Wheat free diet

Wheat free diet

Introduction

This booklet provides advice for adults or children who need to follow a diet that is
completely free from wheat and wheat products. Wheat is an important carbohydrate
source and contains nutrients such as fibre, B vitamins, calcium, iron and folate so it is
important to find suitable alternatives.

It is designed for use by people with a suspected or proven wheat allergy or
intolerance.

Wheat allergy involves the immune system. Allergic reaction to wheat may occur
within minutes or several hours after eating or inhaling wheat. Symptoms can include,
eczema, urticaria, diarrhoea, constipation, abdominal pain, asthma symptoms,
swelling of the face, eyes, lips or tongue. Skin prick tests or blood tests can be
performed by the allergy specialists to help with diagnosing wheat allergy.

Wheat Intolerance does not involve the immune system. Symptoms can occur hours
or even days after eating wheat and are usually less severe than wheat allergy. Typical
symptoms include wind, bloating, abdominal pain, diarrhoea, nausea, stomach
gurgling, urgency and constipation.

At present, the most reliable way of diagnosing intolerance is by exclusion of the
suspect food for a set period of time and then gradual reintroduction to see if it causes
a reaction.

Coeliac disease is not a wheat allergy or intolerance. It is a disease caused by a
reaction to the protein (gluten) found in wheat, barley and rye. This diet sheet is
therefore not suitable for someone with coeliac disease.

Wheat is present in a wide variety of foods including flour, pasta, many breakfast
cereals, cakes, biscuits and in many manufactured foods including processed meats,
fish, ready meals, sauces, desserts and hot drinks.

EU food labelling laws require that labels must clearly state whether wheat and other
common allergens are being used as ingredients in a food product. If you travel
outside the EU, be aware that labelling laws are different and may not always list
wheat as an ingredient.

Allergens are usually highlighted in bold or italic writing in the ingredients list.
Manufacturers do change their ingredients therefore it is safer to check from time to
time.

Food sold without packaging such as in a bakery, café or pub allergen information has
to be provided either in writing or verbally.

By strictly avoiding all sources of wheat from your diet it may be possible to find out if
wheat is causing your symptoms.

Your Dietitian or Doctor will advise you how long to follow the diet.

Wheat and wheat products are found in a variety of foods as wheat flour and wheat
starch are often used as thickening agents or fillers.

Foods containing the following ingredients should be avoided:

Checking Food Labels

You may see the following phrases on food labels which can help you to choose
appropriate wheat free products.

CHOOSE

• Wheat-Free.
• Free from wheat.

AVOID

• Contains wheat.
• May contain wheat.
• Not suitable for wheat allergy suffers
• ‘May contain’ or ‘made in a factory….’

Check labels each time you buy as:-

• Recipes change frequently.
• Different batches and packet sizes may be produced in separate packing /production areas with different risks of cross contamination with wheat starch.

If there is no allergy statement on the label, do not assume the product is safe to eat.

Where can I buy Wheat-Free Products?

Supermarkets provide many reasonably priced wheat-free products e.g. bread, flours,
cereals, cakes and biscuits.

Supermarkets may also provide a list of their own brand wheat-free products on
request or as a download from the internet. This may give you ideas and save time in
the supermarkets. Always refer to the most up to date list and always check the label
each time you buy.

You can also try specialist health food shops if you are unable to find everything you
need at the local supermarket.

Foods to CHOOSE, CHECK and AVOID – bread, rice, potatoes, pasta and other starchy food. Try to eat with every meal.

Foods to CHOOSE, CHECK and AVOID.

Foods to CHOOSE, CHECK and AVOID – meat, fish, eggs, beans and other non-dairy sources of protein. Try to eat 2-3 portions each day.

Fruit and Vegetables – Try to eat at least 5 different portions per day.

Milk and Dairy Foods – Try to eat 3 portions a day, choose low-fat options wherever you can.

Foods to CHOOSE, CHECK and AVOID – Foods high in fat and / or sugar. Try to limit these foods.

Foods to CHOOSE, CHECK and AVOID.

