can come in a variety of unexpected ways, including a kiss from a loved one, and any gluten that comes into contact with your mouth is a potential source of contamination. Cross-contamination can occur when a meal is prepared on cooking equipment shared with gluten-containing foods. It can also come from touching anything that has come into contact with gluten. It is therefore important to gluten-proof your house and to keep everything you eat separate from gluten and gluten residue. If you eat at restaurants, it is important to only eat at places that you know are safe. To help you avoid accidental gluten ingestion, please follow your instincts and use the following guidelines and avoid potential health hazards. Please remember that these are only guidelines--if you still have questions, please consult with a medical professional.

    What does "Gluten-Free" Actually Mean?

    Since gluten is found in wheat, rye and barley, it is obvious that you will need to avoid these grains. Less obvious however, are the myriad of products that contain gluten as a hidden ingredient. The Food and Drug Administration (FDA) recently regulated the use of "gluten-free" on a food label, and there was already an FDA regulation that requires manufacturers to declare wheat if it is used as an ingredient in a product. Products that don't use "gluten-free" on their label unfortunately don't have to disclose ingredients that are made from barley or rye, which requires you to learn to read and understand ingredient labels. Many additives, natural or artificial, can contain gluten. Sometimes companies label products as "gluten-free" or the ingredients are naturally gluten-free, but the product may have be contaminated if it was manufactured on shared equipment. You will have to decide if you want to include such products in your diet. It is also important to remember, for reasons just mentioned, that “wheat-free” does not mean “gluten-free.”

    Batch Testing:
    According to current FDA proposals, products testing at less than 20 parts per million (PPM)  for gluten will likely be allowed to be labeled "gluten-free," and, according to them, are considered safe for people with gluten-intolerance or celiac disease. There are several organizations that offer gluten-free certification for companies who follow their guidelines and batch test their products. Check out the link below for more information on gluten-free certification and labeling.

    Gluten-Free Shopping

    Shopping will likely take much longer for you than it used to. Don't rush. It is important to read all ingredients carefully. If you are in a hurry, you run the risk of overlooking a key ingredient that might contain gluten. I find it helpful to plan my meals in advance. There is nothing worse than coming home from work hungry and realizing that you have nothing to eat (and it isn't like you can go to the first drive-thru you find). So planning my meals on the weekend and doing my shopping in advance, cuts my stress level down considerably and keeps me from going hungry. Check your products against your gluten-free guidebooks, and contact the manufacturer if you are unsure about something. The following links will help you take the guess work out of shopping for gluten-free products:

    As mentioned, there are also many products that are naturally gluten-free that are not labeled "gluten-free," and there are some very helpful books that can help you find these foods when you are shopping.

    A Gluten-Free Kitchen

    A gluten-free kitchen is very important. If you can have an entirely gluten-free kitchen, that is ideal, but it may not be an option for many households. Therefore it is especially important to keep your house clean and free of gluten contaminates.  It is also important to dedicate special kitchen supplies for gluten-free cooking. I bought a new cutting board that is dedicated only to gluten-free cooking. You may also want to have separate kitchen utensils such as sponges, toasters (a dedicated gluten-free toaster is highly recommended), sifters, bread machines, etc. This is especially important if you use utensils that are made of wood, plastic, or other porous materials that could harbor gluten and possibly contaminate your gluten-free food. If possible use an electric dishwasher to clean your dishes.

    If everyone in your household is going gluten-free it is important to clean out and empty all of the gluten products from your kitchen. If you share a kitchen with gluten eating family members, it is a good idea to store their food products separately from your gluten-free products, and to clean off all surfaces before you prepare your gluten-free food. Dedicating gluten-free cupboards and refrigerator shelves is a great way to start.

    Here are some important links that will help you cook gluten-free meals with ease:


    Kitchen Checklist - Possible Sources of Contamination:

    • Bread-machine
    • Toaster
    • Sponges & cleaning pads
    • All kitchen supplies & utensils
    • Colanders
    • Cutting boards
    • Door handles
    • Soaps

    For more information on maintaining a safe kitchen environment, click the link below:

    Dining Out Gluten-Free

    Dining out presents a challenge for most people on a gluten-free diet. Depending on your level of sensitivities, you may have difficulty eating out at all. Even if the restaurant offers a gluten-free menu, it is always important to find out what safety precautions the restaurant uses to avoid cross-contamination, and to make sure all the ingredients in your food are gluten-free. This may require you to modify your order, and also may mean talking with the chef about their kitchen practices. You may also benefit from utilizing a guide to safe restaurants.

