Gluten-Free Diet

Gluten-Free Diet What is a gluten- It is advised to start with ¼ cup (60 mL) dry oats per day for children, and ½¾ cup (125 mL175 mL) dry free diet? oats per day for adults. Choose oats that are labelled A gluten-free diet completely “pure oats” or “gluten-free oats”. avoids the grains below:  wheat Gluten-free baking and cooking  rye When cooking or baking at home, it’s important to  barley keep your foods gluten-free. Even a crumb from  triticale gluten-containing bread can affect your small intestine.  spelt Baking and cooking surfaces should be clean and  kamut gluten-free. Use these tips to keep your foods from coming in contact with gluten, which causes cross- These grains contain a protein called gluten. Gluten contamination. can damage the lining of the small intestine in people who have celiac disease. When the lining is damaged, To avoid cross-contamination: nutrients (like vitamins and minerals) are not absorbed.  Choose flours labelled gluten-free. Flours without This may lead to health problems such as low iron, the gluten-free claim may be cross- contaminated weak and brittle bones, itchy skin rash, and infertility. during production.

 . If you have celiac disease, you should follow a gluten- Store all gluten-free products separately Have a separate cupboard and containers for free diet for the rest of your life. It is recommended gluten-free products. that you meet with a registered dietitian with expertise in celiac disease. They can help you to adapt to the  Use clean equipment for gluten-free food gluten-free diet and ensure you are including nutrients preparation. Make sure all pots, pans, utensils, that are found in gluten-containing foods (fibre, iron utensil drawers and counter spaces are clean before and B vitamins). A gluten-free diet is the only way to using. Use a separate strainer for gluten-free foods. keep the intestine healthy and reduce the risk of health  Prepare and cook gluten-free foods separately problems. from regular foods. Glass or metal dishes are best.

A gluten-free diet can be tasty and nutritious. You can Shared wooden utensils and wooden cutting boards find many gluten-free food choices at grocery and may contribute to cross contamination. Have a specialty stores. Gluten-free foods can also be made separate cutting board and wooden utensils that are easily at home. just for gluten-free foods.  Have your own toaster. It’s best to buy a new toaster and use it only for gluten-free bread. A What about oats? shared toaster will have crumbs from gluten- Oats don’t have gluten but can be contaminated by containing breads. Another option is to use toaster other grains that have gluten in them. A small number bags. These re-useable bags cover your bread so it of people with celiac disease may not tolerate oats. can be placed in any toaster. Talk to your doctor or dietitian before adding oats to  Use separate condiment containers. Have your diet. separate containers for items such as margarine, jam, peanut butter, honey, mayonnaise, relish, or If you want to start eating oats, wait until all symptoms mustard. A shared dish or jar may have crumbs of celiac disease have resolved and you have been on a from gluten-containing foods. gluten-free diet for at least 6 months.

