12 Gluten free diet
Where can I find gluten free products?
There are a number of gluten free products available. Many of the big grocery store chains carry a wide selection of gluten free products.
Many of the food companies or manufacturers who produce gluten free products often sell their products on site (at the factory) to the public. Gluten free diet
Some manufacturers also provide mail order services. Buying products in bulk and freezing for later use will help save you money. What is gluten? Other tips to help you find out if a food contains Gluten is a protein found in grains such as wheat, rye, barley and gluten: their by-products. When you have celiac disease, gluten damages • The Canadian Celiac Association’s “Pocket Dictionary” will your small intestine and can cause mild to severe symptoms. give you information if a food is gluten free or not. Copies of You also do not absorb all the nutrients from the foods you eat. this book can be ordered from the website: www.celiac.ca • Do not assume that your favourite foods will remain gluten Symptoms of celiac disease include: free. Read the label every time you use a product as food • nausea • weight loss products change all of the time. Ingredient lists available online are not always accurate as they can become outdated. • reflux • lactose intolerance • Contact the food company directly and ask if you have • bloating • anemia questions about whether certain products are gluten free. • gas • stomach pain • diarrhea • tiredness Other resources • constipation • skin rashes • Stay informed through the Canadian Celiac Association by becoming a member and/or attending local chapter events. Even if you do not have symptoms, you must follow a strict gluten There are local chapters in Hamilton, St. Catharines and free diet to reduce the risk of long term complications such as Kitchener/Waterloo. See the website: www.celiac.ca osteoporosis and cancers of the digestive system. • There are many cookbooks available offering gluten free recipes. The Canadian Celiac Association has published several cookbooks and recipes can also be found online.
© Hamilton Health Sciences, 2012 PD PD 7618 – 08/2012 dpc/pted/GlutenFreeDiet-trh.doc dt/January 3, 2012 ______
2 11 Gluten free diet Gluten free diet
Other Foods (continued) Why is it important to follow a gluten free diet? Foods to Include Foods to Question Foods to Avoid A lifelong gluten free diet is the only treatment for celiac disease. Baking Ingredients: Baking powder (may Brewer’s yeast Baking soda, baking contain wheat starch) This diet will help your small intestine heal and will reduce yeast, carob chips and Oat gum, sauces, your symptoms. Your body will then be able to use the nutrients powder, pure baking marinades and gravies in foods needed for good health. chocolate, chocolate made from ingredients chips, pure cocoa, not allowed, such as coconut, cream of HVP or HPP*. tartar, vanilla, pure vanilla extract, artificial *HVP or HPP How do I follow gluten free diet? (synthetic, imitation) (Hydrolyzed Plant vanilla extract, vanillin, Protein or Hydrolyzed You will need to avoid foods that have gluten in them: sauces and gravies Vegetable Protein) made with allowed if made from wheat, Table 1 ingredients or the source is not - Avoid - listed. Grains that contain gluten Sweets: Icing sugar, Licorice, chocolate and Corn syrup, honey, confectioner’s sugar candies made with Barley Graham flour jam, jelly, marmalade, (may contain wheat ingredients not allowed Barley malt/extract Rye maple syrup, starch) molasses, sugar Bulgar Semonlina (brown and white), Spreads (Nutella), Couscous Spelt artificial sweeteners candies, chocolate bars, chewing gum, Durum flour Kamut marshmallows Eikorn Triticale Emmer Wheat Lemon curd (may be thickened with flour) Farina Wheat bran Soups: Canned soups, dried Canned, packaged or Farro Wheat germ Homemade broth, soup mixes, soup bases homemade soups made gluten free bouillon and bouillon cubes with ingredients that Gluten flour Wheat based semolina cubes, cream soups contain gluten Commercial oat products and stocks made from (See Table 1), bouillon ingredients allowed and bouillon cubes containing hydrolyzed wheat protein
please turn over Î ______
10 3 Gluten free diet Gluten free diet
