Wheat

bagelsCoeliac disease

Coeliac disease is a genetically based, immune-mediated enteropathy of the small intestine which means the body produces antibodies that attack its own tissues. It is caused by a reaction to gluten which is found in cereals including wheat, barley, rye, oats, triticale, kamut and spelt. Gluten is really a mixture of plant storage proteins called prolamins. Different prolamins are found in different types of cereal: gliadins and glutelins in wheat, secalins in rye, and hordeins in barley. Coeliacs are known to react to these proteins.

By contrast, the prolamins in maize (zeins) have not been implicated in coeliac disease and most coeliacs don’t react to the prolamins in oats (avenins). Gliadins in wheat seem to be particularly problematic in coeliac disease. Therefore, the strength of a reaction depends on the type of cereal the person has eaten as well as how sensitive they are to begin with.

Wheat allergy

Coeliac disease is not the same as a wheat allergy as it does not involve the production of the allergy antibody IgE and is not associated with anaphylaxis. Instead, gluten causes an inflammatory reaction within the lining of the small intestine which then becomes swollen and breaks down. This in turn leads to malabsorption of nutrients from the gut. As with all allergies, the only treatment is a life-long avoidance diet for wheat products. As with other food allergies, the symptoms of an allergy to wheat are mediated by the production in the body of the antibody IgE. A number of wheat proteins, including albumin, globulin and gliadin have been implicated in allergic reactions.

People with a wheat allergy are sometimes advised to stick to a gluten-free diet. However, it is important to note that wheat allergy and coeliac disease are different and foods that are labelled as being gluten free may not be suitable for people with a wheat allergy as they may contain other proteins such as albumins or globulins.

Non-coeliac gluten sensitivity (NCGS)

NCGS is not the same as coeliac disease and is not a wheat allergy. If someone has NCGS, they become ill after eating gluten-containing food and while some or all of their symptoms may be similar to those associated with coeliac disease, they have tested negative for the disease. This remains an active area of medical research both in terms of defining the illness and verifying if a gluten-free diet alone is sufficient to avoid symptoms.

Common names of wheat and gluten containing products

  • All-purpose flour
  • Wholewheat flour
  • Semolina (refined durum flour)
  • Couscous (cracked wheat)
  • Kamut
  • Spelt
  • Graham flour
  • Bulgar (partially cooked and toasted cracked wheat)
  • Wholemeal flour
  • Plain and self-raising flour
  • Barley (extract, flavour, flour, malt)
  • Farro
  • Farina
  • Polenta

Wheat can be found in many food products in different forms:

  • Food starch
  • Starch / modified starch
  • Corn starch
  • Special edible starch
  • Cereal filler / extract / binders / protein / starch
  • Edible starch
  • Wheat protein/starch/berries/bran
  • Wheatmeal
  • Thickening agent / thickener
  • Hydrolyzed vegetable protein (HVP)
  • MSG
  • Binder
  • Foods in batter/breadcrumbs
  • Rusk

Avoid

  • Breads-including pitta, chapatis, naan, and rye
  • Cakes
  • Pastries
  • Pizzas
  • Pasta
  • Sausage meats
  • Spaghetti
  • Certain soups, sauces, gravies and breakfast cereals.

Eat instead

  • Corn: Flour, pasta, cornflakes, crispbread, chips, polenta, bread, nachos, tortillas, popcorn. Cornflour is one of the best thickening agents (Ensure the corn flour is 100% corn flours with no added wheat flour). Cornmeal can be prepared as polenta.
  • Millet: Flour, pasta, flakes. Millet grains are boiled as rice and are very nutritious, good in soups and in casseroles. Millet flakes are great for making your own muesli.
  • Buckwheat: Also called "kasha", flour, pasta. Despite its name, buckwheat is NOT related to wheat at all. Buckwheat oats are also great for making your own muesli. Japanese soba noodles are made from buckwheat (Check labels on supermarket brands). Buckwheat flour is useful for making blinis, pancakes and other baking recipes (check label to ensure it is 100% buckwheat).
  • Rice: Flour, pasta, flakes, cakes, bread. Basmati or brown rice is best.
  • Quinoa: Flour, flakes, pasta, quinoa puffs (a "complete" protein and very nutritious), quinoa grains are boiled as rice and can be used as an alternative to couscous.
  • Amaranth, tapioca (from the cassava plant), arrowroot, gram flour (from chickpeas).
  • Lentil flour (useful for thickening agents), gram flour can be used to make wheat free poppadums.

If you are avoiding wheat only and can tolerate oats, rye, and barley then the following may be options for you to explore:

  • Oats: Oatmeal, flour, oatcakes. Oats make a great breakfast, raw with fruit and chopped nuts. Oatcakes are a good substitute for crackers.
  • Barley: Flour is useful for pancakes.

Shopping and dining out

  • Each year, the Coeliac Society of Ireland produce a handy shopping guide for those actively avoiding gluten. The Food List is a comprehensive guide to the gluten-free food products currently available in the shops. 
  • Similarly, Coeliac UK produce a Food and Drink Directory that lists gluten-free foods. Both resources are available online to members and the Food and Drink Directory is also via the mobile phone app Gluten-free on the Move.
  • Information on gluten-free dining out and other resources can be obtained from both organisations and also from Gluten-free Ireland.