What is coeliac disease?
Coeliac disease is a serious autoimmune disease that is triggered by gluten. In those with coeliac disease, the body reacts to gluten and attacks itself, damaging the lining of the gut and destroying the small finger-like projections (called villi) which absorb nutrients from food. The only treatment for coeliac disease is to go on a strict gluten-free diet for life.
Is gluten intolerance the same as coeliac disease?
No. Coeliac disease is not an intolerance (nor is it an allergy), it is an autoimmune disease which means the body attacks itself in response to, in this case, gluten. Gluten intolerance is a non immune reaction to gluten and, whilst it is uncomfortable and unpleasant, it doesn't damage the gut.
One day you are eating what you like, and the next you are told to go on a strict gluten-free diet - which is so much more than avoiding bread and pasta.
If you are anything like me, those first few days of re-stocking the kitchen pantry and the hours spent at the shops staring blankly at the shelves of tins and packets wondering where to start, was overwhelming.
So I have put together some guides to hopefully help make things a little clearer and easier for you.
At first
The first few weeks after going gluten-free, I found that by looking at recipes that were already naturally gluten free were the easiest to think about – things like curries served with rice, jacket potatoes and fillings and simple baked chicken or fish with crunchy roast potatoes or sweet potato wedges.
And remember when it feels overwhelming - gluten-free is a diet based around fish, meat, lots of fresh fruit and vegetables, legumes, nuts and seeds – with the odd treat of course!
If you or someone in your family has coeliac disease, it is VERY important to eliminate the risk of cross contamination. Even the smallest crumb of gluten can damage the gut of someone with coeliac disease.
Depending on your situation, you may decide to cater for both diets. We personally decided it was far easier to make our kitchen a completely gluten-free kitchen. (We had been tested for coeliac disease and consulted professional advice before doing this.)
I wanted my son to feel safe, that he could go and get anything from the fridge or pantry and know that he could safely eat it. It is important to me that he still has the enjoyment he used to have before his coeliac diagnosis of baking cakes and biscuits; being involved in the preparation of lunches and dinners, and generally developing a love of cooking and good food.
However your family and requirements may well be different, and that’s OK!
Whether you decide to go completely gluten-free or have a mixed diet kitchen, the most important thing is to:
READ EVERYTHING!!!
Unfortunately you will have to read every single ingredients list on every single packet before you buy the product – and do this every time you buy it, as ingredients change and just because the product didn’t contain gluten one time, unfortunately doesn’t mean it won’t contain it the next time.
Even products that are naturally gluten-free may not be suitable for someone on a strict gluten-free diet – for example I have seen red lentils or pumpkin seeds, can have the PAL statement underneath the ingredients list that they ‘may contain’ gluten.
Common ingredients to avoid:
Wheat
Barley
Rye
Spelt
Oats
Wait, Oats aren’t gluten-free??
In Australia and New Zealand, there is no such thing as 'gluten-free oats'. They can be labelled ‘wheat-free', but legally cannot be labelled, ‘gluten-free’. Therefore be careful when searching for ‘gluten free recipes’ because I find many, especially in kids lunchbox recipes or breakfast recipes, aren’t suitable for someone with coeliac disease.
There are two reasons for this:
Oats are often cross contaminated by wheat in the manufacturing process.
Oats contain a protein called avenin (which is similar to gluten), and a small number of people with coeliac disease react to this protein the same way they react to gluten.
For more information on what you can and can't eat on a strict gluten-free diet, seek professional advice and have a look at Coeliac Australia or Coeliac UK or consult the coeliac society of your country.
This is super important when cooking and preparing food for someone on a strict gluten-free diet.
How to minimise the risk of cross contamination:
- Wash everything that has come in contact with gluten very well in hot soapy water.
- Cook gluten-free food entirely separately from food containing gluten.
- You can cook gluten-free pasta and then use the same water for gluten-containing pasta, but not the other way around.
- Do not use the same toaster for gluten-free bread and gluten-containing bread. You can buy toaster bags, or if you are all going gluten-free, the safest way is to buy a new toaster and only use it for gluten-free bread.
- Don’t cut gluten-free bread on the same bread board or with the same knife that has been used for bread containing gluten, unless you are able to thoroughly clean it before using it.
- When deep frying foods, don’t use the same oil that has been used to fry gluten containing foods. Heat does not kill gluten.
- Take extra care with Air Friers.
- Take extra consideration when using butter dishes and jars of jam or spreads – crumbs from gluten-containing bread can be mixed and even this is enough to spark a reaction in someone with coeliac disease. If you butter a slice of gluten-containing bread then put the knife back in the butter, or into a jar of jam, the butter and jam are no longer considered gluten-free.