    Here is an additional article that may be helpful to your situation:

    A Gluten-Free Bathroom

    Believe it or not, your bathroom is another place where you might be getting sick from gluten contamination, and not even know it. There are many products in your bathroom to watch out for as many body products contain wheat and/or hidden gluten ingredients. Most celiacs can use body products without a negative reaction, though some people experience rashes and other unsavory reactions from gluten body products. However, if you are using face or body products that contain gluten, it is very important not to ingest them. I find it difficult to avoid getting shampoo or makeup near my mouth, so I don't take any chances. I use gluten-free soap, shampoo, conditioner, face-cleaner, toner, make-up, toothpaste; basically nothing goes onto my body that contains gluten. Using gluten-free body products allows me the freedom to worry less about accidental contamination, and gives me more time to enjoy my life. Many gluten-free body products are not labeled gluten-free, so it is important to read ingredient labels carefully and check with the manufacturer if necessary.

    Bathroom Checklist:

    • Toothpaste
    • Shampoo/conditioner
    • Make-up
    • Lip-stick, lip-liner, lip-gloss, cosmetics, etc.
    • Lotion
    • Sunscreen

     

    Gluten-Free Medications (Prescriptions and Supplements)

    Most people with celiac disease or gluten-intolerance also suffer from malabsorption and sometimes malnutrition. Your doctor may prescribe pain, anti-inflammatory, digestive or other medications or supplements to help assist with your recovery. It is very important to note that some medications and supplements can contain gluten. Do not assume that just because your doctor knows you have celiac disease or gluten intolerance that the medications or supplements they may prescribe for you are gluten-free.  Be your own advocate and read the ingredients and contact your pharmacist and/or the manufacturer and find out if your prescriptions, vitamins and supplements are gluten-free.

    Additional Concerns

    Children with Celiac Disease
    Raising children with celiac disease or gluten-intolerance is no easy feat. Your kids will have to deal with immense  peer pressure and there will be a great deal of temptation for them to eat gluten-containing foods. Talk to the staff at their school and help them to understand your child's special needs. The more support you have, the better off your child will be. There are many support groups that advocate for children with celiac disease, and it is important to get involved and learn everything you can to help support your child.

    Pets
    Your pets present another source of potential contamination, especially if you have pets like mine that love to smother you with unexpected kisses, sometimes on the mouth. What your pet eats can affect you too. Handling your pet's food, cleaning your pet's dishes and having young celiac children in a house where they may eat dog or cat food are all legitimate concerns. I decided to switch my pets to gluten-free pet food. Most pet food is not labeled gluten-free, so it is important to read ingredients carefully. I found grain-free, all natural pet food to be a great alternative to gluten-containing pet foods, that way I don't have to worry about accidental contamination or getting kisses from my pets--and it's healthier for them too!  It is also important to check all other pet products that you come into contact with for hidden gluten ingredients, like shampoos and soaps. It is of course always important to talk to your veterinarian before making any dietary changes for your pet.

    Other Food Sensitivities
    Most people who begin a gluten-free diet experience almost immediate relief from their symptoms. However, many people experience gluten-like reactions to other foods, and often suspect that their food was contaminated by gluten. As it turns out, many people who experience such reactions may in fact have additional food sensitivities. Some of the most common food sensitivities include, dairy/casein, soy, corn, sugar, nuts, shell-fish and processed or fatty foods. While many people report that they are able to add these foods back into their diet after they have established a gluten-free diet for many months, and after their intestines have had time to heal, it is up to you and your doctor or nutritionist to determine which foods may be causing you trouble. The 'elimination diet' is often recommended for determining what additional food sensitivities you may have. Ask your doctor if the elimination diet is right for you.

    Food Diary
    It is important to keep a food diary, especially when first initiating a gluten-free diet. Making notes of the foods you eat and the reactions you have to the foods you eat, and how you feel that day, can give you more insight as to which foods are hurting you and which foods your body can easily digest.

    Final Thoughts

    Be Picky
    Having a gluten intolerance means taking pride in your body, but not being too proud to say, "no, thank you." Don't worry about appearing too picky to others, you simply can't take care of yourself and worry what others think of you at the same time. You have the right to eat what you want; if something doesn't look, smell or taste right to you, or if you just don't feel right about eating something, don't eat it! It is better to come across as too finicky, than to spend the night in the bathroom or worse yet, the emergency room. Everyone has a different level of gluten sensitivity and you will have to find out through trial and error what works best for you.

