For reasons that are still not clear to doctors and researchers, incidence of gluten sensitivity, gluten intolerance, and celiac disease are on the rise in the United States. This has prompted food producers to offer more gluten-free foods as well as more clearly identifying gluten-containing foods. Nevertheless, there are a number of foods widely available around the country that contain gluten, and many of those foods may not be obvious to the average consumer. Being aware of these “hidden” sources of gluten is increasingly important as greater portions of the population are at risk.

What Is Gluten?

The term gluten typically refers to a combination of proteins (mainly prolamin and glutelin) found naturally in certain cereal grains like wheat, barley, rye, and their derivatives. When these grains are used to make bread or as an additive in other foods, gluten provides the end product with elasticity and strength; this helps bread rise as well as maintain its familiar shape and consistency. Below are some common sources of gluten:

  • wheat: wheat flour, spelt, durum, semolina
  • barley: malt, malt extract
  • rye: rye flour, triticale (hybrid of wheat and rye)
  • oats: while oats don’t naturally contain gluten, they can become cross-contaminated with gluten in the product process

Why Worry About Gluten?

For the majority of people, gluten isn’t really a cause for concern; most people can consume wheat gluten or other gluten-containing grains without experiencing any problems. For about 6-10% of the population, though, eating food products with gluten can cause a range of reactions and even lead to disease. Moreover, incidence of gluten-related problems have been increasing in recent decades at a rate that can’t be explained by being a more commonly recognized set of conditions.

In addition to a general increase in gluten-related health problems, the perception of gluten in the culture at large has led many people to avoid it even if they haven’t experienced symptoms. This has similarly led to a whole new genre of gluten-free options becoming widely available even though they are not technically any healthier. Even some naturally gluten-free foods are marketed as such in order to capitalize on the growing fear of what the substance might cause in the body.

In reality, however, gluten doesn’t generally need to be avoided unless eating gluten actually causes symptoms. For those who do have a negative reaction to gluten, it can trigger a variety of inflammatory, immunological, and autoimmune reactions and conditions. Below are some examples of gluten-related health problems:

  • Celiac disease: Celiac disease is an autoimmune disorder that is characterized by the immune system reacting negatively to gluten by damaging the lining of the small intestine. This can lead to malabsorption of nutrients and various health issues. Symptoms can include diarrhea, abdominal pain, bloating, and weight loss.
  • Non-celiac gluten sensitivity (NCGS): Also sometimes referred to as gluten intolerance, NCGS is a syndrome with a number of gastrointestinal and other symptoms. In these cases, it is sometimes unclear why gluten is the cause of the symptoms, but the symptoms nevertheless tend to improve when gluten is removed from the diet. In addition to common gastrointestinal symptoms like diarrhea and constipation, NCGS can manifest as headaches, fatigue, fogginess, or joint and muscle pain.
  • Wheat allergy: People with a wheat allergy are prone to an allergic reaction to gluten and other wheat proteins. Symptoms of a wheat allergy can range from mild (hives, itching) to severe (anaphylaxis).
  • Inflammatory bowel disease (IBD): Inflammatory bowel disease (principally Crohn’s disease and ulcerative colitis) is a group of conditions characterized by inflammation in the small and large intestines. Although not directly caused by exposure to gluten, it may make development of IBD more likely as well as cause the symptoms of IBD to be more severe or pronounced.

Hidden Sources of Gluten

As noted above, most people don’t need to worry about whether or not a food has gluten unless they’ve experienced symptoms and consulted with a doctor. For those with celiac disease or any other gluten-related problem, identifying and avoiding potential sources is an important part of managing the condition. While bread is an obvious area of caution, there are also a wide variety of foods and food products that can contain gluten that you might not expect. Below are some examples of hidden sources of gluten to be on the lookout for in grocery stores and restaurants:

  • Processed meats: Perhaps one of the more surprising hidden sources of gluten is deli meats like sausage, hot dogs, and salami. Gluten-containing substances are often added as fillers or binding agents; gluten may also be present in marinades used to add flavor.
  • Meat substitutes: In many vegan or vegetarian meat substitutes, wheat gluten (seitan) is used as a base because of how it thickens after absorbing moisture and how it incorporates additional protein.
  • Sauces and soups: Many familiar canned or packaged soups, sauces, and bouillon cubes use wheat flour as a thickener.
  • Condiments: Condiments like salad dressing, barbeque sauce, and marinades often contain gluten in the form of malt vinegar or flour for flavor or thickening. Even soy sauce and tamari are made with fermented crushed wheat that also contains gluten.
  • Beer: Beer is made from barley, which contains gluten.
  • Candy and confections: Many types of candy, like chocolate and licorice, use flour, emulsifiers, or flavoring agents that can contain gluten.
  • Processed foods: In general, many processed foods use additives that contain gluten as binding, thickening, or flavoring agents. Examples include granola bars, energy bars, pancake batter, potato chips, and tortilla chips.
  • Ice cream: Ice cream bars and milkshakes are often made with gluten-containing additives like malt or wheat starch.
  • Fast food: Even aside from wheat-based hamburger and hot dog buns, many elements of fast food meals contain gluten. Examples include french fries, chicken nuggets, and dipping sauces.
  • Personal care products: Some cosmetics, shampoos, and lotions contain gluten and may cause a reaction for those with sensitive skin

As this list demonstrates, gluten in various forms is present in a significant number of foods and products that we encounter on a daily basis. Most people don’t need to worry about following a gluten-free diet if they haven’t experienced any adverse effects. For those with celiac disease or another gluten-related disorder, however, it is important to be vigilant in selecting the foods they eat. This requires becoming adept at regularly scanning food labels and ingredients lists to ensure that gluten isn’t present.

Contact Cary Today

Even though the number of people who seem to have a gluten-related condition is on the rise, it still represents a relatively small segment of the population. This set of conditions, and particularly celiac disease, appears to be due to genetic factors, though research into the causes and factors is still ongoing. If you have experienced symptoms related to the consumption of gluten and are concerned you might have a sensitivity or allergy, contact us at Cary Gastro to request an appointment.