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Allergy to Wheat Products

Wheat is the most allergenic of all cereals. IgE antibodies have been found in many components of wheat kernels, including albumin, globulin, gliadin, wheat germ agglutinin, a concanavalin A-purified glycoprotein, and a trypsin inhibitor. Wheat is most rich in gluten, with the other grains containing a lesser mixture of gluten and gliadin.


In addition to being present in all wheat-based food products, wheat gluten is frequently added to baked products made from other grains, including those made from soy flour.


Wheat-sensitive individuals should avoid a product that includes other flours, because it is likely that at least some wheat flour or a derivative will also be present. Even gluten-free bread may contain small amounts of gluten (0.4 mg per 30 gm slice). Bread wheat, durum wheat, triticale, rye and barley, to a lesser extent, are the main gluten-containing cereals. Others include semolina, spelt, and kamut. Cereal products, such as couscous and graham flour, are also prepared from wheat. Spelt has occasionally been marketed as a wheat alternative but is actually part of the wheat family. Spelt may better be described as non-hybridized wheat. No data have indicated differences in the allergenic profiles of the various wheat varieties, and they should all be viewed as potential allergens.


Hydrolyzed wheat proteins can be used in processed foods for flavoring purposes (e.g., in meat flavorings) or as a binder in vegetarian burgers. In the United States legislation dictates that this form of wheat must be labeled as wheat-derived, but this is not always the case in other countries. Wheat can appear under various names on ingredient panels (see first table) and can be found in many food products (see second table). Gluten finds its way into a few pharmaceutical products (e.g., Dimetapp LA, Nulacin, and Fybranta).
Buckwheat is not a member of the grass family and is thus not a true cereal. The grain may be used for human food in various forms from pancake flour to buckwheat noodles and baby foods.


For the wheat-hypersensitive individual, products made from oats, rice, rye, barley or corn or speciality foods made for gluten-sensitive individuals generally may be used instead of wheat. However, cross-reactions, although unusual, may occur between wheat, barley, rye, maize and rice.


Coeliac disease is a disorder of the small intestine, caused by a reaction to a gluten protein appearing in wheat, rye, oats, spelt and barley.   Symptoms include chronic diarrhea and fatigue.  Note that, while triggered by wheat, the disease is not the same as a wheat allergy.  Coeliac disease – also called coeliac sprue – is determined with blood testing.  A gluten-free diet remains the only defense against this condition.


TABLE IX -- Labels that may indicate the presence of wheat protein
All-purpose flour
Bleached flour
Bulgur (cracked wheat)
Bran
Cornstarch
Couscous
Durum wheat
Enriched flour
Farina
Gelatinized starch *
(or pre-gelatinized)
Gluten
Graham flour
Hard durum flour
High gluten flour
High protein flour
Hydrolyzed vegetable protein
Kamut
Miller's bran
Modified food starch*
Modified starch *
MSG (monosodium glutamate)
Protein
Semolina
Spelt
Starch*
Unbleached flour
Vegetable gum *
Vegetable starch*
Vital gluten
Wheat bran
Wheat flour
Wheat germ
Wheat gluten
Wheat starch
White flour
Whole wheat
Whole wheat flour

* May indicate the presence of soy protein or may be manufactured from cassava (tapioca), maize, or rice. May be soy. Sometimes produced from soy or wheat but now mostly by synthetic means

 

TABLE X -- Foods that may contain wheat
Alcoholic beverages(made
from grain alcohol)
Ale
Beer
Wine
Bourbon
Whiskey
Baked goods
Biscuits
Breads (including rye bread)
Cakes
Cookies
Crackers, etc.
Baking mixes
Barley bread and drinks
Battered foods
Bouillon cubes
Breaded meats
Breaded vegetables
Breakfast cereals
Candy or chocolate candy
Canned processed meat
Cereal grains
Cousous
Gravy
Hot dogs
Ice cream
Ice cream cones
Luncheon meats
Licorice
Macaroni
Malt
Malted milks (e.g., Horlicks)
Milk shakes
Noodle products
Pasta (noodles, spaghetti, macaroni)
Pepper (compound or powdered flour filler)
Pies
Processed meats
Sausage
Semolina
Snack foods
Spaghetti
Soup mixes
Soups
Soy sauce
Tablets
 

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