- Store gluten-containing products and gluten-free products in well sealed separate containers, clearly labelled – having a colour-coded system is a great way for everyone to clearly see what contains gluten and what does not contain gluten.
Fruit and vegetables, and un-processed meat, poultry and fish are a great place to start as they are naturally gluten-free.
The free-from aisle is useful, especially if you are new to the gluten-free diet. The feeling of having something ‘safe’ in the pantry can be an enormous relief. Remember to still read the packets – they are ‘free from’ but that doesn’t mean they are all gluten-free, some are dairy-free or egg-free but still contain gluten.
Also, this aisle tends to be expensive, and the food on it is often heavily processed.
Get ready to major in label reading, it is something that unfortunately cannot be avoided and you will need to continue to do, even with brands and products that you trust as manufacturing processes can change.
- Allergens must be emphasised – either written in bold or underlined - on the ingredients list.
- If a product says ‘gluten-free’ then by law, it has to be gluten-free (per the definition of the country you live in).
- If a product contains barley but is labelled ‘gluten free’ then it is safe for coeliacs, if there is no mention of ‘gluten free’ then it is not safe.
- If wheat starch says it is ‘gluten-free wheat starch’ then it is safe for coeliacs, if it just says ‘wheat starch’ then it is not safe for coeliacs.
‘May contain’ labelling [Precautionary Allergen Labelling (PAL)]
On some products you will see advisory statements such as 'May contain gluten' or may be present: gluten'. These are voluntarily used by manufacturers.
If a product says ‘may contain gluten’ you should avoid these products. Whilst gluten may not literally be in the product, there is a chance that the product has come into contact with gluten during production and therefore could be contaminated. If you are considering using these, I'd recommend contacting the manufacturer first to determine whether the product is ok for your use.
What is classed as gluten-free can differ from country to country:
- In Australia it means the product needs to contain 5ppm (parts per million) or less of gluten.
- In the UK and the US the products needs to contain 20ppm (parts per million) or less.
It's confusing, and I only mention it as although we live in Australia our family is in the UK and so we have had many conversations over this! Bottom line is, stick to the classifications in the country you live in. Coeliac Australia, Coeliac UK or the coeliac society of your country are a great resource to refer to.
If you are following a gluten-free diet because of a wheat allergy:
- Take care when reading packets that say ‘gluten-free’ as they could contain ‘gluten-free wheat starch’ which is not suitable for those with a wheat allergy.
- Read the ingredients list on the packet – not a supermarket website. As mentioned above the ingredients list can change, and sometimes websites don’t update their images.
There is no doubt that eating gluten-free costs a great deal more than eating foods containing gluten, wherever you live.
Here are some ways to try and reduce the costs:
- Buy things that are naturally gluten-free instead of gluten-free equivalents like gluten-free bread, gluten-free pasta. Think rice, potatoes, sweet potatoes, quinoa.
- Cook from scratch. Yes it can be hard work, especially when you are busy, but you can batch cook, freeze things for later and most of the time it will be far healthier for you and your family than buying pre-made things anyway!
- Shop around - take advantage of offers in the supermarkets and stock a few extra packets when they are on offer.
- Buy in bulk – this tends to take time to find them, but if you can buy ingredients you find that you use often, in bulk, it saves alot.
- The free-from aisle is expensive - shop from elsewhere in the supermarket when you can.
- Meal plan – this way you buy exactly what you need, and save wasting food, which is both annoying - and expensive.
Eating out can seem daunting, and it's true - there is no longer any spontaneity in it. However it doesn't mean that you don't eat out, you just have to plan ahead.
The coeliac society’s of your country can have a list of approved restaurants, which means that not only are the gluten-free menus, but the preparation process has been approved too.
There are a number of coeliac Facebook groups that you can search for other peoples recomendations.
Look at the menus of restaurant online. If they don’t have a menu, it is often best to move on.
Do they have gluten-free options?
Ring them up and ask – or email if you aren't a fan of talking on the phone.
If they sound as though they don’t know what gluten is, it’s probably better to move on.
Say you / your child is coeliac.
Ask them about their stance on cross-contamination. For example do they use a separate fryer for the gluten-free chips or do they use the same fryer for the whole menu, gluten-free and gluten-containing food.
Don’t go along with it just to be polite – you need to put yourself / your child first! If something doesn’t seem right then don’t be afraid to check again, or leave. (And always carry a snack in your bag.)