Are you eliminating wheat or gluten as part of the RPAH or failsafe chemical elimination diet?
Find out which gluten free grains are low in salicylates and which are not.
JOIN THE COMMUNITY: BRAND NEW Dietitian led Facebook group: Amines, Salicylates and Glutamates: The Food Intolerance Dietitian for great information and community support.
AVOIDING WHEAT
Some people who cannot tolerate wheat find they can actually tolerate spelt. Spelt flour, spelt bread or spelt wraps can be substituted directly for their wheat counterparts.
Technically spelt is a type of wheat, but its ancient form means it may be tolerated better than more modern wheat strains.
If you are avoiding wheat, the trick is to look at the label of the food you have bought and check out the allergen information. If the food contains wheat then it has to be stated as an allergen.
Gluten free products are also wheat free so even if you are not avoiding gluten (which is not only in wheat but in rye and barley and maybe oats), at least these products will be wheat free. Watch out though as gluten free products commonly have food additives and some high salicylate grains such as corn or maize.
AVOIDING GLUTEN
Gluten is the main protein found in wheat, rye, barley, triticale (hybrid of wheat and rye) and less so in oats.
Not only do these need to be avoided but products made from these such as couscous, malt, semolina and wheaten cornflour also need to be excluded.
Gluten free grains that are low in food chemicals need to be chosen instead. This is an important point as not all gluten free grains are actually suitable, notably corn or maize flour which is naturally high in salicylates. This extends to foods made from corn such as corn in rice cakes (corn thins), corn chips and taco shells.
See below for gluten free grains that are low in salicylates.
OATS: a special mention
Oats is the 2nd most likely grain to cause issues after wheat, however oat sensitivity is far less common than wheat sensitivity.
Deciding whether to include oats or not depends on any previous reactions or current suspicions about oats and/or oat milk.
Even when strictly avoiding gluten, oats can sometimes be retained in the diet. For people with Coeliac Disease who exclude even small amounts of gluten, oats are not necessarily an issue as the gluten equivalent in oats (avenin) does not always trigger problems unless contaminated with wheat. For this reason, only uncontaminated oats which are not grown in Australia are appropriate in these scenarios.
If you have Coeliac Disease- seek specific information before allowing oats in your diet and only do so under the guidance of your Gastroenterologist
GLUTEN FREE AND LOW SALICYLATE GRAINS
Amaranth
Traditionally grown in South America and was a staple food of the Aztecs. Amaranth has grown very popular in the last few years. Puffed amaranth is a terrific breakfast cereal and can be mixed with rice flakes or quinoa to make porridge.
Amaranth is low in FODMAPs for very small serves only (1/4 cup). At 1/2 cup it is moderate in FODMAPs.
Arrowroot
A less well known GF flour that is a starch extracted from the roots of a tropical plant. It can replace corn starch as a thickener. Use 1/3 to 1/2 arrowroot as a substitute and add at the end of a recipe as opposed to cooking with it. Low in FODMAPs.
Buckwheat
Although has wheat in its name, it is not a wheat and is not even a grain but related to rhubarb.
Use puffed for a cereal, the flakes as a substitute for oats, or use the kernels in a similar way to rice.
Although buckwheat flour is low FODMAP, note that buckwheat kernels (cooked) are low for 1/8 cup but moderate for 1/4 cup.
Corn starch
Although corn is high in salicylates, the corn starch is fine to use as the salicylates have been processed out. Just check corn starch is made from maize and not wheat to be gluten free.
Note that corn starch can sometimes be called cornflour which is a bit tricky as the flour from corn (also called corn flour) needs to be avoided as naturally high in salicylates/food chemicals. Corn is low in FODMAPs.
Millet
Low in salicylates and gluten free. Millet and teff are similar but teff has not been tested for salicylate content by The Royal Prince Alfred Hospital.
Psyllium
You will find psyllium as a husk or powder and is known to be useful as a fibre supplement to keep bowels regular if consumed with adequate water.
Also useful in lowering cholesterol levels thus handy if you have diabetes. Quite a handy little grain. Also useful in GF cooking as a binder instead of guar gum or xanthum gum and in baked goods that rely on gluten (provides elasticity).
Psyllium is low in FODMAPs.
Quinoa
Versatile gluten free seed that can be used as puffs for a breakfast cereal, flakes that can be made into a porridge, seeds that can be served like rice, used whole in stews or soups or ground into a flour. Quinoa is low in FODMAPs.
Rice (white or brown)
We all know how useful rice is. Rice puffs sometimes contain a small amount of gluten (malt extract) when sold as the breakfast cereal (rice bubbles), but plain rice puffs are gluten free. Baby rice cereal- just check no added herbs such as rosemary. Rice is low in FODMAPs.
Sago
Similar to tapioca but the balls of starch are smaller. Can be bought alone for example pearl sago.
Sorghum
Used in some GF foods such as GF Weet-bix, and some GF baked goods. Wholemeal sago is a good way to increase fibre in baking. Best used as part of a GF flour blend than on its own. Sorghum is low in FODMAPs.
Soy flour
Great choice but needs to be avoided if soy is being completely eliminated. Often added to gluten free products so always check ingredient list if avoiding soy flour. Soy flour is high in FODMAPs, although around 3-4g is acceptable as an ingredient in foods.
Tapioca
Tapioca is a starch made from the root of the cassava plant. Can be used in place of cornflour or arrowroot to thicken sauces and soups. Replace wheat flour with tapioca for a thin, slightly pale pancake. Tapioca starch is low in FODMAPs but cassava flour has not been tested (note: cassava as a vegetable is low for 1 serve = 1/2 cup but moderate for 2/3 cup)
Other grain alternatives:
Such as chick pea flour, lentil flour or potato flour. The grains from legumes (chick pea flour = besan flour = gram flour, or lentil flour are high in FODMAPs, potato flour is low in FODMAPs)
GF GRAINS HIGH IN FOOD CHEMICALS
Almond meal (also high in FODMAPs)
Banana flour
Coconut flour or coconut products
Corn flour (= maize flour)
Hi-maize
Polenta (maizemeal or cornmeal).
Corn flour (when it is actual flour) is naturally high in salicylates but when it is processed to form corn starch it is low in salicylates as the salicylates are processed out.
INCREASE YOUR VARIETY FOR A MORE BALANCED DIET
Experiment with some GF flours to make sure you have a variety of grains to make your elimination diet more nutritious and enjoyable.
REFERENCES
Dr Kim Faulkner-Hogg. Coeliac Disease & the Gluten Free Diet, Gluten Free Nutrition, May 2017
Joy Anderson, food-sensitive babies, Specialist Dietetics and Lactation Services, 2016.
Monash University low FODMAP app. Version 2.0.12. Accessed 08/08/2018.