A gluten-free diet is a diet that excludes the protein gluten. Gluten is found in grains such as wheat, barley and rye. A gluten-free diet is used to treat celiac disease. Gluten causes inflammation in the small intestines of people with celiac disease. Eating a gluten-free diet helps people with celiac disease control their signs and symptoms and prevent complications. Initially, following a gluten-free diet may be frustrating. But with time, patience and creativity, you'll find there are many foods that you can eat and enjoy while observing a gluten-free diet.
The gluten-free diet is a treatment for celiac disease.
Avoid food and drinks containing:
- Graham flour
- Matzo meal
- Spelt (a form of wheat)
Avoid unless labeled 'gluten-free'
Avoid these foods unless they're labeled as gluten-free or made with corn, rice, soy or other gluten-free grain. Also, check the label to see that they're processed in a facility that is free of wheat or other contaminating products:
- Imitation meats or seafood
- Processed luncheon meats
- Salad dressings
- Sauces (including soy sauce)
- Self-basting poultry
- Cakes and pies
NOTE: Certain grains, such as oats, can be contaminated with wheat during growing and processing stages of production. It's not clear whether oats are harmful for most people with celiac disease, but doctors generally recommend avoiding oats unless they are specifically labeled gluten free. The question of whether people eating a gluten-free diet can consume pure oat products remains a subject of scientific debate.
Many other products that you eat or that could come in contact with your mouth may contain gluten. These include:
- Food additives, such as malt flavoring, modified food starch and others
- Lipstick and lip balms
- Medications and vitamins that use gluten as a binding agent
- Play dough
Cross-contamination also may occur anywhere ingredients come together, such as on a cutting board or a grill surface. You may be exposed to gluten by using the same utensils as others, such as a bread knife, or by sharing the same condiment containers — the condiment bottle may touch the bun, or a knife with breadcrumbs may contaminate a margarine stick or mayonnaise jar.
There are still many basic foods allowed on a gluten-free diet. With all foods, check to see that each is labeled gluten-free or call the manufacturer to double-check.
Grains and starches allowed in a gluten-free diet include:
- Fresh meats, fish and poultry (not breaded, batter-coated or marinated)
- Most dairy products
- Wine and distilled liquors, ciders and spirits
- Gluten-free flours (rice, soy, corn, potato, bean)
- Hominy grits
- Pure corn tortillas
People with celiac disease who eat a gluten-free diet experience fewer symptoms and complications of the disease. People with celiac disease must eat a strictly gluten-free diet and must remain on the diet for the remainder of their lives.
In some severe cases, a gluten-free diet alone can't stop signs and symptoms of celiac disease. In these cases, doctors might prescribe medications to suppress the immune system.
Not eating enough vitamins
People who follow a gluten-free diet may have low levels of certain vitamins and nutrients in their diets. Many grains are enriched with vitamins. Avoiding grains with a gluten-free diet may mean eating fewer of these enriched products. Ask your dietitian to review your diet to see that you're getting enough:
Iron, Calcium. Fiber, Thiamin, Riboflavin, Niacin, Folate
Not sticking to the gluten-free diet
If you accidentally eat a product that contains gluten, you may experience abdominal pain and diarrhea. Some people experience no signs or symptoms of eating gluten, but this doesn't mean it's not damaging their small intestines. Even trace amounts of gluten in your diet may be damaging, whether or not they cause signs or symptoms.
If you are allergic to wheat, read food labels carefully and avoid all products that list wheat as an ingredient. Some ingredients are obvious, such as refined wheat, wheat bran, whole-wheat or just plain wheat. Some less obvious wheat terms include semolina, durum, couscous, stone-ground, bulgur, dinkle, spelt, einkorn, fu, kamut, matzo, seitan, and triticale. People with celiac disease should avoid all of these ingredients, as well as any foods made with rye and barley.
People with wheat allergies can safely eat foods made with any grains except wheat, including rye- and barley-based products. If you have a wheat allergy or celiac disease, you can also safely enjoy foods that contain almond flour, amaranth, brown or white rice, corn, arrowroot, tapioca, coconut flour, dasheen flour, flaxseed, hominy, maize, and quinoa.
Food Preparation Tips
When you're preparing gluten-free meals or snacks, remember that four of the five food groups are naturally gluten-free in their natural state. You can comfortably add fresh, canned or frozen vegetables and fruits to your diet as long as gluten hasn't been added as a thickener or preservative. Milk and most dairy products are also gluten-free.
Gluten is a plant protein, so animal foods such as meat, poultry and fish are gluten-free as long as you don't add breading or gluten-laden sauces to them. If you have a wheat allergy but can safely ingest other forms of gluten, you have more freedom to plan healthy meals.
Sharp rises in celiac disease diagnoses since 2000 have brought the gluten content of food to the forefront. Grocery stores have incorporated gluten-free food sections, pizza shops are offering gluten-free dough and many microbreweries now offer gluten-free beers. While no two cases of celiac disease are the same, avoiding wheat gluten is essential to remain healthy and prevent symptoms from worsening. The U.S. Food and Drug Administration has a fairly strict guideline as of 2015 for what is gluten-free, so food labels are reliable in the U.S. once you learn how to identify the hidden gluten words.
Cereals and Grains
Wheat, barley, and rye are high in gluten content, so it is important to read ingredient labels and avoid these when shopping. Quinoa--a South American grain high in protein--and rice make suitable substitutes, according to the Celiac Disease Center at Columbia University Medical Center. Buckwheat can replace flour in pancake recipes, while millet can take the place of oatmeal or cream of wheat at breakfast. Major food manufacturers are getting in on the game. General Mills makes gluten-free versions of Bisquick, its Betty Crocker baking mixes and five varieties of Chex cereal.
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Fruits and vegetables are open for consumption by people with celiac disease or gluten intolerance. Fresh and frozen fruits and vegetables can be eaten in all quantities. The Celiac Association says some canned varieties may contain thickeners or preservatives that may contain wheat gluten. Potatoes and sweet potatoes, while starchy, do not contain wheat gluten.
Examine the ingredients labels on meats and meat products carefully. The Celiac Association reports that processed and butchered meats may contain fillers, including grains, that may trigger reactions. Sausages are typically loaded with fillers according to the CA and may need special evaluation before consumption. Deli meat makers Boar's Head and Dietz & Watson have taken the lead in the marketplace to offer a selection of gluten-free meats. Hard cheeses are acceptable for people with gluten tolerance issues, according to the Celiac Association.