Before starting the analysis of the various food groups, let us briefly recall WHAT CELIAC is. CELIAC is a GENETIC CONDITION of INTOLERANCE towards a PROTEIN COMPLEX called GLUTEN and, in particular, of the GLIADINE component.
CELIAC is characterized by extremely DIFFERENT clinical pictures. The pathological mechanism affects first of all the INTESTINAL MUCOSA; this, once exposed to gluten (and therefore to gliadin) activates an AUTOIMMUNE process (ie mediated by ANTIBODIES) and a subsequent more or less severe and evident INFLAMMATORY reaction.
By virtue of its CLINICAL HETEROGENEITY, CELIAC can be classified into: TYPICAL, ATYPICAL, SILENT, LATENT and POTENTIAL; as can be deduced, it is not so easy to understand whether or not you are suffering from this food intolerance. However, thanks to scientific research, screening and popular information, today it is possible to estimate that 1 ITALIAN IN 100 IS AFFECTED BY CELIAC.
The CURE of celiac disease is represented by the so-called GLUTEN-FREE DIET, composed exclusively of FOODS FREE (and NOT with LITTLE…) GLUTEN inside them. This need is NOT UNMOTIVE and arises from the fact that, sometimes, gluten is able to activate the immune response of the intestinal mucosa even at VERY LOW CONCENTRATIONS.
Gluten is a peptide complex made up of TWO separate PROTEINS, namely GLYADIN and GLUTENIN. These polymers, if placed in conditions to interact, COMBINE with the presence of WATER and form a COLLOSO and ELASTIC network. This reaction is the BASE of the LEAVENING process used in the so-called BAKERY PRODUCTS.
We have said that gluten is a typical protein of some cereals ... BUT WHICH?
The cereals CONTAINING gluten are: ALL i WHEAT, BARLEY, OATS, RYE and HYBRIDS such as TRITICALE ... Where WHEAT means cereals belonging to the Genus TRITICUM, that is: DURUM WHEAT, SOFT WHEAT, SPELLED, MONOCOCCO (or SMALL SPELLED), SPELTA (or LARGE SPELLED) and certain HYBRIDS or particular cultivars such as KAMUT.
Gluten is therefore present in all the cereals from which the FLOURS ABLE TO LEAVE are obtained.
However (and UNFORTUNATELY!), Human nutrition is NOT ONLY made up of RAW foods, or to be consumed WITHOUT further processing (such as, for example, whole and whole grains). RATHER! Nowadays, there are many more refined foods, ground, blended and, in general, ARTIFACTS.
This consideration, apparently BANAL, is instead FUNDAMENTAL to understand that: among the food sources of GLUTEN, in addition to the RAW MATERIALS ALREADY MENTIONED, their FLOURS, REFINING PRODUCTS and EXTRACTION PRODUCTS (such as starch, proteins and bran). These, in addition to acting as an INGREDIENT, can further undermine the group of FOOD ADDITIVES. Furthermore, EVEN THE GLUTEN-FREE RAW MATERIALS, IF processed in ENVIRONMENTS and FACTORIES exploited for the processing of cereals containing the UNWANTED protein, can be contaminated and act as an HIDDEN vehicle for GLUTEN in the diet. Then, the same theory is to be considered valid in CROSS CONTAMINATION within PROFESSIONAL COOKING WORKSHOPS (as in restaurants) but also within the home.
In light of all this, it is therefore deductible that the gluten-free diet for celiacs must be managed on the basis of a TETRA-VALENTE control, that is: USE OF GLUTEN-FREE RAW MATERIALS, USE OF RAW MATERIALS NOT CONTAMINATED BY GLUTEN IN THE PRODUCTION CYCLE, USE OF RAW MATERIALS WITHOUT ADDITIVES WITH GLUTEN and CONSUMPTION OF FOOD NOT CONTAMINATED BY GLUTEN IN THE CULINARY PREPARATION.
In the next slide we will see more precisely which foods CONTAIN GLUTEN and therefore prohibited for celiacs.
