About Celiac Disease Celiac Disease Foundation, celiac.org

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In previous e-Alerts I've looked at celiac disease (CD); a condition in which gluten reduces the small intestine's ability to absorb nutrients. That prompted an e-mail from an HSI member named Panna who is apparently sensitive to gluten. Panna writes: "Can you send out an email of everything that GLUTEN is in? I am not supposed to have Gluten, but I have no idea what all it is in. Not knowing that, how do I know what not to eat? I know I would greatly appreciate it as I am certain others would as well." Gluten is a typical component of several grains. As a primary ingredient of flour, gluten delivers protein and gives bread a higher rise. In the e-Alert "The Good, the Bad and the Gluten" (12/15/05), HSI Panelist Allan Spreen, M.D., offered this mnemonic device to help remember the four primary sources of gluten: BROW. That's barley, rye, oat and wheat. If you're gluten sensitive, give those four a wide berth. But gluten is often hidden in foods such as soups, soy sauce, low-fat or non-fat products, and even in candy. Which brings us to the difficulty in answering Panna's question. A list of every gluten product might be long enough to fill several e-Alerts. But don't despair. The best way to steer clear of gluten (besides avoiding BROW) is to know what phrases and terminology to look for on ingredient panels. According to the Celiac Disease Foundation (CDF), ingredients that may tip off hidden gluten content include:

Unidentified starch Modified food starch Hydrolyzed vegetable protein (HVP) Hydrolyzed plant protein (HPP) Texturized vegetable protein (TVP) Malt and other natural flavorings Binders, fillers, excipients, extenders Note that the last item on that list would include certain dietary supplements and medications that use binders and fillers. This is one of the reasons you sometimes see the statement "no binders or fillers" printed on supplement containers. The CDF also notes that the contents of vinegars and alcohols should be scrutinized before use. Malt vinegars, for instance, contain gluten because they're not distilled. To Your Good Health, www.hsibaltimore.com