The wheat free diet is a way of eating where all products containing wheat are eliminated. Such products may include wheat proteins like wheat flour, pasta, semolina, bulgur, couscous, bread, muffins, hydrolyzed vegetable protein, and crackers. Individuals who experience allergic symptoms after ingesting wheat products often use this diet. Some people allergic to wheat may also be allergic to gluten, and thus must place significant restrictions on their dietary intake.
Wheat allergy refers specifically to adverse reactions involving immunoglobulin E (IgE) antibodies to one or more protein fractions of wheat, including albumin, globulin, gliadin and glutenin (gluten). The majority of IgE-mediated reactions to wheat involve the albumin and globulin fractions. Gliadin and gluten may also induce IgE-mediated reactions rarely.
The incidence of wheat allergy has been investigated over the last few decades in an attempt to learn more about the specific interactions between wheat proteins and immunoglobulins. Current research indicates that wheat proteins are very allergenic, meaning that even extremely small amounts are capable of activating the immune response in allergic individuals. Currently, there are no accurate figures describing the prevalence of wheat allergy. Clinical experience suggests that wheat allergy is relatively uncommon. However, it may be more common in certain subgroups e.g. wheat allergy is responsible for occupational asthma in up to 30% of individuals in the baking industry.
However, wheat is among 1 of 6 products that are responsible for about 90% of all food allergies. Seen most commonly in infants and young children, wheat allergy can also occur in adults. The most widely used method to diagnose a wheat allergy is a skin patch test conducted by a qualified health care professional, where small amounts of the suspected allergen are applied to the skin or injected subcutaneously. A positive result would be a localized allergic reaction that indicates the presence of a true, or immune-mediated, allergy.
Symptoms of wheat allergy can vary among individuals, ranging from bothersome but relatively unserious symptoms such as rash, hives, or gastrointestinal distress to a life threatening anaphylactic reaction. In many instances, allergic symptoms do not appear until after physical exertion, and is referred to as an exercise induced allergy. This may make a true allergy difficult to recognize.
There has been a recent increase in cases of documented wheat allergy among children and adults. This may be due to self-reporting of symptoms and may not accurately represent the true number of individuals with an allergy to wheat. However, efforts to manufacture wheat-free products are on the rise. Spelt is a grain used to make baked goods that has been substituted successfully for wheat in allergic individuals. Alternate forms of flour derived from grains such as kamut and chickpeas are available at specialty markets. Dietary staple foods such as pasta may be easily replaced with rice to create a balanced meal while adhering to the wheat free diet.
For those with allergies to wheat or those with Celiac disease (an inherited genetic disorder that causes inflammation of the intestinal lining in response to the ingestion gluten, found in wheat) the wheat free diet is successful in keeping symptoms at bay. The wheat free diet has also been studied for treatment of steatorrhoea (an excess of fat in the stools). More high-quality trials are needed to make any firm recommendations regarding the long-term safety and efficacy of this diet for the treatment or prevention of other conditions.
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Following the wheat free diet involves eliminating all wheat products from the diet. This requires careful attention when reading food labels. Some manufacturers require provide information on their products indicating if contamination with wheat is possible, but this is not always the case.
Individuals are advised to read labels and be able to recognize wheat constituents as ingredients. Alternative food items exist for those wishing to exclude wheat from their diets and are available at most specialty and natural food stores.
Currently, the only effective method of managing a true wheat allergy is avoidance of any wheat-containing products. Some evidence suggests that certain antihistamine medications such as fexofenadine (Allergra) may prevent allergic symptoms when taken before ingestion of wheat in patients with a mild allergy.