The gluten-free diet ought to be simple enough to implement — ditch the wheat, barley and rye products and you're living gluten-free, right?
But while it is easy to drop whole wheat bread and wheat thins from your own personal menu (the gluten in them is pretty obvious), rooting out all the covert gluten takes some time ... and that's where newcomers to the gluten-free diet tend to get tripped up.
So where can gluten hide? Practically anywhere. To really root it out, you'll need to learn how to find gluten on food labels. But as a starter, these nine foods, products and situations are high-risk. Beware.
1. Soy Sauce
Yes, despite the soy-based name, almost all soy sauce contains wheat — often as the number one ingredient. And because almost all Chinese food contains soy sauce, this places Chinese take-out on the danger list, as well.
It's possible to find a wheat-free soy sauce to substitute — look for tamari, which is traditionally brewed Japanese soy sauce without wheat. San-J brand tamari is even gluten-free certified.
Some Japanese restaurants also stock tamari for their gluten-intolerant guests — something to keep in mind when you're looking for a good gluten-free ethnic restaurant. In addition, traditional Thai soy sauce also should be gluten-free, but you always should ask, since many U.S.-based Thai restaurants use wheat-based varieties.
- Learn more: Gluten-Free Soy Sauce List
2. Cream-Based Soups
Like soy sauce, you probably wouldn't think that cream-based soups should cause a gluten problem — after all, the label says "cream," not "cream of wheat."
Well, the sad little secret is that most commercial "cream" soups get their creamy texture from starch, not real cream. And that starch most often comes from wheat flour. In fact, the top commercial soup manufacturers use tons of wheat every year to produce canned soup.
To avoid the gluten, read labels carefully and look for higher-end soups as opposed to the less expensive stuff. Prepared soup that comes in boxes often carries a gluten-free label (although it's not as creamy). You might not wind up with the flavor you want, but you might discover a new favorite in the process.
- Learn more: Gluten-Free Soups (Plus Some That Aren't Safe)
3. Ice Cream
As with cream-based soups, ice cream shouldn't include gluten ... it's a dairy product. But it's unfortunately not that simple.
Plenty of ice cream brands include flavors such as "Chocolate Chip Cookie Dough" and "Key Lime Pie," which contain gluten. Others add cookies or unsafe candies to their products, so you'll have to check ingredients lists carefully before purchasing.
And believe it or not, some commercially produced ice creams do contain wheat flour as an ingredient — it serves as a thickener. Blue Bell is one brand that does this.
You also need to be aware of the risk of cross-contamination when you're enjoying ice cream in an ice cream parlor, since the workers frequently use the same scoops for all the flavors. To purchase ice cream out, first locate a known gluten-free flavor. Then, ask the workers to get a fresh tub of it from the back and use a clean scoop. Get your toppings from a new container, too.
- Learn more: Which Ice Cream Brands Are Gluten-Free?
4. "Wheat-Free" Products
Lots of people equate "wheat" with "gluten." I'm as guilty as the next gluten-intolerant person — in restaurants, I've been known to say I have a "wheat allergy" instead of saying I have "celiac" or "a gluten sensitivity."
But if you focus only on wheat, it's easy to get tripped up by choosing products labeled "wheat-free." They're free of wheat, of course (that's what the label says, after all), but they still can contain barley or rye ingredients ... and they often do.
If you've got celiac disease or non-celiac gluten sensitivity, you need to omit all gluten, not just wheat. So don't be fooled by "wheat-free" banners on packaging — those products still can gluten you.
- Learn more: Wheat-Free vs. Gluten-Free
It always surprises me how many people don't know that conventional beer contains gluten. But then I think back to my own early days following the gluten-free diet, and remember how I got tripped up — badly — by beer.
When you only indulge in it occasionally (think: summer barbecue or picnic), you don't necessarily focus on beer's ingredients. But those ingredients feature barley ... as I found out after I downed one for the first time in a year.
These days, you can find gluten-free beer in many supermarkets and in many restaurants. Most people frankly don't like it as well as regular beer, but brewers are getting more skilled and the beer gets better every year.
- Learn more: Are the New 'Gluten-Removed' Beers Safe?
6. Prescription Medications
Food labels must declare all wheat ingredients (but not barley or rye ingredients), making it easier for us to rule out particular products. But prescription drug manufacturers don't follow the same rules. Some prescription drugs contain gluten grains (almost always wheat) as a filler, and there's no requirement that they disclose the wheat or gluten to consumers.
In fact, it can be difficult to determine if the drug you're taking is gluten-free — ingredients can change, even on brand-name prescription drugs, and the company's customer service representatives may not know.
To cope with this problem, make sure your pharmacist knows you need to be gluten-free (and knows what "gluten-free" means). Also, double-check every single refill.
7. Gourmet Meats
Plenty of high-end grocery retailers sell gourmet prepared meats these days. You can buy all sorts of sausages, along with pre-prepared ribs and chicken or fish already in a delicious sauce.
However, I've found ingredients lists for many of these appetizing-looking foods are lacking. The stores often obtain the sauces and spice rubs from outside suppliers, and may not track the ingredients carefully.
Even if the meat counter workers know exactly what's in them (and know for sure there's no gluten), you still need to beware. These products are "prepared in a facility that also processes gluten" — as you'll see when you look at all the bread crumb-containing items at the meat counter. Steer clear, especially if you're particularly sensitive.
8. Restaurant Meals
It's getting easier to eat out gluten-free — restaurants seem more aware of gluten issues, and many restaurant chains offer gluten-free menus. But dining out still contains plenty of pitfalls.
In the beginning of your diet, it's easy to persuade yourself to order something that "looks safe" off the menu, without making a pest of yourself with the server. But that approach is fraught with peril — hamburgers can contain bread crumbs, marinades can include soy sauce, and cross contamination may be rampant in the kitchen.
As tough as it is (and I still find it difficult), you need to tell your server your meal must be gluten-free. In many cases, you'll need to get the manager and/or chef involved to learn the ingredients and get a safe meal.
9. Meals with Friends and Family
I think it's more difficult to stay gluten-free when eating out at the home of a friend or family member than it is at a restaurant. Many restaurant chefs and staffs undergo training on allergies, but your mom doesn't.
As you likely know well, going gluten-free involves a steep learning curve, and most people can't create a perfectly gluten-free meal without some study. Sadly, that goes for your friends and family too.
Honestly, I don't advise you to eat food fixed by friends or family unless you supervised the entire process — they may not realize that a dash of soy sauce or a dusting of flour means they've just glutened your meal, and they won't know to watch for crumbs in the butter or other hazards. It's safer to bring your own food.