OTHER

DRINKS

Meal / Snack Ideas

Breakfast

• Wheat-free cereal, porridge, Cornflakes, Rice Krispies or wheat-free muesli with milk. Serve with fresh or dried fruit e.g. sliced banana, raisins or apricots.
• Permitted yogurt with fresh or dried fruit.
• Wheat free bread or toast, with butter/margarine and jam/marmalade/honey, and a glass of fruit juice.
• Cooked breakfast – egg, bacon, tomato, mushrooms with wheat-free toast or homemade potato cakes and glass of orange juice.
• Scrambled / boiled egg with wheat free crumpets and glass of orange juice.

Light Meals

Sandwiches made from wheat free bread / bagel / pitta with:-

• Egg and salad.
• Tuna/salmon and cucumber.
• Ham or roast beef and salad.
• Chicken and salad.
• Cheese and pickle.

Baked potato with:-

• Cottage cheese and pineapple.
• Chilli con carne.
• Tuna mayonnaise and Sweetcorn.
• Egg mayonnaise and cress.
• Homemade coleslaw and cheese.
• Wheat-free baked beans.

Wheat-free soup with wheat-free bread/roll

Filled omelette, with side salad.

Ploughman’s lunch with oatcakes or wheat-free bread.

Meal / Snack Ideas

Snacks

• Yoghurt (not muesli type or ones containing wheat germ).
• Oatcakes or permitted crispbreads with margarine or preserve.
• Fresh fruit, dried fruit and nuts.
• Plain crisps, popcorn or rice cakes.

Main Meals

• Minced beef casserole or stew thickened with corn flour, mashed potatoes and carrots and peas.
• Roast chicken / pork / beef, roast potatoes, sweet-corn, carrots and gravy made with corn flour.
• Grilled salmon with new potatoes, baby corn and green beans.
• Ham risotto with mixed side salad.
• Lentil / chicken / beef curry (using pure spices) served with boiled rice and salad.
• Grilled gammon steak, boiled potatoes and peas
• Chilli con carne (using pure herbs and spices and thickened with corn flour). Boiled wholegrain rice and side salad.
• Spaghetti Bolognese using wheat-free pasta and served with side salad.
• Chicken stir-fry with rice noodles.

Desserts

• Stewed fruit and custard made with wheat free custard powder.
• Baked apple with cream.
• Fresh fruit salad/ tinned fruit and natural yogurt.
• Fruit jelly and fresh cream.
• Raspberry Pavlova.
• Sorbet.
• Wheat-free ice-cream and fruit.
• Home-made rice pudding.

Cross Contamination

Food can become cross contaminated with wheat flour or wheat containing products at
home or in commercial production.

Clean utensils, work surfaces and chopping boards thoroughly.

It is advisable to use a separate toaster, clean grill pan or toaster bags to make toast
and to have separate jam, spreads, and margarine.

It is also important to check any medicines and supplements to ensure they are wheat-free.

Eating out

• Eating out on a wheat free diet is still possible.
• Ring the restaurant in advance to ask if they can cater for food allergies. Speak with waiter/waitress/chef on arrival.
• Check out the restaurants website if available.
• Avoid busy periods to help give staff more time to check ingredients properly.
• Keep to simple foods on the menu. Sauces and gravies contain many ingredients which may not be remembered by the staff.
• In self service areas; be aware of cross contamination.
• Carry any rescue medication with you.
• If eating with friends or at a party remember to discuss your allergy with the host in advance. It may be helpful to take some wheat free foods with you.

Travelling

• If you are travelling abroad, check in advance how to describe your allergy in the local language. There are various websites that can help with translation (www.dietarycard.co.uk, www.allergyuk.org/getting-help/translation-cards)
• If you are flying, speak to your airline/hotel in advance to check if they can meet your dietary needs.
• Consider taking suitable snacks for the journey in case your flight is delayed.
• Try to obtain a letter from your Doctor explaining your need to take special food items or medications e.g. adrenaline autoinjector.
• Ensure you always carry some sort of allergy ID.
• Carry contact numbers for local hospital or emergency services with you in case you need it.