Other Foods Hidden sources of gluten Foods to Include Foods to Question Foods to Avoid Beverages: Instant tea, flavoured Cereal and malted There are many hidden sources of gluten. Always read food labels Cider, instant or and herbal teas and beverages such as to find out which products have gluten in them. ground coffee, soft coffee substitutes, hot Ovaltine Avoid food products that do not list the source of their ingredients drinks, tea chocolate mix (may such as: Distilled alcoholic contain grain additives) Beer, ale and lager beverages – rum, gin, • modified starch bourbon, brandy, rye, Fruit-flavoured drinks, Instant hot chocolate • seasonings and flavourings whiskey, scotch chocolate drinks and mixes • hydrolyzed vegetable protein (HVP) whiskey, vodka and chocolate mixes (may liqueurs, wine contain wheat starch or • hydrolyzed plant protein (HPP) barley malt) Most large chain grocery stores and specialty food stores have a Gluten free beer, lager and ale “gluten free” section, which makes finding products easier. Condiments and Seasoning mixes, Regular soy sauce Check with your pharmacist about the ingredients in prescriptions Seasonings: imitation pepper, curry (made from wheat), Ketchup, gluten free paste, Worcestershire mustard pickles (made and over-the-counter medications to make sure they are gluten free soy sauce, plain sauce (may contain with wheat flour) malt such as: prepared mustard, wheat or HPP, HVP) vinegar, Teriyaki sauce, • vitamins, minerals, herbal supplements olives, plain pickles, hydrolyzed wheat protein • toothpaste pure black pepper, • mouthwash pure herbs and spices, relish, tomato paste • cough and cold medications and vinegar (apple, • nutrition supplements (such as protein powders and shakes, cider, rice, balsamic, weight loss drinks) grape), Monosodium Ask your pharmacist if you are not sure if a product has gluten. Glutamate (MSG) Desserts: Milk puddings and Desserts made with Ice cream, sherbet, pudding mixes (may ingredients not allowed egg, custards, contain a gluten source) whipped toppings, What is cross contamination? gelatin desserts, Cake icings and cakes, cookies, pies frostings Cross-contamination is when bits of food such as crumbs from foods made with allowed that contain gluten, accidentally mix with gluten free foods. This can ingredients happen in your home, restaurants, bulk food bins, and in food manufacturing plants where there are both gluten containing and gluten free products.
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4 9 Gluten free diet Gluten free diet
Can I eat oats? Meats and Alternatives
You can eat oats only if they are free from gluten. This means Foods to Include Foods to Question Foods to Avoid that they have not been cross-contaminated with gluten. Pure, uncontaminated oats are available in Canada and are likely Meat, fish, shellfish, Prepared or processed Fish canned in vegetable safe in moderate amounts for most people with celiac disease. and poultry that is meats, luncheon meats, broth containing HVP or fresh, frozen, canned wieners, bologna, HPP* However, it is not easy to buy pure oats in Canada since most of the salted or smoked bacon, meat, spreads, oats are cross-contaminated with gluten containing grains or cereals meat patties, sausages, Turkey basted or during milling and processing. Eggs imitation meat or fish injected with HVP or products (crab meat), HPP* If you choose to include oats in your diet, you must make sure that Lentils, chickpeas, dried meats (beef jerky), the oats are free from gluten contamination. dried peas, dried pates may contain fillers beans, plain nuts, or flavourings made *HVP or HPP seeds and tofu from wheat (Hydrolyzed Plant The best way to be sure the oat product is safe is to contact Protein or Hydrolyzed the food company. The label must state “pure, uncontaminated, Plain seed and nut Egg substitutes, Vegetable Protein) gluten free”. butters dried eggs if made from wheat, or the source is not