    Be Prepared
    As a former Boy-Scout, my high-school teacher used to always say, "Be prepared".  I cannot emphasize enough the importance of this statement. It is important to be prepared and think ahead. Keep gluten-free snacks on hand at all times, because you never know when you are going to get hungry somewhere that doesn't offer gluten-free food. Keep shelf-stable snacks in your car, office, purse, and anywhere you spend time. It is better to have gluten-free snacks on hand, then to get hungry and make a bad decision to eat something you might later regret.


    Gluten-Free Quick-Check:

    • Read all labels carefully
    • Call the manufacturer whenever necessary
    • Avoid cross-contamination at all times
    • Keep your hands clean
    • Check personal-care products for hidden gluten
    • Check all vitamins, supplements and RX prescriptions for hidden gluten
    • Make sure your pets are gluten-free
    • Maintain a food diary
    • Get involved-join a support group
    • Rule of thumb-if you think it's possibly contaminated, don't take any chances. It's better to go hungry than to suffer later.
    • Above all, trust your body

    Additional Resources:

    Edited by Scott Adams


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    Recommended Comments



    Guest jaime hunt

    Posted

    My Daughter and Son (ages 3 and 1) have just been diagnosed with celiac disease. It has been a daunting task to rid our house of gluten. I have found this article very helpful. Thank-you.

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    Guest Sheila

    Posted

    I think this message will greatly help me in trying to understand what gluten -free really is all about.

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    This article scared me to death since I'm getting tested next week. I don't know how I am going to avoid the cross contamination which may I add looks impossible especially if you live with others who are not celiacs.

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    This article has been incredibly helpful in understanding gluten free and celiac disease. I have a student with it and wanted to understand what the implications are.

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    This article scared me to death since I'm getting tested next week. I don't know how I am going to avoid the cross contamination which may I add looks impossible especially if you live with others who are not celiacs.

    The only thing that makes something impossible is attitude. A gluten-free diet is a blessing, a solution, a "cure" of sorts, not a curse. It will lead you to eat healthier foods than you would have either, like more vegetables and unprocessed meat and fewer processed foods and processed grains. As a member of the health field that sees so much misinformation out there on nutrition, a gluten-free diet seems like a good idea regardless of who you are. One way or another, just being careful and having a good attitude is 90% of the solution.

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    Guest Jessica

    Posted

    I live in a house with 7 other people, none of whom have had the constant problems that I have... I had a blood test done to check for celiac and it came back negative, but I've had constant gastrointestinal issues since I was a child. I don't see how I'm going to manage trying a gluten free diet (especially with all of the avoiding cross contamination and the constant worrying) with so many other people in my house. I'm extremely underweight as is, and looking at all of the things that I cannot eat... I fear I may wind up even worse than if I just kept eating what I do already!

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    Guest Celiac Diet

    Posted

    I appreciate the thoroughness of this article. Leaves no stone unturned, as it were. As mentioned earlier, I think gluten-free is a good way to go even if you don't have celiac disease. I've been reading up on "Paleo" diets...which seems to be essentially a gluten-free diet...back to our roots! Thanks for putting this article together!

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    Guest ester

    Posted

    Very good article , and so true - it validates what I am going through!

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  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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    Sodium Nitrate
    Sodium Phosphate
    Sodium Polyphosphate
    Sodium Silaco Aluminate
    Sodium Stearoyl Lactylate
    Sodium Sulphite
    Sodium Stannate
    Sodium Tripolyphosphate
    Sorbic Acid
    Sorbitan Monostearate
    Sorbitol-Mannitol (can cause IBS symptoms)
    Sorghum
    Sorghum Flour
    Soy
    Soybean
    Soy Lecithin
    Soy Protein
    Soy Protein Isolate
    Spices (pure)
    Spirits (Specific Types)
    Spirit Vinegar
    Starch (the single word ingredient is, by law, cornstarch)
    Stearates
    Stearamide
    Stearamine
    Stearic Acid
    Stearyl Lactate
    Stevia
    Subflower Seed
    Succotash (corn and beans)
    Sucralose
    Sucrose
    Sulfosuccinate
    Sulfites
    Sulfur Dioxide
    Sweet Chestnut Flour
    T
    Tagatose
    Tallow
    Tapioca
    Tapioca Flour
    Tapioca Starch
    Tara Gum
    Taro
    Tarro
    Tarrow Root
    Tartaric Acid
    Tartrazine
    TBHQ is Tetra or Tributylhydroquinone
    Tea
    Tea-Tree Oil
    Teff
    Teff Flour
    Tepary Bean
    Textured Vegetable Protein
    Thiamin Hydrochloride
    Thiamine Mononitrate
    Thiamine Hydrochloride
    Titanium Dioxide
    Tofu (Soy Curd)
    Tolu Balsam
    Torula Yeast
    Tragacanth
    Tragacanth Gum
    Triacetin
    Tricalcium Phosphate
    Tri-Calcium Phosphate
    Trypsin
    Turmeric (Kurkuma)
    TVP
    Tyrosine
    U
    Urad/Urid Beans
    Urad/Urid Dal (peas) Vegetables
    Urad/Urid flour
    Urd
    V
    Vinegar (All except Malt)
    Vanilla Extract
    Vanilla Flavoring
    Vanillin
    Vinegars (Specific Types - Except Malt Vinegar)
    Vitamin A (retinol)
    Vitamin A Palmitate
    Vitamin B1
    Vitamin B-12
    Vitamin B2
    Vitamin B6
    Vitamin D
    Vitamin E Acetate
    W
    Waxy Maize
    Whey
    Whey Protein Concentrate
    Whey Protein Isolate
    White Vinegar
    Wines
    Wine Vinegars (& Balsamic)
    Wild Rice
    X
    Xanthan Gum
    Xylitol
    Y
    Yam Flour
    Yeast (except brewer's yeast)
    Yogurt (plain, unflavored)
    Z
    Zinc Oxide
    Zinc Sulfate
    1) Cellulose is a carbohydrate polymer of D-glucose. It is the structural material of plants, such as wood in trees. It contains no gluten protein. 2) Methyl cellulose is a chemically modified form of cellulose that makes a good substitute for gluten in rice-based breads, etc.  

