What foods to avoid if you have a wheat allergy?

If you have been diagnosed with a wheat allergy you will need to avoid any food containing wheat as the wheat protein can cause an allergic reaction. Strict avoidance is particularly important if you have an immediate allergy to wheat (known as IgE-mediated). If you have a wheat intolerance you may be able to tolerate small amounts of wheat.

If you think you may have coeliac disease check out our Food Fact Sheet here.

A dietitian will be able to support you with your wheat-free diet. They can tell you which foods to avoid, help you to find suitable alternatives, and ensure that your diet remains balanced and nutritionally sound.

Do I need to avoid gluten?

Gluten is a protein found in wheat. Having a wheat allergy does not necessarily mean that you need to avoid gluten. Most wheat-free products are gluten-free unless they contain rye, barley or standard oats. Your doctor or dietitian will be able to advise if you need to avoid gluten.

Some gluten-free foods may still contain wheat starch and are not suitable if you have wheat allergy. Always check the label.

Where is wheat found?

Wheat is a grain and is a main ingredient of many foods such as: breads, chapattis, naan breads, breakfast cereals, biscuits, crackers, crumpets, scones, pancakes, wafers, cakes, pizza, pasta, pastries and Yorkshire puddings. It is also found in many convenience foods such as soups, sauces, spices, malted drinks, processed meats, battered/breaded meat and fish, and ready-made meals.

Always check the label

Under current UK law, wheat along with other common allergens, must be clearly labelled on all packaged foods and drinks. These allergens have to be clearly emphasised e.g. in bold, italics or highlighted. For foods sold without packaging, such as in restaurants, cafes or delicatessens, allergen information must be provided in writing or verbally.

Wheat allergy foods to avoid

The following are all types of wheat and will need to be avoided:

• Bulgar wheat
• Couscous
• Durum wheat
• Einkorn
• Emmer
• Farola
• Freekah
• Hydrolysed wheat protein
• Kamut
• Malt
• Modified wheat starch
• Rusk
• Semolina
• Triticale
• Wheat bran
• Wheat flour
• Wheat germ
• Whole wheat

Wheat-free alternatives

There are many wheat-free alternatives you can use as a substitute to wheat that will provide variety to your meals or can be used in baking, and will help you get all the nutrients you need from your diet. 

There are now plenty of wheat-free products available to buy:

• Baked goods such as breads, breadcrumbs, cakes, cereals, crackers, crispbreads, rye crackers, oatcakes, corn cakes, rice cakes, pasta, pizza bases
• Grains: amaranth, barley, buckwheat, corn, maize/polenta, millet, oats, quinoa, rice, rye, sorghum
• Flours: barley, bean, buckwheat, carob, coconut, corn, gram, ground nut (e.g. peanut, almond), lentil, millet, oat, pea, potato, rice, soya, teff, tapioca
• Flakes: amaranth, barley, buckwheat, millet, rice, soya
• Other alternatives are available, such as gravy, baking powder, fish and meat in breadcrumbs or batter, lager/beer, ready meals, soy sauce, soups, sauces, processed meat (e.g. sausages, burgers)

Useful tips

• Finely crushed cornflakes make a good substitute for breadcrumbs.
• Sausages often contain rusk so check labels and buy wheat-free versions available in supermarkets, butchers, and farmers' markets.
• Chinese, Thai or Japanese cuisine: unless specified as gluten-free, soy sauce contains wheat. Check labels and ask in restaurants and take away venues if they use wheat-free soy. 
• Gravy: try vegetable stock or wheat-free stock cubes and thicken with corn flour, or use wheat-free instant gravy. If a little colouring is needed add gravy browning.
• Pasta: wheat-free pasta takes less time to cook than regular pasta and breaks up if cooked too long. Wheat-free pastas are made from grains such as corn, rice, buckwheat, quinoa or legume (bean, pea, lentil) flours.
• Sauces: use a wheat-free flour such as corn, rice or potato to thicken the sauce. To prevent lumps forming, mix the flour with a little cold water, add a little heated milk or milk alternative, stir well, and pour the mixture slowly to the rest of the heated milk and continue to stir over heat until thickened. Then add flavouring e.g. cheese, parsley.
• Beers and lagers are mostly made from barley. However, some beers are made from a mix of barley and wheat and some European beers are made from wheat. There are also now many gluten-free and wheat-free beers available. Always check the label.
• Baking: wheat-free flours have different baking properties to wheat flour but can make tasty biscuits, cakes and pastries. Xanthan gum is a useful ingredient that can be added to improve the texture and help to bind the mixture. Ready blended self-raising and plain wheat-free flours are convenient and widely available. If baking powder is needed, remember to check that it is wheat-free.
• When making your own pastry, chill for 20 minutes before rolling it out between two sheets of cling film to stop it from sticking. Good flour combinations are rice and soya flour or potato and polenta flour. You could also try a ready-to-roll wheat-free pastry.

Summary

• Wheat is found in many foods that are commonly eaten on a daily basis, so excluding it can feel a little daunting. But fortunately, there are lots of wheat-free alternatives, so a wheat-free diet does not need to restrict dietary variety or compromise nutritional intake.
• Having a wheat allergy does not necessarily mean that you need to avoid gluten – ask your doctor or dietitian.
• Wheat must be clearly labelled on all packaged foods and drinks. Make sure to check labels on packaged foods, and ask if you are eating out and unsure if a food or dish contains wheat.
• Using wheat-free alternatives will help you get all the nutrients you need. 
• A dietitian can support you to follow a wheat-free diet safely. Ask your doctor to refer you.

