FDA Defines Gluten-Free for Food Labeling

By: Jill Nowak, RD, CDE, registered dietitian at CHOC Children’s

Gluten-Free Labeling of Foods
On August 2, 2013, the Food and Drug Administration (FDA) issued a long awaited final rule defining “gluten-free” (GF) for food labeling.  This  GF ruling  will now mandate food manufacturers to follow practices to ensure food labeled  either “gluten-free”, “without gluten,” “free of gluten,” and “no gluten”  must meet a threshold standard of <20 ppm (parts per million) of gluten.   This threshold is the amount that can consistently be detected in foods using valid scientific analytical tools, as well as the level shown through research to be tolerated with the majority of people with celiac disease.  Now individuals requiring a GF diet will feel more confident when selecting food products labeled GF.

What is a Gluten-Free Diet?
Following a GF diet involves removing gluten from the diet and avoiding cross-contamination when preparing food.  Gluten is a storage protein found in wheat, barley, and rye, which is found in most breads, pastas, breakfast cereals, baked goods and crackers.  In addition, hidden sources of gluten are found in foods such as soups, sauces, and gravies.  Proper food preparation at home and when dining out is essential to avoid cross-contamination from products with gluten coming into contact with GF products.

Celiac disease is one particular disease where treatment requires following a strict GF diet.  Celiac disease is an autoimmune digestive disorder affecting approximately 3 million Americans, with at least 83% of people remaining undiagnosed.  When a person with celiac disease eats gluten an immune-mediated response causes damage to the small intestines and interferes with absorption of nutrients from food. A host of other symptoms may also occur.

In recent times the GF diet has become somewhat of a fad diet.  One should think twice before following this diet, however, due to possible nutritional deficiencies and weight gain that may occur because many gluten-free products are made with highly processed, unenriched flours and added fat and sugar.  It’s strongly recommended that a person who requires a GF diet seek nutrition counseling by a registered dietitian.  Eating well on a GF diet is possible — aim for eating GF whole grains, choose enriched or fortified GF grains, cook with less fat, eat more fiber rich foods, and calcium rich foods.

Try out this delicious recipe along with other GF recipes at www.livingwithout.com

GF Quinoa Salad with Fresh Herbs
1 cup quinoa, thoroughly rinsed
7 ounces slim green beans, trimmed and halved
3 tablespoons extra-virgin olive oil
2 tablespoons lemon juice
1 clove garlic, peeled and crushed
1 teaspoon Dijon mustard
½ teaspoon salt
– Freshly ground black pepper, to taste
1 cup cherry tomatoes, halved
¼ cup small basil leaves
1 tablespoon chopped flat-leaf parsley
2 tablespoons cilantro sprigs
1 tablespoon snipped chives

1. Cook quinoa in plenty of gently boiling water for about 12 to 15 minutes or until it softens (organic quinoa may take a few minutes longer). Tip quinoa into a fine sieve, making several steam holes through it with a skewer, and let it drain.

2. Plunge green beans into a saucepan of lightly salted boiling water and cook uncovered for 4 to 5 minutes, or until fork-tender. Drain and rinse with plenty of cold water to stop the cooking. Dry off on paper towels.

3. In a large bowl, whisk oil, lemon juice, garlic and mustard together with ½ teaspoon salt and plenty of black pepper. Add quinoa and toss to coat with dressing.

4. Just before serving, stir in green beans, tomatoes and herbs. Serve immediately.
Each serving contains 184 calories, 9g total fat, 1g saturated fat, 0g trans fat, 0mg cholesterol, 122mg sodium, 22g carbohydrate, 3g fiber, 3g protein.

To learn more, check out these helpful links:
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm363069.htm
http://celiacdiseasefoundation.org/
http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

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Wheat Alternative Carbohydrates & Grains

If your child’s allergist has suggested a wheat-free diet, there are a variety of grain and carbohydrate alternatives. It is important when choosing alternatives to include some whole grains because many wheat-free mixes and prepared baked goods contain refined flours with little nutritional value.

Amaranth
Amaranth is a tiny seed from a plant. It is sold as flour, a thickener or puffed (like pop corn). Amaranth flour can be used in combination with other flours to make wheat-free breads and baked goods.  Puffed amaranth can be used as a cold or hot cereal, added as a topping to salads or desserts, used for breading meats or in baked desserts.

Arrowroot Starch
Arrowroot starch can be used as a thickener for sauces, soups, puddings and baked goods. It is tasteless and can replace – measure for measure – cornstarch in recipes.

