Wheat allergy
Treat wheat allergy according to type and extent
Wheat allergy therapy includes an allergological consultation and, in the case of severe symptoms, the prescription of an emergency kit. In addition, an expertly supervised wheat allergy diet therapy is required. Depending on the type and extent of the wheat allergy, wheat should be more or less strictly eliminated from the diet.
How can a wheat allergy be treated?
Patients with the diagnosis of a wheat allergy should receive a specialist allergological consultation; in the case of severe symptoms, an emergency kit with epinephrine for injection should be prescribed. In addition, wheat allergy sufferers should receive personalised nutritional therapy from a trained nutritionist.
Goals of nutritional therapy for wheat allergy:
- Avoid allergic reactions
- If necessary, inform about cofactors
- Ensure a balanced diet
- Maintaining tolerance and quality of life
What should I remove from my diet if I am allergic to wheat?
The implementation of a wheat allergy diet plan is often difficult for those affected: on the one hand, wheat is a staple food in many countries, on the other hand, it is often used in processed products due to its food technology properties. This means that not only wheat grains, wheat flour, wheat starch, wheat germ, wheat germ oil, wheat flakes, wheat semolina, wheat groats and corresponding baked goods are taboo in a wheat allergy diet. Wheat can also be found on the list of ingredients of sausages, spices, ready meals, sauces, soups, pasta, dumplings and sweets. Even medicines occasionally contain wheat ingredients. Some experts also advise avoiding original forms of wheat such as spelt, green spelt, einkorn, zweikorn and kamut. Cross-reactions - e.g. to products made from pure rye, barley or oats - are rare and such are generally foods well tolerated. People who are sensitised to omega-5 gliadin are an exception: In this case, there is often a cross-reaction between the IgE antibodies against omega-gliadin and those of secalin in rye and hordein in barley.
A selection of foods critical for wheat allergy
- Rolls, bread, baked goods
- Biscuits, biscuits, cakes
- Muesli, breakfast cereals
- Pasta, such as noodles
- Bulgur, couscous
- Baking powder, cake icing, cream stiffener
- Fresh and dry yeast
- Baked peas, breadcrumbs
- Pudding powder, ready-made desserts
- Baking wafers, wafers
- Confectionery, ice cream, nut nougat cream
- Breaded meat and fish
- Grated parmesan cheese
What to look out for when shopping or eating out with a wheat allergy
Not only everyday life, but also shopping and eating out can be challenging for patients with a wheat allergy - especially for children. A look at the list of ingredients of packaged foods helps with a wheat-free diet: caution is advised with terms such as gluten, bulgur (wheat), couscous (wheat), durum wheat, flour (wheat), (modified) starch (wheat), wheat bran, wheat malt, wheat protein, breadcrumbs (wheat), vital gluten, spelt, gluten-free wheat starch. Other grain types and products such as rye or barley flour, oat flakes or cornflakes made from maize (with barley malt) as well as so-called pseudo-cereals or wheat-free binders are possible alternatives in the context of wheat allergy nutritional therapy.
Outside the home, people with a wheat allergy should specifically choose wheat-free food and drinks, e.g. uncoated vegetables, potatoes, rice, fish and meat without breading and no ready-made sauces or soups. Mineral water and fruit juices are suitable drinks - if beer is drunk, then only with barley malt (Pilsner, Kölsch).
Why gluten-free products are not automatically suitable for wheat allergies
Gluten-free products are not always suitable for people with a wheat allergy: In some cases, gluten-free wheat starch is used, which does not contain gluten but may contain other wheat proteins that can trigger a wheat allergy.
How can a wheat allergy diet be balanced?
Creating a wheat allergy diet plan is not just about eliminating wheat and related forms, but also about ensuring that the diet is still varied and balanced. The correct replacement of wheat products with tolerable and healthy alternatives is therefore an important part of practical nutritional therapy for wheat allergies.
It is particularly important to ensure a sufficient intake of zinc and folic acid, as well as fibre. Nutrient-rich cereals or pseudo-cereals are recommended, preferably from whole grains. Rye, oats, barley, amaranth, millet, quinoa and buckwheat, for example, are usually safe (without any foreign/wheat). The quality of the food is also very important.
Suitable substitutes for wheat-allergic diets
| Nahrungsmittel | Sorten |
|---|---|
| Cereals | Oats, barley, rye, sorghum (millet), rice, maize as flour or starch |
| Pseudocereals | Quinoa, amaranth (buckwheat*) |
| Starchy tubers | Tapioca starch, potato starch |
| Pulses | Soya flour (full-fat), locust bean gum, guar gum |
| Others | Chicory, chestnut flour, chickpeas, lentils |
*In the case of buckwheat, attention must be paid to possible foreign/wheat trimming
How strict is the dietary therapy for wheat allergy?
How strictly the wheat allergy diet must be adhered to on the type and extent of the wheat allergy. Some patients can tolerate products with traces of wheat or wheat products that have been sufficiently heated beforehand. A distinction must be made in particular between children and adults, between immediate and delayed type allergies or whether a WDEIA (wheat-dependent exercise induced anaphylaxis) is present.
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Read moreSources
- Aljada B, Zohni A, El-Matary W. The Gluten-Free Diet for Celiac Disease and Beyond. Nutrients. 2021; 13(11):3993.
- Leonard MM, Silvester JA, Leffler D, et al. Evaluating Responses to Gluten Challenge: A randomised, double-blind, 2-dose gluten challenge study. Gastroenterology. 2021;160(3):720-733.e8. doi:10.1053/j.gastro.2020.10.040
- Hischenhuber C, Crevel R, Jarry B, et al. Review article: Safe levels of gluten for patients with wheat allergy or coeliac disease. Aliment Pharmacol Ther. 2006;23(5):559-575. doi:10.1111/j.1365-2036.2006.02768.x
- Sabença C, Ribeiro M, Sousa T, Poeta P, Bagulho AS, Igrejas G. Wheat/Gluten-Related Disorders and Gluten-Free Diet Misconceptions: A Review. Foods. 2021;10(8):1765. published 2021 Jul 30. doi:10.3390/foods10081765
- Zheng W, Wai CYY, Sit JKC, Cheng NS, Leung CWM, Leung TF. Routinely used and emerging diagnostic and immunotherapeutic approaches for wheat allergy. Biomedicines. 2024;12(7):1549. published 2024 Jul 12. doi:10.3390/biomedicines12071549
- Felber J et al. Updated S2k guideline coeliac disease of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS), Z Gastroenterol 2022; 60: 790-856