Grain Allergy
Symptoms of Grain Allergy
People who are grain-allergic may experience symptoms similar to those of wheat allergy. Symptoms occur in three major organ systems:
♦ Gastrointestinal tract: diarrhea, nausea, vomiting, gas, bloating, pain
♦ Respiratory tract: nasal congestion, sneezing, runny nose, itchy/watery eyes
♦ Skin: hives; angioedema; eczema
A Type I hypersensitivity reaction (immediate-type allergy) can occur within a few minutes to a few hours after ingesting the grain. A delayed reaction may occur up to 72 hours after eating the grain (more commonly within 24 to 48 hours). People showing this type of reaction must avoid the grains that cause it. The following information provides you with guidelines for avoiding all major cereal grains. Reintroducing each grain separately in a controlled “challenge” should enable you to identify the specific grain that is responsible for your symptoms.
Corn Allergy
Corn is a difficult allergen to avoid in the Western diet because so many prepared foods contain corn in the form of corn starch, corn syrup, or their derivatives. There are likely to be corn products in cereals, baked goods, snack foods, syrups, canned fruits, beverages, jams, jellies, cookies, luncheon meats, candies, other convenience foods, and infant formulas.
Corn oil is not usually allergenic, unless the product is contaminated during its manufacture by protein from the grain. Because corn protein is an extremely rare cause of anaphylaxis and because the quantity likely to be present is very small, it is not usually necessary to restrict corn oil as an ingredient in foods.
Elimination of corn does not lead to nutritional deficiencies as long as the usual intake of corn itself is small. However, if the usual diet contains many convenience foods, alternative corn-free products will be needed for adequate nutrition.
Corn is likely to be present in foods containing
| Corn | Corn flour |
| Cornmeal | Corn starch |
| Cornflakes | Popcorn |
| Cornmeal | Caramel corn |
| Corn sweetener | Maize |
| Corn syrup solids | Corn alcohol |
| Baking powder | Food starch |
| Hominy | Modified starch |
| Grits | Vegetable starch |
| Vegetable gum | Vegetable protein |
| Vegetable paste | Starch |
Hydrolyzed plant protein (HPP), hydrolyzed vegetable protein (HVP), and textured vegetable protein (TVP) may be made from corn. However, as with similar products derived from wheat, the hydrolysis process breaks down the protein to the point where it is unlikely to be allergenic. As a result, it is usually unnecessary to exclude these from a corn-restricted diet.
The Grain-Restricted Diet
This diet is designed to eliminate a variety of grains in addition to wheat to determine their possible role in causing symptoms of allergy or intolerance. The grains most likely to be involved as causative factors in grain-associated allergy include
♦ Wheat and grains derived from wheat, such as triticale, kamut, and spelt
♦ Rye
♦ Oats
♦ Barley
♦ Corn
More information on restricted foods can be found in Table The grain-restricted diet on the next page.
Table The grain-restricted diet
The following are restricted:
| Wheat | Corn |
| Semolina | Cornstarch |
| Spelt | Oatmeal |
| Triticale | Barley |
| Bulgur | Kamut |
| Couscous | Farina |
| Durum | Cornmeal |
| Rye | Oats |
Flours, breads, and crackers made from any of the above grains are restricted:
| White bread | Rye bread |
| Whole-wheat bread | Oat bread |
| Sourdough bread | Barley bread |
| All-purpose flour | Bread crumbs |
| Gluten flour | Cracker meal |
| Graham flour | Graham crackers |
| Phosphated flour | Matzos |
| Protein flour | Starch |
| Cracked wheat flour | Cream of Wheat |
| Durum flour | Wheat germ |
| Pastry flour | Bran |
| Self-rising flour |
These corn and corn products are restricted:
| Corn sugar* |
| Corn dextrose* |
| Corn syrup* |
| Sorbitol* |
The following Mexican foods are frequently made with corn:
| Tamales | Nachos |
| Tortillas | Tacos |
| Masa harina |
* Sugar, syrup, and sugar alcohols derived from grains are usually non-allergenic. However, if they are contaminated with a small amount of protein, they may cause an allergic reaction in extremely sensitive individuals. It is wise to avoid them until the limit of tolerance is known
The following products may contain grains as a “hidden ingredient” and should be avoided by people who are grain-allergic unless it is certain that they do not contain the grain responsible for the allergy:
| Weiners | Meat loaf |
| Sausages | Breaded meat or fish |
| Luncheon meats | Meat or fish in batter |
| Stuffing | Some canned soups |
| Spreads | “Thickened” soups or gravies |
| Pate | Bouillon cubes |
| Pies | Ice cream cone |
| Pie fillings | Some salad dressings |
| Croquettes | Icing sugar |
| Patties | Cereal coffee substitutes (Postur |
| Root beer | Commercial baking powder |
| Mustard pickles | Some soy sauces |
| Grain-derived alcoholic beverages (see below) | |
| Any product containing bread or bread crumbs | |
| Any product labeled “gluten-enriched” | |
| Malted milk | |
| Some cheese spreads or “cheese foods” | |
These products may contain corn:
Commercial baking powder
Breads, cookies, cereals, desserts (may contain cornstarch)
Commercial gravies and sauces (may be thickened with cornstarch) Luncheon meats
Miscellaneous products that are derived from grains, especially hydrolyzed proteins and Monosodium glutamate, are unlikely to cause an adverse reaction, because the protein is broken down to a form that is usually not allergenic. They need to be avoided only in the rare case where there is any risk of an anaphylactic reaction to grains.