    Scott Adams
    A
    Abyssinian Hard (Wheat triticum durum)
    Alcohol (Spirits - Specific Types)
    Atta Flour
    B
    Barley Grass (can contain seeds)
    Barley Hordeum vulgare
    Barley Malt
    Beer (most contain barley or wheat)
    Bleached Flour
    Bran
    Bread Flour
    Brewer's Yeast
    Brown Flour
    Bulgur (Bulgar Wheat/Nuts)
    Bulgur Wheat
    C
    Cereal Binding
    Chilton
    Club Wheat (Triticum aestivum subspecies compactum)
    Common Wheat (Triticum aestivum)
    Cookie Crumbs
    Cookie Dough
    Cookie Dough Pieces
    Couscous
    Criped Rice
    D
    Dinkle (Spelt)
    Disodium Wheatgermamido Peg-2 Sulfosuccinate
    Durum wheat (Triticum durum)
    E
    Edible Coatings
    Edible Films
    Edible Starch
    Einkorn (Triticum monococcum)
    Emmer (Triticum dicoccon)
    Enriched Bleached Flour
    Enriched Bleached Wheat Flour
    Enriched Flour
    F
    Farik
    Farina
    Farina Graham
    Farro
    Filler
    Flour (normally this is wheat)
    Freekeh
    Frikeh
    Fu (dried wheat gluten)
    G
    Germ
    Graham Flour
    Granary Flour
    Groats (barley, wheat)
    H
    Hard Wheat
    Heeng
    Hing
    Hordeum Vulgare Extract
    Hydroxypropyltrimonium Hydrolyzed Wheat Protein
    K
    Kamut (Pasta wheat)
    Kecap Manis (Soy Sauce)
    Ketjap Manis (Soy Sauce)
    Kluski Pasta
    M
    Maida (Indian wheat flour)
    Malt
    Malted Barley Flour
    Malted Milk
    Malt Extract
    Malt Syrup
    Malt Flavoring
    Malt Vinegar
    Macha Wheat (Triticum aestivum)
    Matza
    Matzah
    Matzo
    Matzo Semolina
    Meripro 711
    Mir
    N
    Nishasta
    O
    Oriental Wheat (Triticum turanicum)
    Orzo Pasta
    P
    Pasta
    Pearl Barley
    Persian Wheat (Triticum carthlicum)
    Perungayam
    Poulard Wheat (Triticum turgidum)
    Polish Wheat (Triticum polonicum)
    R
    Rice Malt (if barley or Koji are used)
    Roux
    Rusk
    Rye
    S
    Seitan
    Semolina
    Semolina Triticum
    Shot Wheat (Triticum aestivum)
    Small Spelt
    Spirits (Specific Types)
    Spelt (Triticum spelta)
    Sprouted Wheat or Barley
    Stearyldimoniumhydroxypropyl Hydrolyzed Wheat Protein
    Strong Flour
    Suet in Packets
    T
    Tabbouleh
    Tabouli
    Teriyaki Sauce
    Timopheevi Wheat (Triticum timopheevii)
    Triticale X triticosecale
    Triticum Vulgare (Wheat) Flour Lipids
    Triticum Vulgare (Wheat) Germ Extract
    Triticum Vulgare (Wheat) Germ Oil
    U
    Udon (wheat noodles)
    Unbleached Flour
    V
    Vavilovi Wheat (Triticum aestivum)
    Vital Wheat Gluten
    W
    Wheat, Abyssinian Hard triticum durum
    Wheat Amino Acids
    Wheat Bran Extract
    Wheat, Bulgur
    Wheat Durum Triticum
    Wheat Germ Extract
    Wheat Germ Glycerides
    Wheat Germ Oil
    Wheat Germamidopropyldimonium Hydroxypropyl Hydrolyzed Wheat Protein
    Wheat Grass (can contain seeds)
    Wheat Nuts
    Wheat Protein
    Wheat Starch
    Wheat Triticum aestivum
    Wheat Triticum Monococcum
    Wheat (Triticum Vulgare) Bran Extract
    Whole-Meal Flour
    Wild Einkorn (Triticum boeotictim)
    Wild Emmer (Triticum dicoccoides)
    The following items may or may not contain gluten depending on where and how they are made, and it is sometimes necessary to check with the manufacturer to find out:
    Amp-Isostearoyl Hydrolyzed Wheat Protein2 Artificial Color2 Baking Powder2 Clarifying Agents2 Coloring2 Dry Roasted Nuts2 Emulsifiers2 Enzymes2 Fat Replacer2 Gravy Cubes2 Ground Spices2 Hydrolyzed Wheat Gluten2 Hydrolyzed Wheat Protein2 Hydrolyzed Wheat Protein Pg-Propyl Silanetriol2 Hydrolyzed Wheat Starch2 Hydrogenated Starch Hydrolysate2 Hydroxypropylated Starch2 Miso2 Natural Juices2 Non-dairy Creamer2 Pregelatinized Starch2 Protein Hydrolysates2 Seafood Analogs2 Seasonings2 Sirimi2 Soba Noodles2 Soy Sauce2 Soy Sauce Solids2 Sphingolipids2 Stabilizers2 Starch1, 2 Stock Cubes2 Suet2 Tocopherols2 Vegetable Broth2 Vegetable Gum2 Vegetable Protein2 Vegetable Starch2 Vitamins2 1) If this ingredient is made in North America it is likely to be gluten-free. 2) Can utilize a gluten-containing grain or by-product in the manufacturing process, or as an ingredient.

