Wheat allergy, sometimes referred to as gluten allergy, refers specifically to adverse reactions involving immunoglobulin E (IgE) antibodies to one or more proteins of wheat, including albumin, globulin, gliadin and glutenin (gluten). The majority of true allergic reactions to wheat involve the albumin and globulin fractions. Gliadin and gluten may also, rarely, induce an allergic reaction. Wheat allergy reactions are most commonly caused by ingestion of wheat-containing foods, although inhalation of flour containing wheat (Baker’s asthma) can induce wheat allergy symptoms.
There are no accurate figures for prevalence of wheat allergy. Clinical experience suggests that wheat allergy is relatively uncommon. However, it may be more common in certain subgroups. For example, wheat allergy is responsible for occupational asthma in up to 30% of individuals in the baking industry.
Wheat allergy symptoms and gluten allergy symptoms usually begins within minutes or a few hours after eating or inhaling wheat. The most common symptoms involve the skin (hives, atopic eczema, and swelling), the gastrointestinal tract (oral allergy syndrome, abdominal cramps, nausea and vomiting), and the respiratory tract (asthma or allergic rhinitis). Allergic reactions to gliadin or gluten can cause hives and swelling or life-threatening anaphylaxis in association with exercise. Other gluten-containing cereals such as rye, oats and barley may also cause these symptoms due to cross-reactivity of the allergens.
The diagnosis of wheat allergy or gluten allergy may be easy if a person always has the same reaction after eating wheat-containing food or eats wheat infrequently. But more often the diagnosis is difficult because wheat is such a common food. Diagnosis usually entails clinical evaluation (medical history, family history, food history) supported by appropriate laboratory tests (skin prick-testing or RAST/blood test). Elimination and challenge testing remains the most reliable method of diagnosis.
Avoidance of wheat and wheat-containing foods is the most important step in the treatment of wheat allergy. However, because wheat is a common food product, wheat avoidance diets are particularly difficult. Persons on wheat-restricted diets are sometimes severely limited in their selection of foods.
Spelt, an ancient wheat, and kamut, a cereal grain, have recently been marketed as safe for wheat-allergic individuals. This claim is untrue, however. Wheat allergic patients can react as readily to spelt and kamut as they do to common wheat.
Celiac disease and wheat allergy are two distinct conditions. Allergy to wheat may occur in any individual, unlike celiac disease, which is hereditary. Celiac disease, sometimes called celiac “sprue”, is a permanent intolerance to gluten. Those with celiac disease will not lose their sensitivity to this substance. This disease requires a lifelong restriction of gluten. The major grains that contain gluten are wheat, rye, oats, and barley. Gluten proteins are extremely resistant to intestinal digestion, despite grinding, cooking, processing and digestion. These grains and their by-products must be strictly avoided by people with celiac disease.
What items on a food label contain wheat?
Be sure to avoid foods that contain any of the following ingredients:
What are other possible sources of wheat or wheat products?
Ingredients that may indicate the presence of wheat protein include the following:
1-cup wheat flour equals:
Food Group: Beverages
Food Allowed: Coffee, tea, fruit juices, decaffeinated coffee, carbonated beverages, all milks, cocoa
Food Not Allowed: Cereal beverages, coffee substitutes. Beverages made from wheat products: beer, ale, root beer. Instant chocolate drink mixes
Food Group: Breads & Cereals
Food Allowed: Ry-Krisp, rice wafers. Pure corn, rice, arrowroot, barley, potato, or rye bread made without wheat flour or wheat products. Cornmeal, cornstarch, soybean, flour, barley flour, oat flour, rice flour, potato starch, arrowroot flour. Oatmeal, cream of rice, puffed rice, or other cereals made from pure corn, oats, or rice to which no wheat has been added.
Food Not Allowed: Whole wheat, enriched, or white bread, rolls, or bread crumbs. Graham or gluten bread. Donuts, sweet rolls, muffins, french toast, waffles, pancakes, dumplings, bread stuffing, rusk, povers. Prepared mixes for pancakes, waffles, biscuits, breads, and rolls. Cornbread, potato, or soybean bread unless made without wheat flour or wheat products. Cereals made from farina, wheat, or those with wheat products or malt added. Pretzels, crackers, Semolina, spelt, or triticale
Food Group: Desserts
Food Allowed: Custards, Bavarian creams. Oatmeal, arrowroot, rice, or rye cookies made without wheat products. Cornstarch, tapioca, or rice puddings, water or fruit ices, meringues, and gelatin.
Food Not Allowed: Cakes, pastries, commercial frosting, icing, ice cream, sherbet, ice cream cones. Cookies, prepared mixes, or packaged pudding containing wheat flour, graham crackers, donuts
Food Group: Eggs
Food Allowed: Eggs prepared any way without wheat products
Food Not Allowed: Souffles or creamed eggs made with wheat products
Food Group: Fats
Food Allowed: Butter, margarine, animal, or vegetable fats and oils, cream. Salad dressings or gravy prepared without wheat flour or products
Food Not Allowed: Any salad dressing thickened or gravy with wheat flour or products
Food Group: Fruit
Food Allowed: All fresh, canned, dried, or frozen fruits and fruit juices
Food Not Allowed: Strained fruits with added cereals
Food Group: Meat, Fish, Poultry
Food Allowed: Baked, broiled, boiled, roasted or fried: beef, veal, pork, ham, chicken, turkey, lamb, or fish. “All meat” wieners or luncheon meats prepared without wheat flour fillers or wheat products.
Food Not Allowed: All breaded or floured meats, meats containing filler such as meatloaf, frankfurters, sausage, luncheon meats, bologna, or prepared meat patties
Food Group: Milk & Milk Products
Food Allowed: Milk, buttermilk, yogurt, cheese, some cottage cheese
Food Not Allowed: Malted milk, milk drink containing powdered wheat cereal or products. Cottage cheese with modified starch or other wheat containing ingredients
Food Group: Potatoes & Substitutes
Food Allowed: White and sweet potatoes, rice
Food Not Allowed: Scalloped potatoes, noodles, spaghetti, macaroni, and other pasta products prepared with wheat or semolina flour
Food Group: Soup
Food Allowed: Clear bouillon, consommé, or broth. Homemade soups made without wheat products
Food Not Allowed: Cream soups unless made without wheat flour. Soups with noodles, alphabets, dumplings, or spaghetti. Soup thickened with wheat flour.
Food Group: Sweets
Food Allowed: Corn syrup, honey, jams, jellies, molasses, sugar
Food Not Allowed: Chocolates, chocolate candy containing malt, candy with cereal extract
Food Group: Vegetables
Food Allowed: All fresh, frozen, or canned vegetables, and vegetable juices
Food Not Allowed: Vegetables combined with wheat products, breaded or floured vegetables
Food Group: Miscellaneous
Food Allowed: Salt, chili powder, condiments, flavoring extracts, herbs, nuts, olives, pickles, popcorn, peanut butter
Food Not Allowed: Malt products, Worcestershire sauce, gravies thickened with wheat flour, Monosodium glutamate (MSG), meat tenderizers containing MSG, prepared oriental food seasoned with MSG, soy sauce
Always remember to read the ingredient labels for details about every food.