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HEALTH CONCERN? BioHealth Health Concerns

Gluten Allergies and Diet

Contributing Author: Ross, Steven D.C, F.A.S.B.E, D.A.A.P.M.

Ross StevenDr. Steven Ross, President and Co-Founder of The Institute For Integrative Medicine. The IFIM is an evidence based educational institution focusing on teaching the integrative practitioner the evidence based medicine, business, marketing acumen and personal development needed to succeed in their practices. Dr. Ross has been practicing Integrative and Functional Diagnostic Medicine since 1982. He maintains an active practice in the southern California while consulting with patients and doctors worldwide. He is the author of Curing the Cause and Preventing Disease; a guide not only for patients seeking a new and scientific method of treatment but, also for health care professionals interested in incorporating evidence based treatment plans in helping their patients achieve optimum health without the use of dangerous drugs.

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Recent studies suggest that one in 250 people live with celiac disease, a lifelong, dangerous intolerance to gluten-containing foods such as wheat, rye, kamut, spelt, barley, and oats. An even larger percentage of the population suffers allergy, sensitivity, or food intolerance to glutens, without having full-blown celiac disease. For those following a strict vegan diet, imposing a gluten restriction considerably reduces already reduced menu options. However, while a gluten-free vegan diet requires extra creativity and vigilance, it can be maintained—deliciously. After years of experimentation, I have decided to share what I have learned.

If you've been diagnosed with or suspect celiac disease or a wheat allergy, the severity of your symptoms will determine how much you change your diet. For celiacs, ingestion of proteins (glutens) found in cereal grains damage the small intestines and can result in abdominal cramping, anemia, low bone density and body weight, lupus, fatigue, depression, and a host of other ills. The only known treatment for celiac disease is a lifelong avoidance of all glutens. On the other hand, people who suffer wheat or gluten sensitivity usually feel better on a gluten-free diet, but they may grow to tolerate some forms of "forbidden grains." For example, eating durum or semolina pasta gives me an excruciating migraine headache, yet I have no problem eating sprouted Ezekiel bread.

Glutens can affect our health in surprising ways. In particular, if you have unsuccessfully "tried everything" to treat a health issue, you might want to try a gluten-elimination diet. When you reintroduce glutens, observe your reactions. Acne, chronic fatigue syndrome, fibromyalgia, headaches, constipation, and asthma are some of the many problems occasionally relieved by avoiding gluten.

Unfortunately, wheat and its gluten-containing cousins appear in more foods than you might expect. Reading labels only helps if you can recognize the ingredients. Some hidden forms of gluten include:

  • modified food starch
  • textured vegetable protein
  • hydrolyzed plant protein
  • extenders and binders
  • hydrolyzed vegetable protein
  • malt

Most restaurant and canned soups contain flour, pasta or barley, and commercial enchilada sauces and "Spanish rice" mixes usually contain some form of wheat. Always check the ingredient list, even on products like Rice Chex, which uses malt as a sweetener. Kashi cereal, which contains kashi, or buckwheat (a non-gluten grain), also contains wheat.

Given the growing demand for gluten-free processed foods, a number of companies have begun to offer nut and rice crackers to replace more traditional snacks, and many health food stores carry at least one gluten-free cereal. Mochi, a Japanese rice treat, contains no gluten and can often be found in the refrigerated section of natural food stores. The cinnamon raisin version with a little "vegan butter" usually satisfies my craving for cinnamon buns. Arrowhead Mills also offers a wide variety of flours and gluten-free products, available in most health food stores and online. Following a whole food, organic diet will not necessarily remove all the hidden glutens from your plate. If you prefer home baked goods, then Bette Hagmann's The Gluten-Free Gourmet belongs in your kitchen. She includes recipes for two flour mixtures that exchange cup for cup with all-purpose flour. Hagmann also offers recipes for biscuits, potpies, stews, and other tasty, normally wheat-laden treats. Unfortunately, few of her recipes are vegan, and Hagmann does not address typical vegan alternatives.

Contains Gluten


Semolina or durum (wheat) pasta

Rice, corn or quinoa pasta

Udon noodles

Rice or (sometimes) soba noodles

Soy sauce

Wheat-free tamari

Worcestershire sauce

Bragg's Liquid Aminos

Seitan ("wheat meat")

Tempeh or baked tofu

Bulgur (in tabouleh, salads and some chilis)



Quinoa or millet


Brown Rice



Flour tortillas (also the base for most "wraps")

Corn tortillas

Regular cornbread

Use quinoa meal instead of flour

Flour for frying

Rice flour or corn meal

Thickening for soups

Arrowroot, potato starch, corn starch

Because glutens can comprise so much of a vegan diet, I list suggested substitutions alongside the offending foods.

In some cases, people seem to tolerate certain types of glutens, while experiencing symptoms from others. People allergic to wheat may be able to eat spelt, kamut or rye, for example, (although most "rye bread" contains a lot of wheat). Sprouting grains increases the availability of enzymes that support digestion, and combining a variety of grains lessens the impact of any one allergen. For this reason, moderate allergy sufferers can sometimes enjoy tortillas and breads made from a mixture of sprouted grains. If so, you're in for a treat, because Ezekiel products—the most popular brand of sprouted breads—taste delicious. They also more closely resemble the texture and density of bread when compared with the totally gluten-free frozen loaves.

