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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Nutrition

Allergy: Wheat Allergy Diet (273)

Allergy: Wheat Allergy Diet (273) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition

273

1


Wheat Allergy Diet


The only proven treatment for a person with food allergies is complete avoidance of the food (s)
he/she is allergic to. Wheat protein is present in a wide variety of food products. This means
you need to carefully read the labels of any processed food. Wheat is commonly used in
preparing baked goods, pasta, crackers and cereal, as well as some sauces, candies, processed
meats, soups and salad dressings.

A wheat allergy is different than Celiac Disease, in which a person needs to follow a gluten free
diet. Someone with a wheat allergy will have an instant reaction to eating wheat. This may
include hives, face swelling and vomiting. It is called a type 1 hypersensitivity. Celiac disease
is an autoimmune disorder. Both need to avoid wheat in their diet but for different reasons.

The Food Allergen and Consumer Protection Act of 2004 requires that foods must list
ingredients by their common names for the top 8 allergenic foods. The top 8 allergenic
foods in the United States are eggs, milk, soy, wheat, peanut, tree nuts, fish, and shellfish.

However, it is still very important to read labels of all food purchased and avoid all forms
of wheat protein. If unsure, call the maker of the product to get more specific information about
the food item.

Read labels each time you shop, since ingredients change often. Sometimes products have the
phrase “may contain wheat” or “made in a facility that processes wheat” on them. You will want
to avoid these foods as well.

Label ingredients which show the presence of wheat are:

All-purpose flour Graham flour Unbleached wheat flour
Bran Gluten flour Wheat, wheat bran
Bread crumbs High-protein flour Wheat berries
Bulgur Kamut Wheat flakes
Cake flour Malt Wheat flour
Cereal extracts Pastry flour Wheat germ
Couscous Seitan Wheat gluten
Cracker meal Semolina Wheat meal
Durum Spelt Wheat starch
Enriched flour Sprouted wheat White flour
Farina Triticale Whole wheat flour

Label ingredients which may show the presence of wheat are


Gelatinized starch Modified starch Vegetable gum
Starch Modified food starch Vegetable starch
Natural flavoring Monosodium glutamate (MSG)
Soy sauce Hydrolyzed vegetable protein



2
Can Eat Avoid

Drinks:
Milk; coffee; tea; fruit and
vegetable juices;
carbonated drinks.
Malted and cereal drinks; malted milk;
beer; ale; gin; some whiskeys; instant
coffee not 100% coffee; coffee
substitutes; prepared milk drinks made
with cereal or malt.

Bread/Grains:
Breads made from pure
potato, arrowroot, corn,
rice, oat, barley, or
soybean flours/starches. Rice
wafers or crackers.
Buckwheat is not related to
wheat so can be included.
Amaranth, flax, hominy,
maize, Montina® Flour
(Indian Rice Grass), millet,
legume flours (peas, lentils,
beans), quinoa, rice bran,
sesame, sunflower, tapioca,
tef, sago, and sorghum are
allowed grains/seeds/flours.
Can use gluten-free breads.
All bread products made with wheat
flour, white flour, all-purpose flour,
wheat germ, wheat bran, bulgar,
graham flour. Most crackers, croutons,
matzo or matzo meal,
doughnuts, biscuits, muffins, rolls,
pretzels, pancakes, popovers, waffles,
etc. not specified as being wheat-free.
matzo products; commercial tortillas;
melba toast; commercial rye and soy
breads. Also avoid kasha, kamut
triticale, semolina or Durham wheat,
einkorn, emmer, farro and spelt. Avoid
farina and Cream of Wheat.
Avoid bulk flours due to cross-
contamination. Communion wafers.

Candy:
Hard candy and candy made
without wheat.
Chocolate candies, candy bars and
commercial candies often contain
wheat.

