WANT TO KNOW more about... A GLUTEN-free diet?

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Beverly Simon
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1 WANT TO KNOW more about... A GLUTEN-free diet?

SMART thinking A gluten-free diet does involve adopting a new attitude to food. You will have to plan your meals and think carefully before you eat anything away from home.

2 SMART thinking A gluten-free diet does involve adopting a new attitude to food. You will have to plan your meals and think carefully before you eat anything away from home. Here are just a few suggestions and tips to help you get started. Planning Ahead Shopping Eating Out Holidays When eating away from home always check in advance the availability of gluten-free food, or take along a suitable glutenfree meal or snack. Always remember to take a copy of The Gluten-Free Food & Drink Directory (available from Coeliac UK) with you when you go food shopping. If you are unsure always check the label carefully. Remember, many supermarkets now label their own-brand foods as gluten-free. More and more restaurant chains are considering the needs of people on special diets and now provide or label glutenfree dishes. If unsure, notify the restaurant in advance of your special requirements, and always confirm again when ordering your meal. If choosing a full-board holiday check to see if the hotel provides gluten-free meals. Coeliac UK provide a very useful publication - The World Travel Guide. Many airlines and other transport operators now offer gluten-free meals which must be requested at the time of booking. ENJOYING A VARIED gluten-free diet A gluten-free diet can be both varied and interesting. Coeliac UK, through its regular magazine Crossed Grain, and manufacturers of gluten-free foods provide plenty of recipe ideas. So why not experiment with gluten-free cooking and discover your own favourite gluten-free dishes and recipes.

This information leaflet has been written by dietitians to help answer some of the questions you may have about what a gluten-free diet involves.

3 This information leaflet has been written by dietitians to help answer some of the questions you may have about what a gluten-free diet involves. If you are undergoing investigations for suspected coeliac disease or have been recently diagnosed with the condition, it is very important that you see your doctor or dietitian for individual advice before starting on a gluten-free diet. A gluten-free diet is the recognised treatment for coeliac disease 1 - a lifelong intolerance to gluten, which affects the lining of the bowel - and dermatitis herpetiformis - a serious skin condition. After diagnosis is confirmed by a gastroenterologist, you should be referred to a dietitian who will provide practical advice about following a gluten-free diet. A gluten-free diet is a medical diet and should only be followed with medical supervision. If you are considering following a gluten-free diet for any other medical conditions, please consult your doctor first. WHAT IS A GLUTEN-free diet? A gluten-free diet requires the exclusion of all sources of gluten in the diet. Gluten is the protein found in wheat, rye, barley and possibly in oats. It is possible to follow a gluten-free diet by simply avoiding all foods containing gluten. However, to make a gluten-free diet more interesting, less restrictive and easier to comply with, there are a number of specially manufactured gluten-free products available. WHAT INFORMATION is available? Your dietitian will be able to give you detailed advice on how to set about following a gluten-free diet for the first time. Coeliac UK, the charity supporting people with gluten intolerance, also provide support and help including a regularly updated food list called The Gluten-Free Food & Drink Directory. Manufacturers of special gluten-free foods also provide a range of information and services including recipes, starter packs and special events. For further details please refer to the contact page at the back of this leaflet. (1) For further information on the coeliac condition,the Juvela Nutrition Centre produce an information leaflet Want to Know More About Coeliac Disease? Please refer to the How to contact us section at the back of this leaflet.

