what is a wheat allergy
A wheat allergy is an immune system response to a protein that is consumed in wheat. The immune system reacts by treating the foreign protein as a “threat.” The allergic symptoms result from the immune system releasing certain chemicals to attack the protein. Symptoms usually occur within a few minutes of ingestion and in some cases arise after a few hours. Wheat allergy is one of the most common food allergies, with wheat listed as one of the top 8 allergens.
Wheat allergy is not to be confused with Gluten intolerance, also known as Celiac Disease. In gluten intolerance, the body cannot digest gluten. As a result the intestinal lining becomes damaged and cannot absorb vitamins, minerals and nutrients.
There are four proteins that can cause the immune system to respond: albumin, globulin, gliadin and gluten. When wheat is consumed the immune system treats one of these proteins as a threat to the body. Immunoglobulin E, or IgE, is an antibody that is produced by the body to attack the food protein (the antigen). IgE signals an attack on the protein by releasing histamine and other chemicals once the antibodies come into contact with the antigen. These chemicals cause the allergic symptoms that develop.
- Wheezing, difficulty breathing
- Runny nose, congestion
- Swelling of the lips, eyes, face, tongue and/or throat
- Mouth tingles or is itchy
- Skin rash (note: eczema is a common skin condition often associated with food allergies, see your doctor for proper diagnosis)
- Loose stools
- Dizziness, lightheadedness
- Anaphylaxis (can occur in some severe cases) Anaphylaxis is when the throat swells making breathing difficult because the airways constrict. Other symptoms may include a rapid pulse, dizziness, shock, and lightheadedness. This is life threatening and needs to be treated immediately by a clinician.
how to test and diagnose
Food Diary: If you think you have a wheat allergy track your diet and symptoms. Keep a diary of the foods you are eating and record the signs and symptoms you are experiencing after eating those foods.
Elimination Diet: Remove wheat from your diet for 2-3 weeks. After 2-3 weeks gradually reintroduce foods with wheat into your diet and see how your body reacts. You can use www.foodfacts.com as a guide for ingredients to avoid or substitutions. If your symptoms are relieved during the time the food is eliminated, you may be allergic to that food. See your doctor for proper diagnosis.
Skin Test: See your doctor or an allergist and get tested. Your doctor can perform a skin test. A tiny amount of food that can possibly cause an allergy is applied to your skin, and then your skin is pricked to allow that amount of food to get below the skin’s surface to see if you have a reaction. If you are allergic a rash may develop or another type of reaction can occur on the area that the food was applied.
Blood Test: A blood test can determine the amount of immunoglobulin E (IgE) antibodies in your blood. Your blood is sent to a lab where they test foods with your blood to see if a particular food causes you have high amounts of IgE. If you have high amounts of IgE then you are allergic to that food
how to manage
Avoidance is the only way to prevent symptoms from a food allergy. Be careful to read food labels to avoid your allergen and educate yourself on the names of the ingredients that may indicate your allergen is present. There are many substitutions that you can use for the foods you need to avoid.
Wear a Medical Alert bracelet to alert others to be aware of your allergy in case there is an emergency.
Be sure to tell family, friends, co-workers, teachers etc. of your allergy if there should be an emergency.
Carry an epinephrine autoinjector as directed by your doctor. If you have a severe allergy, and in the event that anaphylaxis occurs, this is advisable. This requires a prescription from your doctor. Your doctor may also prescribe other antihistamines. Antihistamines may be used; however, it is not as effective.
ingredients to avoid
- Wheat, wheat berries, wheat bran, wheat germ, wheatgrass
- What starch
- Flour (all-purpose, instant, breads, cakes)
- Enriched white flour
- Brown flour
- Granary flour
- Graham flour
- Wholemeal flour
- Cracker meal
- Orzo vegetable gum
- Tempura crumbs
- Triticale (cross pollination of wheat and rye)
- Jerusalem artichoke
- Steel cut oats, cream of rice or rye, buckwheat (not the same family as wheat), corn grits
- Pure buckwheat (check labels in case of cross contamination if wheat is grown nearby buckwheat)
- Pure buckwheat soba noodles (from an allergy-safe manufacturer, can substitute for pasta)
- Rice flour-based baking mixes and bread
- Organic puffed rice
- Rice noodles (from an allergy-safe manufacturer; can substitute for pasta)
- Corn: Corn flour, corn starch, corn pasta, corn tortillas, corn crackers
- Millet, millet flour, and puffed millet
- Chick pea
- Ground flaxseeds
- Arrowroot powder
- Corn flakes
- Puffed millet
- Sprouted rye breads and rolls
- Wheat-free Tamari (can substitute for soy sauce)
- Potatoes (white, sweet, yams)
- Winter squash
- Rice cakes
- Spaghetti squash
- Tortilla crumbs or cornmeal (use instead of breadcrumbs)
- Commercial wheat-free breads and baking, pancakes, waffle mixes
suggestions for wheat-free cooking
Generally, you can use any of the following for 1 cup of wheat flour:
- 7/8 cup rice flour (white or brown)
- 5/8 cup potato starch flour
- 1 cup soy flour plus1/4 cup potato starch flour
- 1 cup corn flour (if finely milled) or a scant cup finely ground cornmeal
- 1/3 cup soy flour, 1/3 cup potato flour plus 1/3 cup rice flour
- 1/2 cup soy flour plus 1/2 cup potato starch flour
- Non-wheat flours are heavier in texture and usually need to three times as much leavener (baking soda).
