Article from the Celiac Disease Foundation’s web site – Newsletter of Winter 2002:

Nutritional deficiencies and lactose intolerance

Speaker: Shelley Case, B.Sc., RD

The Gluten-Free Diet A Comprehensive Resource Guide

The nutritional status of newly diagnosed Celiacs can vary. Depending on severity of symptoms and degree of malabsorption. The average length of time from symptoms to diagnosis can be from 5 - 10 years. Supplemental vitamins and minerals might be needed for several months. Iron, B Vitamins, Folate, Calcium, and Vitamin D are difficult for Celiacs to get. Lactose intolerance affects 20-40% of diagnosed Celiacs. Gluten free/ lactose free products are Lactaid or Lactese or lactose reduced milks. Some soy products are also good, but watch for the soy drinks flavored with Barley. Also choose ones that are fortified with Calcium and Vitamin D.

Clarification of Gluten. Defined as the general name of storage proteins that are called prolamines that are found in wheat, rye and barley. Until 1996, oats were thought to be toxic. Now it is believed they are not harmful. There have been many studies of children and adults who have consumed oats and it was determined that oats are safe. It still is a source of argument, however, mainly because of cross-contamination. Until that issue is resolved, oats are not recommended at this time. Corn gluten and rice gluten are not toxic. So you must ask if the product contains wheat, rye or barley, not if the product is gluten free.

There has been a lot of misinformation and confusion among Celiac and support groups regarding other grain and grain like foods such as buckwheat, quinoa, flax, millet, and amaranth. In order to better understand the acceptability of these foods in the gluten free diet, we need to look at plant taxonomy. This is a system of classifying plants. For more information on this subject, you can look up Don Kasarda, PhD. The knowledge of taxonomy does, however, help you understand what families different plants and grains are related to. For example, "Wheat Free" labeling may contain Spelt and Kamut which are related to wheat, these do contain gluten and are to be avoided.

Buckwheat is actually classified as a fruit, and is part of the rhubarb family. It does not contain gluten, even though the word has "wheat" in it. Buckwheat provides a high source of protein, iron, B vitamins and zinc.

Quinoa is also classified as a fruit and is in the same family as spinach. You can buy it as seeds, flakes, flour or pasta. It contains more high quality protein as other grains and cereals and the quality compares to dried skim milk. It is high in iron, magnesium, phosphorus, potassium and zinc and also a source of many B vitamins, calcium and dietary fiber.

Amaranth is also not classified as a grain, but is a part of a broadleaf plant family. High in protein, dietary fiber, magnesium, phosphorus and zinc and is a source of calcium and B Vitamins.

Flax is available as a seed or ground as flax meal. It is rich in the essential Omega 3 Fatty Acids which may be beneficial against heart disease and cancer. High in B6, Folate, protein, magnesium, and zinc. You need to consume it ground, however, to get the benefits. As a seed it acts as a laxative.

Some luncheon meats, baking powder, bullion cubes, soups, soy sauces, seasoning mixture, rice crispies, licorice and corn flakes all can contain gluten through Hydrolyzed Plant Protein. Most are made from corn, soy, wheat and sometimes from peanuts. The U.S. Code of Federal Regulations says that the source of the protein must be identified.

"Starch" means corn unless identified otherwise as "potato starch," "tapioca starch," "wheat starch," etc. "Modified food starch" is not, however, identified specifically. Wheat starch contains varying amounts of gluten. You can find it in some baking powders and some seasoning mixes. Check with the manufacturer.

Dextrin is partially hydrolyzed starch. It is used as a thickener and binder. It is almost always made from corn in North America. To be 100% you should contact the manufacturer to find out what starch source was used.

Malto-Dextrin is used in a variety of foods. It can come only from potato, corn or rice. It is not a problem.

Seasonings is the subject that causes the most grief. There is no specific regulation for the word "seasoning" in U. S . or Canada. It is very important to confirm the components of the ingredients of these foods. Also, know that pure spices are gluten free. The problem is when these spices are added with other ingredients to create a seasoning mixture.

Flavorings are complex mixtures that can be composed from over 2,000 substances. The current regulations do not require that the manufacturer give you the components when listing the ingredients of the food. It will just say "flavoring." Are gluten containing grains used in flavorings? They are occasionally used in meat products or products containing meat, deli meats, beef jerky and imitation bacon bits. As well as soy beverages and cereals which use barely malt flavoring or extract. It is usually on the label but not always described beyond the word "flavoring."

Carmel Color in North America does not use gluten containing products.

Buckwheat flour that is 100% buckwheat is gluten free. Some companies mix it with wheat flour, however, so you have to check. The same goes for buckwheat pancake mixes and soba noodles.

It is important to be adventuresome and try new grains such as quinoa and amaranth as they are more nutritious then potato and rice. Be careful of prepared products for fillers that may have wheat in it. Dry roasted nuts may have flour in the coating on them. French fries are often fried in the same oil in smaller restaurants as the fried chicken and fish so you have to be wary of contamination.

Even when gluten containing grains are used as the starting mash in alcohol, the protein can not get to the final product because of the distillation process. Alcohol is therefore gluten free. For this reason, beer and lager cannot be gluten free as they are simply fermented.

Regarding vinegar. All vinegar is distilled. The only vinegar that is at issue is Malt Vinegar which is fermented. Therefore all vinegars are gluten free. 

I am deeply concerned about products made by commercial bakeries and health food stores. They could be using the same scoop, the same sifter with rice flour as wheat, for example. So do rely on gluten free manufacturers for your products.

On the other hand, there are still some sources that present confusing information.  See, for example, a report on the Celiac Sprue Association as well as the Safe and Forbidden Food Lists on this web site:

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