If you have celiac disease or non-celiac gluten sensitivity (NCGC) but are still experiencing symptoms despite eliminating gluten from your diet, you could be getting exposed to gluten from hidden sources. It is easy to unknowingly consume gluten. It hides in a wide range of foods and products. Identification of gluten in products can be tedious and often label reading alone is not enough. To add to the confusion, wheat-free does not always equate to gluten-free. In fact, multi-ingredient products are the most common sources of hidden gluten. Depending on the product, regulations may or may not require labeling of gluten. Consuming even minimal amounts of gluten from one of the hidden sources below can illicit adverse effects in at-risk individuals.
What is gluten?
Gluten is a protein found in grains like wheat, rye and barley. It is formed from two proteins: glutenin and gliadin. The term “gluten” is derived from the glue-like consistency that arises when this protein is mixed with water. If you’ve ever kneaded bread or stretched pizza dough then you’ve seen gluten in action. Grains such as wheat, rye, barley, malt, triticale, and spelt all contain gluten. Foods made from these types of grains including pastas, breads, cereals or beer will also contain gluten.
Top 8 Sources of Hidden Gluten:Medications
Labeling standards for gluten in medications are developing. There are many prescription medications that contain excipients (that can contain gluten) to bind pills together, yet, this identification does not always happen. In general, generic versions are more likely to contain gluten. However, that will soon change.
On April 3, 2019, Representatives Tim Ryan (D-OH) and Tom Cole (R-OK) introduced H.R. 2074, the Gluten in Medicine Disclosure Act of 2019. The bill intends to make it easier to identify gluten in prescription medications by requiring drug manufacturers to label medications with the list of ingredients, their source, and whether gluten is present. Always verify with a pharmacist if the medication or its label looks different than what you’re accustomed to. You can also ask the pharmacist or manufacturer to confirm the medication is gluten-free.
Sauces and gravies
Sauces such as soy or teriyaki typically contain wheat protein, hydrolyzed wheat starch or wheat flour. Other sauces often contain soy sauce or malt vinegar. Additionally, the base of many cream sauces and gravies is a roux, which is wheat flour mixed with butter. Get familiar with your favorite restaurants and products to ensure your sauces are gluten-free.
Wheat can be found in starches and starch derivatives. Explore the ingredient label and look for terms like “wheat starch”, “hydrolyzed wheat starch” or “contains wheat”. Wheat starch must have wheat removed to less than 20 ppm in order to be certified as gluten-free. While the term “starch” in products generally refers to cornstarch, especially in FDA regulated foods, it can also mean wheat starch. There are some gluten-free starches including tapioca starch, rice starch and potato starch.
Brown Rice Syrup
Brown rice syrup is a sweetener created by fermenting brown rice with enzymes, which break down starch to sugar. While the enzymes can be derived from fungi, they are typically from barley. This prevents the product from being gluten-free. Brown rice syrup is a stand-alone product but it is also used as an ingredient in multi-ingredient products. Some companies that use cereal enzymes will list “barley” or “barley malt” in their ingredient list. It may be difficult to verify gluten-free status in mainstream products that contain brown rice syrup as a sub-ingredient. Testing has shown that in some products, the amount of gluten detected can be problematic for individuals with celiac disease.
Companies often use wheat flour or wheat starch as a thickener for soups, which can get hidden in the ingredient label. Many soups also contain barley or other grains. Read labels carefully as pre-packaged and canned soups along with soup bases and bouillons usually contain gluten, especially those that are cream-based.
Dressings can contain wheat flour, soy or malt vinegar. Many of your standard salad dressings contain wheat or gluten-containing additives like modified food starch as a thickener. Additionally, salad dressings often contain artificial colors, flavorings, dextrin, malt, soy sauce and flours that can contain gluten as a sub-ingredient. Even if the label states “wheat free”, you must still ensure there are no other gluten-containing ingredients hidden in the product.
Chips and fries
Potatoes are gluten-free; however, malt vinegar and wheat starch are often used to make potato chips. These seasonings contain gluten. Additionally, French fries are often fried in the same oil that is used to make other gluten-containing fried foods leading to cross-contamination.
Meat is likely the last place you’d think to look for gluten. Yet, processed meats such as preformed hamburger patties, meatballs, meatloaf, sausages and even deli meats contain gluten. Wheat-based fillers are often used in processed meats to either bind meat or improve texture. Seasoned or marinated meats often contain hydrolyzed wheat protein or soy sauce and breadcrumbs are also added to bulk up products.
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