Common hidden sources of gluten

Whether you suffer from Celiac disease or have a gluten intolerance or sensitivity, if you’re adhering to a gluten-free diet, you probably already know that you can’t eat breads, pizza, pastries, and other foods that are made with wheat flour. But these items are not the only foods you should avoid if you’re avoiding gluten. If you are intolerant or sensitive to gluten—which is in not just wheat flour, but also barley, rye, spelt and more—it’s a good idea to get a handle on the common hidden sources of gluten so that you can do your best to avoid them, too. Some of these may surprise you!

Salad dressing, gravy, Worcestershire sauce, barbecue sauce—many (but not all) sauces and condiments contain gluten-containing ingredients


Breaded finger foods like mozzarella sticks and chicken fingers—they’re typically breaded with wheat flour


Marinades—or pre-cooked meat that has already been marinated. Many (although not all) marinades have glutenous ingredients.


Certain flavors of ice cream—While there are plenty of gluten-free ice cream choices out there, avoid flavors that contain chocolate chip cookie dough, brownie batter/pieces, graham cracker, and other similar treats that contain gluten


Bacon and other smoked meats/cold cuts—In some (but not all) cases, the smoking agent used on the meat is glutenous. Look for bacon and other meats that are labeled gluten-free.


Oats—While oats are actually gluten-free, they’ve often been processed in facilities that process wheat. Your safest bet is to buy oats that are certified gluten-free.


Flavored teas and coffees—These might seem innocuous, but many of the flavorings in these beverages contain gluten. Look for teas and coffees that are labeled gluten-free.


Foods from the bulk bin or salad bar—While many foods offered here may be gluten-free, you don’t know whether the person who was there before you selected their food with the proper tongs, or whether they dipped the tongs from the pasta salad into the lettuce. The cross-contamination risk here is high; play it safe by avoiding these areas with shared serving utensils. Instead, pick your own veggies from the produce department, or buy a can of packaged nuts or candy that you’re sure is gluten-free.


Lipstick, lip balm—It may come off on your lips as you eat, so if it’s glutenous, some of it may get swallowed along with food or drink. Although many manufacturers don't list whether their lipsticks or other cosmetics are gluten-free, there are quite a few cosmetics companies that sell gluten-free lip products.


Toothpaste and mouthwash—many are safe, but if you use one that contains gluten and you swallow it, you may experience symptoms

To ensure that a food is safe for you to eat, always read the product packaging. Some products may clearly state "gluten-free"; other products may say there are no gluten ingredients used, but that the food is produced in a facility that also produces wheat (which could lead to cross-contamination); some foods (like fresh fruits and veggies) are clearly innocuous; and other foods may have ingredient listings that are difficult to decipher. In general, if you aren’t absolutely certain that a food or beverage is gluten-free, your best bet is to call the product manufacturer, or visit their website, to get a definitive answer on a particular food, beverage, or personal care product.

It’s normal to feel overwhelmed when adhering to a diet that requires that you avoid eating certain foods, but good news—there are tons of delicious options available that are gluten-free. Not only are gluten-free food manufacturers making breads, cinnamon rolls, pizzas, pastas, snack foods, and more that are safe for you to eat, there are also plenty of foods that are naturally gluten-free. Vegetables, fruits, rice, potatoes, nuts, beans and quinoa are naturally gluten-free (just watch out for any flavorings or additives that render them unsafe for you to eat); many meats and cheeses are also gluten-free.

Are you interested in talking to a doctor about Celiac disease or finding out if a gluten-free diet is right for you? If you’re a Health Advocate member, call us to help you find an in-network primary care physician or a specialist (like a gastroenterologist) in your area. Remember, it’s best to not remove foods from your diet without consulting with a doctor first, so it’s a good idea to wait to speak to a health care professional before beginning a gluten-free diet.

