Gluten Free Diet for Coeliac Disease

My Nutrition

Gluten free diet for coeliac disease

This sheet is for people with coeliac • Iron deficiency anaemia and/or other disease diagnosed by a doctor. It may not vitamin and mineral deficiencies

be suitable for those with gluten • Osteoporosis intolerance. • Weight loss

What is coeliac disease? • Gastrointestinal symptoms e.g. Coeliac disease is a condition where the diarrhoea, nausea, bloating body’s immune system reacts to gluten. Other complications which can relate to Gluten is a protein found in foods made untreated coeliac disease include: with: • Infertility

• Wheat • Gastrointestinal cancer • Barley • Altered mental state • Rye My My• Increased risk of other autoimmune • Oats Nutrition Nutritionconditions

How is it managed? The only treatment is a strict life-long gluten free diet. Eating any gluten causes the small, finger-like projections (villi) in the bowel to become inflamed and flattened. Eating a gluten free diet allows the bowel wall to heal and digestion to return to normal.

What are the risks of not following a strict gluten free (GF) diet? Consequences of small bowel damage and poor absorption of Used with permission from Coeliac New Zealand nutrients include:

This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: www.health.qld.gov.au/global/disclaimer Reviewed: March 2020 Copyright: www.health.qld.gov.au/global/copyright-statement Due for review: March 2022

How do I make my diet gluten free? Read the ingredient lists

Suitable foods on a GF diet include: Gluten containing products have: 1) Naturally gluten free foods • Ingredients derived from gluten- • Fresh fruits and vegetables containing grains including:

• Fresh/unprocessed meat, fish, o wheat, rye, oats, barley or gluten chicken and eggs o wheat starch, cornflour (wheat), • Plain legumes and nuts thickeners 1400-1450 (wheat • Naturally gluten free grains - rice, derived) or wheat maltodextrin

quinoa (see full table below) Ingredients that are gluten free: • Gluten free breads and cereals • Starches and thickeners not specified • Plain dairy (milk, yoghurt, cheese) as made from wheat

2) Packaged foods with an ingredient • “wheat glucose syrup” and “caramel list: colour from wheat” - processing • Products labelled ‘gluten free’ removes the gluten

• Products that do not contain Read food labels ingredients derived from gluten- My Be aware that wheat free and gluten NutritionMy containing grains Nutritionfree are not the same: • Products with the Coeliac Australia • “Wheat free” may still include other Endorsement Logo gluten-containing ingredients, such Products with the as oats in muesli Coeliac Australia • Products labelled “gluten free” Endorsement Logo contain no detectable gluten contain no detectable • Products labelled “(may) contain gluten. Not all gluten traces of wheat/gluten” should be free products use this logo. avoided by people on a GF diet

What about food labelling? What about food preparation? th In Australia, products need to list all Even 1/100 of a slice of wheat bread ingredients and allergens on packaging. can damage the small bowel. It is essential to prepare, store and cook GF foods away from foods that contain gluten. This avoids cross

contamination. Try the following: This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: www.health.qld.gov.au/global/disclaimer Reviewed: March 2020 Copyright: www.health.qld.gov.au/global/copyright-statement Due for review: March 2022

AT HOME OR WHILST TRAVELLING Wash your hands after handling gluten-containing food Use separate, labelled containers for GF foods (bread, biscuits) Use separate, labelled appliances e.g. bread makers, toasters, sandwich presses for GF options Trial toast bags for GF toast Use separate spreads e.g. margarine for GF products Use separate water in a clean pot for cooking GF pasta Use a separate colander to drain gluten free pasta Use clean oil when deep frying. If sharing, make sure the GF foods are fried before the gluten-containing options Prepare gluten free meals first or in a separate area Wash all cooking utensils before and after use e.g. chopping boards, pans, storage containers, cutlery, bowls and plates