Baked beans, soy nuts, listed. Please talk to your doctor or dietitian before adding oats to your diet. dry roasted nuts, flavoured tofu, miso, seasoned nuts/seeds To avoid cross-contamination: Fats • prepare gluten free foods first • have a separate toaster and separate container of peanut Foods to Include Foods to Question Foods to Avoid butter, margarine, butter, jams, jellies and mayonnaise containers Butter, margarine, lard, Mayonnaise Packaged suet • clean all meal preparation surfaces, cutting boards, utensils vegetable oil, cream, and pots and pans to make them free from gluten before you shortening Commercial salad Salad dressings made prepare a gluten free meal dressings (seasonings with ingredients not Homemade salad may contain flour) allowed • be cautious when buying foods from bulk food bins as they dressings with allowed can be contaminated with gluten from scoops being used ingredients Cooking sprays from other bins • avoid buying foods from the deli counter as they may be contaminated with gluten containing foods
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8 5 Gluten free diet Gluten free diet
Milk and Alternatives (continued) What can I eat? Foods to Include Foods to Question Foods to Avoid There are many foods you can still enjoy on a Gluten free diet. Most ice cream Flavoured yogurt and Choosing foods from the “Foods to Include” list in each food group frozen yogurt (may will help you eat a nutritious, balanced diet. Most soy, nut and rice be thickened with a beverages gluten source or Grain products contain granola or cookie crumbs) Foods to Include Foods to Question Foods to Avoid
Cheese spreads and Breads, crackers, pasta • Items made with Breads, crackers, pasta sauces (may be and baked products made Buckwheat flour and baked products thickened with from gluten free grains – made with grains that wheat, flavourings amaranth, arrowroot, contain gluten and seasonings may corn, millet, quinoa, rice, – See Table 1 contain wheat) soy, sorghum, flax,
tapioca, buckwheat, corn Sour cream (low fat bran, cornstarch, potato or fat free may flour, taro, teff, legume contain oat gum) flour
Rice and soy drinks Hot Cereals such as: Oats: Cereals: (may contain barley, barley malt extract • Cornmeal • Oats (some may • Cereals made from or oats) • Cream of rice be contaminated grains in Table 1 • Hominy grits with gluten) including wheat, rye, Some soy, nut and • Cream of buckwheat triticale, barley and rice beverages • Rice flakes Cereals: oats contain barley malt • Quinoa • Rice and corn • Cereals with added extract or flavouring • Soy flakes cereals (may malt extract or malt • Pure oatmeal contain barley flavouring malt extract or oat syrup)
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6 7 Gluten free diet Gluten free diet
Grain products (continued) Fruits and Vegetables
Foods to Include Foods to Question Foods to Avoid Foods to Include Foods to Question Foods to Avoid
Cold cereals (without Fresh, frozen and canned Dried fruits (often Vegetables with creamy malt flavouring) fruit and fruit juices dusted with flour to sauces (may contain such as: • Rice and corn prevent sticking) wheat) • Puffed corn cereals may Fresh, frozen and canned such as dates • Puffed rice contain barley vegetables and juices Scalloped potatoes with • Puffed millet malt flavouring Fruit pie filling wheat flour • Amaranth flakes • Rice flakes Creamed canned Battered vegetables • Soy cereals vegetables and including french fries french fries (often • Corn flakes contain wheat) • Puffed corn
• Puffed or flaked Vegetables in sauces amaranth • Rice crisps French fries (in restaurants and Other: Other: Other: frozen) • Plain corn tacos or • Rice cakes, corn • Ice cream cones tortillas cakes and rice • Wafers Milk and Alternatives • Plain rice cakes crackers • Waffles • Popcorn (multigrain or • Communion wafers Foods to Include Foods to Question Foods to Avoid • Corn cakes flavoured often • Wheat flour tacos • Rice tortillas contains barley and tortillas Milk, cream, buttermilk Milk drinks and milk Malted milk • Plain corn chips and/ or oats. • Some imported • Rice (basmati, brown, Some contain soy foods labelled Plain yogurt Puddings, Nesquick Ice cream made with jasmine, white, wild) sauce which “gluten free”. These (chocolate milk, ingredients not allowed contains wheat). may still contain Cheeses, cream cheese, flavoured drinks • Seasoned potato ingredients with processed cheese, and puddings may and corn chips gluten, such as cottage cheese contain wheat starch • Seasoned or wheat starch or barley malt) flavoured rice • Modified food starch mixes (if source not identified)