This is the LIST of foods CONTAINING GLUTEN drawn up by the AIC (the Italian Celiac Association). Without listing them all, I suggest paying more attention to those classified in food groups other than cereals and MA derivatives which, by formulation, contain flour or refined ones. Some examples are: BREADED meat, fish, cheeses or vegetables, minestrone and soups WITH PROHIBITED cereals, dehydrated and FLOURED fruit, non-alcoholic drinks with oats, barley coffee substitutes, beer and many others.
Cereals, Flours and Derivatives
- Flours, starches, semolina, meal, creams and flakes of prohibited cereals
- First courses prepared with forbidden cereals (pasta, stuffed pasta, potato gnocchi, Roman-style gnocchi, pizzoccheri, crepes)
- Bread and substitute bakery products, sweet and savory, prepared with prohibited cereals (breadcrumbs, breadcrumbs, focaccia, pizza, wraps, panzerotti, breadsticks, crackers, rusks, taralli, croutons, pretzels, cracotte, biscuits, snacks, pastries , cakes)
- Wheat germ
- Flours and ethnic derivatives: bulgur (or boulgour or burghul), couscous (from prohibited cereals), cracked wheat, frik, greis, greunkern, seitan, tabulè
- Bran of prohibited cereals
- Malt from prohibited cereals
- Forbidden cereal-based breakfast products (puffed, flaked, muesli, porridge)
- Polenta taragna (if buckwheat flour is mixed with wheat flour)
- Breaded meat or fish (cutlet, sticks, fried fish, etc.) or floured or mixed with breadcrumbs (hamburgers, meatballs, etc.) or cooked in gravies and sauces thickened with prohibited flours
- Ready-made cheese-based dishes breaded with prohibited flours
- Malted yoghurt, cereals, biscuits
- Milk with cereals, biscuits
- Oat-based drinks
- Vegetables (minestrone, soups, etc.) with prohibited cereals
- Breaded, floured, battered vegetables with prohibited ingredients
- Floured dehydrated fruit (dried figs etc.)
- Oat drinks
- Instant coffee or coffee substitutes containing prohibited grains (e.g. barley or malt)
- Forbidden cereal-based beverages and preparations (eg malt, barley, rye); soluble barley and similar products
- Barley and / or wheat malt beer
- Chocolate with cereals
- Cakes, biscuits and sweets prepared with prohibited flours and / or unsuitable ingredients
- Natural yeast or mother yeast or sour yeast
- Seitan.
It would therefore be possible to eat in an optimal way and without any deficiency while TOTALLY excluding gluten from the diet but, as we have already said, the risks of contamination are really many.For this reason, in addition to verifying the possible presence of gluten in the ingredients and additives, it is DETERMINING to assess the risk of CONTAMINATION at an INDUSTRIAL level.
Here in the slide (and once again available in the description cited on our web page as well as taken from the same source), we report the list of GLUTEN-FREE foods and therefore defined SAFE for CELIAC.
In the two previous SLITES we have already underlined how to evaluate the food SAFETY of the various gluten-free products. Without going too far, I invite listeners to dwell in particular on the foods belonging to the III ° group that represent THE SUBSTITUTION PAR EXCELLENCE of those prohibited, that is, CEREALS that DO NOT contain gluten.