EATING OUT Call restaurants before to ask about suitable gluten free options Alert staff and ask for their gluten free options Try cuisines that include a selection of naturally GF options (Thai, Mexican, Vietnamese, Indian). Always double check options are GF Choose foods labelled GF on the menu Check salad dressings and sauces used in cooking are GF Avoid foods fried in the same oils as batter which contains wheat Avoid foods prepared on the same board My My List of food options Nutrition Gluten free MNutritionay contain gluten Contain gluten (AVOID) (READ LABEL)

Grains & • Almond meal • Baking powder • All varieties of wheat flours • Amaranth • Wheaten cornflour (including spelt, kamut, • Arrowroot couscous, durum, farro) • Buckwheat • Barley • Corn/maize • Oats • Glutinous rice flour • Products using malted • Gram/besan gluten grains e.g. malt • Lentil and soy flours barley • Lupin • Rye • Millet • Semolina • Polenta • Triticale (a hybrid of • Potato starch/flour wheat and rye) • Quinoa • Rice • Sago/tapioca • Sorghum • Teff

Gluten free May contain gluten Contain gluten (AVOID) (READ LABEL)

Cereal • GF corn tortillas • Corn & rice • Egg noodles products • GF muesli tortillas/wraps • Lasagne • GF pasta & lasagne • Soba noodles • Muesli sheets • Vermicelli noodles • Noodles/spaghetti • Plain rice & corn cereals • Oat porridge (no malt) • Pasta/macaroni • Rice noodles • Ravioli/tortellini • Rice porridge • Udon noodles • Wheat-based & mixed grain breakfast foods Breads, • Breads, biscuits, cakes • Flavoured rice cakes • Barley bread biscuits, labelled as gluten free and crackers • Crispbreads cakes, etc. • Plain rice crackers • Plain rice and corn • Croissants • There are many gluten cakes • Ice cream cones or free breads, biscuits, wafers cakes and pizza bases, • Pizza bases etc. now available • Pumpernickel bread • Regular biscuits/cakes • Regular bread & rolls • Rye bread • Sourdough breads • Waffles/pancakes Meat/meat • Eggs • BBQ chicken (stuffing & • Crumbed/battered alternatives • Fresh (non-marinated) Myseasoning) meats meats Nutrition• DeliMy meats (ham/turkey/ • Hamburgers • Fresh seafood Nutritionsalami etc.) • Imitation seafood e.g. • Plain tinned fish (check • Flavoured tinned seafood sticks for ‘may contain’ fish/chicken • Meat pies/sausage rolls statements) • Marinated meats/seafood • Sausages • Tofu Dairy • Buttermilk • Artificial cream • Cheese (hard/soft) • Custard (powders) • Condensed milk • Dairy desserts • Evaporated milk • Flavoured milk • Fresh cream • Ice cream • Milk (goats/cow) • Processed cheeses & • Plain cream cheese cheese spreads • Yoghurt • Soy milk Vegetables • Dried legumes & lentils • Frozen & canned (check for ‘may contain’ vegetables statements) • Frozen or take-away • Fresh salad items chips • Fresh vegetables • Processed/canned • Olives legumes • Vegetable/potato salad/coleslaw

Gluten free May contain gluten Contain gluten (AVOID) (READ LABEL)

Fruit • Fresh/frozen/tinned fruit • Christmas mince • Fruit mince • Thickened fruit products