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6 7 Gluten free diet Gluten free diet
Grain products (continued) Fruits and Vegetables
Foods to Include Foods to Question Foods to Avoid Foods to Include Foods to Question Foods to Avoid
Cold cereals (without Fresh, frozen and canned Dried fruits (often Vegetables with creamy malt flavouring) fruit and fruit juices dusted with flour to sauces (may contain such as: • Rice and corn prevent sticking) wheat) • Puffed corn cereals may Fresh, frozen and canned such as dates • Puffed rice contain barley vegetables and juices Scalloped potatoes with • Puffed millet malt flavouring Fruit pie filling wheat flour • Amaranth flakes • Rice flakes Creamed canned Battered vegetables • Soy cereals vegetables and including french fries french fries (often • Corn flakes contain wheat) • Puffed corn
• Puffed or flaked Vegetables in sauces amaranth • Rice crisps French fries (in restaurants and Other: Other: Other: frozen) • Plain corn tacos or • Rice cakes, corn • Ice cream cones tortillas cakes and rice • Wafers Milk and Alternatives • Plain rice cakes crackers • Waffles • Popcorn (multigrain or • Communion wafers Foods to Include Foods to Question Foods to Avoid • Corn cakes flavoured often • Wheat flour tacos • Rice tortillas contains barley and tortillas Milk, cream, buttermilk Milk drinks and milk Malted milk • Plain corn chips and/ or oats. • Some imported • Rice (basmati, brown, Some contain soy foods labelled Plain yogurt Puddings, Nesquick Ice cream made with jasmine, white, wild) sauce which “gluten free”. These (chocolate milk, ingredients not allowed contains wheat). may still contain Cheeses, cream cheese, flavoured drinks • Seasoned potato ingredients with processed cheese, and puddings may and corn chips gluten, such as cottage cheese contain wheat starch • Seasoned or wheat starch or barley malt) flavoured rice • Modified food starch mixes (if source not identified)
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8 5 Gluten free diet Gluten free diet
Milk and Alternatives (continued) What can I eat? Foods to Include Foods to Question Foods to Avoid There are many foods you can still enjoy on a Gluten free diet. Most ice cream Flavoured yogurt and Choosing foods from the “Foods to Include” list in each food group frozen yogurt (may will help you eat a nutritious, balanced diet. Most soy, nut and rice be thickened with a beverages gluten source or Grain products contain granola or cookie crumbs) Foods to Include Foods to Question Foods to Avoid
Cheese spreads and Breads, crackers, pasta • Items made with Breads, crackers, pasta sauces (may be and baked products made Buckwheat flour and baked products thickened with from gluten free grains – made with grains that wheat, flavourings amaranth, arrowroot, contain gluten and seasonings may corn, millet, quinoa, rice, – See Table 1 contain wheat) soy, sorghum, flax,
tapioca, buckwheat, corn Sour cream (low fat bran, cornstarch, potato or fat free may flour, taro, teff, legume contain oat gum) flour
Rice and soy drinks Hot Cereals such as: Oats: Cereals: (may contain barley, barley malt extract • Cornmeal • Oats (some may • Cereals made from or oats) • Cream of rice be contaminated grains in Table 1 • Hominy grits with gluten) including wheat, rye, Some soy, nut and • Cream of buckwheat triticale, barley and rice beverages • Rice flakes Cereals: oats contain barley malt • Quinoa • Rice and corn • Cereals with added extract or flavouring • Soy flakes cereals (may malt extract or malt • Pure oatmeal contain barley flavouring malt extract or oat syrup)
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4 9 Gluten free diet Gluten free diet
Can I eat oats? Meats and Alternatives