Recipes

Pizza base

Ingredients: Makes 2 medium (8”/20cm)
150g (5oz) rice flour
150g (5oz) potato flour
Pinch of salt
1 tsp gluten/wheat free baking powder
½ tsp xanthum gum
½ tbsp. sunflower oil
½ tbsp. olive oil
½ tsp. sugar
200ml (7 fl oz) warm water

Method:
Preheat oven to 220°C/425°F/Gas Mark 7. Mix all dry ingredients together. Add the oils
and warm water and bring together and knead into a ball. Split into two and roll into 8”
round bases approximately 2mm thick or for mini party size use a 3” pastry cutter. Use
extra rice flour to prevent from sticking. Top with tomato puree and chosen toppings.
Bake on a tray in oven for 15 minutes for 8″ bases or 8 minutes for 3″ bases.

White sauce

Method:
Use approximately 15g (1/2 oz) cornflour to 280ml (1/2 pint) milk. First mix the
cornflour with a little cold milk to prevent lumps forming. Heat the remaining milk in a
pan. Add a small amount of the hot milk to the cold milk and stir. Stir whilst adding this
mix to the remaining hot milk in the pan and cook through. Then add any flavouring,
e.g. grated cheese, black pepper.

Gravy

Method:
Use either homemade vegetable or meat juices, and thicken with arrowroot, soya, rice
or corn flour. To colour gravy use wheat free gravy browning.

Chocolate cake

Ingredients:
75g (3oz) margarine
5 tbsp. wheat free cocoa powder
100g (4oz) rice flour*
75g (3oz) ground almonds*
1 tsp. wheat free baking powder
225g (8oz) caster sugar
2 eggs

*If you are allergic to nuts then use 175g (7oz) self-raising pre-blended wheat free flour
instead of the rice flour and ground almonds.

Method:
Preheat the oven to 180°C/350°F/Gas Mark 4. Line a 20cm/8” cake tin with grease
proof paper. Beat together the fat and sugar until light and fluffy. Bring 100ml/3oz water
to the boil, pour onto the cocoa, mix well, and then beat into the creamed mixture.
Beat in the eggs, adding a spoonful of rice flour with each. Mix the baking powder into
the remaining rice flour and ground almonds and fold into the mixture. Spoon the
mixture into the tin and bake in the oven for approximately 35 minutes or till the cake is
firm to touch. Cool on a wire rack before cutting. Decorate as desired.

Cooking Tips

Be extremely accurate with weights and measures.

Xanthum gum is a useful ingredient to add to wheat free baking to improve texture.

Potato flour or cornflour can be used instead of wheat flour to thicken sauces.

Crushed cornflakes can be used as an alternative to breadcrumbs.

There are lots of wheat/gluten free recipes available online and in recipe books:
www.glutenfreegoodness.blogspot.co.uk
www.wheatfree.org
www.freefromfairy.com

Useful Contacts

www.allergyuk.org
www.anaphylaxis.org.uk
www.nhs.uk/conditions/food-allergy/
Www.bda.uk.com
www.gluten-freefoods.co.uk
www.goodnessdirect.co.uk
www.ogranglutenfree.co.uk
www.geniusglutenfree.com

Software apps which help you to find ‘free from’ food and drink using the camera on
smartphones:

www.foodmaestro.me
www.spoon.guru

Worcestershire Acute Hospitals NHS Trust

Covering the Alexandra Hospital, Redditch, Worcestershire Royal Hospital and
Kidderminster Treatment Centre.

Tel: 01905 733953

Email: wah-tr.paeds.diet@nhs.net

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best
placed to answer any questions or resolve concerns quickly. If the relevant member of
staff is unable to help resolve your concern, you can contact the PALS Team. We offer
informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can
investigate your concerns. You can make a complaint orally, electronically or in writing
and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Thursday from 8.30am to 4.30pm and
Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy
times, but messages will be returned as quickly as possible.

If you are unable to understand this leaflet, please communicate with a member of
staff.

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