Living wheat-free is a challenge

Some people seem to be allergic to just about everything. If the problem is a wheat allergy, their claim may be close to the truth.

I often hear from readers who say they're allergic to wheat. Wheat is one of a handful of the most allergenic foods, but more children than adults appear to be affected. And though it appears to be uncommon in adults, the prevalence is unclear.

Anyone with a wheat allergy, though, knows how difficult it is to avoid a food ingredient that seems to be everywhere.

In wheat allergy, the body reacts to one of several proteins in wheat. Typical symptoms may include an upset stomach, stuffy nose, hives or irritated skin, and swelling or itching in the mouth and throat.

Be aware that gluten-induced enteropathy, also called celiac disease, is different from wheat allergy, even though the culprit in celiac disease is gluten, a wheat protein. I've written about celiac disease in a past column that you can read at www.onthetable.net/gluten.html.

If you think you have a wheat allergy, your doctor can run tests to confirm it or to rule out wheat allergy or other medical problems. You can also do a little detective work yourself.

Standard treatment for most food allergies is an elimination diet. The first step is to keep a detailed food diary, recording everything you eat or drink for a week. That will make you more aware of what you typically eat. Then, figure out which foods contain wheat and wheat-based ingredients, and stop eating them.

Easier said than done, of course.

Wheat is used to make bread, cookies, cake, crackers, breakfast cereals, pancakes, biscuits, couscous, pasta and thousands of other foods. In natural foods stores, you may see spelt, an ancient variety of wheat. Bran, graham, bulgur, semolina, starch, malted wheat and durum flour are all forms of wheat, too.

Wheat can turn up in some surprising places. For example:

• Chinese restaurants and vegetarian meat substitutes. Seitan, made from wheat gluten, is used to make vegetarian versions of chicken, seafood, beef and pork used in meat-free entrees. Imitation crabmeat and hydrolyzed vegetable protein used in meat substitutes such as veggie burger patties and hot dogs can also contain wheat.
• Thickening agents. Modified food starch, wheat starch, vegetable starch and vegetable gums may contain wheat. You may see them listed on food labels for salad dressings, ice cream, sherbet, cake frosting, cream soups and packaged pudding mixes.
• Sauces and condiments. Gravy thickened with wheat flour, Worcestershire sauce and soy sauce, which is often made with wheat, are examples. On food packages, "natural flavorings" may include wheat ingredients.
• Beer and ale. Some are made with wheat and others aren't, so you'll need to check the Web site of your favorite brand to determine whether the brew is wheat-free.

Natural foods stores are a good source of common foods made with wheat-free ingredients, including wheat-free breads, crackers and breakfast cereals. You can also make your own wheat-free recipes at home with some simple substitutions. You may need to experiment a bit, depending upon the recipe, but these ingredients can generally be swapped for one cup of all-purpose wheat flour:

• 11/3 cups rolled oats or oat flour
• 1 cup of potato flour, corn flour or rye meal
• 5/8 cup potato starch or 1 cup soy flour plus 1/4 cup potato starch
• 7/8 cup rice flour or 5/8 cup rice flour plus 1/3 cup rye flour

For more information about wheat allergies, see the nonprofit Food Allergy Initiative at www.foodallergyinitiative.org.

Patience and a keen eye focused on food labels are what you need most to manage a food allergy. It's a simple fix, but it's never easy.