Celiac 101: Surviving the Summer BBQ

Summer BBQ season is here! But if you suffer from Celiac Disease or gluten intolerance, barbecues and other social events with food might make you feel anxious and fearful about getting glutened. Make social events easier to handle by following these tips:

• Eat before you go. This way, you’re already pretty full, and the sights and smells of glutenous food won’t seem nearly as tempting.
• Bring your own snacks. Keep some gluten-free energy bars, gluten-free pretzel sticks, or other treats stashed in your handbag.
• Bring a snack to share. Bring something gluten-free to share at the party, such as a fruit or veggie tray or a homemade gluten-free baked good. This way you know there’s something there you can eat.
• Read ingredient labels carefully. It may be a good idea to only choose foods whose ingredients you can read on a label. That way, you can see for yourself whether something is gluten-free or a potential risk.
• Know where gluten hides. Those yummy marinades for chicken, steak, and other meats? They often contain gluten. Dips and barbecue sauces may also be hidden sources of gluten. Hot dogs can contain gluten, too. If you can’t read the label on the bottle or package to determine whether something is gluten-free, you may be better off just not eating it.
• Know how cross-contamination could happen. Even if that delicious turkey dog is gluten-free, is it being cooked on the same grill that marinated chicken was just being grilled on? That may not be safe for you to eat. Did the kid whose hands are covered in cookie crumbs just grab a bunch of carrot sticks from the veggie tray? That could be problematic for you.
• Arrive—and pick your food—early. You may reduce your risk of cross-contamination if you are the first one to reach for a gluten-free goodie. Get there early to better your chances of being the first one to snag snacks.

If you feel comfortable, let the party hosts know in advance about your food intolerances/sensitivities. Tell them that you do not need or want them to go to any trouble on your behalf, but that you are going to handle it on your own by bringing your own snacks or something to share, avoiding any food that may be potentially risky for you, and arriving early or exactly on time to get first crack at any gluten-free food that’s available.

Another thing to consider is that well-meaning family and friends may try to convince you that “you can eat that; I’m sure it doesn’t have gluten in it!” Remember that although these folks tend to have your best interests at heart, they likely do not have the wealth of knowledge that you have when it comes to gluten. They may be mistaken about what foods are gluten-free and safe for you to eat. Do not be tempted to eat these foods just to please other people. You are not being impolite by avoiding these foods—you are being smart by putting your health and well-being first. Although pressure from family and friends may feel frustrating, just smile and explain that yes, you might be able to eat that, but you’d rather be safe than sorry. Be polite, but firm—and then nosh on one of your packed snacks or other food that you know is safe for you to have.

And, as always, no matter how yummy something looks, if you have any doubt whether the treat is safe for you to eat, you’re probably better off not eating it. Although it’s often tough to resist a delicious-looking food, remember that it’s much easier to walk away from that treat than it is to deal with feeling ill for hours or even days because you’ve been glutened.

If you suspect you may have Celiac Disease or gluten intolerance, talk to your primary care physician. Your doctor may suggest getting tested for Celiac or going on a gluten-free diet to see if your symptoms disappear. If you don’t already have a primary care physician, an advocacy company like Health Advocate or Health Proponent can help you find a doctor that is local, in-network, and has hours that are convenient for your schedule.

All about gluten: what it is, where it hides, and what's safe for Celiac sufferers to eat

In honor of today being National Celiac Awareness Day, we thought we'd talk a little bit about gluten.  Gluten is the sticky protein found in wheat.  It's found in many grains, cereals, breads, and more.  Gluten is present in many food products and other products that people frequently use.  Those who suffer from Celiac Disease, and also those who suffer from gluten intolerances, have to avoid eating or ingesting products that contain gluten.  Besides foods, some alcoholic beverages, medications, and beauty and skincare products contain gluten.

According to Celiac.com, you might suspect a gluten intolerance or Celiac disease if you have general gastric complaints, like intermittent diarrhea, abdominal pain and bloating.  But many of these symptoms also mimic those of other diseases like Crohn's or anemia.  Also, some people who suffer from a gluten intolerance or Celiac disease don't have any symptoms at all.  If you suspect that you may have a gluten intolerance or Celiac disease, it's important that you talk to your doctor, who can evaluate your symptoms and determine if you should be tested for these conditions.  Since Celiac disease can cause malabsorption of nutrients, it is important that you get diagnosed so you can modify your diet to exclude glutenous foods.

