Original article posted on Everyday Health by Madeline Vann, MPH. Medically reviewed by Farrokh Sohrabi, MD.
If you have celiac disease, you may respond strongly and negatively to even small amounts of gluten. So you scour packaged foods labels before you buy, and you question your servers carefully at restaurants. But you might be surprised to learn that certain products, including non-food items, can contain various forms of hidden gluten. And while the U.S. Food and Drug Administration (FDA) has developed and will soon begin implementing “gluten-free” labeling standards for food products, these standards do not apply to every item that could contain gluten.
Sniffing out hidden gluten may require some extra attention. Here are some sources to put on your radar.
Medications. This one may surprise you. “When you look at the word gluten, think glue. It is often used as a binder,” explains Alice Bast, executive director and founder of the National Foundation for Celiac Awareness. The group has successfully educated the public about the issue, leading to an effort on the part of the FDA to address medication labeling, which today does not include specific mention of gluten or wheat products.
Bast acknowledges it can be difficult to figure out whether a medication has gluten in it or not. In general, she says, generics seem more likely to contain traces of gluten.
Beauty products. Research presented at the 2011 annual meeting of the American College of Gastroenterology demonstrated how difficult it is for consumers to find out whether their beauty products contain forms of gluten. Even though you’re not actually eating cosmetics, even a small amount of gluten in a lip balm could cause a problem — think of how often you bite or lick your lip. Researchers have raised the question of whether gluten-containing lotions and moisturizers might trigger a response in the skin of a person with celiac disease. The investigation was prompted by case studies of two women who had contact irritation on their skin that went away when they stopped eating gluten in their diet and stopped using beauty products containing gluten. In beauty products, hydrolyzed gluten is used to make both emulsifiers and stabilizers. This is an area of research that requires further exploration, but people with celiac disease who want to live a gluten-free lifestyle should be aware of the ingredients in their cosmetics.
Vitamin supplements. As with prescription medications and cosmetics, gluten may appear in vitamin supplements purely as a binding agent, says Bast.
Pickles. “The problem with pickles is beer,” says Bast. And you thought you were being so good by cutting out the suds. Some pickling processes include malt vinegar (a beer-like liquid), which may contain gluten.
Bouillon cubes. This seemingly harmless soup base can be a gluten landmine. As with many packaged spice combinations, you’ll find gluten in some bouillon cube brands. The ingredient to avoid is maltodextrin, a gluten product. A better bet, if you have the time, is to make your own stock on a Sunday afternoon and freeze it in containers for future soups and stews.
Gravy. Homemade gravies made with flour are obvious sources of gluten, but so are many instant gravy packets, making this cooking convenience not so helpful after all. At home, you can use cornstarch as a thickener. Away from home, it might be best to skip the gravy.
Bleu cheese. There are conflicting messages about these blue-veined cheeses. Bread mold may be used to make them, but any potential gluten they contain is a miniscule amount, below the 20 parts per million considered the FDA uses as a cut-off for “gluten free” labeling. However, if you really like cheese, Bast suggests opting for a hard cheese instead.
Hot dogs. Yes, your favorite ballpark snack could be hiding gluten. Read package labels to find a variety without it.
Soy sauce. Wheat is perhaps the last thing you associate with salty soy sauce, but it is a key part of the manufacturing process, making the condiment problematic for people with celiac disease and gluten insensitivity. Try gluten-free tamari instead.
Frozen veggies in sauce. What could be easier than popping a bag of frozen vegetables into the microwave and getting back a hot, tasty side dish? Check the ingredients first — many of the sauces contain gluten products or soy sauce. Look for unadulterated frozen vegetables when shopping.
Hot chocolate. There’s something so comforting about a warm cup of hot cocoa on a cold day — if you’ve made it yourself from scratch with cocoa, sweetener, and milk. Beware of handy prepackaged cocoa mixes, which may be processed on machines exposed to wheat products and subject to gluten cross-contamination. Good news when making your own steamy brew: If you love to toss in marshmallows, rejoice — they are gluten free.
French fries. When you eat out, you also run the risk of cross-contamination, Bast points out. While an order of French fries is gluten-free (made from potatoes, oil, and salt), if the fries are dipped in the same frying oil as breaded onion rings or hush puppies, it’s gluten-free no longer. Ask before you order.
Items labeled “wheat free.” Gluten comes from wheat, right? So that labeling should make shopping easy. However, says Bast, gluten also comes from other grains and grain combinations, including spelt, barley, and rye. So, just because a product is labeled wheat free doesn’t mean it is gluten-free.
While it might seem like there’s something watch for on every grocery-store aisle, your choices aren’t as limited as you might think. “Go with whole foods if you possibly can,” Bast advises. Yes, you’ll have to prepare meals from fresh ingredients, but you’ll gain control over what you eat and how it tastes. For non-food products, make sure you read labels and do your detective work to protect your overall health.
Do you know of any other foods that contain hidden gluten? Please share them in the comments.