Cereals, Flours and Derivatives
- Rice in grains
- Corn (maize) in grains
- Buckwheat in grains
- Amaranth in grains
- Manioc
- Millet in seeds
- Quinoa in seeds
- Sorghum in grains
- Teff in beans
- Gluten-free dietary products (e.g. mix of flours, bread and bread substitutes, pasta)
- All types of meat, fish, molluscs and crustaceans as such (fresh or frozen) not mixed with other ingredients
- Preserved fish: natural, in oil, smoked, free of additives, flavorings and other substances (with the exception of sulphites)
- Egg
- Pasteurized liquid eggs (whole, yolks or egg whites) free of additives, flavorings and other substances (unflavoured)
- Raw ham
- Lardo di Colonnata IGP and Lardo d "Arnad DOP
- Milk: fresh (pasteurized), long-life (UHT, sterilized), delactosed or highly digestible, with no added flavorings or other substances (with the exception of vitamins and / or minerals)
- Baby milk (0-12 months)
- Fermented milk, probiotics (containing only milk / yogurt, sugar and lactic ferments)
- Fresh and aged cheeses
- Natural yogurt (low-fat or whole)
- Creamy white yogurt without the addition of thickeners, flavorings or other substances (containing only yogurt, sugar and lactic ferments)
- Greek yogurt (containing only milk, cream and lactic ferments) without added flavorings or other substances
- Cream: fresh (pasteurized) and long-life (UHT) not mixed with other ingredients, except carrageenan (E 407)
- All types of vegetables as is (fresh, dried, frozen, deep-frozen, freeze-dried)
- Vegetables, preserved mushrooms (in brine, pickled, in oil, in salt) if they consist solely of: vegetables and / or mushrooms, water, salt, oil, vinegar, sugar, sulfur dioxide, ascorbic acid, citric acid
- Fresh, dried, frozen mushrooms as they are
- All legumes as they are (fresh, dried and canned): carob, chickpeas, cicerchia, beans, broad beans, lentils, lupins, peas, soy
- Preparations for minestrone (frozen, fresh, dried) consisting solely of vegetables
- All types of fruit as it is (fresh and frozen)
- All types of nuts with and without shells (as is, toasted, salted)
- Dehydrated, dried non-floured fruit (dates, figs, prunes, sultanas, etc.)
- Fruit in syrup
- Smoothies, mousses and fruit purees consisting solely of fruit, sugar, ascorbic acid (E300 or vitamin C) and citric acid (E330)
- All types of fruit as it is (fresh and frozen)
- All types of nuts with and without shells (as is, toasted, salted)
- Dehydrated, dried non-floured fruit (dates, figs, prunes, sultanas, etc.)
- Fruit in syrup
- Smoothies, mousses and fruit purees consisting solely of fruit, sugar, ascorbic acid (E300 or vitamin C) and citric acid (E330)
- Coffee, decaffeinated coffee, coffee pods
- Sachet, filter of: coffee, decaffeinated coffee, chamomile
- Sachet, filter (also flavored) of: tea, decaffeinated tea, herbal teas
- Sparkling wine
- Distillates (cognac, gin, grappa, rum, tequila, whiskey, vodka) with no added flavorings or other substances
- Honey, sugar (white and brown)
- Raw licorice root
- Maltodextrin and glucose syrups, including dextrose also derived from prohibited cereals
- Pure Fructose
- Butter, lard, cooking lard, cocoa butter
- Vegetable oils
- Wine vinegar (unflavored)
- Traditional Balsamic Vinegar DOP: from Modena, Reggio Emilia; Balsamic Vinegar of Modena PGI
- Apple cider vinegar
- Fresh, freeze-dried, dry yeast (beer)
- Yeast extract
- Agar Agar in leaves
- Royal jelly, pollen
- Tomato puree, peeled tomatoes and tomato concentrate not mixed with other ingredients except ascorbic acid (E300 or vitamin C) and citric acid (E330)
- Pepper, salt, saffron, spices and aromatic herbs as they are.
It includes foods of various kinds that are produced in mixed establishments or potentially subject to gluten pollution.
Cereals, Flours and Derivatives
- Flours, starches, starches (e.g. cornstarch), groats, meal, creams and flakes of permitted cereals
- Flour for pre-cooked and instant polenta, ready-made polenta
- Malt, malt extract from permitted cereals
- Malt extract from prohibited cereals
- Tapioca
- Wheat starch swallowed
- Permitted cereal-based breakfast products (puffed, flaked, muesli)
- Waffles, cakes of permitted cereals
- Bran of allowed cereals
- Vegetable and dietary fibers
- Packaged popcorn
- Ready risottos (in bags, frozen, flavored)
- Couscous, tacos, tortillas from permitted cereals
- Cured meats and sausages of pork, beef or poultry (bresaola, coppa, cotechino, lard, mortadella, pancetta, cooked ham, salami, sausage, speck, frankfurter, zampone, sliced chicken or turkey, etc.)
