With thanks to Natasha McLaughlin-Chaisson, Registered Dietitian.

Celiac disease is a medical intolerance to gluten, which damages the body and causes the inability to absorb nutrients such as protein, vitamins, minerals and fat. Patients with this disease can easily become deficient in certain nutrients, with or without the presence of symptoms. Even though you may not feel sick, this does not mean that your body is absorbing nutrients properly. A gluten-free diet is the only treatment for Celiac disease and is a lifelong commitment.

As a Registered Dietitian, I often come across newly diagnosed celiac disease patients who gluten freetend to have done some research before their initial nutrition consultation. Most of these patients are good at avoiding sources of evident gluten in their diets; however, this is usually as far as it goes. The fact is, in order to completely control this disease, it is crucial to avoid ALL sources of gluten and this task is much more difficult than it seems.

Cross-contamination

You wouldn’t give a product that may contain peanuts to someone who is deathly allergic to them, so why risk it with gluten just because it does not cause anaphylactic shock? Is this still not torturing your body from the inside?

Studies show that miniscule amounts of gluten can affect a person’s ability to absorb nutrients for days afterwards. This is why it is important to properly remove gluten and its risk of cross-contamination from your diet. If you are using the same toaster, butter knife or peanut butter container as a family member who eats regular whole grain bread, chances are you are also consuming gluten through the crumbs. Fryers can also hold gluten in the grease from battered and fried foods.

Cross-contamination can occur in industries where foods containing gluten may come into contact with gluten-free foods. For example, oatmeal and rice cakes are often contaminated with gluten. Some companies also dust flour on production belts in order to keep the non-gluten foods from sticking. In addition, companies from different countries may have different criteria to meet in order to call a product “gluten-free”. At times, the risk of cross-contamination may not be taken into consideration.

Surprising food sources of gluten

It is always surprising to find the places where gluten can hide. A few items that have surprised my clients in the past include: some non-hydrogenated margarines, some spices, soya sauce, certain candy, turkey or chicken (injected with broth), rice mixes, some processed meats, roasted nuts, flavored teas and hot chocolate mixes (may contain malted barley), sweetened yogurt, imitation crab, some salad dressings (may contain malted vinegar or hydrolyzed wheat protein), and cake frosting (may contain starch).

Just because a product is gluten-free today does not mean it will never contain gluten in the future. A company can easily be change the composition of a product without announcing it. However, they are obligated to include any changes to the ingredient list.

Non-food sources of gluten

Even the most cautious celiac patients can sometimes forget about non-food sources of gluten such as envelope glue, vitamin supplements and mouthwash. Other products that are absorbed through the skin such as shampoo and soaps can also contain gluten. It is therefore crucial to research everything that comes in contact with your skin or mouth.

What to do?

The goal of this post is not to scare anyone, but to make people aware so that ALL sources of gluten can be avoided in the case of celiac disease. Here are some tips to help you avoid hidden sources of gluten:
1. Read ALL ingredients regularly. Companies can change ingredients without letting you know.

2. If you are unsure, call the company and ask if a certain product is in fact gluten-free.

3. Have your own gluten-free toaster, peanut butter jar and utensils. Also, wash the counter with a separate dishcloth.

4. Consult with a Registered Dietitian to find out more.