Developed by Registered Dietitians Nutrition Services 404219-NFS

Grocery shopping tips  if fried foods are fried in the same oil as other foods Foods labelled gluten-free or having the  to have your food cooked or baked in separate Canadian Celiac Association gluten- Gluten-Free pans or dishes that have been washed before using free symbol shown here, are safe Certification Program (to reduce the risk of cross-contamination) choices. Trademark is used with permission of Most grocery and health food stores the Canadian Celiac Association. Do I need vitamin and mineral carry gluten-free products. supplements? By law, all gluten-containing ingredients have to be People who follow a gluten-free diet may not get listed on the food label. If a food isn’t labelled gluten- free, it’s important to check two places on the food enough of certain vitamins and minerals. Some gluten label: the ingredient list and the “contains” or “may -free grains may not have all the vitamins and contain” list. See the list of foods to choose on pages minerals that are added to regular grains. 36 of this handout.  Use gluten-free whole grains at meals and snacks as these may give you more vitamins and When shopping for gluten-free foods: minerals.  Read the label every time you buy a product.  Choose gluten-free foods labelled as enriched Ingredients can change from time to time even when available, as these are higher in some with the same food product. vitamins and minerals like iron and B vitamins.  Contact the manufacturer for more information. Ask your doctor or dietitian if you need to take a  Use only products that contain ingredients allowed vitamin or mineral supplement. on a gluten-free diet.  Avoid bulk food bins. Foods labelled gluten-free may be stored in bins that were used before for Medicine and supplements gluten-containing foods. Shoppers may use the Check prescriptions, over-the-counter same scoop for all kinds of foods. It’s easy for medicine, and vitamin and mineral cross-contamination to happen. supplements to make sure they are gluten-free. Eating away from home Cough and cold medicines often have gluten in The Canadian Celiac Association has Gluten Alert them. Ask the pharmacist if you aren’t sure. Restaurant Cards you can order. They list gluten- containing foods and ingredients you need to avoid. You can give these cards to your server when eating Resources out.  www.celiac.ca (1-800-363-7296) The Canadian Celiac Association is a volunteer organization. It Some restaurants may not understand what you mean offers reliable and up-to-date information about if you ask for gluten-free foods. Tell your server that celiac disease, dermatitis herpetiformis, and the you can’t eat anything with wheat, rye, barley, or oats gluten-free diet. The Alberta chapters listed on the in it, as these make you sick. website can give you more information. Avoid salad bars, buffets, and fondues since gluten-  www.celiac.nih.gov (National Institute of Health free foods are easily contaminated by spoons, serving Celiac Awareness Campaign, US). This American utensils, and small food pieces from gluten-containing website has information about celiac disease. foods.

Ask the server:  to ask the chef which menu items are gluten-free

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Check the ingredient Food Group Choose Don’t eat/drink list on the label These foods gluten These foods gluten don’t have may have These foods have gluten in them when eaten plain in them if it was added during or unprocessed. processing. in them.

Grain foods Baked products, bread or  communion wafers Baked products, bread or bread crumbs, crackers, pasta  corn tacos and tortillas bread crumbs, crackers, * Choose these made with these gluten-free  oats (regular) pasta made with: whole grains ingredients:  popped corn cakes  arrowroot biscuits more often.  amaranth*  rice and soy pablum  atta

 arrowroot flour  barley, barley flakes, barley  buckwheat, pure* flour, barley malt, barley  cassava, manioc, tapioca malt extract, barley malt  cereals (cold) without flavour, barley malt syrup flavouring or malt extract  buckwheat products with such as: gluten-containing o puffed corn, millet, or ingredients (soba noodles) rice  bulgur (tabbouleh) o rice flakes  cereals made with  cereals (hot) such as: gluten-containing o buckwheat groats ingredients o cream of rice  cereals with added o grits gluten-containing o hominy/hominy corn flavouring or malt extract o soy cereal  couscous  corn*  farina  corn starch  freekeh  cornmeal  gluten flour  flax  graham flour  legume flours (bean,  hydrolyzed wheat protein chickpea, lentil, pea)  ice cream cones, wafers,  maize waffles  millet*  matzoh  nut flours  oat gum  oats*, pure or gluten-free  oatmeal, oat bran, oat  plain rice cakes flour, whole oat groats, oat  popcorn* hull fibre (not labelled as  potato flour or starch gluten-free)  quinoa*  rye  rice (black*, brown*, red*,  triticale white, wild*)  wheat, all types including:  rice bran, rice flour, rice malt dinkel, spelt, farro (faro),  sago einkorn, emmer, or kamut  sorghum*  wheat bran, wheat germ  soy  wheat-based semolina  tapioca  wheat flour, durum flour  taro  wheat gluten  teff*  wheat starch or modified

wheat starch

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Check the ingredient Food Group Choose Don’t eat/drink list on the label These foods gluten in These foods gluten don’t have may have These foods have gluten them when eaten plain in them if it was added during in them. or unprocessed. processing.

