Wheat intolerance is an increasingly familiar term in the western press. While some people find food containing wheat (mian) makes them a little uncomfortable, others have a more severe reaction. Coeliac's Disease (ru mi xie/ fu qiang ji bing) is a condition where the body attacks the small intestine in response to food containing gluten (mian jin), which is a protein found in wheat. This is a type of autoimmune disease and not an allergy. The villi which line the small intestine in the digestive tract become flattened and it becomes difficult to digest and absorb food.

This results in symptoms such as bloating, abdominal discomfort, diarrhea, wind and constipation. Coeliac's Disease is usually present from birth although some people are only diagnosed later in life. Anemia may develop because the body cannot absorb iron; osteoporosis, because of poor calcium absorption and in children it can lead to faltering growth.

Certainly day-to-day eating becomes a bit tricky, but with careful attention and thorough gluten exclusion it is possible to live symptom-free. Gluten is found in most wheat breads, wheat noodles, pasta, many breakfast cereals, wheat biscuits and crackers. It is also found in products made from rye and barley, and some people also react to oats. When eliminating these foods it is very important to replace them with alternatives otherwise you could find yourself losing weight and missing out on essential B vitamins and minerals found in such staple foods.

Northern and Western Europeans, as well as some African populations, show the highest incidence of Coeliac's Disease and its occurrence is low amongst Chinese people. Consequently Chinese supermarkets and restaurants are fairly unfamiliar with it. There are many hidden sources of gluten in Chinese cuisine. Sauces are a prime culprit -- soy, oyster, hoisin and plum sauces tend to contain gluten as do stock cubes and powder, and some types of MSG. The corn starch often used as a thickener for sauces on vegetables is thankfully gluten-free. Beware the mock meat served in Buddhist vegetarian restaurants as this is made almost entirely from gluten. Mantou, wheat noodles, baozi and jiaozi also need to be avoided.

Of course, there is a great abundance of rice and rice products (rice flour, rice noodles etc) that can be safely eaten. Alternative whole-grains are widely available both in Chinese supermarkets and in the Western and organic stores around Beijing. Such gluten-free options include buckwheat (qiao mai) which is from a completely different family to wheat, millet (xiao mi), sorghum (gao liang), and various types of rice including black and wild. Be cautious as they are often sold from open barrels in Chinese supermarkets - inviting ample opportunity for gluten-contamination. Organic shops such as Lohao City and De Run Wu stock many flour versions of these grains, as well as rice and buckwheat noodles. Although bread without gluten does not rise well, millet flat bread is tasty as are buckwheat pancakes. Starchy food such as potatoes, sweet potatoes, corn and pumpkin also make good alternatives.

Many snack food such as potato chips, savory snacks, sweets, biscuits and cakes contain gluten products such as wheat starch. This is a good excuse, if ever you needed one, to steer clear of these processed baddies and rely instead on fruits, dried fruits, nuts, seeds and homemade treats for your snacks.

This nutrition-related column is written by Nina Lenton, a qualified dietitian living in Beijing and working at Bayley and Jackson Medical Center. Contact her at nina.lenton@ikang.com

(China Daily 10/17/2007 page14)