Find out which ones are enriched with vitamins, fiber, iron and protein in the charts below.

Print them and bring them along the next time you go grocery shopping.

GF pastas available in the U.S.:

GF pastas available in Canada:

Shelley Case, RD, is an international celiac and gluten-free expert, a featured columnist in Allergic Living magazine and author of Gluten-Free Diet: A Comprehensive Resource Guide.

Related reading:
- The Celiac Expert: Comparing Gluten-Free Cereal & Oatmeals

What Are They?

Whole grains are the seeds or kernels of plants that are composed of:

• the bran, the outer seed layer and source of fiber, B vitamins and antioxidants;
• the germ, the part that sprouts into a new plant and contains protein, healthy fats, B vitamins, vitamin E and minerals;
• and the endosperm, the largest portion of the seed that is mostly starch and small amounts of minerals and vitamins.

Gluten-free whole grains include amaranth; buckwheat; corn; millet; pure, uncontaminated oats; quinoa; rice (black, brown, red, wild); sorghum and teff.

Getting Whole Grains on the Gluten-Free Diet

The typical gluten-free diet is built around white rice and baked products, cereals, snack bars and pasta – often made from white rice flour and starches (corn, potato and tapioca). If you see your own diet in that description, it’s time to change how you eat since these refined flours and starches do not contain the bran and germ. That means you’re missing out on important nutrients. By using gluten-free whole grains, you can boost the quality of your diet.

How to incorporate whole grains into your meals and snacks:

• Jump start your day with a hot cereal such as gluten-free rolled oats, buckwheat or quinoa flakes, cream of brown rice or cooked amaranth, millet, quinoa, steel-cut gluten-free oats or teff grains. Sprinkle with cinnamon, brown sugar or honey and top with fresh or dried fruits like sliced bananas, blueberries, mangoes, peaches, apricots and raisins.
• Another breakfast option is granola. There are many gluten-free granolas on the market. Or make your own using gluten-free oats, seeds (flax, sesame, sunflower, hemp, chia) and nuts (almonds, walnuts, pecans).
• Top yogurt with granola for a great snack.
• Dress cooked buckwheat, gluten-free oat groats or steel-cut oats, quinoa, millet, colored rice (black, brown, red), wild rice, sorghum or teff with a zesty salad dressing. Add chopped green and red onions, peppers and other favorite veggies, along with nuts and seeds for a hearty salad.
• Buy pasta made with amaranth, brown rice, buckwheat, millet or quinoa.

For more ideas about adding whole grains to the gluten-free diet see http://www.glutenfreediet.ca/img/WholeGrainHandoutFinal2012.pdf.

Next page: Cooking with Whole Grains

Gluten-free whole grains that you’ll want to consider include amaranth, buckwheat, corn, millet, (pure, uncontaminated, gluten-free) oats, quinoa, rice (black, brown, red, wild), sorghum and teff.

How to Cook Whole Grains

Bring liquid (water or gluten-free broth) to a boil and then simmer for suggested cooking time (see below). Generally speaking, the grain is done when tender. If not tender, add more water and continue cooking; if done before all the liquid has been absorbed, simply drain the excess.

You can also buy whole grain side dishes such as brown or wild rice that have been pre-cooked and only need to be warmed in the microwave or cooked briefly. Cooled leftover grains can be stored in the refrigerator for up to five days or frozen for two to three months.

Shelley Case is a consulting dietitian and author of Gluten-Free Diet: A Comprehensive Resource Guide. She is on the advisory boards of the Canadian Celiac Association, the Celiac Disease Foundation and Gluten Intolerance Group.

The editors at Allergic Living highly recommend her book Gluten-Free Diet, a vital resource for those interested in celiac disease and living gluten-free.

Start Your Day with a Healthy Breakfast

Studies prove it: those who skip breakfast tend to overeat later in the day – often resulting in weight gain. So fuel your body with a healthy breakfast such as: a gluten-free cold cereal made with a nutritious grains like amaranth, brown rice, buckwheat, millet, quinoa or teff and topped with fresh fruit. Compare cereal nutrient levels in the comprehensive chart I created for Allergic Living magazine. (Canadians, see this version.)

For a hot cereal, make a tasty bowl of oatmeal from pure, uncontaminated oats with raisins and slivered almonds. Try a smoothie with low fat yogurt, fresh or frozen fruit, ground flax, dash of vanilla and honey. Or bake and freeze muffins from a healthy gluten-free mix.

