Gluten-Free Diet (Gluten-Restricted Diet)

What Is Gluten?

Gluten is a type of protein found in wheat, barley, rye, and numerous other foods containing or made from these ingredients. Gluten can also be found in many non-food items, such as medicines, lipstick, and stamp adhesives.

Why Should I Follow a Gluten-Free Diet?

If you have gluten intolerance, or celiac disease , your body is unable to digest gluten. Consuming gluten may result in symptoms such as cramping, bloating, gas, and diarrhea . The only treatment is to eliminate gluten from your diet. Following a gluten-free diet can reverse any intestinal damage and nutrient deficiencies that may have occurred as a result of consuming gluten.

Gluten-Free Diet Basics

On this diet, gluten must be completely avoided, as any amount of gluten can cause damage to the small intestine. Learning how to eat gluten-free can be challenging, since gluten is found in many so-called staple foods, such as cereals, breads, and pasta.

Moreover, gluten is often found in unsuspecting foods, such as frozen yogurt, soy sauce, and beer. Fortunately, there are many gluten-free alternatives, making it possiblewith a little practice and help from a registered dietitianto still eat a well-balanced, satisfying diet.

Gluten-Free Eating GuideThe following guide lists foods that are recommended, foods that should be questioned because they may contain gluten, and foods that should be avoided. While this guide is fairly comprehensive, it is not a complete list of all the foods that should or should not be avoided. It is important to work with a registered dietitian who specializes in gluten intolerance to learn which foods can safely be a part of your diet.Food CategoryFoods RecommendedFoods to Question*Foods to AvoidGrains and Starchy VegetablesAmaranthArrowrootBuckwheat Bean flours (garbanzo, fava, romano) CassavaCornFlaxKashaHominyIndian rice grassJobs tearsMesquite flourMilletMontinaNut flours and mealsPea flourPotatoes, potato flour/starchQuinoa All forms of rice (eg, white, brown, jasmine, wild)SagoSorghumSoy flour Tapioca (manioc, cassava, yucca)Teff Uncontaminated oats **Yucca Baked products made with buckwheat (Buckwheat is sometimes blended with wheat flour in baking mixes.) Cereals (may contain barley malt flavoring or barley malt extract) Communion waferFrench friesMatzoRice mixes, rice pilafBarleyBulgurChapatti flourCouscousCracked wheatDinkelDurumEinkornEmmerFarinaFaroFuGluten, gluten flourGraham flourHydrolyzed wheat proteinKamutMaltMatzo flour/meal Oats (most commercial brands) **OrzoPankoRyeSeitanSemolinaSpeltTriticaleUdonWheat (wheat flour, wheat bran, wheat germ, other wheat products)Vegetables
All plain fresh, frozen, and canned vegetablesVegetables in sauceBreaded vegetablesFruitsAll plain fresh, frozen, and canned fruits Dried fruits (may be dusted with flour) Thickened fruitsMilkMilk, buttermilk, and creamPlain cheese, cream cheese, cottage cheeseYogurtCheese sauces and spreadsFlavored cheeseMalted milkMeats and BeansAll plain, fresh meat, poultry, and fishEggsLegumesNuts, nut butters (eg, peanut butter)SeedsTofuCold cuts, hot dogs, salami, sausageImitation seafoodFlavored tofuMeat marinades and flavoringsSeasoned nutsPoultry basted or injected with brothBreaded meat, poultry, or fishOils Vegetable oils (eg, canola and olive)Margarine (choose trans-free margarines)MayonnaiseSweets and Snack FoodsCakes, cookies, and pastries made from gluten-free floursCorn and rice tortillasEgg custardsGelatin dessertsPlain popcornPlain rice cakes or rice crackersPlain corn chips or corn crackersWhipped toppingsCandyIce cream, sherbet, sorbet, and popsiclesPotato chipsSeasoned or flavored snack chipsChocolate bars and candy that contain barley malt flavoring or wheat flour Ice cream made with gluten-containing ingredients (eg, cookie dough, brownies) Ice cream conesIcing and frostingBeverages
