April 23, 2023

Should You Follow a Gluten-Free Diet? Learn About What It Is and What You Can Eat

If you have celiac disease, you need to avoid foods that contain gluten

Gluten free meat pies offered at bakery counter.

You may have come across gluten-free recipes and even seen gluten-free items on menus at restaurants. But should you start following a gluten-free diet?

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While it may be a dietary choice for some people, those who have celiac disease need to follow a gluten-free diet for their entire life.

So, what does a gluten-free diet plan require? Registered dietitian Anna Taylor, MS, RDN, LD, CDCES, explains what a gluten-free diet is, what to avoid and what you can eat.

What is a gluten-free diet?

If you follow a gluten-free diet, you need to exclude foods that contain gluten, a protein found in wheat, rye and barley. Gluten is typically found in flour and certain pastas and grains.

Your meals should focus on eating whole foods that don’t have gluten. Think fruits, vegetables, meat, fish, poultry, eggs, beans, nuts, seeds, oils, dairy and gluten-free grains like quinoa, rice and corn.

“Instead of thinking about all the foods that do contain gluten, start with making a list of all the foods you already love that naturally don’t have gluten,” suggests Taylor. “Then, make a list of the gluten-containing foods you think you’ll miss. Specialty gluten-free products typically exist to fill these gaps.”

Who should be following a gluten-free diet?

If you’ve been diagnosed with celiac disease, your healthcare provider likely informed you that you’ll need to follow a strict and lifelong gluten-free diet. This means avoiding all foods that contain or have come in contact with wheat, barley or rye ingredients.

You should be very careful to avoid gluten because, when you have celiac disease, ingesting even small amounts can trigger an autoimmune response in your body that can damage your intestinal lining. The damage can lead to a variety of symptoms that can affect your overall health, so it’s important that you understand how to follow a gluten-free diet.

Some people may have a gluten sensitivity or intolerance, while others may be allergic to wheat and need to avoid foods that have wheat.

For still for others, avoiding gluten can be a lifestyle choice. There are claims that eating gluten-free can aid in weight loss and increase energy, but more research is needed to fully understand the role gluten plays in our bodies if you don’t have celiac disease.

Eating gluten-free may also lead to nutritional deficiencies in certain minerals and vitamins like fiber, iron and calcium for those who don’t have a medical condition that requires them to avoid gluten. Many gluten-free products are higher in calories, lower in fiber or higher in fat or sugar to compensate for the lack of gluten, which helps make grain products tender.

“A gluten-free diet will definitely take some adjusting to, but it isn’t a sentence to a life without bread, pasta or other foods you love,” explains Taylor. “Thanks to the many gluten-free products and recipes readily available today, it’s possible to follow a gluten-free diet and still enjoy many of your favorite foods. It just requires some extra effort and care.”

How to start a gluten-free diet

The tenets of a gluten-free diet require you to avoid foods and ingredients that contain gluten. Taylor outlines a gluten-free diet list of what you can and can’t eat.

Foods to avoid

When you’re following a gluten-free diet, you’ll need to avoid these gluten-containing ingredients:

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  • Barley.
  • Barley malt/extract.
  • Bulgur.
  • Couscous.
  • Durum.
  • Einkorn.
  • Emmer.
  • Farina.
  • Faro.
  • Graham flour.
  • Kamut.
  • Matzo flour/meal.
  • Orzo.
  • Panko.
  • Rye.
  • Seitan.
  • Semolina.
  • Spelt.
  • Triticale.
  • Udon.
  • Wheat.
  • Wheat bran.
  • Wheat germ.
  • Wheat starch.

When it comes to gluten, not all foods are so straightforward. Some ingredients and foods may or may not contain gluten, depending on how they’ve been made. It’s best to avoid these products unless you can verify that they don’t contain gluten or aren’t derived from gluten-containing grains:

  • Brown rice syrup (can be made from barley).
  • Flour or cereal products.
  • Hydrolyzed vegetable protein (HVP), hydrolyzed plant protein (HPP) or textured vegetable protein (TVP).
  • Malt vinegar (distilled vinegar is OK).
  • Modified food starch.
  • Rice malt.
  • Seasonings or “natural flavors.”
  • Soy sauce or teriyaki sauce.

