Gluten-free bread, flour and grains: what they are and what they are made from

In the store, next to regular flour, there is now gluten-free flour. Let's calmly figure out what is hidden behind the word "gluten-free", what such products are made from, and whether you specifically need them.

What "gluten-free" means and what gluten is

Gluten is a protein found in three types of grains: wheat, barley and rye. It is present in any product made from them — in pasta, baked goods, most types of bread, some sauces and ready-made meals, as well as in most types of beer, which is made from barley. Oats themselves do not contain gluten, but they can cause a reaction if they were produced in the same place as wheat, barley and rye.

For most people, gluten is an ordinary part of the diet. But in celiac disease, the immune system perceives substances within gluten as a threat and attacks the body's own tissues, damaging the surface of the small intestine and interfering with the absorption of nutrients. According to data for the UK, celiac disease occurs in at least 1 in 100 people, more often in women, and can develop at any age.

What gluten-free bread and flour are made from

Gluten-free flour is made from rice, corn, buckwheat, millet, quinoa, sorghum, amaranth, tapioca. Such products are made from grains and other plants that do not contain gluten. Gluten-free products may contain hidden sources of it — for example, wheat flour under the name "thickener" in sauces and sausages, as well as gluten in some vitamins, supplements, toothpaste, mouthwash and lip balm.

Which grains and porridges do not contain gluten

The list of gluten-free products includes rice, buckwheat, corn, millet, quinoa, sorghum, amaranth, tapioca, as well as legumes — beans, peas, lentils, soy. Ordinary meat, fish, eggs, fruits and vegetables do not contain gluten. Pure oats, cleaned and not mixed with other grains, can be safely consumed by more than 95% of patients with celiac disease.

• Rice, buckwheat, corn, millet
• Quinoa, sorghum, amaranth, tapioca
• Legumes: peas, lentils, soy, beans
• Meat, fish, eggs, vegetables and fruits

How to read labeling and what cross-contamination is

Many grains do not contain gluten themselves, but may be processed in the same facilities where wheat is processed. This is cross-contamination. Reading labels sometimes helps avoid gluten, but if the composition is not indicated, the manufacturer can be asked to provide a list of ingredients. The absence of any mention of gluten on the packaging does not mean that the product does not contain it.

Who needs gluten-free products for medical reasons

The treatment of celiac disease is a lifelong gluten-free diet: the disease cannot be completely cured, but the diet helps control symptoms and prevent complications. In celiac disease, diarrhea, abdominal pain, bloating, constipation, fatigue, weight loss, itchy rash, problems conceiving, nerve damage are possible, and in children — stunted growth and delayed puberty.

The diagnosis is made based on blood tests and a biopsy of the small intestine during endoscopy of the upper gastrointestinal tract. Examination is usually recommended for people with symptoms or at increased risk, for example with a family history. Increased risk of celiac disease is noted in type 1 diabetes, autoimmune thyroid diseases, Down and Turner syndromes. In close relatives (parents, brothers, sisters, children), the risk of celiac disease is higher.

How a gluten-free diet differs from a regular one

A gluten-free diet contains less fiber; its sources can be whole rice, meat, potatoes and a sufficient amount of vegetables. Deficiency of iron, folic acid, calcium may occur, rarely vitamin B12. In most patients, the clinical response to the diet occurs quickly, after about two weeks. At the same time, there is no evidence of the benefit of a gluten-free diet for autism, and for people without celiac disease it is not mandatory.

Celiac disease and gluten-free products are not in themselves a reason to call an ambulance; 103/112 — for life-threatening conditions.

This is reference material, not a substitute for consultation with a doctor: if you suspect celiac disease, discuss with your family doctor which examinations you specifically need.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer