A Growing Need for Gluten-Free Foods

Images of Minnesota wheat farms at harvest and the morning breeze ruffling acres of golden wheat are American icons. Wheat has been pounded and kneaded for generations into our daily bread, the nutritional backbone of America's diet. But this innocent grain has become the root of many problems for a significant number of people with gluten intolerance.  

Last year, the University of Maryland Center for Celiac Research in Baltimore released the results of a six-year, multi-center study which revealed that celiac disease (CD) is more common than previously thought, occurring in 1 out of 133 Americans.

CD is considered to be the most under-diagnosed disease in the country. A hereditary, lifelong digestive disorder affecting children and adults, it is a condition in which every speck of gluten (the protein contained in wheat, barley, rye and their derivatives) consumed sets off an autoimmune reaction that causes the destruction of villi in the small intestine. Nutrients quickly pass through the intestine rather than being absorbed. Symptoms of CD may include diarrhea, weight loss, abdominal pain, chronic fatigue, weakness, malnutrition and other gastrointestinal problems. In children, symptoms can include failure to thrive, irritability, inability to concentrate, diarrhea and bloating. And celiacs -- people with CD -- may face other symptoms that can involve the bones, blood, reproductive and nervous systems, as well as behavioral changes.                 

Once diagnosed with CD via a blood test and biopsy, celiacs face a lifetime of gluten-free eating. Just the tiniest bit consumed can cause problems: The smallest amount of gluten proven to show damage is 0.1 gram per day. There is no cure or drug for CD, but celiacs can live a normal life as long as they avoid gluten.  

People with wheat allergy also must avoid gluten. Wheat allergy, a separate condition from CD, occurs when people have an IgE-mediated response to wheat protein. Wheat is on the list of the top eight most common food allergens, a sizable concern with an estimated 11 million Americans living with food allergies. Wheat allergy symptoms may include hives, swelling of the tongue and closing of the throat after consuming wheat.  

With so many people needing to avoid foods containing wheat and gluten, a need for special products has arisen and more and more gluten-free products are finding their way onto supermarket and health-food store shelves or are being offered via the Internet. Popular gluten-free products that consumers search for include bread products, pizza crusts, pastas, snack foods, gluten-free flours and baking mixes, cakes, cookies and bars.

"There is a growing market for gluten-free foods. This market niche is not going to come and go, it's here to stay. People are interested in gluten-free grab-and-go foods, snack bars and quick foods," says Shelley Case, B.Sc., R.D., and author of "Gluten Free Diet: A Comprehensive Resource Guide."    

It takes a certain degree of skill to produce baked products with a desirable texture and taste using gluten-free flours. "The primary function of gluten is binding. Baking without it requires creativity and exploring other ingredients that can serve a similar function," says Cindy Kaplan, vice president of marketing at Enjoy Life Foods, a Chicago-based food company specializing in gluten-free foods. The company had first-year sales of half a million dollars, and projects sales of $2 million in 2004.  

Gluten contamination is a real concern, both in food preparation and in food manufacturing. Food developers must be careful to provide products that are truly gluten-free, as some sources of gluten can be hidden in food additives. "The big ingredients that food developers need to pay attention to in order to make products gluten-free are maltodextrin, modified food starch, flavorings and seasonings," says Case. "Manufacturers can choose nongluten sources for these ingredients. If a product contains modified food starch, a gluten intolerant should avoid it. But by using modified corn starch, the product is gluten-free." In fact, FDA only allows corn-derived maltodextrin to be labeled as "maltodextrin" (21 CFR Pt. 184, Sec. 184.1444).

Shared food preparation surfaces, utensils and appliances also can introduce gluten into foods. Some manufacturers are calling for separate lines for gluten-free products.

Things are about to get easier for gluten intolerants. The American Celiac Task Force helped push through the Food Allergen Labeling and Consumer Protection Act, which will require manufacturers to clearly state if a product contains any of the top eight most common allergens (including wheat) and also calls for FDA to issue final regulations defining gluten-free by Jan. 2006.  

Developing gluten-free products is a challenge. First, obvious gluten sources must be avoided. All products made with wheat (durum, semolina, kamut, spelt), farina, rye, barley, and triticale contain gluten. Products frequently made with these ingredients include breads, pastas, crackers, and cereal products. Gluten intolerants often are advised to avoid oats, as oats are often contaminated with gluten during manufacturing and storage. Alternative grains may be incorporated into product development, such as rice, corn, soy, potato, tapioca, bean, sorghum, quinoa, millet, buckwheat, arrowroot, amaranth, tef and nut flours.

Foods and ingredients possibly overlooked that may contain gluten include breading or coatings, broth, croutons, imitation bacon, imitation seafood, marinades, pastas, processed meats, roux, sauces, self-basting poultry, soup base, and stuffing. Other ingredients that gluten intolerants avoid include brown-rice syrup, which is frequently made with barley; caramel color, which may contain wheat depending on how it is manufactured; hydrolyzed vegetable protein (HVP), vegetable protein, hydrolyzed plant protein (HPP) and textured vegetable protein (TVP), which all potentially may come in contact with a gluten-containing grain or by-product during manufacturing; dextrin; flour or cereal products; malt or malt flavoring; malt vinegar; natural as well as artificial flavors; soy sauce and/or soy sauce solids; and vegetable gum, which may be made from oats. Product designers who use these ingredients should check to see if they are gluten-free and if so, prepare ingredient legends that cite the source of the ingredient, such as "hydrolyzed soy protein" or "xanthan gum."

And while the likelihood is rare, mono- and diglycerides may be problematic. Mono- and diglycerides themselves do not contain gluten. But, according to www.celiac.com: "Mono and diglycerides can contain a wheat carrier in the United States. While they are derivatives of fats, carbohydrate chains may be used as a binding substance in their preparation, which are usually corn or wheat, so this needs to be checked out with the manufacturer."

  By selecting and listing ingredients that are clearly gluten-free, manufacturers may offer many regular products to gluten-free consumers.

Sharon Palmer is a registered dietitian with a 16-year career in healthcare-food and nutrition management. She now focuses her interest in the world of journalism as a freelance writer and editor, cookbook contributor and culinary instructor.

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