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 diet, which foods can be eaten and which foods should be avoided. What is gluten? Gluten is a protein found in wheat. A similar protein is found in barley and rye. The term gluten is often used to describe all of these proteins. These cereals play an important part in our diet. They provide energy, fibre and some products are fortified with vitamins and minerals. Long term avoidance of these foods should only be undertaken with clinical supervision. Who needs to avoid gluten? A gluten-free diet is the treatment for people with a medically confirmed diagnosis of Coeliac disease or Dermatitis Herpetiformis. Which foods contain gluten? These foods must be avoided on a gluten free diet: Wheat, barley, rye, and their flours Bread, cakes, biscuits, crackers, breakfast cereals and muesli which contain wheat, rye, barley, spelt, kamut Pasta, noodles, couscous, semolina, bulgar wheat Pastry, pies, and quiches Fish fingers, battered/breaded fish Scotch eggs Beer, lagers, stout Malted milk drinks, barley water Manufactured foods containing bran, cereal filler, cereal binder, rusk, edible starch or vegetable protein e.g. sausages, burgers, soups, soy sauce, ready meals, desserts. 2
Which foods may contain gluten? Instant mashed potato, potato waffles Pâté, burgers, sausages, processed meats e.g. ham Bottled or packet sauces Yoghurts and processed cheese Gravy granules or powder and stock cubes Dry roasted/coated nuts and other snack products Suet Some corn or rice based breakfast cereals (may contain barley malt) Ready meals, processed foods e.g. tinned soup Cloudy fizzy drinks and some dark coloured fizzy drinks e.g cola, Dandelion & Burdock Manufactured foods containing malt and modified starch Current guidelines advise that oats are avoided for the first year after people are diagnosed with Coeliac disease or Dermatitis Herpetiformis. Limited quantities of pure oats may then be allowed but this must be discussed with your dietitian or doctor. Which foods are naturally gluten-free? Rice Cornflour, maize (corn), sweetcorn, polenta Sago, tapioca, arrowroot, buckwheat, quinoa, millet, cassava, sorghum, teff Breakfast cereals, pasta and crackers made from rice/maize only Potatoes, potato flour Fresh or frozen meat and poultry (unprocessed) Fresh or frozen fish without coatings Eggs Milk, fromage frais, crème fraiche and cheese Vegetables, salad and fruit Nuts and seeds Margarine, oil, butter Wine, spirits, cider Tea, coffee, fruit juices 3
Can people without Coeliac disease and Dermatitis Herpetiformis benefit from avoiding gluten? Some people are sensitive to gluten although they do not have Coeliac disease or Dermatitis Herpetiformis. They should be medically investigated before starting a gluten free diet. Will avoiding gluten improve my quality of life? Most people with Coeliac disease or Dermatitis Herpetiformis will feel an obvious improvement within a few weeks of starting a gluten free diet. If you do not have these conditions it may help you to keep a food and symptom diary to show your health improvement. Can you eat out on a gluten-free diet? Yes, some restaurants do provide gluten-free menu choices. Contact the restaurant of your choice to check before attending. Are free from foods helpful? Yes, they are useful to increase variety in the diet. Specifically manufactured gluten-free foods are now widely available in supermarkets and health food shops. All food products and alcohol will list ingredients on the packaging. Therefore, carefully check this list. If in doubt check with the supplier e.g supermarket website or customer services telephone helpline or refer to Coeliac UK for information as detailed below: Coeliac UK 3rd Floor Apollo Centre Desborough Road High Wycombe Bucks HP11 2QW Telephone: (0845) 3052060 www.coeliac.org.uk 4
Reference source www.coeliac.org.uk If you feel you need further assessment or advice please ask your GP or Consultant to refer you to a Registered Dietitian. This leaflet is produced by the dietetic department at The Royal Surrey County Hospital, NHS Foundation Trust. It is not a substitute for dietary advice given to a specific individual by a dietitian. If you need to see a dietitian, ask your GP or consultant for a referral. Please note that the information in this leaflet was correct at time of writing. The ingredients of manufactured products can change. If you have any questions about the information in this leaflet please contact the dietetic department at the address below: Nutrition and Dietetics Department The Royal Surrey County Hospital Egerton Road Guildford GU2 7XX Telephone: 01483 464119 5
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Contact details Nutrition and Dietetics Department The Royal Surrey County Hospital Egerton Road Guildford GU2 7XX Telephone: 01483 464119 Royal Surrey County Hospital (RSCH) NHS Foundation Trust fully subscribes to the National Patient Safety Agency (NPSA) Being Open best practice framework, November 2010. PALS and Advocacy contact details Contact details of independent advocacy services can be provided by our Patient Advice and Liaison Service (PALS) who are located in far left corner as you enter the main reception area. PALS are also your first point of contact for health related issues, questions or concerns surrounding RSCH patient services. Telephone: 01483 402757 Email: rsc-tr.pals@nhs.net Opening hours: 9.00am 4.00pm, Monday to Friday If you would like information documents in large print, on tape or in another language or form please contact PALS. Review date: March 2018 Author: Susan Hendry PIN150324 199 Royal Surrey County Hospital NHS Foundation Trust 2015