Wheat Free Diet
What is wheat exactly?
Wheat, a member of the grass family Triticeae, is one of the three most produced cereal grains worldwide (along with maize and rice). One of the earliest domesticated crops, originally grown in the Fertile Crescent, it is now cultivated all over the world and is the world’s most heavily traded cash crop. This is partially because of its adaptability to different environments, (it can tolerate a wide range of both climate and altitude) but also because of its ease of grain storage and convertibility into versatile flour. It is the second most produced food crop in the world after rice (not including the production of maize for animal feed) and has more land dedicated to its cultivation than any other food in the world (240 million hectares).
A major source of carbohydrate, wheat is higher in protein content than other major cereals, like maize (corn) or rice. The whole grain is a concentrated source of vitamins, minerals, protein and lipids. Milled white flour is the endosperm, which is predominantly starch; bran and germ are the by-products of the milling process.
How do I know if I am allergic or sensitive to wheat?
An immediate response wheat allergy is caused by an immunoglobin E reaction to one or more of the proteins found in the wheat grain: globulins, abumins, glutenins and gliadins. This type of allergy is most common in infancy and is usually outgrown within the first few years. The allergy is rarely seen in adults but those who do have it often also suffer from hay fever (pollen allergy). Symptoms can include: inflammation of the nasal membrane (rhinitis), asthma, hives (urticaria), swelling of the skin (angiodema) and itchy, weepy and swollen eyes (conjunctivitis). Other symptoms that may develop within a few hours of consuming the allergenic protein include diarrhoea, abdominal pain and aggravation of eczema. People may also experience exercise-induced anaphylactic reaction to wheat, which often is characterised by severe asthma-like symptoms (as reported by bakery workers who inhale a lot of flour in the workplace).
Delayed allergic reactions, usually visible within 24-48 hours, are known to exacerbate eczema symptoms in children. Sometimes regular consumption of wheat over the course of a few days (triggering eczema, diarrhoea or weight gain) can confound the skin prick allergy test during diagnosis, so your GP will need to make a diagnosis after a controlled elimination of wheat from the diet over a period of time.
It is important to be aware that a wheat allergy differs from both Coeliac Disease, which is an autoimmune condition where the body reacts to the presence of gluten affecting the small intestine, as well as wheat (specifically gluten) intolerance (also known as ‘non-coeliac gluten sensitivity’), which can have incredibly unpleasant gastrointestinal symptoms. However unpleasant, the symptoms of intolerance are not potentially life-threatening like those of a severe allergic reaction. Most of the time, the symptoms of an allergic reaction to wheat are time limited – as with most allergies – and do not cause long lasting tissue damage as is the case with Coeliac disease.
What does a wheat-free diet entail?
Anything that has wheat or wheat-related names listed on the label should be avoided, including: durum wheat, wheat bran, wheat germ, wheat gluten, whole wheat flour, wheat flour and wheat starch. There are quite a few ingredients that contain wheat-protein where this isn’t directly indicated by the name; a few to remember are: spelt (triticum spelta), kamut (triticum poloncium), bran, farina, rusk, semolina, durum wheat semolina, starch, modified starch, hydrolised starch, food starch, edible starch, vegetable starch, vegetable gum, vegetable protein.
Avoiding foods containing wheat can seem like a real challenge, as it is used for many of the things that we often take for granted as part of our diet, including leavened, flat and steamed breads, biscuits, cookies, cakes, breakfast cereal, pasta, noodles and couscous. Wheat is also used for fermentation to make beer and other alcoholic beverages like whiskey and vodka.
Most breakfast cereals, except porridge oats, contain wheat, so be careful to always read the label – it may not be listed as wheat but as cereal protein, cereal filler or cereal binder. All pasta and flour contains wheat as well, unless it is made from buckwheat (a different family of grain) or specifically labelled ‘wheat-free’. In terms of baked goods, a good rule of thumb is to avoid anything made with flour; even the less obvious ones often contain some wheat, such as pumpernickel, rye and corn loaves. As well as loaves, you should avoid pitta, crumpets, muffins, tortillas, and tacos (which should be corn but are actually mostly wheat in the UK), doughnuts, cakes, cookies/ biscuits and crackers. Desserts and puddings like pancakes and cheesecake, or other desserts with a biscuity base, will contain wheat protein as well, as does most ice-cream. Also be wary of chocolate and sweets.