Buckwheat/kasha
Buckwheat is actually classified as a fruit and is safe to consume while following a wheat-free diet.  It has a slightly sweet flavor, and can be cooked the same way as rice and used in grain salads or as a side dish.  Buckwheat can be ground into grits and used as a hot cereal or ground into flour and used to make pancakes or pasta (often called Soba noodles). (It is important to note that some brands of flour mixes and pasta also contain wheat so always read the label.)  Buckwheat is a good source of fiber, riboflavin and niacin.

Millet
Millet is a widely used grain in India and Africa.  It has a mild flavor, and can be boiled and eaten as a side dish, breakfast cereal or used in making polenta. The flour can be used in all baked goods in combination with other flours. Millet has also been used to make cold cereal products such as millet flakes or muesli. Millet is a good source of B vitamins and fiber.

Quinoa
Quinoa is a seed that is a staple food source in South America. It is available as flour, flakes, pasta and quinoa puffs. The grain can be boiled like rice and is similar to couscous when prepared.  Quinoa has an excellent nutrient profile.  It is a complete protein source, containing much higher amounts of high quality protein than other grains. It is also high in iron, calcium, magnesium, B vitamins and fiber.

Tapioca Starch:
Tapioca starch comes from the root of the cassava plant.  It can be used with other flours in baked goods or as a thickening agent instead of cornstarch.

Teff
Teff is a small African grain.  It can be used to make hot cereal. It is also often used to make a crepe-like flatbread called injera, a staple in Ethiopian cuisine. (A recipe for injera is available at www.bobsredmeal.com).  Teff provides a good source of fiber, calcium, iron, magnesium and zinc.

Sago
Sago is produced from the inner trunks of sago palm trees.  It can be purchased in the form of starch or flour, and can be used in baked goods or as a thickening agent in puddings, desserts and sauces.

Sorghum
Sorghum is a cereal grain with a slightly sweet and nutty flavor.  Sorghum can be used in soups, casseroles and side dishes.  Its flour can be used in combination with other flours to make baked goods.

For more information and tips for baking delicious wheat-free recipes, check out the following sites:

www.bobsredmill.com
www.kidswithfoodallergies.org
www.foodallergy.org

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What is Celiac Disease?
Celiac disease is an autoimmune digestive disorder affecting approximately 1% of the population.  When a person with celiac disease eats gluten an immune-mediated response causes damage to the small intestines and interferes with absorption of nutrients from food.  Therefore, the only treatment for celiac disease is following a gluten-free diet.  Over time if left untreated, celiac disease can lead to an increase risk for anemia, osteoporosis, nutritional deficiencies, skin disorders and other health problems.

People with other autoimmune disorders, in particular type 1 diabetes, rheumatoid arthritis and thyroid disease, are at increased risk for celiac disease.  Unfortunately, it may take as long as 11 years to correctly be diagnosed with celiac disease.  By being aware of the symptoms of celiac disease and discussing with your doctor to screen for celiac disease if you have another high risk autoimmune disorder, this time frame can possibly be decreased.

Symptoms for Celiac Disease
• Stomach pain, gas, constipation  and/or diarrhea
• Change in mood
• Weight loss
• Slowed growth in children
• An itchy, blistering skin rash

Following a Gluten-free Diet
A gluten-free diet involves not consuming gluten, a storage protein found in wheat, barley, and rye.  Most breads, pastas, breakfast cereals, baked goods and crackers have gluten.  In addition, hidden sources of gluten are found in foods such as soups, sauces, and gravies.  During recent times the gluten-free diet has become somewhat of a fad diet.  Ironically, this diet could lead to nutritional deficiencies and weight gain because many gluten-free products are made with highly processed, unenriched flours and added fat and sugar.  Therefore, it is strongly recommended that a person diagnosed with celiac disease seek nutrition counseling by a registered dietitian.  Eating well on a gluten free diet is possible.  Aim for eating gluten-free whole grains, choose enriched or fortified  gluten-free grains, cook with less fat, and eat more fiber rich and calcium rich foods.  Lastly, cross contamination is a major concern and food handling techniques is crucial in your own kitchen and when dining away from your home.

To find more information about celiac disease and the gluten-free diet, check these sites out:
• Celiac Disease Foundation ( http://celiacdiseasefoundation.org/ )
• National Digestive Diseases Information (http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/ )
• Shelley Case, RD  (http://www.glutenfreediet.ca/ )

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