Protein foods  beans  baked beans  breaded or battered, fish,  buttermilk  cheese, packaged shredded meat or poultry  cheese, processed cheese  cheese spreads or sauces  fu (concentrated wheat slices  dried eggs gluten and wheat flour  chickpeas  dry roasted nuts used in vegetarian dishes)  chocolate milk  fish canned in  malted milk  cottage cheese, plain vegetable broth or sauce,  peanut butter with wheat

 cream seasoned or smoked fish germ  cream cheese, plain  flavoured cottage cheese  products with  egg whites, egg substitutes  flavoured cream cheese gluten-containing  eggs  flavoured yogurt ingredients   fish, plain  ice cream or frozen yogurt seitan (vegetarian “wheat

 gluten-free deli meats and  imitation seafood such as meat”)

sausages* crab or surimi

 kefir  liquid eggs, seasoned

 lentils  liver pate   liquid egg products peanut and other nut butters   meat prepared or processed  milk meats: o beef jerky  nuts and seeds, plain o bologna  peas o chicken or turkey  poultry breasts, seasoned, frozen  quark o ham  shellfish that is fresh, frozen, o hamburgers or canned (unseasoned, in o luncheon meats water or oil) o meat patties  tofu, plain o meat spreads  yogurt, plain o meatloaf

o sausages

o wieners *Meat slicers may be  pudding contaminated if used for  soy beverages, soy yogurt, gluten-containing products. coconut yogurt or soy ice cream  tofu, flavoured or seasoned

 fruit juice or vegetable juice  dried vegetables or fruit  fruit desserts such as pies Vegetables  plain fresh, frozen, or  fruit pie fillings  scalloped potatoes and canned fruit and vegetables  seasoned frozen vegetables with wheat flour fruits  vegetables or fruit with batter or sauces

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Alcohol: Alcohol: Alcohol: Other  gluten-free beer  flavoured alcoholic drinks  ale  liqueurs (unless gluten is  beer declared)  lager  spirits such as: bourbon, gin, rum, rye, vodka, whiskey  wine

Baking ingredients: Baking ingredients: Baking ingredients:  baking chocolate  baking powder  brewer’s yeast  baking gums:  yeast (autolyzed, yeast o carrageenan extract) o guar

 baking soda  baking yeast  carob chips and powder  chocolate chips  cocoa powder  coconut  cream of tartar  gelatine

Beverages: Beverages: Beverages:  cider  flavoured coffee  coffee whiteners  cocoa, plain  herbal tea  malted beverages  coffee, ground or instant  hot chocolate mixes  juice  rice/almond/oat/hemp  soft drinks beverages

 tea

Condiments: Condiments: Condiments:  black pepper, pure  BBQ sauce  malt vinegar  gluten-free soy sauce  flavoured miso or tempeh  herbs and spices, pure  marinades  ketchup  mayonnaise  monosodium glutamate  meat coatings (MSG)  mustard  olives  rice vinegar  pickles, plain  smoke flavour  relish  soy sauce  tomato paste  spice mixture  vinegar  Worcestershire sauce

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Fats/Oils: Fats/Oils: Fats/Oils: Other (Continued)  butter  cooking spray  foods that have been fried  canola oil  salad dressing in oil with gluten-  homemade salad dressings containing ingredients  lard  margarine  shortening  sour cream  vegetable oil

Soups: Soups:  broth  bouillon cubes  gluten-free bouillon cubes  canned soup  soups and stocks made  dried soup mixes from gluten-free  soup bases ingredients

Sweets: Sweets: Sweets:  corn syrup  candies  candies and licorice with  honey  chocolate bars gluten-containing  jam  custard ingredients

 jelly  frostings  maple syrup  pudding mixes

 marmalade  marshmallows  molasses  sugar (brown, white, and icing)  sugar substitutes like Equal® or Splenda®

Other: Other: Other:  flavour extracts, natural or  deep fried foods  pizza crust made with artificial  trail mixes gluten-containing  maltodextrin  dextrin ingredients

Gluten-Free Diet Page 6 of 6 404219-NFS This is general information and should not replace the advice of your health professional. Alberta Health Services is not liable in any way for actions based on the use of this information. Licensed under the Creative Commons Attribution-Non-Commercial-No Derivatives 4.0 International License. Contact [email protected].  Alberta Health Services (Oct 2019)