The only treatment for celiac disease is a gluten-free diet. Anyone who is newly diagnosed should realize that "the learning curve is steep" for leading a gluten-free lifestyle, says registered dietitian Tricia Thompson in the February 2012 issue of Practical Gastroenterology.
One of the big eye-openers for celiac disease is the ever-present need to read labels on processed foods. It's imperative to avoid gluten -- the naturally occurring proteins in wheat and a handful of other grains.
Thompson is the founder of Gluten Free Watchdog and advocates for accurate information for celiac patients. In "Celiac Disease: What Gluten-Free Means Today," Thompson gives a rundown on how to interpret the proposed Food and Drug Administration rules on gluten-free labeling that are scheduled to be finalized in 2012.
For a food to be labeled gluten-free:
It cannot contain barley, wheat of any kind, rye or triticale.
It cannot contain an ingredient that is derived from any of these prohibited grains unless it has been processed to remove gluten. Thus, a consumer will have to pay attention to labeling for items such as wheat germ, wheat bran, barley malt extract or flavoring, malt vinegar and certain flours.
It can contain an ingredient derived from a prohibited grain as long as the gluten-removing process leaves less than 20 parts per million of gluten in the product. This can include products such as wheat starch, modified food starch from wheat and dextrin.
Generally, the product must contain less than 20 ppm of gluten, which is considered the threshold for keeping celiac patients safe from adverse reactions.
Thompson's article includes a chart called "Categories of Food Allowed on a Gluten-Free Diet," which warns about processed foods not labeled gluten-free.
The chart also points out that oats -- although they can be a good addition to a celiac patient's diet -- can sometimes be contaminated with gluten. It's important to choose oats and oat products that have been labeled gluten-free, she writes.
Another area of concern is the category of grains that are inherently gluten-free, such as corn, rice, millet, sorghum, buckwheat and quinoa, yet could be cross-contaminated with gluten during processing.
Celiac patients buying gluten-free grains, gluten-free flours and products made from these grains and flours might want to follow Thompson's recommendation to buy products with the gluten-free label whenever possible.
"It is essential that patients receive up-to-date, timely, and ongoing counseling from a registered dietitian proficient in CD (celiac disease) and the GFD (gluten-free diet)," Thompson concludes.
A consumer-oriented article on the FDA website notes that most people have digestive systems that can tolerate gluten, but for those with celiac disease the ingestion of gluten is a serious health threat.
The FDA says that its definition of gluten-free will eliminate uncertainty about how food producers may label their products. In addition, new labeling will assure consumers who must avoid gluten that the gluten-free label meets a clear standard enforceable by the FDA.
Thompson, Tricia. "Celiac Disease: What Gluten-Free Means Today." Practical Gastroenterology. Web. 23 April 2012. http://www.medicine.virginia.edu/clinical/departments/medicine/divisions/digestive-health/nutrition-support-team/nutrition-articles/Parrish_Thompson_Feb-1.pdf
"A Glimpse at 'Gluten-Free' Food Labeling." Food and Drug Administration. Web. 23 April 2012.
Reviewed April 24, 2012
by Michele Blacksberg RN
Edited by Jody Smith