So where exactly is gluten found?

• Some obvious places...  Gluten is found in wheat, barley, malt, and rye; it can also be found in oats.
• Some less obvious places...  Gluten can often (although not always) be found in sauces (including soy sauce) and gravies, salad dressings, processed meats and cold cuts, soups, and ice creams.  Glutenous ingredients are often used to thicken these products.  If you are gluten-free and would like to eat one of these products, always be sure to read the label carefully to ensure the product is free of anything glutenous.  Click here for celiac.com's comprehensive list of unsafe and potentially unsafe ingredients for people who must avoid gluten; Allergic Living also has a detailed list of potentially glutenous products.
• Read food labels carefully.  Before, you may never have had a reason to understand what substances like hydrolyzed vegetable protein, modified food starch, dextrin, natural and/or artificial flavorings, or things labeled as "extracts" are.  These mysterious-sounding ingredients--depending on where they were made--may contain gluten.  
• It's not just in food...  If you must avoid gluten, beer is off-limits to you, as are malt beverages like wine coolers.  
• Talk to your pharmacist.  Many medications contain gluten, which acts as a "filler."  Ask your pharmacist about whether gluten could be present in your prescription or over-the-counter medications or supplements.
• Makeup and personal care products can contain gluten.  Products like lipstick, shampoo, body lotions and sunscreens, and toothpaste can contain gluten.  Again, read the product label carefully to make sure that all ingredients are safe for you to use if you're gluten-sensitive.
• One really unexpected place that gluten hides...  The adhesive on envelopes.  If you have a gluten intolerance, use a moistened paper towel to wet the envelope adhesive before you seal it--don't like the adhesive.  

OK, so what food products can Celiac or gluten intolerance sufferers eat?

• Click here to see what foods Celiac.com has deemed safe.  All-natural foods like fresh fruits and veggies, eggs, unseasoned white or brown rice, beans, many un-cured and un-smoked meats, many (but not all) cheeses, nuts, tea, sugar, corn, honey, milk, potatoes, quinoa, tofu, and soy and soybeans are generally considered safe foods.
• Again, read food labels carefully.  For instance, while rice is considered a safe food, a rice mix with spices and other ingredients may contain thickening agents or other glutenous substances.  Do not assume that a natural and "safe" food product is still safe when combined with other ingredients to become a processed food.  
• There are many food products designed with the gluten-free consumer in mind.  There are pizzas made with rice crusts, pastas made from rice or quinoa, breads made from tapioca flour, snack foods made from corn.  Some of these can be found at your local grocery store, others can be found at specialty and health food stores, and even more can be found at numerous online retailers that cater to those who maintain gluten-free lifestyles.  Many restaurants also have gluten-free menus; Outback Steakhouse, Olive garden, and Pizzeria Uno, among others, all have a variety of tasty gluten-free choices.

Other helpful tips...

• If you are unsure of whether or not a food is gluten-free, call the manufacturer and ask. 
• If you're dining out, talk to your server.  Let them know you must maintain a gluten-free diet.  Ask for their help in verifying that the entree you've selected will be prepared gluten-free.  
• Find a nutritionist.  If you want to plan healthy gluten-free meals, a nutritionist may be a very handy resource.  
• Never be caught without a snack.  If you're headed to a social event or meeting where food will be served, chances are that it will not be gluten-free food.  Always carry gluten-free snacks with you (a piece of fresh fruit, gluten-free pretzels or a breakfast bar, celery or carrots, a bag of corn tortilla chips, etc) so that you aren't starving the whole time.  
• Have a medical team. Make sure your primary care physician and any other specialists, such as a nutritionist, allergist, or gastroenterologist, are aware of your Celiac diagnosis and/or gluten intolerance.  If you don't yet have a primary care doctor lined up, or you need a specialist, reach out to an advocacy service like Health Advocate or Health Proponent, who can connect you to providers who meet your needs.