Gluten makes up between 75% and 85% of the protein in bread. The two proteins that create gluten, glutenin and gliadin, need water to do their job. As flour and water mix, gluten develops, giving the dough elasticity and strength. Fermentation creates air pockets, and the protein network of gluten holds the gas produced in this process.
Foods like white bread and cake aren’t as chewy as a bagel or spaghetti noodles, because some flours, including cake flour, has less gluten. The percentage of gluten in any flour varies by country of origin and brands. Here’s a general guideline:
- Cake Flour: 7-8%
- Pastry Flour: 9%
- All-Purpose Flour: 10-12%
- Bread Flour: 14-16%
Gluten and Celiac Disease
Gliadin is the component of gluten that people with celiac disease, wheat allergies and non-celiac gluten sensitivity can’t tolerate, because their stomachs don’t have the gastropancreatic enzymes necessary to properly digest gliadin. As a result, this protein triggers symptoms of celiac disease.
Symptoms of celiac disease may vary widely from one person to the next. As with other autoimmune diseases, symptoms are often painful and can affect every part in and process of the human body. For people with celiac disease and gluten sensitivities, the trigger is gluten and avoiding it relieves symptoms.
In individuals with celiac disease, the immune system sees gluten as a foreign body. In the process of trying to destroy the gluten, the villi on the inside of the small intestines are damaged. Since their job is to absorb nutrients, this damage may cause malnutrition in celiac disease sufferers.
There are more than 200 celiac disease symptoms and variations of gluten sensitivity, including non-celiac gluten sensitivity and non-celiac wheat sensitivity, that can potentially complicate a diagnosis. In many cases, removing gluten from the diet helps resolve symptoms, but it’s important to see a doctor who can conduct a complete health assessment and offer guidance regarding proper nutrition and transitioning to a gluten-free diet.
Gluten, Fiber and Nutrition
Removing gluten from the diet doesn’t necessarily cause nutritional deficiencies. However, many Americans suffer the effects of a diet low in fiber. And for many people, whole grains are a reliable source of dietary fiber and removing them from the diet may cause a fiber deficiency. That’s why people on a gluten-free diet must be careful to maintain adequate fiber in their diet from sources other than popular and plentiful grains.
Commercially, adding what seem like odd ingredients to already processed foods, to earn the right to a “high fiber” label, helps boost sales. Consumers may regard those foods as healthier and choose them over a competitor’s product.
Foods labeled “high in fiber” must have a minimum of five grams per serving. Food manufacturers often add extra fiber in the form of resistant starch, extra bran, inulin from chicory root, bamboo fiber, cornstarch or the synthetic ingredient xylooligosaccharides.
People who transition to a gluten-free diet often look for substitutes in processed foods.
Over-processed gluten-free food isn’t necessarily more nutrient rich, nor does it usually have as much fiber and easily absorbable nutrients as a whole food that is naturally gluten free.
For example, a whole apple with the skin has 4.4 grams of fiber. It’s also rich in vitamin C. One russet potato has 4.5 grams of fiber and is a wonderful source of B vitamins. The seeds from half of a pomegranate offer 5.6 grams of fiber, and a cup of chopped and cooked broccoli has5.1 grams of fiber. The list of whole, nutrient-dense, fiber-filled food is long.
Which Foods Contain Gluten?
Wheat, rye, barley and triticale are four gluten-containing grains. Any food that has even one of those four grains on its ingredient list has gluten. Doctors advise people diagnosed with celiac disease and those who have gluten sensitivities to avoid eating foods that contain these grains.
Derivatives of wheat also contain gluten. Going gluten free can be tricky, because so many ingredients contain this protein. For example, there are many wheat varieties and byproducts that may cause problems for someone who lives with celiac disease or experiences sensitivity to gluten.
Here are just a few gluten-containing grains that are derivatives of wheat:
- Einkorn wheat
- Malted milk
- Malt extract
- Malt syrup
- Malt vinegar
- Malted barley flour
- Malt flavoring
For some gluten-sensitive individuals, the oat storage protein avenin, which is similar to proteins found in wheat, also causes symptoms. The addition of pure oats to the diet provides nutritional value, but after following a gluten-free diet for a few months, oats may cause a relapse in some people with celiac disease.
Potatoes are technically gluten free, but processed versions may also cause problems for people sensitive to gluten. French fries may be treated with wheat to improve their crisp texture. Some mashed potato mixes contain flour. Potato chips also may have malt vinegar and wheat starch as ingredients.
Some Non-Food Items Contain Gluten
People with celiac disease must adhere to a 100% gluten-free diet to heal the small intestine and prevent further damage. Because non-food items may include gluten and can trigger symptoms, it’s important to be aware that these products aren’t safe for people with celiac disease.
Gluten in vitamins, supplements, prescription drugs, cosmetics applied around the mouth and dental products can cause the same negative reaction in people with celiac disease as the gluten in food.
Individuals with celiac disease should call dentists and pharmacists in advance to verify that they won’t be exposed to gluten during treatment in an office or via prescription medications.
Gluten-containing starches may be present as inactive ingredients in both prescription and over-the-counter drugs. Formulations may change, causing an unexpected reaction to a new gluten-containing ingredient.
Often used as binders in vitamins and supplements, the following ingredients aren’t safe for people with celiac disease:
- Modified starch
- Pregelantinized starch
The FDA and Gluten-Free Labeling
The FDA’s final rule for labeling gluten-free foods mandates that any food labeled gluten-free by the manufacturer must contain less than 20 ppm of gluten.
Labeling is not mandatory, however, and certification is not required for foods labeled as gluten free.
There currently is no gluten-free certification endorsed by the FDA. When evaluating gluten-free certification programs, people diagnosed with celiac disease or gluten sensitivities should consult their health-care provider about which certification program follows criteria that best meets their individual needs.
Manufacturers are not required to test their products for gluten under the FDA’s rule about gluten-free labeling. While manufacturers bear the responsibility of ensuring that products labeled as gluten free have less than 20ppm of unavoidable gluten, they can use a variety of methods to determine the actual amount. Here are some examples:
- Participate in a certification program administered by a third party
- Obtain gluten analysis from suppliers
- Conduct in-house testing for gluten
- Contract with a third-party to conduct in-house testing for gluten
The FDA has no record-keeping requirements for manufacturers making gluten-free claims. Relying solely on a manufacturer’s claim that a product is gluten free may pose risks to people living with celiac disease.
The most important thing to understand about gluten is that people who suspect they have a wheat allergy, gluten sensitivity or celiac disease should speak with their health-care provider right away.