Dr Sue Shepherd has coeliac disease and knows how rough it can be to buy gluten-free products. She explains what to look for – and what to avoid.
If you're part of the 1% of Australians who have coeliac disease, an allergy to gluten, you're part of a growing group. The Coeliac Society of Australia estimates that we now have 10 times the amount of sufferers we did 10 years ago.
In coeliacs, the immune system reacts abnormally to gluten and is unable to process nutrients properly because the cells lining the intestines are damaged and inflamed. If you're a coeliac, you'd know that symptoms can be quite severe - they range from fatigue, diarrhoea, anaemia, constipation, cramping, bloating and nausea, to vomiting and weight-loss.
What is gluten?
Gluten is the protein component of the grains wheat, rye, barley, oats and triticale. For people with coeliac disease or dietary gluten intolerance, a gluten-free diet is required for good health.
Foods containing gluten
Wheat-based foods are the main source of gluten in most people's diets. This wheat is usually in the form of flour (including spelt, dinkel and kamut varieties), semolina, couscous, bulgar, farina, wheat starch and wheat-added cornflour. Foods commonly made from these ingredients – such as regular breads, breakfast cereals, pasta, noodles, dry biscuits, sweet biscuits, cakes, muesli bars, pastries, crispbreads, breadcrumbs and batter – are the more obvious sources of gluten to avoid.
The tricky issue when looking for gluten-free products, is that gluten can also be found in a range of other foods – such as potato chips, confectionery, smallgoods, beer, baking powder, stuffings, seasonings, soy milk, powdered drink flavourings, sauces, soy sauce, custard powder, imitation seafood, yeast extract spreads and Communion wafers. Medications (over-the-counter and prescribed) may also be sources of gluten.
How do I know which foods contain gluten?
The Australian Foods Standards Code requires that any food labelled 'gluten-free' must not contain oats, malt or any detectable gluten (less than 0.0005% gluten), and must have been tested for the presence of gluten. Any food with gluten-free labelling will also have the gluten content specified on the nutrition information panel. However. it's not just as simple as looking for 'gluten-free' labels. Not all gluten-free foods are labelled, so the only way you can know for sure is to scrutinise the list of ingredients – Australian law makes it compulsory for food manufacturers to list any ingredients derived from wheat, rye, oats or barley on their food packaging.
Some of the everyday products to watch include particular varieties of yoghurts, condiments, soups, sauces, smallgoods and ice-creams.
Don't worry if you find glucose, glucose syrup, dextrose or colour caramel (colour 150) listed in the ingredients; although these are derived from wheat, the gluten has been removed through processing. As companies often change their recipes, it's best to check the ingredients each time you buy. And make sure the product was manufactured on gluten-free production lines.
Are there any food substitutes?
An enormous variety of specialty gluten-free foods are now widely available, including delicious baking mixes, pasta, breakfast cereals and bars, breads, biscuits, condiments and snack bars. You can find many of these specialty gluten-free products in the health food aisle of your supermarket and in health food stores.
Individual ingredients vary by brand, but these products are generally made from gluten-free grains and starches.
Also, all unprocessed fruit, vegetables, nuts, legumes, meat, eggs and dairy are all naturally gluten-free.
Corn (also called maize)
Besan or gram flour
Hydrolised vegetable protein
*Gluten is not detectable in these ingredients, even if derived from wheat.
Gluten-free cooking hints
Cooking without gluten can seem a little daunting at first, but these handy hints will make it easier for you.
Flour for baking: Although there is no single flour that substitutes directly for wheat flour in baking, a combination of flours (usually three or more) work well. Try any of the following to make a wheat-flour substitute:
1/2 cup fine rice flour, 1/4 cup maize cornflour and 1/4 cup soy flour
1/2 cup soy flour and 1/2 cup potato flour
1/2 cup cornflour, 1/2 cup tapioca flour and 1/4 cup soy flour
1/2 cup fine rice flour, 1/4 cup rice bran, 1/4 cup arrowroot
1/2 cup buckwheat flour and 1/2 cup cornflour
1/3 cup besan flour, 1/3 cup rice flour, and 1/3 cup cornflour
1/4 cup rice flour, 1/4 cup potato flour, 1/4 cup soy flour and 1/4 cup maize flour
Some of these flours can be found in Asian grocers, or there are gluten-free flour mixes now available in the health food aisles of supermarkets and in health food stores.
Improve quality: To improve the quality of cooking, add approximately 1 teaspoon of xanthan gum or guar gum (look for this in health food stores or the health food aisle in larger supermarkets).
Thickening a sauce or gravy: Use maize cornflour.
Breadcrumbs: Use specialty gluten-free crumbs, crushed gluten-free cornflakes or polenta.
Lasagna sheets: Use pre-soaked round rice paper rolls, about three sheets per layer as a substitute.
Pizza bases: Use gluten-free bread mix batter and spread out to make a circular base.
Gluten-free food labels – what should you look for?
Many gluten-free foods have been endorsed by The Coeliac Society of Australia, indicating that they have met all the regulations for a gluten-free food product.
Need help with your gluten-free diet?
If you want further advice on choosing gluten-free foods, an Accredited Practising Dietitian can teach you how to read and interpret ingredients correctly.
To find an APD, call the Dietitian's Association of Australia on (02) 6163 5200 or go to 'Find An APD' on their website www.daa.asn.au