You can eat oats only if they are free from gluten. This means Foods to Include Foods to Question Foods to Avoid that they have not been cross-contaminated with gluten. Pure, uncontaminated oats are available in Canada and are likely Meat, fish, shellfish, Prepared or processed Fish canned in vegetable safe in moderate amounts for most people with celiac disease. and poultry that is meats, luncheon meats, broth containing HVP or fresh, frozen, canned wieners, bologna, HPP* However, it is not easy to buy pure oats in Canada since most of the salted or smoked bacon, meat, spreads, oats are cross-contaminated with gluten containing grains or cereals meat patties, sausages, Turkey basted or during milling and processing. Eggs imitation meat or fish injected with HVP or products (crab meat), HPP* If you choose to include oats in your diet, you must make sure that Lentils, chickpeas, dried meats (beef jerky), the oats are free from gluten contamination. dried peas, dried pates may contain fillers beans, plain nuts, or flavourings made *HVP or HPP seeds and tofu from wheat (Hydrolyzed Plant The best way to be sure the oat product is safe is to contact Protein or Hydrolyzed the food company. The label must state “pure, uncontaminated, Plain seed and nut Egg substitutes, Vegetable Protein) gluten free”. butters dried eggs if made from wheat, or the source is not
Baked beans, soy nuts, listed. Please talk to your doctor or dietitian before adding oats to your diet. dry roasted nuts, flavoured tofu, miso, seasoned nuts/seeds To avoid cross-contamination: Fats • prepare gluten free foods first • have a separate toaster and separate container of peanut Foods to Include Foods to Question Foods to Avoid butter, margarine, butter, jams, jellies and mayonnaise containers Butter, margarine, lard, Mayonnaise Packaged suet • clean all meal preparation surfaces, cutting boards, utensils vegetable oil, cream, and pots and pans to make them free from gluten before you shortening Commercial salad Salad dressings made prepare a gluten free meal dressings (seasonings with ingredients not Homemade salad may contain flour) allowed • be cautious when buying foods from bulk food bins as they dressings with allowed can be contaminated with gluten from scoops being used ingredients Cooking sprays from other bins • avoid buying foods from the deli counter as they may be contaminated with gluten containing foods
______
10 3 Gluten free diet Gluten free diet
Other Foods Hidden sources of gluten Foods to Include Foods to Question Foods to Avoid Beverages: Instant tea, flavoured Cereal and malted There are many hidden sources of gluten. Always read food labels Cider, instant or and herbal teas and beverages such as to find out which products have gluten in them. ground coffee, soft coffee substitutes, hot Ovaltine Avoid food products that do not list the source of their ingredients drinks, tea chocolate mix (may such as: Distilled alcoholic contain grain additives) Beer, ale and lager beverages – rum, gin, • modified starch bourbon, brandy, rye, Fruit-flavoured drinks, Instant hot chocolate • seasonings and flavourings whiskey, scotch chocolate drinks and mixes • hydrolyzed vegetable protein (HVP) whiskey, vodka and chocolate mixes (may liqueurs, wine contain wheat starch or • hydrolyzed plant protein (HPP) barley malt) Most large chain grocery stores and specialty food stores have a Gluten free beer, lager and ale “gluten free” section, which makes finding products easier. Condiments and Seasoning mixes, Regular soy sauce Check with your pharmacist about the ingredients in prescriptions Seasonings: imitation pepper, curry (made from wheat), Ketchup, gluten free paste, Worcestershire mustard pickles (made and over-the-counter medications to make sure they are gluten free soy sauce, plain sauce (may contain with wheat flour) malt such as: prepared mustard, wheat or HPP, HVP) vinegar, Teriyaki sauce, • vitamins, minerals, herbal supplements olives, plain pickles, hydrolyzed wheat protein • toothpaste pure black pepper, • mouthwash pure herbs and spices, relish, tomato paste • cough and cold medications and vinegar (apple, • nutrition supplements (such as protein powders and shakes, cider, rice, balsamic, weight loss drinks) grape), Monosodium Ask your pharmacist if you are not sure if a product has gluten. Glutamate (MSG) Desserts: Milk puddings and Desserts made with Ice cream, sherbet, pudding mixes (may ingredients not allowed egg, custards, contain a gluten source) whipped toppings, What is cross contamination? gelatin desserts, Cake icings and cakes, cookies, pies frostings Cross-contamination is when bits of food such as crumbs from foods made with allowed that contain gluten, accidentally mix with gluten free foods. This can ingredients happen in your home, restaurants, bulk food bins, and in food manufacturing plants where there are both gluten containing and gluten free products.
