Virtual Medical Centre

Gluten Free Diet

• What is a gluten free diet?
• Who follows a gluten free diet?
• How does a gluten free diet work?

What is a gluten free diet?

A gluten free diet, as the name suggests, is a diet free of gluten. Gluten is a storage protein derived from wheat, barley, rye and a number of other cereals, and thus is commonly found in modern diets. Each of these cereals has a specific glutenous protein:

• Wheat (including kamut and spelt): Contains gliadins
• Barley: Contains hordiens
• Rye: Contains secalins

In order to keep gluten out of your diet, you must exclude not only these cereal foods, but also manufactured foods and products that have even a small amount of gluten.

Who follows a gluten free diet?

A gluten free diet is typically followed by people with an intolerance to gluten for medical purposes. These include people with dermatitis herpetiformis or coeliac disease. A gluten free diet is the only effective treatment for gluten intolerance, and must be strictly followed for life.

Gluten free diets are also used to diagnose gluten intolerance when the condition is suspected. After prescribing a gluten free diet, a health professional will monitor your response to the diet. If the symptoms of gluten intolerance diminish while adhering to the diet, gluten intolerance can be diagnosed.

How does a gluten free diet work?

A gluten-free diet manages gluten intolerance by removing the toxic agent (i.e. gluten) from the diet (and the intolerant individual's digestive system) and subsequently reduces the small intestine's inflammatory response to gluten.

What is not eaten on a gluten free diet?

A gluten-free diet, as the name suggests, is characterised not by what is, but by what isn't eaten. Individuals following the diet must completely avoid all foods containing gluten, even in small amounts. The key foods to avoid are gluten containing cereals, which include:

• Barley
• Barley malt/extract
• Bran
• Bulgur
• Couscous
• Durum
• Einkorn
• Emmer
• Farina
• Faro
• Graham flour
• Kamut
• Matzo flour/meal
• Orzo
• Panko
• Rye
• Seitan
• Semolina
• Spelt
• Triticale
• Udon
• Wheat
• Wheat bran
• Wheat germ
• Wheat starch

Consumption of oats also results in symptoms of gluten-intolerance in some 5% of individuals, however there is controversy about the reasons for this. Some believe that oats themselves do not contain glutens, rather, they become contaminated with small amounts of gluten in the manufacturing process. Others believe that oats themselves are a source of glutens (specifically of proteins called avidins).

In countries such as Australia, where wheat is a key staple food, avoiding the above listed cereals means avoiding a wide range of manufactured foods which include these gluten-containing cereals. Some of the key foods which must be avoided include:

• Breads
• Pasta
• Packet soups, gravy and other artificial thickeners
• Beer
• Processed meats
• Communion wafers
• Many sauces

It is also necessary for individuals following a gluten free diet to approach with caution, many manufactured foods or other products which may contain hidden sources of gluten. These include:

• Hydrolysed vegetable protein;
• Modified food starch;
• Malt or malt flavouring;
• Vegetable gum;
• Natural flavourings;
• Some medications;
• Lipsticks;
• Grain derived alcoholic beverages.

Individuals who are intolerant to gluten should also be aware of the ease with which foods that do not contain gluten can become gluten contaminated. For example oats, a supposedly non gluten containing cereal often cause allergic reactions in gluten intolerant individuals. Research suggests that this is due to cross-contamination in the harvest and manufacture process. Oats may be mixed with small quantities of wheat during harvesting, or be exposed to wheat derived products (e.g. flour on a conveyor belt to stop foods sticking). It may therefore be necessary to purchase foods manufactured by a company dedicated to ensuring their produce is gluten-free.