Gluten Free Diet and Starch
The gluten-free diet is based on the complete elimination of wheat, barley, rye and products made from them. While oats are naturally gluten-free, they may be subject to cross-contamination in the fields where they are grown or during processing-packaging. Fresh fruits and vegetables, legumes, milk and dairy products; Food groups such as red and white meats and eggs do not contain gluten.
Carbohydrates make up 50-55% of our daily energy needs. Starch is also a type of carbohydrate. Starch, which is released as the main product of photosynthesis in plants, is the most common storage form of polysaccharides in plants. Although starch forms the basis of human and animal nutrition, it has an important place in our nutrition.
Starch is in the form of granules insoluble in cold water; It is the main component of many plant products such as maize, potatoes, rice and wheat. It consists of two types of molecules, amylose and amylopectin. Starch, which is the main component of many plant products such as corn, potatoes, rice and wheat, is divided into three as slow-digesting starch, fast-digesting starch and resistant starch. Resistant starch is known as the type of starch that is not digested by amylase enzymes and therefore is not absorbed in the small intestine. It is a good source of fiber as it is fermented by the gut microbiota. Pectin found in fruits and vegetables and B-glucan found in oats are types of soluble fiber. It has a positive effect on blood sugar control, cholesterol balance and protection of intestinal health.
Since resistant starch can be used in products produced for celiac patients, it is considered a functional food component. Resistant starch is about half of the starch in buckwheat, which is a gluten-free carbohydrate source. It is beneficial to increase fiber intake in gluten-free diet and to keep blood sugar more balanced. Resistant starch, which can also be added to gluten-free bakery products, helps to increase the porous structure in products. Celiac individuals should prefer products that are free from the risk of cross-contamination when consuming buckwheat.
Legumes, which are an important part of a gluten-free diet, also contain resistant starch. Legumes such as chickpeas, beans and lentils should be included in the diet twice a week to help meet the carbohydrate, vegetable protein and fiber needs in a gluten-free diet.
The starch that we see in the markets industrially is usually obtained from potatoes, wheat or corn. Even if potatoes and corn do not naturally contain gluten, cross-contamination may occur in these food products if they are not produced under appropriate conditions. When purchasing these products, brands that are declared gluten-free should be preferred.
Wheat Starch and Gluten Free Nutrition
Wheat starch is a white substance obtained from the endosperm in the germ of wheat grains. It is formed by the separation of starch and protein components of the grain. Whether or not wheat starch is gluten-free depends on how the wheat starch is processed. Wheat starch needs to go through an additional process to become gluten-free and eliminate gluten proteins. Although the maximum amount of gluten that can be found in a gluten-free diet varies from country to country; The FDA (Food and Drug Administration) also allows products containing wheat starch to be labeled gluten-free if the product contains less than 20 ppm of gluten per kilogram.
What is Modified Starch?
Modified starch is a starch derivative and is obtained by changing some properties of starch by undergoing physical or chemical processes. Most often this ingredient is made from corn. If it is derived from wheat starch, the modified starch may not be gluten-free.
What is Modified Starch? Modified starch is a starch derivative and is obtained by changing some properties of starch by undergoing physical or chemical processes. Most often this ingredient is made from corn. If it is derived from wheat starch, the modified starch may not be gluten-free.
Starch in Medicines Patients with celiac disease have gluten sensitivity and should avoid wheat, barley and rye for life. Starch from wheat, maize or potato can be added to the medicine as a filler, binder or diluent. The gluten ratio of the added starch should not be ignored. In celiac disease, even small amounts of gluten damage the structure of the small intestine. Various pharmaceutical companies declare their products to be gluten-free. Excipients such as dextrin and sodium starch glycolate are usually made from corn and potato respectively, but can also be made from wheat or barley. At this point, celiac patients and people who eat gluten-free should be careful when using drugs, they should definitely inform their doctor about their disease and prescribe the appropriate drugs for them.
Dietitian Dilara Tuygan
Alas, Celiac! What will happen now?
The only cure for celiac disease is a gluten-free diet. Patients need to maintain strict gluten-free meals for life. People diagnosed with celiac disease as a result of clinical symptoms, serological tests, and small bowel histology should immediately start a gluten-free diet. He should stay away from the consumption of wheat, barley, rye and oat foods and beverages that should eliminate gluten from his life. Gluten-containing and iced tea such as white bread, whole wheat bread, bran bread and pasta, bulgur are not consumed in the gluten-free diet. It should be used with gluten-containing foods, which we call cross contamination, which do not contain gluten, but in this utility, attention should be paid to gluten contaminated contents.
Serological, hematological and biochemical tests (complete blood count, iron profiles, thyroid tests, calcium, magnesium, zinc, B12, folic acid and vitamin D) density and dietary compliance should be monitored. It is also important in follow-up in children.
Transglutaminase needs to be measured in a certain way to observe the effect of gluten-free treatment. If there are serological findings that do not improve at the end of a year, it should be considered that there is contamination in the diet. Serological tests are considered as a symptom of reaching normal levels, and it is known that the fastest serological tests in celiac disease reach their normal values in the 6th month and the slowest at the end of the 1st year.
A gluten-free diet should be followed very strictly. Very low amounts of gluten can cause clinical symptoms to persist. Celiac patients and their relatives should be well aware of the free, unfavorable foods that are included in the gluten-free diet and which should be controlled.
Dietician Armoni Yılmaz
Guide to Diagnosis, Treatment and Follow-up for Family Physicians in Celiac Disease, 2019
KULOĞLU, Z. (2014). Celiac disease. Turkish Journal of Pediatrics, 8 (2), 105-111.
Öztürk, Y. E., Uyar, G. Ö., Serin, Y., & Gürkan, Ö. E. (2018). Gluten-Free Diet Treatment in Celiac Disease: A Case Report. Journal of Nutrition and Diet, 46 (3), 320-324