    Dr. Ron Hoggan, Ed.D.
    This article appeared in the Spring 2005 edition of Celiac.coms Scott-Free Newsletter.
    Celiac.com 04/10/2005 - Celiac disease is, by definition, a condition in which the intestinal wall is damaged as a result of eating gluten. It is a chronic illness in which the symptoms wax and wane1 for reasons that are not yet understood. Celiac disease is the result of genetic and environmental factors. We now know two HLA markers (DQ2 and DQ8) for the predisposition for celiac disease2. One environmental factor is, of course, the consumption of gluten, but there may be other environmental contributors. Recent research reveals that about 1% of the population suffers from this condition3 although most remain undiagnosed.
    On the other hand, gluten sensitivity is characterized by antigliadin antibodies. This condition afflicts at least 12% of the general population4 and is found in patients with a wide variety of autoimmune diseases. In some studies of neurological diseases of unknown origin, a majority of patients show signs of gluten sensitivity4. These patients are mounting an immune response to the most common food in the western diet, yet many practitioners consider gluten sensitivity to be a non-specific finding, frequently counseling patients to ignore these test results. This is particularly unfortunate since a strict gluten-free diet has repeatedly proven helpful to patients who are fortunate enough to consult a practitioner who is versed in gluten sensitivity and its connection with autoimmunity.
    Untreated celiac disease carries an added risk for a wide variety of additional autoimmune diseases. The most likely cause of this predisposition to additional autoimmune disease is a condition sometimes referred to as leaky gut syndrome. We know that gluten causes intestinal damage. We also know that this damage allows large undigested and partly digested proteins to leak into the bloodstream through the damaged intestinal wall. This leakage results in immune system production of antibodies to attack these foreign proteins as if they were invading microbes. The result is the production of a huge variety of selective antibodies, and each type recognizes a particular short chain of amino acids located somewhere in the proteins structure. Unfortunately, our own tissues can contain very similar or identical sequences of amino acids. Hence, by a process called molecular mimicry, we are producing antibodies that attack both the foreign food proteins that are leaked into our blood through the damaged intestinal wall, and similar amino acid sequences in our own tissues, often resulting in an autoimmune disease5.
    The supposedly non-specific antigliadin antibodies in gluten sensitivity provide two important pieces of information: 1) That the intestinal wall has been damaged and is permitting leakage of food proteins into the bloodstream, and; 2) That the dynamic contributing to increased autoimmunity in celiac disease may well be an important contributing factor in gluten sensitivity5. The currently common view that celiac disease is a serious illness, while disregarding gluten sensitivity, is dangerous to gluten sensitive patients.
    This bias is also a divisive element in the gluten-sensitive/celiac community. Whether a person has "biopsy proven" damage to the intestinal wall, if this person gets sick from eating gluten, or mounts an immune response to gluten, we are all in the same leaky boat (please pardon the pun). We need to work together to get a better understanding of gluten sensitivity in all its forms (including celiac disease). As a community, we need to discourage any kind of dismissal of illnesses that are partly or wholly mediated by gluten.
    If we can stand together in our quest for widespread recognition of the damaging impact of gluten consumption, we can all enjoy a healthier life. Our descendants will also inherit a more gluten-savvy world.
    Ron Hoggan is an author, teacher and diagnosed celiac who lives in Canada. His book "Dangerous Grains" can be ordered at Celiac.com. Rons Web page is: www.DangerousGrains.com
    Sources:
    Cooke W, Holmes G. Coeliac Disease. Churchill Livingstone, New York, N.Y. 1984. Fasano A. Celiac disease--how to handle a clinical chameleon.
    N Engl J Med. 2003 Jun 19;348(25):2568-70. Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, Elitsur Y, Green PH, Guandalini S, Hill ID, Pietzak M, Ventura A, Thorpe M, Kryszak D, Fornaroli F, Wasserman SS, Murray JA, Horvath K. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003 Feb 10;163(3):286-92. Hadjivassiliou M, Grunewald RA, Davies-Jones GA. Gluten sensitivity as a neurological illness. J Neurol Neurosurg Psychiatry. 2002 May;72(5):560-3. Braly J, Hoggan R.. Dangerous Grains, Penguin-Putnam-Avery, New York, N.Y., 2002.

