Monday, May 14, 2012

Hidden and Not So Hidden Sources of Gluten

It can be surprising and a bit daunting to realize all the places gluten can be hidden.  If you have celiac disease or sensitivity to gluten, it is important to be a highly motivated, suspicious label-reader. 

There is evidence that consuming even the smallest amounts of gluten on a regular basis can alter the enteropathy of a celiac patient’s small bowel.1,2   As little as 100 milligrams of gluten can cause mucosal damage to the small intestines in some patients.  A piece of bread typically contains 2.5 grams of gluten.1  A published case-report documented a patient who continued to have abnormal small bowel pathology after consuming only a fragment of a communion wafer daily.  Analysis showed the wafer fragment to contain approximately 1 mg of gluten.3 In other words, people with celiac disease or gluten sensitivity can have extreme variance in their degree of intolerance to trace amounts of gluten exposure.

This list was not created to overwhelm you, but to inform and empower you.  It is for those of us who have worked so diligently to remove gluten from our diet, only to realize that the lip balm and lipstick we’ve been using was contaminating us several times a day.

This is a list of food or non-food items that may contain gluten.  If the label doesn’t say gluten-free, you need to assume that it’s probably not.

  • Alcohol -- Avoid all grain alcohol or alcohol made with malt.  (The process of distilling should remove all gluten, but not all alcoholic beverage companies distill enough times to completely purify their beverages.  Potato-based vodka, rum and tequila are gluten-free.)
  • Art Supplies: play dough (play-doh), glue, etc. (watch out for children putting these in their mouth. Be sure to wash their hands well after use.)
  • Artificial Colors and Flavors
  • Baby Powder
  • Baking Powder
  • Barley
  • Barley Malt
  • Battered foods
  • Beer (unless it is labeled gluten-free)
  • Biscotti
  • Breading
  • Broths
  • Brown Rice Syrup (it often contains barely malt)
  • Bulgur
  • Bouillon Cubes or Powders that contain artificial colors
  • Candy
  • Canned Meats (containing preservatives)
  • Canned vegetables (unless canned in water only)
  • Caramel (made and imported from countries other than the US and Canada)
  • Cheese spreads
  • Chewing Gum (Spry or B-Fresh Gum are gluten-free and don't contain aspartame)
  • Colorings
  • Cough Drops
  • Couscous
  • Curry Powder
  • Dextrin and Maltodextrin
  • Envelopes, Stamps, Stickers and Labels
  • Farina
  • Flavorings
  • French Fries
  • Fried Foods (they often use the same oil for gluten containing foods)
  • Fruit drinks
  • Glucose syrup (often made from wheat)
  • Gourmet and prepared meats
  • Gravies
  • Hamburger patties (unless it says 100% beef)
  • Horseradish sauces
  • Hotdogs
  • HPP (hydrolyzed plant starch)
  • HVP (hydrolyzed vegetable protein)
  • Ice Cream
  • Icing/Frosting
  • Imitation sea food (e.g., crab meat)
  • Instant hot drinks—coffee, tea, hot chocolate
  • Kamut
  • Ketchup
  • Kitchen Appliances: toasters, cutting boards, 
  • Licorice
  • Lipsticks and Lip Balm
  • Lunch Meats
  • Malt Vinegar
  • Margarines
  • Marinades
  • Mayonnaise
  • Medications
  • Modified food starch (it usually refers to cornstarch, but can also be wheat starch)
  • Monoammonium Glutamate or Monopotassium
  • MSG (Monosodium Glutamate) or Glutamic Acid—flavor enhancers
  • Mustards (unless labeled gluten-free)
  • Oat (Oats are often cross-contaminated with gluten.  Purchase gluten-free oats.)
  • Personal care products, shampoo, lotions, makeup, suntan lotion etc.
  • Pickles
  • Processed Foods (read labels carefully)
  • Rye
  • Salad dressing (avoid all commercial dressings unless labeled gluten-free)
  • Sauces
  • Sausages or processed meats
  • Seasonings (if it doesn’t say gluten-free on the label, then suspect gluten)
  • Seitan
  • Soups (especially cream-based soups)
  • Sour Cream
  • Soy Sauce and most Chinese Sauces (except for wheat-free tamari)
  • Spelt
  • Spreads for bread: Be aware of "double dipping" (e.g., Dipping a knife into peanut butter, butter, jam etc. spreading it onto a piece of bread and then dipping the knife back into the container.  This contaminates the entire container for a person with gluten sensitivity.  Label your jars so your family and friends know to keep the food safe for you.)
  • Starch
  • Supplements (read the label carefully)
  • Tea, instant tea, instant coffee
  • Thickeners
  • Toothpaste
  • Triticale
  • TVP (textured vegetable protein)
  • Vegetable Starch
  • Veined cheese (may be created from molds that are of bread origin)
  • Wheat
  • Wheat Bran
  • Wheat Flour
  • Wheat-Free Products (Wheat-free does not mean gluten-free)
  • Wheat Germ
  • Wheat Grass and Barley Grass (often cross contaminated with the gluten-containing seeds when the grass is harvested)
  • Wheat Protein
  • White Pepper
  • Worcestershire sauce 
  1. Snyder CL, Young DO, Green PHR, Taylor AK.  Celiac Disease. Pagon RA, Bird TD, Dolan CR, Stephens K, editors. GeneReviews [Internet].  Seattle (WA): University of Washington, Seattle; 1993-2008 Jul 03.
  2. Hill, ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg E, Horvath K, Murray JA, Pivor M, Seidman EG.  Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.  J Pediatr Gastroenterol Nutr. 2005 Jan;40(1):1-19.
  3. Biagi F, Campanella J, Martucci S, Pezzimenti D, Ciclitira PJ, Ellis HJ, Corazza GR. A milligram of gluten a day keeps the mucosal recovery away: a case report. Nutr Rev. 2004 Sep;62(9):360-3.

Have you found any other hidden sources of gluten that aren't on this list. Please share!  Thank you!

Wishing you a happy, healthy, gluten-free day!