Distilled alcoholic beverages (eg, rum, gin, whiskey, vodka, wine, and pure liqueurs) CoffeeJuicesSoft drinksTeaCocoa drinks Flavored alcoholic beverages (eg, ciders and coolers)Flavored teas and coffeesNon-dairy soy, rice, potato, and nut beverages Undistilled alcoholic beverages (eg, beer, ale, lager) Other (Condiments, Baking Ingredients, Soups, Sauces, and Gravies) AspartameBaking sodaButter, lard, and shorteningCarob chips and carob powder Corn syrup, maple syrup, and sugar (brown, white, and confectioners)Cream of tartarHomemade brothsHoneyJams, jellies, marmaladeKetchupMustardPure cocoa, baking chocolate, and chocolate chipsPlain pickles and relishPure herbs and spicesPure black pepperSaltVanillaVinegars (eg, apple, balsamic, cider, distilled white, grape, wine, spirit)YeastBaking powderBouillon cubesBrown rice syrupGravy and saucesSoups and brothsSalad dressingsWorcestershire sauceMalt vinegarSoy sauceTeriyaki sauce *These are foods that may contain gluten. Many of these products are available in gluten-free versions, but it is important to carefully read the ingredient list.
**Uncontaminated oats may be consumed in limited amounts with approval and follow-up by a physician. Shopping for Gluten-Free FoodsWhen shopping for foods, its easy to become overwhelmed by all the available food products and figuring out which are gluten-free. It helps to begin with loading up on fresh foods that are naturally gluten-free, such as fruits and vegetables, milk, unprocessed cheese, meat, poultry, fish, eggs, legumes, nuts, and tofu. Then, add gluten-free sources of grain, such as rice, corn tortillas, and grits. These foods should be the staple of your diet. You can then supplement with snack foods, sweets, condiments, and special gluten-free items.When choosing food products, be sure to read the labels carefully. In the US and Canada, food manufacturers must list whether a product has any of the most common allergens, including wheat. What About Oats?Until recently, people with gluten intolerance were advised to avoid oats. But recent research shows that uncontaminated oats are generally well-tolerated when consumed in moderation. Regular, commercial oats are often contaminated with gluten-containing grains. Pure, uncontaminated oats, though, can be specially ordered from certain companies. Before adding oats to your diet, be sure to discuss it with your doctor.
Suggestions on Eating a Gluten-Free DietFocus on foods that are naturally gluten-free, such as fresh produce, fresh meat, poultry, seafood, eggs, milk, nuts, and cooking oils.Always read the ingredient list to make sure the food does not contain gluten.When eating out, ask about ingredients and food preparation.Avoid cross-contamination with gluten-containing products when preparing foods.Work with a registered dietitian to create a well-balanced gluten-free diet. RESOURCES: American Dietetic Associationhttp://www.eatright.org Celiac Disease Foundationhttp://www.celiac.org Childrens Digestive Health and Disease Foundationhttp://celiachealth.org CANADIAN RESOURCES: Canadian Celiac Associationhttp://www.celiac.ca Canadian Dietetic Associationhttp://www.dietitians.ca References: Celiac disease. National Institute of Diabetes and Digestive and Kidney Disease website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/ . Accessed April 6, 2007. The gluten-free diet. Canadian Celiac Association website. Available at: http://www.celiac.ca/EnglishCCA/egfdiet2.html#allowed . Accessed April 5, 2007. Gluten-free diet guide for families. Childrens Digestive Health and Disease Foundation website. Available at: http://celiachealth.org/pdf/GlutenFreeDietGuideWeb.pdf . Accessed April 4, 2007.
Raymonnd N, Heap J, Case S. The gluten-free diet: an update for health progessionals. Practical Gastroenterology . 2006 Sep. University of Virginia Health System. Available at: http://www.healthsystem.virginia.edu/internet/digestive-health/nutritionarticles/Sept0601.pdf . Accessed April 4, 2007. Last reviewed May 2008 by Dianne Scheinberg, MS, RD, LDNPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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