Next: Portion sizes

Shelley Case, RD: The only treatment for celiac disease is a strict gluten-free diet for life. Eliminating gluten will allow the villi  in the small intestine to heal, resulting in improved absorption of nutrients. Over time, symptoms will resolve and you will begin to feel better. Damage to the small intestine can still occur if you eat gluten on a regular basis, even if you don’t feel symptoms. The risk of long-term complications, including cancer of the gastrointestinal tract, is greatly reduced if the diet is followed closely.

But the question is: how strict do you need to be?

Response to gluten is highly variable among individuals with celiac disease so it is difficult to establish a safe threshold level. In a 2007 study, 49 adults with celiac disease following a strict gluten-free diet were challenged with 10 or 50 mg of gluten for three months. Those who were exposed to 50 mg of gluten a day had small but significant mucosal damage to the villi of the small intestine. One patient who was challenged with 10 mg of gluten a day developed symptoms. To put this in perspective, one slice of bread with wheat flour contains over 2,500 mg of gluten.

To help you limit your exposure to gluten:

• Read food labels every time you shop. Manufacturers sometimes change product formulations and what had been gluten-free previously may now include gluten-containing ingredients.
• Buy grains, flours and starches that are labeled “gluten-free” from companies that test their products for gluten.
• Be diligent in preventing cross-contamination when eating at home. Read my tips for keeping your kitchen gluten-safe.
• Be especially careful when eating out. Choose restaurants that have a gluten-free menu or are knowledgeable and willing to accommodate those with special dietary restrictions.
• Consult a registered dietitian with expertise in celiac disease who can review your diet and provide comprehensive and practical information about how to follow a strict gluten-free diet.

Shelley Case is a consulting dietitian and author of Gluten-Free Diet: A Comprehensive Resource Guide. She is on the advisory boards of the Canadian Celiac Association, the Celiac Disease Foundation and Gluten Intolerance Group.

Thank you for understanding that Shelley won’t be able to answer every question received. The editors at Allergic Living highly recommend her book Gluten-Free Diet, a vital resource for those interested in celiac disease and living gluten-free.

For more information about the GF diet see:

www.celiac.ca
www.glutenfreediet.ca

Shelley Case, RD: Whether you’re rushing between meetings or getting the kids to music lessons or a sports event, grabbing a snack on the go is all too common for many of us. But on a gluten-free diet, a little planning is required before you are time-crunched and ravenous. The good news is that there are many healthy, gluten-free options that can be kept at home or in your car, backpack or desk at work. Following are some ideas, along with a few recommendations of gluten-free products you may wish to try.

In a Crunch
Keep some gluten-free crackers at your desk and some hummus in the office fridge. A quick nibble on these will keep you going through that next conference call.

• Simply Rice Crackers
• Edward & Sons Exotic Rice Toast
• Mary’s Organic Crackers
• Crunchmaster Multigrain Crackers
• Blue Diamond Nut Thins

On the Move
Make your own trail mix. Combine almonds, cashews, raisins, dried apricots or mangoes with gluten-free cereal. Keep a container in your purse, in the car and one at your desk. You’ll never be without a protein boost.

• Orgran’s Multigrain O’s with Quinoa
• Nature’s Path Mesa Sunrise Multigrain Cereal or Whole O’s Cereal
• Glutino Honey Nut Cereal O’s

Butter Up
Keep some single-serve nut or seed butters on hand. Eat one of the squeezable packs on its own, or spread on fruit such as apples or pear slices or on gluten-free crackers or rice cakes.

• Justin’s Nut Butter (order online: www.justinsnutbutter.com)
• Barney Butter (U.S. only)
• Sunbutter

Before You Go
Top some plain or flavoured yogurt with some gluten-free granola for a nutritious bite as you’re running out the door.

• Enjoy Life Crunch Granola
• Bakery on Main Gluten-Free Granola
• NoNuttin’ Foods Granola Clusters (made with pure, uncontaminated oats)

Bar None
When convenience is of the utmost importance, a gluten-free snack bar (made with nuts, seeds and/or dried fruits) is what you need.

• Kind Bars
• Larabar
• Bumble Bars
• Mrs. May’s Naturals

More No-Fail Snack Ideas

• Yogurt tube
• Canned fruit (in juice or water) or applesauce
• Popcorn
• Fresh fruit
• Pumpkin or sunflower seeds (plain or GF flavoured)
• Dried fruits (e.g. mini raisin box, apricots, cranberries, mangoes)
• Fruit or vegetable juices
• GF bagel and low-fat cream cheese
• Celery sticks with low-fat cream cheese
• Cottage cheese with dill and fresh pepper or with fruit
• Pudding, made with low-fat milk
• Veggies (e.g. mini carrots, cherry tomatoes, peppers, cucumbers, broccoli, cauliflower) and yogurt dip or GF low-fat salad dressing
• String cheese and GF crackers
• GF muffin (made with banana, carrot/pineapple, pumpkin) and yogurt drink

Shelley Case is a consulting dietitian and author of Gluten-Free Diet: A Comprehensive Resource Guide. She is on the advisory boards of the Canadian Celiac Association, the Celiac Disease Foundation and Gluten Intolerance Group.