- Each non-wheat flour has its own effect on a recipe. Corn flour or finely ground cornmeal is crumbly and usually needs to be mixed with another flour to hold together.
- Tapioca and potato flours are known for their holding power and my be used to replace wheat flours. Recipes that require lost of stick-together power (for example, pasta recipes), often use these “sticky” flours in addition to the main non-wheat flour.
- Oat flour is sticky but gives a chewiness to baked goods.
- Barely and rice flours are heavy but similar to wheat in flavor. They combine well with other flours in muffin recipes.
- Soy flour is heavy and should be used only in small amounts.
Alternative Choices for Wheat Flour as a Thickener in Recipes:
Use any one as a substitute for 1 tablespoon of flour
- 1-1/2 tsp. cornstarch
- 1-1/2 tsp. potato starch
- 1-1/2 tsp. sweet rice flour
- 1-1/2 tsp. arrowroot starch
- 1-1/2 tsp. sago (sago palm starch)
- 1-1/2 tsp. gelatin
- 2 tsp. quick-cooking tapioca flour
- 1 Tbs. white or brown rice flour
- 1 Tbs. kudzu per cup of liquid
- ½ Tbs. or 1-1/2 tsp. agar agar per cup of fluid
uggestions for Wheat-Free dining:
- Fresh vegetable or fruit juice, fresh fruit, or fruit smoothie
- Non-wheat cereal like rice, corn, barley, rye, millet, amaranth, teff and buckwheat as a fresh-cooked whole grain
- Cream of rice, rye, barley, cream of buckwheat, and corn grits can be enjoyed either as a commercial or home preparation. You can grind any of these grains to make a fresh creamed cereal. These hot cereals can be eaten thinned with water, cow, goat, rice, soy, almond, or oat milk.
- Many wheat-free cold cereals are available at the health food store and marked as “wheat–free”. These include pure rice or millet puffs, 100% oat cereals, and corn flakes/puffs.
- Pancakes, waffles, muffins, and crackers can be made using wheat-free flours or commercial baking mixes.
- Organic eggs or a vegetable omelet with wheat-free toast or almond butter on rice cakes or crackers are other ideas for breakfast variety.
Lunch and Dinner
- A basic meal of cooked low carbohydrate vegetables with beans or meat (fish, chicken, turkey, beef, etc.), grain, or root crop
- Bean soups (lentil, black bean, etc.) with cooked vegetable and leafy greens
- Stir-Fry vegetables with meat or tofu
- Seafood with wheat-free pasta
- Broiled or poached fish with root vegetables and salad
- Grain casseroles such as Indian millet with currents and sunflower seeds or roasted pecans with wild rice
- Beans dishes, such as twice-cooked beans wrapped in corn tortillas or red lentil dhal or vegetarian chili
- Poultry, such as fresh chicken-vegetable soup or baked, roasted, or stir-fry chicken with vegetables and salad
- Any meal can be spiced up with whole foods substitutes for family favorites such as baked French fries or baked sweet potato chips, vegetables with active-culture yogurt dips, or “jellos” made of agar agar or pure Knox gelatin with fruit juice.
- Japanese rice balls filled with avocado or tuna
- Trail mix with fresh nuts and seeds
- Wheat-free muffins or crackers
- Baked corn or potato chips
- Fresh fruit
- All-natural gelatin sweetened with fruit juice
- Fresh vegetables and bean dip
- Lettuce roll-ups
- Open-face sandwich on rice cakes
Food Allergies and Food Intolerance: A Complete Guide To Their Identification and Treatment
Jonathan Brostoff, M.D., Linda Gamlin
JeanMarie Ceravolo, Certified Health Counselor
Above article written Feb. 2009, JeanMarie Ceravolo, CHC