Cereal:
Oatmeal; rice cereals;
cornmeal; barley; grits.
Can use gluten-free cereals.
Prepared cereals that contain
bran or
wheat; all malted cereals. Avoid farina
and Cream of Wheat. Check cereal box
labels with care. Some
oat cereal, for example, contains
whole wheat or wheat starch.
Dairy: Milk; milk products, such as:
aged cheese, dry milk,
evaporated milk, condensed
milk; plain yogurt; cream
cheese. Pure ice creams
without emulsifiers (wheat).
Malted milk
Some commercial milkshakes contain
wheat.
Check imitation cheese or low-fat/fat-
free cheeses; blue cheese may be
grown on bread;
Check ice creams, especially those
with added candy or chocolate.

3
Can Eat Avoid

Desserts:
Homemade desserts made
without wheat. Use wheat
free or gluten-free recipes or
mixes.
Any dessert that contains flour as an
ingredient such as cakes, cookies,
custards, dumplings, fritters,
doughnuts, ice cream, and cones,
pastries, pies, puddings; commercial
pie fillings.

Fats:
Butter, margarine, vegetable
oils.


Fruits:
All fresh, dried, canned and
cooked fruits.
Any fruits prepared or mixed with
bread crumbs, flour; fritters.

Meat and meat
substitutes:
Plain meat, fish, poultry and
cheese prepared without
wheat products.
Meat, poultry, fish, cheese and other
entrees that are prepared with or mixed
with bread crumbs, flour or bread;
some processed meats such as sausage,
bologna, liverwurst, lunch meats,
salami, and hot dogs with wheat fillers
or additives. Canned meats unless
stated that it is pure meat; fish sticks
and patties. Imitation crab or bacon
bits. Textured vegetable protein or
veggie patties may contain wheat.
Commercial Swiss steak, pot pies,
quiches, meatballs, and meatloaf most
likely contain wheat.

Potato, pasta,
and cooked
grains:
Potatoes, rice; polenta,
quinoa, amaranth, wheat-free
noodles, wheat-free pasta like
corn, potato, rice, quinoa or
soy pasta.
Macaroni, noodles, spaghetti, linguine,
ravioli, manicotti and any other pasta
made with wheat. Potatoes that are
scalloped, creamed or au gratin with
wheat products. Couscous.

Sauces:
Sauces prepared without
wheat flour or wheat
products.
Any sauce thickened with wheat flour.
Commercial sauces and gravies.
Commercial sauce, gravy, and some
seasoning mixes.

Soups:
Creamed and broth soups
made at home, thickened with
rice flour, potato flour, or
cornstarch instead of wheat;
gluten-free soups and broth.
Many broths contain wheat, check
labels with care. Soups that contain
hydrolyzed vegetable protein, soups
with noodles, dumplings or other pasta
products, some creamed soups,
bisques, chowders and minestrones.

4
Can Eat Avoid

Spices
All pure spices and herbs Some spice blends contain wheat. Malt
vinegars, some soy sauces and
ketchups may contain wheat as well.

Sweets:
All sugars; honey, jam, jelly
and syrups. Pure ice creams
just made with cream, milk,
eggs and/or fruit.
Candies with wheat additives. Some
ice creams (usually lower fat products
contain wheat) and frozen desserts with
wheat additives.

Vegetables:
Fresh, frozen or canned
vegetables that are not
prepared with wheat bread,
flour or crumbs.
Vegetables that are scalloped or in
sauces thickened with wheat flour;
French fried vegetables if floured or
breaded; vegetable casseroles,
puddings or soufflés that contain bread.


Non-food sources of wheat
Wheat is common in other non-food items. If you have a young child, these may be things you’ll
want to avoid due to risk of ingestion:
ξ Cosmetics and hair products
ξ Medicines
ξ Vitamins
ξ Play dough
ξ Pet food
ξ Wallpaper paste or glue
ξ Paper mache
ξ Mailing envelopes

Baking and Cooking Tips
Home baking is a safe way of having wheat-free bakery products. Alternative flours can produce
excellent products and the nutritional content can be higher because they are less refined.

