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Celiac disease: What to look for on food labels

Millions in the U.S. suffer from bad food reactions, and celiac disease can be the cause. ‘Today’ food editor Phil Lempert offers a 101 on this condition.

Last week this column focused on the things you HAD to know about food allergies, and many of you e-mailed me writing that you wanted to know even more about celiac disease. Here's the 101:

Celiac disease, more commonly known as gluten intolerance, affects one in 133 Americans. This lifelong disease causes intestinal problems when eating gluten, which is the common name for offending proteins in wheat (including durum, semolina, spelt, kamut, einkorn, and faro), rye, barley and oats. Gluten is like poison to people with celiac disease.

Celiac affects those who are genetically susceptible. In fact, if one member of a family has celiac disease, about one out of 10 other members of the same family are likely to have it as well. Some may harbor the tendency for a while without getting sick, but then stress, physical injury, infection, childbirth or surgery can actually "activate" the disease. The disease mostly affects people of European (especially Northern European) descent, but recent studies show that it also affects Hispanic, Black and Asian populations as well.

Because of the broad range of symptoms celiac disease presents, it can be difficult to diagnose. The symptoms can range from mild weakness, bone pain, and aphthous stomatitis to chronic diarrhea, abdominal bloating, and progressive weight loss. Those with celiac disease who consistently consume gluten can increase their chances of developing gastrointestinal cancer by a factor of 40 to 100 times that of the normal population. Furthermore, gastrointestinal carcinoma or lymphoma develops in up to 15 percent of patients with untreated or refractory celiac disease. Celiac disease should be quickly and properly diagnosed so it can be treated as soon as possible. Testing is fairly simple and involves screening the patient's blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on specific areas of the intestines.

With a strict adherence to a 100 percent gluten-free diet, almost all complications caused by the disease can be prevented. A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This can be a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. It is important to read labels carefully and become educated on what types of ingredients to look out for.

Terms to beware of:

  • Durum flour, couscous, semolina, spelt, kamut, bulgur and triticale, a grain crossbred from wheat and rye, are all names for certain kinds of wheat.
  • Corn starch, wheat starch, dextrin, malt, maltodextrin, modified food starch, fillers, natural flavoring, hydrolyzed vegetable protein (HVP), emulsifier, stabilizer and hydrolyzed plant protein (HPP)

Foods that commonly contain gluten:

  • Most cereals, grains, pastas, breads, and processed foods contain some type of gluten, unless, of course, they are specifically made to be gluten-free.
  • Vegetable cooking sprays, tomato pastes, spaghetti sauces, and veined cheeses, such as roquefort and blue cheese, may contain gluten.

Hidden sources of gluten:

  • Many vitamins and medications can contain gluten in their additives. Always check with your doctor or pharmacist before taking any medication.
  • Be careful of cross-contaminating foods. This can happen in the toaster, deep fryer, griddle, etc.
  • Imitation seafood and instant or flavored coffees and teas
  • Glue on envelopes and postage stamps
  • Chewing gum
  • Some lotions, creams, and cosmetics

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Phil Lempert is food editor of the “Today” show. He welcomes questions and comments, which can be sent to or by using the mail box below. For more about the latest trends on the supermarket shelves, visit Phil’s Web site at .