    Scott Adams
    The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free
    Celiac.com 04/09/2010 - Receiving a celiac disease diagnosis or being told you need to be on a gluten-free diet can be an overwhelming experience, and it is certainly not for the faint of heart. Most people get frustrated with the transition, and many don't know where to begin. While eating gluten-free can improve your health, I must emphasize that it is not recommended to attempt a gluten-free diet without a doctors supervision, as there are many potential health risks involved with making drastic changes to your diet, which can be avoided with assistance of a qualified doctor and/or nutritionist. If you suspect gluten-intolerance to be the culprit for your health problems, get examined by a doctor and get tested for celiac disease before initiating a gluten-free diet. It is very important to continually consume gluten while you are undergoing testing for celiac disease because many of the tests require you to be consuming gluten to get accurate results.
    Prescription: A Gluten-Free Diet
    Now that you have your diagnosis and need to eliminate gluten, you can make the transition to a gluten-free diet with confidence. The following information is a guideline of what you will need to know to get started. I must emphasize that this is only a guideline, and you will need to do your own research and consult with your doctor for more detailed information on a gluten-free diet. It is also a great idea to get involved in local support groups. Support groups will have members that understand what you are going through and they can help direct you to beneficial resources:
    Celiac Disease Support Groups, Organizations & Contacts Create New Habits
    To begin, if you are accustomed to doing things your own way, you will have to throw out many of your old habits. To avoid gluten poisoning you must keep all gluten away from your mouth. You will need to evaluate everything you ingest very carefully. Gluten can come in a variety of unexpected ways, including a kiss from a loved one, and any gluten that comes into contact with your mouth is a potential source of contamination. Cross-contamination can occur when a meal is prepared on cooking equipment shared with gluten-containing foods. It can also come from touching anything that has come into contact with gluten. It is therefore important to gluten-proof your house and to keep everything you eat separate from gluten and gluten residue. If you eat at restaurants, it is important to only eat at places that you know are safe. To help you avoid accidental gluten ingestion, please follow your instincts and use the following guidelines and avoid potential health hazards. Please remember that these are only guidelines--if you still have questions, please consult with a medical professional.
    What does "Gluten-Free" Actually Mean?
    Since gluten is found in wheat, rye and barley, it is obvious that you will need to avoid these grains. Less obvious however, are the myriad of products that contain gluten as a hidden ingredient. The Food and Drug Administration (FDA) recently regulated the use of "gluten-free" on a food label, and there was already an FDA regulation that requires manufacturers to declare wheat if it is used as an ingredient in a product. Products that don't use "gluten-free" on their label unfortunately don't have to disclose ingredients that are made from barley or rye, which requires you to learn to read and understand ingredient labels. Many additives, natural or artificial, can contain gluten. Sometimes companies label products as "gluten-free" or the ingredients are naturally gluten-free, but the product may have be contaminated if it was manufactured on shared equipment. You will have to decide if you want to include such products in your diet. It is also important to remember, for reasons just mentioned, that “wheat-free” does not mean “gluten-free.”
    Batch Testing:
    According to current FDA proposals, products testing at less than 20 parts per million (PPM)  for gluten will likely be allowed to be labeled "gluten-free," and, according to them, are considered safe for people with gluten-intolerance or celiac disease. There are several organizations that offer gluten-free certification for companies who follow their guidelines and batch test their products. Check out the link below for more information on gluten-free certification and labeling.
    Gluten-Free Food Certification Program by the Gluten Intolerance Group Gluten-Free Shopping
    Shopping will likely take much longer for you than it used to. Don't rush. It is important to read all ingredients carefully. If you are in a hurry, you run the risk of overlooking a key ingredient that might contain gluten. I find it helpful to plan my meals in advance. There is nothing worse than coming home from work hungry and realizing that you have nothing to eat (and it isn't like you can go to the first drive-thru you find). So planning my meals on the weekend and doing my shopping in advance, cuts my stress level down considerably and keeps me from going hungry. Check your products against your gluten-free guidebooks, and contact the manufacturer if you are unsure about something. The following links will help you take the guess work out of shopping for gluten-free products:
    Safe Gluten-Free Food List (Safe Ingredients) Unsafe Gluten-Free Food List (Unsafe Ingredients) As mentioned, there are also many products that are naturally gluten-free that are not labeled "gluten-free," and there are some very helpful books that can help you find these foods when you are shopping.
    A Gluten-Free Kitchen
    A gluten-free kitchen is very important. If you can have an entirely gluten-free kitchen, that is ideal, but it may not be an option for many households. Therefore it is especially important to keep your house clean and free of gluten contaminates.  It is also important to dedicate special kitchen supplies for gluten-free cooking. I bought a new cutting board that is dedicated only to gluten-free cooking. You may also want to have separate kitchen utensils such as sponges, toasters (a dedicated gluten-free toaster is highly recommended), sifters, bread machines, etc. This is especially important if you use utensils that are made of wood, plastic, or other porous materials that could harbor gluten and possibly contaminate your gluten-free food. If possible use an electric dishwasher to clean your dishes.
    If everyone in your household is going gluten-free it is important to clean out and empty all of the gluten products from your kitchen. If you share a kitchen with gluten eating family members, it is a good idea to store their food products separately from your gluten-free products, and to clean off all surfaces before you prepare your gluten-free food. Dedicating gluten-free cupboards and refrigerator shelves is a great way to start.
    Here are some important links that will help you cook gluten-free meals with ease:
    Gluten-Free Cooking Gluten-Free Recipes
    Kitchen Checklist - Possible Sources of Contamination:
    Bread-machine Toaster Sponges & cleaning pads All kitchen supplies & utensils Colanders Cutting boards Door handles Soaps For more information on maintaining a safe kitchen environment, click the link below:
    What You Need If You Can't Have A Gluten-Free Kitchen Dining Out Gluten-Free
    Dining out presents a challenge for most people on a gluten-free diet. Depending on your level of sensitivities, you may have difficulty eating out at all. Even if the restaurant offers a gluten-free menu, it is always important to find out what safety precautions the restaurant uses to avoid cross-contamination, and to make sure all the ingredients in your food are gluten-free. This may require you to modify your order, and also may mean talking with the chef about their kitchen practices. You may also benefit from utilizing a guide to safe restaurants.
    Here is an additional article that may be helpful to your situation:
    Take Charge of Your Meal When Eating Out A Gluten-Free Bathroom
    Believe it or not, your bathroom is another place where you might be getting sick from gluten contamination, and not even know it. There are many products in your bathroom to watch out for as many body products contain wheat and/or hidden gluten ingredients. Most celiacs can use body products without a negative reaction, though some people experience rashes and other unsavory reactions from gluten body products. However, if you are using face or body products that contain gluten, it is very important not to ingest them. I find it difficult to avoid getting shampoo or makeup near my mouth, so I don't take any chances. I use gluten-free soap, shampoo, conditioner, face-cleaner, toner, make-up, toothpaste; basically nothing goes onto my body that contains gluten. Using gluten-free body products allows me the freedom to worry less about accidental contamination, and gives me more time to enjoy my life. Many gluten-free body products are not labeled gluten-free, so it is important to read ingredient labels carefully and check with the manufacturer if necessary.
    Bathroom Checklist:
    Toothpaste Shampoo/conditioner Make-up Lip-stick, lip-liner, lip-gloss, cosmetics, etc. Lotion Sunscreen  
    Gluten-Free Medications (Prescriptions and Supplements)
    Most people with celiac disease or gluten-intolerance also suffer from malabsorption and sometimes malnutrition. Your doctor may prescribe pain, anti-inflammatory, digestive or other medications or supplements to help assist with your recovery. It is very important to note that some medications and supplements can contain gluten. Do not assume that just because your doctor knows you have celiac disease or gluten intolerance that the medications or supplements they may prescribe for you are gluten-free.  Be your own advocate and read the ingredients and contact your pharmacist and/or the manufacturer and find out if your prescriptions, vitamins and supplements are gluten-free.
