If you have celiac disease, even traces of gluten (a protein found in wheat, barley, rye and sometimes, oats) can wreak havoc on your intestinal tract.
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When pain and distress persist despite remaining on guard against gluten at home and in restaurants, you may be overlooking hidden sources of gluten.
Dietitian Anna Taylor, MS, RDN, LD, CDCES, shares what has gluten in it and how you can avoid those sneaky sources of gluten-containing foods.
Foods you may be surprised contain gluten
It can be challenging, and overwhelming, to follow a gluten-free diet and avoid foods that contain gluten. Just when you think you have it all figured out, there are foods and ingredients that sneakily contain the protein. So, what unexpected foods have gluten? Taylor says to watch out for these foods.
Medications and supplements
Gluten may be used as a filler or coating in medications and supplements. Always review the ingredients list on any over-the-counter medications or vitamin/mineral supplements.
Any prescribed medications should be reviewed by a pharmacist to be sure they don’t contain gluten — and find gluten-free substitutes if you have celiac disease.
Research also suggests those with celiac disease have a greater need for nutrients like B vitamins, vitamin D and iron. Confer with your healthcare provider to see if your vitamin needs are being met.
Meat, fish and poultry
Watch for hydrolyzed wheat protein in meat, fish and poultry.
And processed lunch meats and deli meats like cold cuts, hot dogs, salami and sausage may contain gluten. Other foods like self-basting poultry or seasoned turkey breast may contain gluten as well.
Meat and fish substitutes
Watch for gluten in veggie burgers, sausage, bacon and crumbles, along with imitation seafood and seitan.
“Many of these products use fillers that contain gluten, which can act like a glue to hold ingredients together and provide an elastic texture,” explains Taylor.
Chips and fries
Potatoes and corn are naturally gluten-free, but potato chip seasoning may contain malt vinegar and wheat starch.
Also, be aware that tortilla chips and French fries may be fried in the same oil/fryer as foods that contain gluten. This will contaminate the oil and may cause harm to someone with celiac disease.
Look for products that say “gluten-free,” “no gluten,” “free of gluten” or “without gluten,” which are all regulated labeling claims.
Oats are naturally gluten-free whole grains that contain important vitamins, minerals and fiber. But oats are at high risk for cross-contamination. They’re sometimes grown next to wheat or packaged in facilities that have gluten-containing products.
When shopping, beware of bulk bins. Only choose oats that are labeled “certified gluten-free.”
Beverages and alcohol
Gluten may be in flavored coffees and teas. But what alcohol has gluten in it? Beer, ale, lager and malt beverages all typically contain gluten. Look for specialty gluten-free beer.
Wine is naturally gluten-free. Distilled alcohol (for example, gin and vodka) is considered safe for people with celiac disease.
Eggs at a restaurant
You’re ready to tuck into a hearty breakfast, but before you do, you may want to rethink those scrambled eggs.
Eggs and omelets are typically cooked on the same griddles that are also used to make pancakes, causing cross-contamination.
Gluten-free pizza and baked goods
Even though it may claim to be “gluten-free,” think twice before eating gluten-free pizza or even baked goods.
These may be contaminated by other grains because they’re typically cooked in the same oven as regular gluten-containing pizza.
Sweet treats and snacks
Flavored ice creams (like cookie dough) and gelatos may contain gluten. Look for gluten in candy (especially licorice), energy bars and granola bars, too.
It’s important to read labels every time you purchase an item to verify that all ingredients are gluten-free, as manufacturing practices may change.
Soy sauce and miso
Condiments can be a sneaky source of gluten. For example, soy sauce (except for tamari) is made with wheat. Miso, a soup base, may be made with barley.
Whether you’re into ranch or Italian dressing, salad dressings may contain gluten. Beware of salad bars or buffets, as cross-contamination is hard to avoid.
If dining out, be sure to ask your server to avoid putting croutons on your salad.
Sure, Ezekiel bread is full of nutrients, but the popular sprouted bread is made from wheat and barley.
“The act of sprouting doesn’t remove the gluten, so this otherwise healthy bread is a no-go for people with celiac disease,” says Taylor.
Soups and gravies
Gluten may be used as a thickener, even in bouillon.
Pay attention to the ingredients in soups like chowders and chilis, and even that turkey gravy you love to ladle over mashed potatoes, as flour can be used as a thickening agent.
Tips for avoiding hidden sources of gluten
Taylor suggests the following to avoid hidden sources of gluten:
- Know wheat in all of its forms. Wheat berries, semolina, spelt, farina, graham, durum, emmer, faro, Khorasan, udon and einkorn all contain gluten. (Watch for “modified” products, too.)
- Look out for tricky ingredients. If a product is NOT labeled “gluten-free,” but contains one of these in the ingredients list, don’t buy it: starch, modified food starch, hydrolyzed vegetable protein, hydrolyzed plant protein, textured vegetable protein, dextrin, maltodextrin, glucose syrup, caramel, malt flavoring, malt extract, malt vinegar (distilled vinegar is OK), brown rice syrup.
- When in doubt, leave it out. If you can’t confirm products are gluten-free, substitute fresh, nutrient-rich whole foods like meat, fish, poultry, beans, nuts, seeds, fruits and vegetables. Choose naturally gluten-free starches like rice, quinoa, corn, buckwheat, potatoes, sorghum and wild rice.
- Prevent kitchen cross-contamination. Crumbs linger in shared toasters, cutting boards and community peanut butter, jam and cream cheese. Wipe counters regularly and clean gluten-free dishes with a separate sponge. Line baking pans with parchment paper or foil and wrap gluten-free bakery in foil.
Being vigilant when it comes to what you eat — making sure you read labels and look out for cross-contamination — can help you stay healthy and avoid pain and discomfort caused by gluten.
“Celiac disease is a lot to manage. Gluten is in a lot of processed foods — and some unprocessed ones as well,” says Taylor.
“Knowing what to look for, reading labels and preventing cross-contamination while following a gluten-free diet is currently the only effective treatment for celiac disease,” she continues. “If you’re struggling, reach out to celiac disease support groups and talk to a dietitian from your healthcare team. You aren’t alone.”