Wheat is a common cereal grain which forms the basis of many staple foods in Australia such as breads, breakfast cereals, pasta and baked goods. Wheat is also commonly used as the base ingredient for many additives in commercial food products such as thickeners and stabilising agents.

Wheat contains a number of different proteins and children who suffer from wheat allergy may have a reaction to one, or a combination, of them.

Other grains such as rye, spelt, oats, barley and millet contain similar proteins to wheat and can trigger reactions in people with wheat allergy. These should be avoided by susceptible children unless advised in writing by the child’s parents. Corn or maize, rice, buckwheat, potato and soy flours are generally well tolerated by children who are allergic to wheat.

A range of wheat free breads, breakfast cereals, flours, pastas and noodles are readily available at local supermarkets and health food stores.

Wheat allergy and coeliac disease

Coeliac disease is a lifelong condition where the lining of the small intestine is damaged as a result of exposure to a protein called gluten. This causes a variety of gastrointestinal symptoms such as diarrhoea, bloating, constipation, nausea and vomiting). The only treatment for coeliac disease is strict avoidance of all gluten containing cereals such as wheat, barley, oats and rye.

In contrast, people with a wheat allergy may tolerate other grains that contain gluten such as rye and oats. It is also common for children to grow out of a wheat allergy.

Products labelled ‘gluten free’ are suitable to include in a wheat free diet.

Allergy action plan

Allergy action plans are recommended to advise staff what to do if a known allergen is ingested. The action plan should be developed with the child’s family and treating team (doctor, allergist, paediatrician) and be approved and signed by a recognised health professional involved in their care.

On enrolment, centres should request written documentation of confirmed allergies from the child’s treating team. Parents should document exactly what their child can and cannot tolerate to avoid confusion and this should be written on the allergy action plan.

Specialised anaphylaxis action plans are essential for children with anaphylactic reactions.

For information about developing an allergy action plan refer to Allergy policy and allergy action plans or the Australasian Society of Clinical Immunology and Allergy (ASCIA) website http://www.allergy.org.au/.

Label reading

In Australia all packaged foods must include a food label with an ingredients list. By law, all potential food allergens (peanuts, tree nuts, seafood, fish, milk, eggs, soybeans and wheat) must be clearly identified, no matter how small the amount. If an ingredient includes wheat, this should be listed on the ingredients list. For example, if a product contains maltodextrin it should be listed as ‘maltodextrin (wheat)’ or ‘wheat maltodextrin’.

When purchasing packaged items, carefully check the food label and ingredient list for wheat products. Check these each time the product is purchased, as ingredients and processing techniques may change.

The following table outlines foods and ingredients which include wheat and should be avoided by children with a wheat allergy.

Do all wheat based ingredients need to be avoided?

Some ingredients made from wheat are so well processed that all the wheat proteins have been removed. These products include glucose, glucose syrup, dextrose, caramel colour and monosodium glutamate. Whilst these items are still labelled as containing wheat, the chance of an allergic reaction to such ingredients is unlikely and these products may not need to be avoided.

‘May contain traces of wheat’

This statement is used by manufacturers to indicate that products may be contaminated with wheat during processing and packaging. At present ‘May contain traces of wheat’ is a voluntary statement and there are no clear guidelines to direct food companies how and when it should be used.

The wording of this statement makes it very difficult to determine risk level and a product that does not include the statement may be no safer than a product that does. The risk of significant allergic reaction through contamination during processing is extremely low. Many families choose to ignore ‘May contain traces of wheat’ statements as the only safe alternative is to exclude all commercial food products from the diet.

As a precaution, ask families to document their stance on ‘May contain traces of wheat’ statements in writing on allergy action plans so that centres can be clear about families’ expectations.

Avoiding wheat in food

The table on the following page outlines foods which are likely to contain wheat, and foods which are likely to be wheat free.

* Products are not gluten free and thus not suitable for children with coeliac disease.
# Products may or may not be gluten free. Check label to determine if suitable for children with coeliac disease.

Cooking without wheat

Wheat is a major part of the Australian diet. When wheat is excluded, it is important that it is replaced with other cereals and grains which are wheat free such as:

• arrowroot
• buckwheat
• corn or maize flour (check label)
• polenta
• potato flour
• rice flour
• soy flour
• millet
• sago
• tapioca
• quinoa
• sorghum

In cooking and baking, the following substitution for wheat can be used:

1 cup wheat flour = ½ cup rice flour + ½ cup potato flour

Alternatively, many commercial wheat free flour mixes are available. It is worth experimenting with different options to find out which one works best for you.

Food preparation

Chopping boards, toasters, bread slicers, knives and margarine or butter containers can be sources of wheat contamination and can trigger reactions in children who are highly sensitive.

For more advice on avoiding cross-contamination with wheat in your centre, visit Coeliac disease.

Adapted with permission from: Wheat allergy, Department of Allergy and Immunology, Royal Children’s Hospital Melbourne, November 2007.
Additional reference: Wheat allergy, Women’s and Children’s Health Network, Women’s and Children’s Hospital SA, September 2010