Shanghai Expats with celiac disease (also known as coeliac disease) or other gluten sensitivities can find a number of locations in Shanghai to purchase gluten-free products.
There is also an organization especially to help gluten-sensitive Shanghai expats, Gluten-Free China, which hosts various events and works with several partners to provide gluten-free products.
We have a list of gluten free food in Shanghai at the end of this article.
Celiac (coeliac) disease is a disease of the small intestine. When sufferers ingest gluten, found in wheat, barley and rye, they have an immune reaction which damages the lining of their intestine.
Approximately 1-2 percent of Caucasians have the disease, but due to its often mild symptoms or even being asymptomatic (experience no symptoms), only about 30 percent are diagnosed. Symptoms of the disease include diarrhea, constipation, weakness, infertility, hair loss, skin problems and stomach pains.
Although the symptoms are very mild in most sufferers, it can lead to a deficiency in the absorption of needed nutrients. Over time, sufferers can have more serious problems such as osteoporosis, colon cancer, rheumatoid arthritis, eczema, thyroid abnormalities and reduced blood flow to the brain.
There is no cure for the disease and people must be born with the genetic predisposition to develop it.
Previously it was very difficult to get tested for celiac disease in China, as it is rarer among Asian people. Even in most Western countries blood tests to multiple intestine biopsies to gene tests might be required to get a definitive answer.
In 2014 Gluten Free Shanghai (GFSH) begun to distribute a home test kit for the detection of celiac disease from a fingertip blood sample; the Biocard Celiac Home Test developed by Labsystems Diagnostics Group of Finland.
The author of this article was concerned about this disease, so purchased one of the test kits from GFSH. The test proved to be quite simple to apply by myself.
There are diagrams for most steps, but not all steps so you need to read the instructions carefully 2-3 times before you start.
A tiny pin prick is required, but almost painless. I did not squeeze enough blood out at the start so had to squeeze a bit more, but it is still a tiny amount required. Overall the test was simple, quick and easy to get the result.
Coeliac disease is just one part of a broader category known as gluten sensitivity or gluten intolerance, aka Non-coeliac gluten-sensitivity (NCGS), none of which can be cured. Eating gluten-free Shanghai food, therefore, is a life long requirement for 5-10 percent of the population.
Apart from digestive problems, gluten sensitivity can lead to mood problems such as anxiety, and depression, due to lack of nutrient absorption.
If you have ruled out Celiac disease, you can test yourself for such sensitivities by avoiding any gluten containing foods for a few weeks, followed by slowly bringing them back into your diet, and observing the differences in your digestion and mood.
It is better to test for celiac before you start the gluten-free diet, as the test could bring back negative results even for people who have the disease if they have already been off gluten foods.
Another condition which is sometimes confused with Celiac disease or gluten intolerance is wheat allergy.
People who are allergic to wheat rather than gluten have to abstain from wheat products only, and not other grains. It is, therefore, recommended to get tested for wheat allergy in addition to celiac disease before you start a gluten-free diet.
People with any gluten intolerance should avoid wheat, rye and barley, but also must be careful of the many processed foods that contain these ingredients or any form of gluten. Unlike wheat, sometimes rye and barley are hidden ingredients in processed food and not found on the label.
Oats do not contain gluten, but often get mixed with grains that do, so you must also be careful with them.
Shanghai expats with celiac disease or gluten intolerance also need to be careful of traditional Chinese vegetarian food, which has many mock meat dishes made from Seitan (pronounced "say-tahn") (miàn jīn 面筋), which is actually wheat gluten.
Although you might think that you have to give up some of your favorite foods, such as bread and pizza, actually there are many substitute flours that can be used to make these items. There are cookbooks with gluten free recipes and you can buy foods labeled as “Gluten-free”.
For an excellent resource on
Gluten and other Food sensitivities refer to The Anti-anxiety Food
Solution, written by Trudy Scott.
Gluten-free food is now a very big industry in the West, but only recently started to be regulated. The US created its first standard for Gluten-Free, no gluten, free of gluten and without gluten in August 2013, with a one year grace period for food manufacturers to comply.
This new standard requires
foods so labeled to have no more than 20 parts per million of gluten,
considered to be a safe amount even for people with the celiac disease.
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