Thank you for understanding that Shelley won’t be able to answer every question received. The editors at Allergic Living highly recommend her book Gluten-Free Diet, a vital resource for those interested in celiac disease and living gluten-free.

For more information about oats in the GF diet see:

www.celiac.ca
www.glutenfreediet.ca

A: Dermatitis herpetiformis is a skin disease caused by an intolerance to gluten. It is a form of celiac disease, the inherited autoimmune intestinal disorder that affects between one in 100 and one in 200 people worldwide. Gluten, found in the grains wheat, rye and barley, damages the small intestine and can also affect other body systems, such as the skin. About 10 per cent of celiacs will also have dermatitis herpetiformis (DH).

Although most people with DH have varying degrees of small intestinal damage, many will have no or few bowel complaints typically associated with celiac disease.

The DH skin rash burns and itches intensely. It is symmetrically distributed and usually found on the elbows, knees and buttocks. It also can appear on the back of the neck, upper back, scalp and hairline. Groups of small blisters will form that will erupt into small red lesions.

The condition typically appears between the ages of 20 to 45, but can occur at other times. It is most common in people of northern European descent and rare in Asians and African-Americans.

DH is often misdiagnosed as other skin conditions such as herpes, eczema, contact dermatitis, hives or psoriasis and treated with a variety of topical creams. The only way to diagnose DH is a skin biopsy from unaffected skin adjacent to blisters or lesions. A biopsy of the small intestine, normally used to diagnose celiac disease, is not essential if the skin biopsy tests positive for DH.

Next: Managing dermatitis herpetiformis

A: Quinoa (pronounced “keen-wah”) was a staple of the Incas who called it “the mother grain”. It is not actually a grain but a seed from a broad-leafed plant that is closely related to the weed lamb’s quarters and to spinach. Numerous varieties are grown in South America, and more recently in North America as well.

The quinoa seed looks like a cross between millet and sesame seed and is protected by a bitter, resin-like substance called saponin, which should be rinsed off before cooking. Some companies remove the saponin (like NorQuin brand) making it pan-ready, but quinoa is sold in several forms. (See below.)

It is a nutritious, gluten-free alternative that contains more high-quality protein than any other grain or cereal. In fact, its protein quality is comparable to that of dried skimmed milk. Quinoa is also high in iron, magnesium, phosphorus and zinc, and is a source of calcium, B vitamins and fibre.

How to Use:
• side dish instead of potatoes or rice
• in salads or pilafs, stuffing, casseroles
• thickener for soups, stews and chili

Cooking Tips
• rinse quinoa in cold water, drain.
• In a saucepan with a tight lid, bring 1 cup of quinoa and 2 cups liquid to a boil. Simmer for 15 minutes or until liquid is absorbed.
• let stand covered for 5 minutes.
Makes 3 cups.

How to Use:
• breakfast cereal
• substitute for up to 1/3 of the g-f flour in a cookie, muffin or bread recipe
• add to pancakes or waffles

Cooking Tips:
• add 1⁄3 cup flakes to 1 cup boiling water and boil 1 ¹⁄_² to 2 minutes, stirring frequently.
• remove from heat and cool. Then add chopped nuts, dried fruits and brown sugar.
• Or in microwave: high heat for 2 to 2 ¹⁄_² minutes.

How to Use:
• in baked items such as breads, muffins, pancakes, cookies, biscuits

Cooking Tips:
• has a slightly nutty, strong flavour so best combined with other g-f flours. Use no more than 25 per cent quinoa flour in recipe

How to Use:
• as a side dish or in salads

Cooking Tips:
• Follow directions on package.
Cooking time varies.

A: Celiac disease, also known as celiac sprue or gluten sensitive enteropathy, is an inherited digestive disorder affecting between one in 100 and one in 200 people worldwide. With this disease, specific proteins in wheat, barley and rye (collectively known as “gluten”) damage a person’s small intestine, so nutrients are not well absorbed. Gluten can also affect other parts of the body.

The symptoms are many, and vary in different individuals. They range from abdominal pain and bloating, to nausea, diarrhea or constipation, migraines, difficulty digesting lactose, weight loss or easy bruising. Since these symptoms can be common to other conditions, people with CD are often misdiagnosed with irritable bowel syndrome, lactose intolerance, chronic fatigue syndrome, diverticulosis (a condition of weakness in the walls of the colon), ulcers or allergies. Those with CD often suffer for years before a correct diagnosis is made.