And while many products advertise their gluten-free status on their packaging, you won’t see products that aren’t gluten-free with labels that say, “Full of gluten!” You’ll have to get good at checking food labels carefully and scrutinizing every ingredient.

Be especially careful with products that might contain unexpected gluten like:

  • Breading.
  • Brewer’s yeast.
  • Broth/bouillon.
  • Brown rice syrup.
  • Communion wafers.
  • Croutons.
  • Salad dressings.
  • Drugs or over-the-counter medications.
  • Energy bars.
  • Herbal or nutritional supplements.
  • Ice cream or gelato.
  • Imitation bacon and seafood.
  • Licorice.
  • Marinades.
  • Medication or supplements (rarely; look for words like starch, pregelatinized starch or flour).
  • Playdough (wash your hands after using).
  • Processed meats (deli meats, salami, bologna, hot dogs, lunch meats).
  • Roux.
  • Sauces and gravies.
  • Thickeners.
  • Veggie burgers.

Foods to eat

So, what can you eat on a gluten-free diet? First, know that all fruits, vegetables, legumes, nut and seeds, oils, meat, seafood, eggs, poultry and dairy products are free of gluten in their natural forms.

But if these foods have been processed — and have had additives, flavors or other ingredients added to them — they may not be safe to eat.

When it comes to other gluten-free diet foods, there are plenty of gluten-free grains. Grains and starches that are green-lighted on a gluten-free diet include:

  • Amaranth.
  • Arrowroot.
  • Buckwheat.
  • Corn.
  • Millet.
  • Potatoes, including sweet potatoes.
  • Quinoa.
  • Rice.
  • Sago flour.
  • Sorghum.
  • Tapioca.
  • Teff.
  • Wild rice.

“Oats are naturally gluten-free and are also a great source of vitamins, minerals and fiber that might otherwise be lacking in a gluten-free diet,” notes Taylor. “However, they’re often grown, processed or stored near wheat or products that contain wheat. If you do purchase oats, look for a certified gluten-free label.”

Tips for gluten-free diet beginners

Need a gluten-free diet plan for beginners? Taylor says doing the following can help you find your footing:

  • Plan your grocery list ahead of time. It can be helpful to think of what meals you want to make throughout the week and write out a list of ingredients you need. That way you can take the time to look for recipes that are gluten-free.
  • Look for substitutes. You’re bummed that you can’t use wheat flour for that birthday cake you wanted to make. Luckily, today, there are plenty of gluten-free options available like gluten-free flours or alternative grain flours. You can also use gluten-free grains as a replacement in recipes that call for grains that contain gluten. For example, try chickpea pasta, brown rice pasta or quinoa pasta instead of regular gluten-containing semolina pasta.
  • Consider storage. Think about how you store your gluten-free items. You may want to set up or establish a separate area from foods that contain gluten to avoid cross-contamination. Also, it’s a good idea to keep a set of utensils just for cooking or baking with gluten-free ingredients. For example, gluten-free bread should be toasted in a toaster that is only reserved for gluten-free products, otherwise the crumbs from regular bread can contaminate your gluten-free bread. Similarly, although regular peanut butter is gluten-free, if people are double-dipping their knife in to spread on their regular wheat bread, that peanut butter can become a carrier for crumbs of gluten onto your gluten-free bread.
  • Have a conversation. It’s important to let family members and friends know that you’re going gluten-free. They’ll be more likely to pick restaurants that have gluten-free options and can make sure they have gluten-free dishes during meals and celebrations.

“Start with replacing all the obvious gluten-containing grain products with naturally gluten-free grains. Then, start working on reading ingredients lists on condiments, experimenting with different gluten-free recipes and buying a couple specialty gluten-free products to see if you can find a bread, wrap, pasta and cracker you like,” advises Taylor.

“Finally, think about where cross-contamination could be coming into play. Take it all in steps — you’re not going to overhaul your entire eating pattern overnight. It’s going to take a few weeks to get all that gluten out of your diet.”

How to shop for gluten-free foods

Most national and regional grocery chains stock gluten-free packaged and convenience foods. Sometimes, they’re located in a special aisle or section, but often they’re on the shelf alongside other foods. If you have access to health food stores, these typically have a good variety of gluten-free items.