4 WHAT FOODS are naturally gluten-free? The good news is that there are many foods that are naturally gluten-free. Potatoes, meat, poultry and fish, as well as fruit and vegetables are all gluten-free. Flours, breakfast cereals, pasta and crackers are normally made from wheat and other gluten-containing grains. However, alternatives made from rice and corn are available. Most milk and dairy foods are gluten-free, including milk, eggs, yogurt (check for added ingredients), cheese, margarine and butter. Other naturally gluten-free foods are nuts, cooking oils, wine, spirits, cider, tea, coffee and fruit juices. WHAT FOODS should be avoided? All foods made from wheat, barley, rye and their flours must be avoided. That means cutting out many of the everyday staple foods most of us take for granted, such as bread, cakes, biscuits and pasta. Most breakfast cereals are made from these grains and must be excluded too. Many manufactured and processed foods contain gluten. The main examples here are fish fingers, chicken nuggets and all breaded and battered fish and meat. Pastry, scotch eggs and yogurt with muesli should also be avoided. Some drinks and beverages contain gluten including malted milk drinks and barley water. Beer, lager and stout are made from barley and must also be eliminated from your diet. WHAT FOODS SHOULD BE checked carefully? Many manufactured and processed foods contain hidden gluten. When out shopping you will need to check carefully the ingredient lists of these types of foods as some varieties will be gluten-free, whilst others will contain gluten as a mixer or filler ingredient. Suspect ingredients to watch out for include malt, rusk, thickener and modified starch, where their origin is not specified. Foods to check carefully will include sausages and burgers, processed cheese and meat, instant mashed potato and paté. Look out too for ready meals, particularly meals with sauces and gravies. Some drinks to watch out for include herbal tea, carbonated drinks and milkshakes.

5 One important area is medication, including vitamins, minerals and supplements. Always check with the pharmacist that the medicine you have been prescribed is gluten-free. It is important to remember to check that the information you refer to is up to date, as the ingredients for some manufactured foods change from time to time. The Gluten-Free Food & Drink Directory (available from Coeliac UK and updated monthly), and supermarkets own gluten-free labelling will help you make a safe choice. Please note: The foods mentioned here are just examples of some of the foods you will need to check before eating. For a more comprehensive list of these foods please consult with your dietitian. WHAT ABOUT oats? Recent work suggests that oats may contain very small amounts of gluten and may be tolerated by some people with coeliac disease. Do not include oats in your diet unless you have discussed this with your gastroenterologist or dietitian, as some sources of oats may be contaminated through the manufacturing process. Oats are still not recommended for children with coeliac disease. WHAT SPECIAL GLUTEN-FREE foods are available? In order to make the gluten-free diet more adaptable and easier to comply with, a number of specially manufactured gluten-free products have been developed. These include bread, biscuits, flour mixes, breakfast cereals, pizza bases and pasta. HOW DO I OBTAIN gluten-free foods? Many of these gluten-free products are available on prescription for people medically diagnosed with coeliac disease. If you pay for prescriptions you might consider buying a prescription season ticket. Ask your pharmacist or Coeliac UK for details. In addition, some of these items are now available from health food shops, supermarkets and via mail order.

6 Coeliac UK is the national charity supporting people with gluten intolerance. The charity provides support and information, including The Gluten-Free Food & Drink Directory (which is a regularly updated food list of over 10,000 manufactured gluten-free products) and a regular magazine. For further information please contact: Coeliac UK, PO Box 220, High Wycombe, Bucks, HP11 2HY. Help Line: E mail: admin@coeliac.co.uk Website: This leaflet is one in a series produced by the Juvela Nutrition Centre, an information and advice service on coeliac disease and gluten-free diets, provided by SHS International Ltd., manufacturers of the JUVELA Range of Gluten-Free Products. For free copies of these leaflets and information on JUVELA Gluten-Free Products and Support Services please contact us via: Our Advice Line: The Juvela Nutrition Centre Advice Line is open Monday to Friday from 9 a.m. to 5 p.m Our Website: Visit our website for full product information and recipe ideas Or write to us at: The Juvela Nutrition Centre, 100 Wavertree Boulevard, Liverpool L7 9PT. Or E mail us at: USEFUL information HOW TO contact us juvela@shsint.co.uk (For The Republic of Ireland and Northern Ireland contact: Nutricia Ireland, 1B Sandyford Business Centre, Burton Hall Road, Dublin18. Tel R.O.I. Freephone Tel N.I. Freephone: ) Whilst every care has been taken to check that the dietary advice published represents current opinions, SHS International strongly recommends that anyone needing to follow a specialist diet seeks medical advice first. SHS International would like to express their thanks to Fiona Brown and Tanya Thomas, State Registered Dietitians, for their help and advice in compiling this leaflet. The dietary information in this leaflet has been checked by The British Dietetic Association is a registered trademark of Semper AB JANUARY 2002 JNC0094

Introducing a gluten-free diet

Patient information leaflet Royal Surrey County Hospital NHS Foundation Trust Introducing a gluten-free diet Nutrition & Dietetics Department This leaflet tells you about who should follow a gluten-free