Some substitutes for 1 Tbsp. wheat flour:
ξ 1 tsp. potato starch flour
ξ 2 to 3 tsp. rice flour
ξ 1 tsp. arrowroot starch
ξ 2 tsp. tapioca flour
ξ 1 tsp. cornstarch




5
For larger recipes, try switching out 1 cup wheat flour with one of these:
ξ 7/8 cup rice flour
ξ 5/8 cup potato starch flour
ξ 1 cup soy flour plus 1/4 cup potato starch flour
ξ 1 cup corn flour

Non-wheat flours have different properties from wheat. This can make them much trickier to
use than wheat flour. You may need to play around with different flours and ratios of flour
mixtures when changing standard wheat recipes. See the table on page 8 for more information.
Expect to have a few failures among the successes.

Products prepared with non-wheat flours tend to be drier, coarser, and heavier.

Baking temperature should be lower than those used with wheat batter.
Bread crusts will be rougher and browning will be lighter.

Flours with less gluten such as rice, potato, and soy do not rise well. They will require more
leavening than wheat flour. (Use about 2 teaspoons of baking powder for each cup of flour.)

Xanthan gum added to bread batter has been found to improve the texture.

The texture of products made with substitute flours may be improved by adding dried fruits,
wheat-free chocolate chips or nuts to the recipe. Frosting tends to improve the flavor and adds
moisture to products.

Refrigerate the dough before baking for cookies and doughnuts made with low gluten flours to
make the dough easier to handle and improve the texture of the final product.

Baking in smaller pan sizes also improves product texture. Baking at lower temperatures for
longer periods of time may also improve product quality.

By combining flour substitutes rather than only one kind of flour, you will be able to make
products more like familiar wheat flour products.

Some flours will mix into batters better if they are sifted into the batter while mixing to prevent
lumping. Add the flours slowly because they tend to thicken faster than wheat flour does.

When using no eggs, add only enough flour to make batter the consistency of a normal, wheat
flour cake batter. Adding more flour than this will produce a doughy, heavy product.

Cakes made with wheat-substitute flours will tend to be dry. Adding fruits or vegetables, like
zucchini, pumpkin, carrots, or pureed fruit will often increase moisture and improve texture.
They will also be a more nutritious product.

Sauces can be thickened with arrowroot, cornstarch, potato starch, rice starch or tapioca.


6

Wrap baked products tightly and store in the freezer when able, as low gluten products tend to
absorb both moisture and flavors quickly.


Gluten Free Flour Mixture
1 cup cornstarch
2 cups brown rice flour
3 cups soy flour
3 cups potato starch
Sift well and store in covered container.
Gluten-free all purpose flour may substitute
for wheat flour in most recipes.


Wheat-Free Play Dough

1 cup corn starch
1 pound baking soda
1¼ cup water
1 Tbsp. cooking oil
food coloring

Mix all ingredients together in a sauce pan. Cook until mealy.
Put on a plate and cover with a damp cloth. Allow to cool and
knead. Note: This mixture does not keep very well, but it is
fun for children who cannot use wheat-based dough.
(Recipe from Celide Barnes Koerner and Hugh A. Sampson,
M.D.)

Flour Good In Texture
Compared To
Wheat Starch
Rises Flavor
Compared to
Wheat Flour
How to
Substitute in
Place of 1 Cup
Wheat Flour
Problems and
Tips
Barley Quick
breads,
muffins,
cookies,
cakes, pie
crust.
Heavier Not well
in yeast
products
.
Mild ½ - 1 c. barley
Oat Quick
bread,
cookies
Slightly
heavier
Well Mild, similar
to wheat
2/3 – 1 c. oat Can make by
blenderizing
quick cooking
rolled oats.
Potato
starch
Best
when
combined
with
other
flours in
cakes and
cookies
Much heavier Not well Strong 10 Tbsp. potato
starch

¼ c. potato + 1
c. soybean

1/3 c. potato +
2/3 c. rye

¼ c. potato + ¾
c. rice
Good thickening
agent in soups,
gravies, stews,
etc. Good for
breading meat,
fish, poultry.
Cannot use in
bakery products
when not
combined with
other flours.