Any packaged product marketed as “gluten-free,” “without gluten,” “free of gluten” or “no gluten” must contain less than 20 parts per million of gluten — the lowest detectable level in foods — according to the U.S. Food and Drug Administration (FDA)’s safety standards.

But it’s a good idea to get in the habit of checking every product’s ingredient list, regardless of the claims made on its packaging. (Beware of products marketed as “wheat-free” — that’s not the same as gluten-free.) And don’t be afraid to ask store managers or staff if a particular item is gluten-free.

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An important caveat when grocery shopping: Gluten-free doesn’t equal healthy.

Processed gluten-free foods like breads and sweets can still be high in fat, sugar and sodium, and low in fiber.

Follow these tips to make the healthiest choices at the grocery store:

  • Shop mostly in the perimeter of the store. This is where you’ll typically find nutritious foods like fruits, vegetables, meat, fish, poultry and dairy products.
  • Look for packaged gluten-free items made from whole grains. Choose packaged gluten-free foods that are made from whole grains like brown rice or quinoa instead of white rice or corn flour.
  • Review the ingredient list. Scour the ingredient list for any of the red-flag ingredients mentioned above.
  • Make fruits, vegetables, beans and lean protein your best friends. If you make a gluten-free pizza or pasta dish, load it up with vegetables and lean protein.
  • Watch out for gluten-free frozen meals. Like all frozen meals, they can be loaded with sodium.
  • Save the gluten-free specialty products, snacks and desserts for special occasions. Not only are they pricey, but they’re also typically lacking in fiber, protein and vitamins and minerals, often marking them as a source of excess calories that could lead to undesired weight gain. Instead, reach for mostly fruits and vegetables between meals.

Tips for dining out

The best way to avoid gluten when you’re eating out is to prepare ahead of time. Start by calling the restaurant you plan to visit to see if they’re able to safely prepare your food without gluten and without risk of cross-contamination.

Then, check out the menu online and make a mental note of dishes that sound good to you.

If you’re gluten-free because of celiac disease, when you get to the restaurant, tell your server that you can’t be exposed to gluten. It’s important to be firm.

You might say: “I have celiac disease, so I can’t eat foods that contain or that have come in contact with wheat, barley, rye or oats (unless oats are certified gluten-free) or else I’ll get very sick.”

They may offer you a gluten-free menu or suggest items that can be prepared gluten-free. Don’t be afraid to ask questions. Even a little bit of gluten contamination could make you sick, so it’s best to be safe rather than sorry.

Here are some things to note when you’re selecting items from the menu:

  • Salads. Make sure your server knows that croutons can’t come in contact with your salad. Some salad dressings contain flour as a thickener, so ask your server about the ingredients. You can ask for just olive oil and balsamic vinegar as a safe bet.
  • Soups. They’re often thickened with flour. Ask your server.
  • Meat. Opt for grilled meats instead of fried, and ask what the meat has been marinated in.
  • Meat substitutes. Veggie burgers and other meat substitutes are often made with fillers that contain gluten. Check with your server.
  • Fried foods. Avoid anything fried like French fries, onion rings or tortilla chips unless the restaurant has a separate fryer dedicated to gluten-free foods.
  • Alcohol. Distilled alcoholic beverages like gin, rum, vodka and wine are safe on a gluten-free diet. Most wine coolers, beers, ales and lagers — unless they’re specified as gluten-free — do contain gluten because they were fermented from gluten-containing grains.

Avoid dishes that have these words in their name or description, which suggest they contain wheat:

  • Au gratin.
  • Bechamel.
  • Cordon bleu.
  • Encrusted.
  • Farfel.
  • Fricassee.
  • Fritter.
  • Gnocchi.
  • Meuniere.
  • Pan gravy.
  • Raspings.
  • Roux.
  • Scallopini.
  • Soy or teriyaki sauce.
  • Tempura.
  • Veloute.

Still feeling overwhelmed? Know that you’re not alone. If you’re having trouble navigating a gluten-free diet, seek out a dietitian in your area who can help you identify healthy gluten-free foods, develop meal plans and make sure all your nutritional needs are being met.

“For celiac disease, the food is the medicine,” says Taylor. “Currently, the only treatment for celiac disease is a gluten-free diet — but when done right, it’s an incredibly effective treatment. Changing your eating pattern can be a lot of work, but take it one day at a time — one food at a time — and you’ll be feeling better within a few weeks.”

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