______
2 11 Gluten free diet Gluten free diet
Other Foods (continued) Why is it important to follow a gluten free diet? Foods to Include Foods to Question Foods to Avoid A lifelong gluten free diet is the only treatment for celiac disease. Baking Ingredients: Baking powder (may Brewer’s yeast Baking soda, baking contain wheat starch) This diet will help your small intestine heal and will reduce yeast, carob chips and Oat gum, sauces, your symptoms. Your body will then be able to use the nutrients powder, pure baking marinades and gravies in foods needed for good health. chocolate, chocolate made from ingredients chips, pure cocoa, not allowed, such as coconut, cream of HVP or HPP*. tartar, vanilla, pure vanilla extract, artificial *HVP or HPP How do I follow gluten free diet? (synthetic, imitation) (Hydrolyzed Plant vanilla extract, vanillin, Protein or Hydrolyzed You will need to avoid foods that have gluten in them: sauces and gravies Vegetable Protein) made with allowed if made from wheat, Table 1 ingredients or the source is not - Avoid - listed. Grains that contain gluten Sweets: Icing sugar, Licorice, chocolate and Corn syrup, honey, confectioner’s sugar candies made with Barley Graham flour jam, jelly, marmalade, (may contain wheat ingredients not allowed Barley malt/extract Rye maple syrup, starch) molasses, sugar Bulgar Semonlina (brown and white), Spreads (Nutella), Couscous Spelt artificial sweeteners candies, chocolate bars, chewing gum, Durum flour Kamut marshmallows Eikorn Triticale Emmer Wheat Lemon curd (may be thickened with flour) Farina Wheat bran Soups: Canned soups, dried Canned, packaged or Farro Wheat germ Homemade broth, soup mixes, soup bases homemade soups made gluten free bouillon and bouillon cubes with ingredients that Gluten flour Wheat based semolina cubes, cream soups contain gluten Commercial oat products and stocks made from (See Table 1), bouillon ingredients allowed and bouillon cubes containing hydrolyzed wheat protein
please turn over Î ______
12 Gluten free diet
Where can I find gluten free products?
There are a number of gluten free products available. Many of the big grocery store chains carry a wide selection of gluten free products.
Many of the food companies or manufacturers who produce gluten free products often sell their products on site (at the factory) to the public. Gluten free diet
Some manufacturers also provide mail order services. Buying products in bulk and freezing for later use will help save you money. What is gluten? Other tips to help you find out if a food contains Gluten is a protein found in grains such as wheat, rye, barley and gluten: their by-products. When you have celiac disease, gluten damages • The Canadian Celiac Association’s “Pocket Dictionary” will your small intestine and can cause mild to severe symptoms. give you information if a food is gluten free or not. Copies of You also do not absorb all the nutrients from the foods you eat. this book can be ordered from the website: www.celiac.ca • Do not assume that your favourite foods will remain gluten Symptoms of celiac disease include: free. Read the label every time you use a product as food • nausea • weight loss products change all of the time. Ingredient lists available online are not always accurate as they can become outdated. • reflux • lactose intolerance • Contact the food company directly and ask if you have • bloating • anemia questions about whether certain products are gluten free. • gas • stomach pain • diarrhea • tiredness Other resources • constipation • skin rashes • Stay informed through the Canadian Celiac Association by becoming a member and/or attending local chapter events. Even if you do not have symptoms, you must follow a strict gluten There are local chapters in Hamilton, St. Catharines and free diet to reduce the risk of long term complications such as Kitchener/Waterloo. See the website: www.celiac.ca osteoporosis and cancers of the digestive system. • There are many cookbooks available offering gluten free recipes. The Canadian Celiac Association has published several cookbooks and recipes can also be found online.
© Hamilton Health Sciences, 2012 PD PD 7618 – 08/2012 dpc/pted/GlutenFreeDiet-trh.doc dt/January 3, 2012 ______
Gluten free diet Can I go out to eat?
If you and your family want to go to a restaurant, try to pick one that offers gluten free choices.
Tips for eating out • Most restaurants will not understand if you ask for “gluten free foods”. Instead, tell your server that you are allergic to anything with wheat flour or barley in it. • Ask your server to have foods cooked or baked in separate pans or dishes. This will reduce the risk of cross-contamination. • Ask for freshly ground pepper. Many pepper packages contain wheat germ. • Before eating french fries, ask if they are coated with a batter or are fried in the same oil as other battered foods. If they are, avoid them as they will contain gluten. • Avoid salad bars, buffets and fondues since other people eating at these places can contaminate the gluten free foods.
© Hamilton Health Sciences, 2012 PD 7618 – 01/2012 dpc/pted/GlutenFreeDietINSERT-trh.doc dt/January 3, 2012