Celiac disease can develop at any age, even in the senior years. It may be triggered by a viral or gastrointestinal infection, pregnancy, severe stress or surgery. If CD is untreated, it can cause nutritional deficiencies and increase the risk of osteoporosis, intestinal cancers, neurological disorders, infertility, as well as possible development of other autoimmune disorders. Celiac disease can occur in combination with Type 1 diabetes, auto-immune thyroid disease, autoimmune hepatitis, Down syndrome and Turner syndrome. If a person has any of these disorders and celiac symptoms or a family history of CD, that person should be screened for the disease.

Once a family doctor suspects CD, you should be tested. The doctor can order specific blood screening called tissue transglutaminase (TTG) and endomysial antibody (EMA). However, these tests are not 100 per cent accurate, the only way to be certain that you have CD is to undergo an intestinal biopsy. This procedure should be done by a gastroenterologist in a hospital outpatient setting. It is essential to get the testing done before starting on the GF diet, as this can interfere with making an accurate diagnosis.

Once the diagnosis is confirmed, the person with CD must stop eating all foods and ingredients derived from wheat, rye and barley. This is challenging as gluten is found in a wide variety of foods. Fortunately, many foods are naturally gluten-free, including plain meat, fish, poultry, eggs, legumes, nuts, dairy products, fruits and vegetables, and as well there are gluten-free flours and starches that can be substituted for wheat, rye and barley. And if you do prove to have CD, you will also come to appreciate the numerous gluten-free specialty products now on the market.

Celiac Symptoms

• abdominal pain, bloating and gas
• indigestion/reflux (heartburn)
• nausea and vomiting
• diarrhea, constipation or both
• lactose intolerance
• weight loss (CD can occur in obese individuals)
• chronic fatigue and weakness
• iron, folate and/or vitamin B12 deficiency
• other vitamin and mineral deficiencies
• bone and/or joint pain
• easy bruising of the skin
• swelling of hands and feet
• migraine headaches
• canker sores
• menstrual irregularities
• infertility (in both women and men)
• recurrent miscarriages
• elevated liver enzymes

Additional Symptoms in Children

• irritability and behavioural changes
• concentration and learning difficulties
• failure to thrive (delayed growth and short stature)
• delayed puberty
• dental enamel abnormalities

Charts from: Gluten-Free Diet by Shelley Case

Shelley Case, RD, is an international celiac nutrition expert, consulting dietitian and author of Gluten-Free Diet: A Comprehensive Resource Guide. See www.glutenfreediet.ca. Shelley Case is on the advisory boards of the Canadian Celiac Association, the Celiac Disease Foundation and the Gluten-Free Intolerance Group.The editors at Allergic Living additionally highly recommend her book Gluten-Free Diet, a vital resource for those interested in celiac disease and living gluten-free.

A: Gluten-free diets can be limited in variety, with white-rice bread, rice cakes, rice crackers and white rice as staples. Also, many commercial gluten-free products such as breads, cereals, pasta and flours are low in iron, B vitamins and fibre because they are made with refined flours and starches such as white rice flour, cornstarch, tapioca and/or potato starch. Following are some tips to help boost the quality of your diet.

Go for Enriched: Food regulations in Canada and the United States allow for enrichment of gluten-free foods. Check the ingredient listing to see if a product contains added vitamins and minerals.

Whole Grains, Fibre: Incorporate whole grains into your diet wherever possible. They contain the entire grain seed – the bran, germ and endosperm, which has more vitamins, minerals, protein and fibre than refined grains. Fibre can play a role in the prevention of coronary artery disease, diabetes and colon cancer. To prevent abdominal pain and gas, gradually increase your fibre intake and drink plenty of fluids.

Iron and Bones: Those newly diagnosed with celiac disease often have iron deficiency anemia because they have not been able to absorb adequate iron and other nutrients. A strict gluten-free diet will allow the intestinal villi to heal and nutrients to be absorbed properly. But the length of time for this varies, so it’s important to get plenty of iron-rich foods. Bone disease is common in those with celiac disease. You should eat three to four servings of low-fat milk products each day. If you are unable to consume enough dairy products, talk to your doctor or dietitian about calcium and vitamin D supplements.

Shelley Case, RD, is an international celiac nutrition expert, consulting dietitian and author of Gluten-Free Diet: A Comprehensive Resource Guide. See www.glutenfreediet.ca. Shelley Case is on the advisory boards of the Canadian Celiac Association, the Celiac Disease Foundation and the Gluten-Free Intolerance Group. The editors at Allergic Living additionally highly recommend her book Gluten-Free Diet, a vital resource for those interested in celiac disease and living gluten-free.