- Meat preserves (e.g. canned meat, in jelly)
- Hamburger
- Preserved fish: natural, in oil, smoked, with the addition of other substances (excluding sulphites)
- Homogenized meat, fish, ham
- Ready-made or pre-cooked dishes based on meat or fish
- Flavored pasteurized liquid eggs (whole, yolks or egg whites)
- Eggs (whole, yolks or whites) powder
- Surimi
- Cream: long-life (UHT) seasoned (with mushrooms, salmon, etc.), whipped, spray, vegetable
- Fruit yoghurt "flavored ... ..", creamy
- Creamy white yogurt with added thickeners, flavorings or other substances
- Greek yogurt with added thickeners, flavorings or other substances
- Soy yogurt, rice
- Sliced, melted, light, spreadable, vegetable cheeses (e.g. tofu)
- Creams, puddings, desserts, milk-based panna cotta, soy, rice
- Milk powder
- Condensed milk
- Milk fortified / enriched with fiber, cocoa, flavorings or other substances (except vitamins and / or minerals)
- Growth milk (1-3 years)
- Milk, soy, rice, almond based drinks
- Homogenized cheese
- Preparations for minestrone consisting of vegetables and other ingredients
- Mashed vegetables
- Soups and broths with permitted cereals
- Ready meals based on pre-cooked frozen vegetables (e.g. vegetables and cheese)
- Pre-fried, pre-cooked frozen potatoes
- Bag-packed potato chips (snack)
- Instant or frozen puree
- Preserved and mixed vegetables with other ingredients
- Homogenized vegetables
- Candied, glazed, caramelized fruit
- Smoothies, mousses and fruit purees mixed with others in gradients
- Homogenized fruit
- Light drinks
- Fruit drinks
- Milk, soy, rice, almond based drinks
- Ginseng coffee flavored drinks
- Milkshakes (ready-made mixes, in powder)
- Saline supplements (liquid, powder)
- Nectars and fruit juices with added vitamins or other substances
- Preparations for chocolate / cocoa drinks, cappuccino
- Syrups for soft drinks and slushes
- Effervescent for drinks
- Ginseng coffee, ginseng coffee flavored drinks
- Instant coffees
- Waffles for hot drinks
- Tea, chamomile, herbal teas (liquid and powdered preparations)
- Alcoholic beverages added with aromas or other substances (eg liqueurs, distillates added with other substances
- Permitted cereal beers and some types of barley and / or wheat malt beer
- Cocoa powder
- Candies, candied fruit, sugared almonds, jellies, chewing-gum
- Chocolate (with and without filling), chocolate and / or hazelnut spreads
- Cake decorations (pralines, sprinkles)
- Sweeteners
- Industrial or artisanal ice cream, semi-finished products for homemade / ice cream parlors
- Jams and marmalades
- Marrons Glacées
- Nougat, crunchy, marzipan
- Powdered sugar, flavored
- Flavored vinegar, balsamic dressing (non-DOP, non-IGP balsamic vinegar)
- Bechamel
- Light butter, margarine and light margarine
- Condiments with an undefined composition
- Ready sauces (ragù, pesto, etc.)
- Sauces (mayonnaise, mustard, ketchup, etc.), paté, anchovy paste
- Mustard
- Nuts, broth preparations, extracts (meat and vegetable)
- Flavoring seasonings
- Agar-Agar in powder, in bars
- Gelatine
- Gelatin
- Chemical yeast (raising agents)
- Fresh liquid beer yeast
- Soy lecithin
- Miso, tamari, soy sauce
- Curry
- Tofu
- Vanillin
- Food supplements.
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