Eating out in restaurants poses special challenges for the gluten-free vegan. As if eating out as a vegan wasn't challenging enough! A little planning can make the difference between eating only a salad—no croutons! —or enjoying a meal with everybody else. Ethnic restaurants tend to provide the most options.

In particular, Thai food usually relies on rice noodles or rice, rather than the typical wheat pasta of Italian fare. (Ask for curries without fish sauce.) Indian food offers another relatively safe haven, as long as you order nonfried entrées and abstain from the enticing array of breads. (Watch out for ghee, or clarified butter.) Inquire ahead of time if the teff-based Ethiopian Injera contains wheat flour. If not, you can sop up the vegetarian platter just like all the other diners. Unfortunately, Chinese food contains a lot of wheat, unless you opt for plain steamed vegetables or some garlic sauces. Anything with soy sauce is probably out, unless the cook uses wheat-free tamari.

At Mexican restaurants, you can order vegetarian entrees with corn tortillas and no cheese. Watch out for sides of rice. Unless the restaurant offers fresh brown rice, their mix probably uses modified food starch or flour. (Also ask if they put lard in their refried beans.) If all else fails, you can probably create your own "entrée" by ordering several sides of vegetables without butter.

What happens if someone invites you over for dinner? I personally dread this, especially if the host is neither a vegan nor a celiac. It's one thing to scour a menu for options and play it off casually, and quite another to seem like an ungracious guest or picky eater. Close friends know and accept my peculiar diet, but acquaintances rarely understand its guidelines. I usually explain that I'm vegan and then offer to bring something substantial. If they assure me that's not necessary, then I mention the wheat allergy and extend a second offer to bring food.

If they still want to serve the entire meal, it helps to give menu suggestions rather than a list of things you cannot or will not eat. For example, "I can eat any kind of rice pasta, any vegetables, or any bean dish as long as you use wheat-free soy sauce." After a few more details, people often hit upon "the perfect menu idea! How does this sound?" If it sounds good, I recommend you go with it. If it really will not work, then being clear about potential modifications is helpful. The easier you make your diet seem, the less of an imposition it becomes to you or anyone else.

Over the years, I have personally struggled with more than a gluten allergy. To varying degrees, I also react to soy, corn, and most tree nuts. Nonetheless, I eat an incredibly wide array of vegetables and grains. Once you familiarize yourself with ingredients, focusing on delicious meals you can eat becomes easier. When you discover just how well you feel without all the allergens, you are bound to experience new levels of dining pleasure!

Gluten is wheat gum, the insoluble component of grains (such as wheat, barley, and rye). It is a mixture of gliadin, glutenin, and other proteins. Gluten causes allergic reactions in certain people. While a gluten-free diet is the primary therapeutic treatment for celiac disease, this diet may also help a host of other conditions, including dermatitis herpetiformis, psoriasis, rheumatoid arthritis, HIV enteropathy, and schizophrenia.

Why do people follow this diet?

Celiac disease (also called gluten enteropathy) is a disorder of the small intestine characterized by sensitivity to gluten. In people with celiac disease, consumption of gluten causes inflammation in and damage to the lining of the small intestine, resulting in diarrhea, malabsorption, fat in the stool, and nutritional and vitamin deficiencies.

A gluten-free diet (GFD) is the primary treatment for celiac disease. Strict avoidance of wheat, barley, and rye (the three most abundant sources of gluten) usually improves gastrointestinal symptoms within a few weeks, although in some cases improvement may take many months. Some people with celiac disease must remove all gluten-containing foods from their diets to relieve symptoms. Following a GFD has been shown to reduce the incidence of cancer, low bone mineral density, and infertility in people with celiac disease.

People with dermatitis herpetiformis (DH) may benefit from following a GFD. The cause of DH is mainly an allergic reaction. Gluten-sensitivity enteropathy is found in 75% to 90% of people with DH. Unlike celiac disease, however, gastrointestinal symptoms are mild or absent. Strict adherence to a lifelong GFD can eliminate symptoms of DH and the intestinal abnormalities, as well as reduce or eliminate the need for medication in most people. However, an average of eight to twelve months of dietary restriction may be necessary before symptoms resolve. Not all people with DH improve on a GFD. Preliminary studies indicate that sensitivity to other dietary proteins may be involved.

Anecdotal evidence suggests that people with psoriasis may improve on a hypoallergenic diet. Three trials have reported that eliminating gluten (as found in wheat, rye, and barley) improved psoriasis for some people. A doctor can help determine for people with psoriasis whether gluten or other foods are contributing to their skin condition.

Preliminary evidence suggests that a GFD may help improve symptoms of rheumatoid arthritis. In one trial, 14 weeks of a gluten-free (no wheat, rye or barley), pure vegetarian diet, gradually modified into a lacto-vegetarian diet (permitting dairy), led to significant improvement in rheumatoid arthritis as evidenced by associated symptoms as well as by objective laboratory measures of disease.

HIV enteropathy, a complication of AIDS characterized by weight loss and chronic diarrhea, may respond to a GFD. In a preliminary trial, men with HIV enteropathy experienced a reduction in the number of episodes of diarrhea as well as significant weight gain while following a GFD.

For many years, researchers have speculated that certain dietary proteins, including gluten, may contribute to the symptoms of schizophrenia. According to some studies, people with schizophrenia are more likely to have immune system reactions to gluten than the general population. While clinical research findings have been inconsistent, some, but not all, people with schizophrenia may benefit from a gluten-free (and dairy-free) diet.