Pastry goods are also normally made with wheat flour and so should be kept off the menu, like waffles, pancakes, crepes, pretzels, pastry, Yorkshire pudding. Breadsticks and croutons obviously also contain wheat – even communion wafers usually do. Lots of processed meat also contains wheat protein, such as burgers, salami, sausages, corned beef, luncheon meat, liver-sausage, pate and processed ham or fish. You should also be wary of vegetable pates and spreads. Anything coated in breadcrumbs should also be avoided, including Scotch eggs, onion rings and meat, fish or vegetable tempura.
Always read the label on tins, jars and packet products. Tinned beans, tinned spaghetti, soups and tinned and packet snack or ready prepared sauces and meals all frequently contain wheat. You should also avoid sauces with thickening agents in them, like gravy, or jarred pasta and curry sauces, as well as stock cubes and granules, some spice mixes, baking powder and monosodium glutamate.
Wheat is also in lots of beverages, both alcoholic and non-alcoholic. Non-alcoholic varieties to watch out for include: malted milk, hot chocolate and other powered drinks. Beer, ale, stout, larger, whisky, malt whisky, gin, and lots of wine and sprits also contain wheat protein in some form.
Many prescribed and over the counter drugs contain wheat protein as binding agent or filler, so it is a good idea to ensure your doctor knows when you are being prescribed medication of your wheat-free diet, and to check with your pharmacist. The glue on postage stamps is another unexpected source of wheat protein.
What foods can I enjoy as part of my wheat-free diet?
Fresh, and frozen, meats and fish that are not coated in batter or breadcrumbs are fine to consume as part of your wheat-free diet, as are eggs and most dairy, including milk, cream, butter, margarine and unprocessed cheese. There are lots of cereals and grains which can provide a wholesome alternative to wheat protein in your diet, including maize (corn), potato, rice, soya beans, millet, buckwheat, sago, tapioca, quinoa, sorghum and arrowroot. Chickpeas, beans and lentils are good fillers and can be added to soup, and maize, potato, rice, soya, gram (chickpeas) and lentils can all be bought as a flour and used in various dishes as a substitute for wheat flour. Sauces that have been thickened with cornflour or other flour alternatives are therefore fine. Baking powder, bicarbonate of soda and cream of tartar can also be used as a substitute in lots of recipes. Pure spices, rather than mixes can be used to liven up home cooked dishes, and it is relatively easy to switch from store-bought mayonnaise and salad dressings to home-made wheat-free ones. French mustard is also normally wheat-free.
Health food shops and lots of supermarkets now also stock wheat-free alternatives to much loved foods, like wheat-free pasta. Desserts like jellies, sorbets, gelatine and vegge gel based desserts are fine for when you fancy something sweet, as are rice, sago and tapioca puddings.
A note on labelling and eating out
It is important to remember that even ‘gluten-free’ labelled products often affect people with a wheat intolerance as the remaining proteins in the wheat are still present. For a wheat-free diet, you will need to make sure you check all ingredient labels (be aware of hidden wheat which can be found in many convenience products such as ready meals, sauces, etc.). Due to customer demand and increased need, there are many ranges available in supermarkets and health food shops which include wheat-free flours, cakes, biscuits and frozen foods. This has made a valuable contribution and extended many peoples' choices enabling them to adapt recipes and use alternative flours and products. Wheat free cooking is more of a challenge. However with practice and trial and error, it can become easier!
Cafes, restaurants and pubs are provided guidance by the Food Standards Agency, but they aren’t required to meet any labelling requirements, so it’s always a good idea to have a word with your waiter or chef before ordering if you are unsure of your menu choice.
What are the benefits / risks of a wheat-free diet?
A wheat free diet is essential for those with a wheat allergy and nasty gastrointestinal symptoms should vanish quickly for those that have an intolerance. Even people who haven’t been diagnosed with an intolerance often find that chronic problems with bloating, constipation or diarrhoea will disappear. A notable benefit of going wheat-free is that you will inevitably reduce your intake of processed foods and increase your intake of natural, whole foods. The nutritional value in terms of vitamin and mineral intake is much higher in whole vegetables, fruits, grains, beans, nuts, seeds and lean meats than in processed foods. Lots of people have also reported that cravings for unhealthy snacks disappear when on a wheat-free diet and a natural side-effect of eating in such a conscientious way is weight loss, and many people are embarking on wheat-free diets for this very reason.
Wheat is nutrient-rich, however, so you do need to make sure that you are consuming enough of these excluded nutrients elsewhere. The ones to be especially aware of are iron, calcium, foliate, thiamine, riboflavin, niacin and fibre. Of course, you can always take supplements, but it’s relatively easy to balance your diet to ensure that you are consuming these from other sources.