    Gluten-Free Medications List Additional Concerns
    Children with Celiac Disease
    Raising children with celiac disease or gluten-intolerance is no easy feat. Your kids will have to deal with immense  peer pressure and there will be a great deal of temptation for them to eat gluten-containing foods. Talk to the staff at their school and help them to understand your child's special needs. The more support you have, the better off your child will be. There are many support groups that advocate for children with celiac disease, and it is important to get involved and learn everything you can to help support your child.
    Raising our Celiac Kids (R.O.C.K) Support Group Pets
    Your pets present another source of potential contamination, especially if you have pets like mine that love to smother you with unexpected kisses, sometimes on the mouth. What your pet eats can affect you too. Handling your pet's food, cleaning your pet's dishes and having young celiac children in a house where they may eat dog or cat food are all legitimate concerns. I decided to switch my pets to gluten-free pet food. Most pet food is not labeled gluten-free, so it is important to read ingredients carefully. I found grain-free, all natural pet food to be a great alternative to gluten-containing pet foods, that way I don't have to worry about accidental contamination or getting kisses from my pets--and it's healthier for them too!  It is also important to check all other pet products that you come into contact with for hidden gluten ingredients, like shampoos and soaps. It is of course always important to talk to your veterinarian before making any dietary changes for your pet.
    Other Food Sensitivities
    Most people who begin a gluten-free diet experience almost immediate relief from their symptoms. However, many people experience gluten-like reactions to other foods, and often suspect that their food was contaminated by gluten. As it turns out, many people who experience such reactions may in fact have additional food sensitivities. Some of the most common food sensitivities include, dairy/casein, soy, corn, sugar, nuts, shell-fish and processed or fatty foods. While many people report that they are able to add these foods back into their diet after they have established a gluten-free diet for many months, and after their intestines have had time to heal, it is up to you and your doctor or nutritionist to determine which foods may be causing you trouble. The 'elimination diet' is often recommended for determining what additional food sensitivities you may have. Ask your doctor if the elimination diet is right for you.
    Food Diary
    It is important to keep a food diary, especially when first initiating a gluten-free diet. Making notes of the foods you eat and the reactions you have to the foods you eat, and how you feel that day, can give you more insight as to which foods are hurting you and which foods your body can easily digest.
    Final Thoughts
    Be Picky
    Having a gluten intolerance means taking pride in your body, but not being too proud to say, "no, thank you." Don't worry about appearing too picky to others, you simply can't take care of yourself and worry what others think of you at the same time. You have the right to eat what you want; if something doesn't look, smell or taste right to you, or if you just don't feel right about eating something, don't eat it! It is better to come across as too finicky, than to spend the night in the bathroom or worse yet, the emergency room. Everyone has a different level of gluten sensitivity and you will have to find out through trial and error what works best for you.
    Be Prepared
    As a former Boy-Scout, my high-school teacher used to always say, "Be prepared".  I cannot emphasize enough the importance of this statement. It is important to be prepared and think ahead. Keep gluten-free snacks on hand at all times, because you never know when you are going to get hungry somewhere that doesn't offer gluten-free food. Keep shelf-stable snacks in your car, office, purse, and anywhere you spend time. It is better to have gluten-free snacks on hand, then to get hungry and make a bad decision to eat something you might later regret.

    Gluten-Free Quick-Check:
    Read all labels carefully Call the manufacturer whenever necessary Avoid cross-contamination at all times Keep your hands clean Check personal-care products for hidden gluten Check all vitamins, supplements and RX prescriptions for hidden gluten Make sure your pets are gluten-free Maintain a food diary Get involved-join a support group Rule of thumb-if you think it's possibly contaminated, don't take any chances. It's better to go hungry than to suffer later. Above all, trust your body Additional Resources:
    Gluten-Free Forum Celiac Disease Support Groups Gluten-Free Newsletters & Magazines

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