Beverages • All distilled spirits (even • Chocolate dusting • Barley drinks malted whisky) powder • Beer/ale/lager/stout • Cider • Cordials (some contain • Milo & other malt • Fortified wines (port, barley) powder beverages sherry) • Drinking chocolate • Fruit & vegetable juices • Soft drinks (some • Mineral water contain malt/barley) • Soda & tonic water • Tea & coffee (some • Sports drinks herbal/flavoured tea • Water bags contain gluten) • Wine • Tea & coffee substitutes (coffee sachets) Sauces, • Fish sauce • All commercial sauces • Malt vinegar spreads & • Golden & maple syrup (BBQ, sweet chilli, etc.) • Vegemite, Promite & herbs • Jams & honey • Asian sauces (soy, Marmite (gluten free • Marmalade oyster, etc.) varieties available) • Molasses • Chutney • Peanut butter • Curry powder/pastes • Pure herbs & spices • Meat & fish pastes • Salt & pepper • MyPickles • Tahini • SaladMy dressings & • Tomato sauce Nutritionmayonnaise • Treacle •Nutrition Stock cubes & gravy • Vinegars (except malt) mixes • Vanilla & flavouring essences • Mixed packaged herbs or spices Other • Butter & margarine • Filled chocolates & • Liquorice (gluten free • Jelly (check for ‘may chocolate snack foods now available) contain’ statements) • Flavoured crisps/chips • Milo and other malt- • Oils • Icing mixture (gluten containing powders • Plain dark or milk free varieties available) chocolate (check for • Lollies/sweets “malt” in the ingredients) • Tinned & packet soups • Plain nuts • Plain popcorn • Pure icing sugar • Sugar • Wheat germ oil

Suggested meal plan

BREAKFAST • GF muesli/high fibre cereal with psyllium and milk & fruit • Eggs and grilled tomato, spinach and mushroom on gluten free toast • GF baked beans (check label) on GF toast • Smoothie – nuts, milk, fresh/frozen fruit

MORNING TEA • Plain rice cakes with cheese topped with tomato and cucumber • Vegetable sticks with hummus or tzatziki

LUNCH • Wrap or sandwich (choose wholemeal or seeded GF bread) filled with salad and chicken/ham/tuna (GF) • Piece of fruit

AFTERNOON TEA • Yoghurt (check label) • Nuts and dried fruit mix

DINNER • Meat/fish/chicken with potato and vegetables (if using gravy check the label to ensure GF) • Stir-fried meat/chicken with vegetables, rice and GF sauces • GF pasta with mince, vegetables and GF bolMyog naise sauce • Curry made with meat/chicken/vegetables,Nutrition tomatoMy and spices/chillies (check the label of any sauces/pastes) Nutrition

SUPPER • GF custard • GF ice cream • GF cake/slice/biscuit • Hot chocolate (check label if using a prepared powder)

Things I can do:

Useful resources

Accredited -Support with transition and adherence to a gluten free diet Practising -Assist to reduce risk of cross contamination Dietitian - Ensure diet is nutritionally adequate Find a dietitian: https://daa.asn.au/find-an-apd/ Coeliac -www.coeliac.org.au; www.coeliac.org.nz Australia, -Supports people with coeliac disease and their families Coeliac New -Offers annual membership and credible information. Membership is Zealand suggested for all people diagnosed with coeliac disease

Recipes, Taste: https://www.taste.com.au/recipes/collections/gluten-free takeaway BBC Good Food: options & https://www.bbcgoodfood.com/recipes/collection/gluten-free pre- Australian Gluten Free Life: https://agfl.com.au/ prepared Gluten Free Eating Directory: www.glutenfreeeatingdirectory.com.au/ meals Gourmet Meals: www.gourmetmeals.com.au Phone Apps iPhone Android Cost* Comment

Coeliac HELP SHOPPING Australia $9.49 Details over 800 gluten free ingredients & 300 additives (AUS/NZ) Find Me Free with HELP EATING OUT Gluten Free in app Lists gluten free My Mypurchas es restaurants filtered to Nutrition specifics e.g. location Nutrition or meal FoodSwitch Free HELP SHOPPING by Bupa Use the GlutenSwitch filter & scan barcodes to find gluten free choices Recipeezi Free initial HELP COOKING Gluten Free trial then Gluten free recipes subscribe and shopping list

* Please note the cost of these apps may change

For any queries or concerns please contact your dietitian:

Name: ______

Contact: ______

This resource has been developed in consultation with Coeliac Australia and Coeliac New Zealand.