7
Rice Breads,
cakes
Smooth to
slightly grainy
Not well Mild, bland 1 c. rice

5/8 c. rice + 1/3
c. rye

¾ c. rice + ¼ c.
potato
Products tend to
have a similar
texture to
gelatin. Good
for thickening
gravies.
Rye Muffins,
breads
Heavy Not well Strong 1 ¼ c. rye

1/3 c. rye + 5/8
c. rice

2/3 c. rye + 1/3
c. potato
Does not rise
well. In yeast
breads, double
the amount of
yeast and the
rising time.
Produces heavy
quick breads.
Products fall
easily while
baking – do not
open oven door
while baking.

GOOD LUCK!

Description of flours and starches:

ξ Gluten free wheat starch – A white, fine wheat starch flour best used with eggs and
milk.

ξ Potato starch flour – A very fine white flour which makes a good thickening agent and
can be used successfully in baking when eggs are added to the recipe. It must be well
sifted to avoid lumping.

ξ Rice flour – A white starchy flour milled from white rice. In order to reduce the grainy
texture in the finished product, mix the rice flour in the liquids of the recipe and bring to
a boil; then cool and add the rest of the ingredients.

ξ Soy bean flour – A light yellow flour of high protein and oil content best used with
potato starch flour.

ξ Tapioca flour – A white velvety flour that makes a great thickening agent for sauces
(substitute one half teaspoon cornstarch for one tablespoon wheat flour).

ξ Cornstarch – A refined starch obtained from corn. Best used as a thickening agent
(substitute one half teaspoon cornstarch for one tablespoon wheat flour).

ξ Corn flour – A smooth flour milled from corn. Best results are obtained if blended with
other flours.

ξ Cornmeal – A coarsely ground corn best used with other flours.

8

Tips to Follow to Prevent an Allergic Reaction

1. Avoid foods that cause a reaction. Sometimes just touching foods can cause a severe reaction.

2. Read the ingredients lists on food labels to make sure allergy-causing foods are not present.
Read the list even if you have had the product before. Ingredients may change.

3. If you are traveling, bring along some of your own special foods.

4. When eating out, always ask restaurant staff about ingredients in food and how it was
prepared. Call the restaurant in advance (not at a busy mealtime) and talk to the manager.
Explain your allergy and when you would like to eat there. Most managers will guide you
through their menu choices that will work for you. Do not order deep-fat fried foods in
restaurants unless they have a separate fryer otherwise the oil may be contaminated. If you
order a grilled item, check if they have a separate wheat-free grill; if not, ask them to grill the
item on foil.

5. For infants, elemental formulas or formulas with altered protein should prevent food reactions.
Discuss the formula options with your doctor. Do not assume products labeled
"hypoallergenic" will not cause a reaction.

6. Make sure your pharmacist knows because sometimes wheat is used in certain medicines and
nutritional supplements. You can call customer service department for the maker of over the
counter medicine to check, if the label is not clear.

Other Resources
Food Allergy and Research and Education – http://www.foodallergy.org/ or 1-800-929-4040 or
email www.foodallergy.org

Kids with Food Allergies- http://www.kidswithfoodallergies.org or 215-230-5394

National Institute of Allergy and Infectious Diseases-
http://www.niaid.nih.gov/topics/foodallergy
Someone with a wheat allergy can benefit from gluten free sites and information because a
gluten free diet also avoids wheat products (as well as other grains). Be aware your diet might
be more limited if you follow a gluten free diet.

Gluten-Free website and magazine- www.glutenfreeliving.com
Simply Gluten-Free www.simplygluten-free.com

Stores That Carry Wheat-Free Products:
Copps, Sentry, Silly Yak Bakery, Trader Joe’s, UBake, Whole Foods, Willy Street Coop,
Woodmans, Aldi



9

Teach Back

What is the most important thing you learned from this handout? What changes will you make
in your diet/lifestyle, based on what you learned today?


If you are a UW Health patient and have more questions please contact UW Health at one of the
phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition



Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s
Hospital (AFCH) can be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at:
(608) 287-2770





The Spanish version of this Health Facts for You is #467








Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2015 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and the Department
of Nursing. HF#273