Gluten-free diet

Today, the only treatment for coeliac disease is a gluten-free diet. However it is difficult to avoid all traces of wheat, barley and rye. Cereals are consumed in virtually all foods, from beer to cold meats, including cakes and pastries. Here are some explanations and advice in how to eat without being at risk.

This diet excludes wheat, barley, oats and rye and it is complicated to follow, since it often involves changing well-anchored food habits. You need to cook simply using natural foods (not prepared industrially) and enhance the food you are allowed instead of thinking in terms of the food you cannot eat. Not only is wheat flour used in all breads and pastries, but it is also used in many ready meals (as a binder for sauces).

Today, there is no legal requirement to mention the gluten content in food and the composition of ready meals varies over time, some containing gluten at a given moment and later not containing any. However, increasingly we find a crossed grain symbol on gluten-free products. This symbol is the property of the French Association for people suffering from gluten intolerance (AFDIAG). It guarantees a product “uncontaminated”, with a gluten content under 20 mg/kg, the European regulation number 41/2009 threshold.

The list of food allowed varies over time and a regular update is essential. It is essential in specialised hospital departments and at the French Association for people suffering from gluten intolerance.

Food prohibited by the gluten-free diet

As a general rule, bread, pastries, pasta, and couscous are prohibited.
Milk products do not pose a problem, except cheese spreads and some jellified creams. It is important to be careful with yoghurts flavoured with chocolate.
Cold pork meats should be avoided with the exception of ham.
There is no problem in eating fruit (except dried figs which are often dusted in flour).
Fresh meat and fish are allowed, but ready meals (fresh, tinned or frozen) should be excluded since they use flour as a binder.
All fresh, tinned or frozen vegetables can be eaten, but tinned vegetables referred to as “steamed” may contain flour.
Lots of sweets contain gluten and only “pure sugar” and “pure fruit” sweets and acid drops never contain any and can be eaten.
Lastly, beer should also be avoided, but we now have gluten-free beers.

Gluten-free products

Although the principle of the diet is straightforward, it is never very easy to follow particularly after the 1st year. As we know, cereals are the basis of food in Europe and excluding bread, pasta and couscous, pastries and sweets is never easy, particularly in school restaurants and community environments.

Besides the usual foods, products guaranteed gluten-free (Apoglut, Rice-diet, Riésal, and other gluten-free flours) do exist, but their cost may be difficult to endure for low-income households.
Asian products, which are often based on rice are relatively cheap and can therefore be recommended.
Moreover, flour can be replaced by cornflour or potato flour in the meals you cook.
At the start of your diet, you often need to exclude lactose from your food. The lesions in the intestinal lining (villous atrophy) are responsible for lowering the activity of lactase, an enzyme essential for digesting lactose and which is found localised in the area of the lining. The length of this diet is theoretically for life.

Dr Lyonel Rossant
Dr Jacqueline Rossant-Lumbroso

 

Our Gluten-free brands