| Malt | Malt flavoring |
| Malt vinegar | Sprouted wheat |
| Monosodium glutamate | Sprouts from any restricted grain |
| Hydrolyzed vegetable protein (HVP) | Beer, lager, ale, porter |
| Hydrolyzed plant protein (HPP) | Bourbon, vodka, and gin (may contain corn) |
Table The grain-restricted diet: foods allowed and foods restricted
| Type of Food | Foods Allowed | Foods Restricted |
| Breads, Cereals,
and Substitutes |
Breads, baked goods,
cereals, pancakes, pasta, and snack foods made from any restricted grain: • Rice flour and starch • Potato flour and starch • Millet flour • Buckwheat groats and flour • Kasha • Amaranth flour • Quinoa flour • Tapioca starch • Sago starch and flour • Soy flour • Lentil flour • Pea and bean flours • Chickpea flour • Arrowroot starch and flour • Nut meal and flour • Seed meal and flour from allowed grains |
Breads, baked goods, cereals,
pancakes, pasta, and snack foods made from any restricted grain: • Wheat • Kamut • Spelt • Triticale • Semolina • Durum • Bulgur • Farina • Couscous • Matzoh • “Gluten enriched” flour • Malt • Rye • Oats • Barley • Corn |
| Milk and
Milk Products |
All milk and milk products
without restricted ingredients, including: • Milk • Yogurt • Buttermilk • Cheeses • Cream cheese • Cottage cheese • Butter • Ice cream (check composition for presence of restricted ingredients) |
Any containing restricted ingredients,
especially • Cocoa powders • Chocolate mixes • Hot chocolate • Cheese sauces • Cheese spreads • Malted milk |
| Meat, Fish
and Poultry |
• All plain, fresh, frozen or
canned without restricted ingredients • Battered with allowed grains, flours, or crumbs • Plain deli products without restricted ingredients |
Meats that might contain restricted
ingredients (check labels): • Luncheon meats • Weiners • Sausages • Pates • Spreads • Stuffing • Meat loaf • Croquettes • Battered meats • Breaded meats • Manufactured products containing -HVP -HPP -Monosodium glutamate |
| Eggs | All plain or prepared | Egg dishes containing restricted |
| without restricted ingredients | grains such as
• Quiche • Mousse • Pavlova • Souffle |
|
| Nuts and Seeds | • All plain, uncoated nuts
and allowed seeds • Raw or roasted with allowed oils |
Snack nuts and seeds coated with
restricted ingredients or coated with flavoring agents such as • HPP • HVP • Monosodium glutamate |
| Vegetables | • All fresh, frozen, or
canned plain vegetables • Prepared with allowed ingredients • Sprouted grains and seeds on allowed list • All plain vegetable juices |
Any vegetable prepared with any
restricted grain as • Coating • Breading • Marinade • Garnish • Sprouted |
| Legumes | All plain peas, beans, and
lentils prepared with allowed ingredients • Dais prepared without added restricted flours and grains • Plain tofu • Soy products • Peanut butter |
All legume dishes containing
restricted grains and flours, such as • Dais with added wheat • Tofu patties coated with wheat flour or bread crumbs |
| Fruits | All pure fruit and fruit juices,
fresh, frozen, or canned |
All fruit dishes containing restricted
ingredients, such as • Pie fillings • Fruit sauces • Dessert fillings and toppings |
| Fats and Oils | • Butter
• Margarines made from allowed oils • All pure vegetable, nut, seed, and fish oils, such as - Olive - Sunflower - Safflower - Canola - Avocado - Grapeseed -Soy - Peanut - Sesame - Mustard - Walnut • Lard • Meat drippings |
• Margarine made with oil from
restricted grains such as corn • Wheat germ oil • Corn oil • Salad dressings made from restricted ingredients • Gravy thickened with any restricted flour or starch |
| Herbs and Spices | All plain herbs and spices | Seasoning mixes with restricted
ingredients • HPP • HVP • Monosodium glutamate |
| Sweeteners | • Sugar
• Honey • Molasses • Maple syrup • Jams • Jellies • Preserves • Date sugar |
Sweets containing restricted
ingredients, such as • Icing sugar • Corn sugar and syrup • Corn dextrose • Sorbitol • Marshmallows |
Oils from Restricted Grains
Pure oils are nonallergenic, however, if the oil is not completely pure, it may contain a small amount of the grain protein as a contaminant. It is wise to avoid corn oil and wheat germ oils until the limit of tolerance is known.
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