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Gastroenterology

  • Gluten-Free Diet for Celiac Disease

    Reading food labels will help you avoid foods with gluten.

    You’ve been told that you have celiac disease. This means that you are sensitive to a protein called gluten. Gluten is found in certain grains. When you ingest gluten, your immune system causes harm to your intestines. The treatment for celiac disease is to avoid foods and products that contain gluten. You will need to do this for the rest of your life. Avoid the temptation to “cheat,” even a small amount of gluten can cause symptoms to return. And it can harm to your body. This sheet gives you the basics about a gluten-free diet. If you need help, a registered dietitian (RD) can teach you what foods and other products have gluten and how to avoid them.

    Always Read Labels!

    Many foods may contain gluten, even if you think they don’t. Get into the habit of reading ingredient labels before you eat.

    Choosing Foods

    The most common source of gluten is wheat flour (this includes “white” flour). Wheat flour is used to make many baked goods, including breads, pastas, cereals, pastries, and pizza dough. But gluten is also found in many foods that you might not think would have it. You will need to read food labels to look for gluten in everything you eat. But your diet does not need to be boring. Many foods are naturally gluten-free. And many foods commonly made with wheat flour now come in gluten-free forms. But keep in mind that if something is labeled “wheat-free” it may not be also gluten-free.

    Foods to Avoid

    Foods You Can Eat

    Bread, cereals, pasta, pastries, couscous, or pizza dough made with wheat flour (this includes white flour and semolina)

    Bread, cereals, pasta, pastries, or pizza dough made with rice flour, almond flour, beans, potatoes, or other substitutes

    Foods containing rye, barley (including malt), spelt, kamut, or bulgur

    Foods containing corn, rice, amaranth, buckwheat, millet, quinoa, or tapioca

    Processed meats

    Fresh meats and seafood (beef, chicken, turkey, lamb, pork, fish, shellfish)

    Some dairy products with additives

    Many plain dairy products

    Many sauces, gravies, dressings, and condiments

    Vinegar, oils, and gluten-free substitutes

    Some granola bars and energy bars

    Gluten-free granola bars and energy bars

    Some beers and spirits

    Wine, and gluten-free beers and spirits

    Some soups

    Gluten-free soups

    Fruits and vegetables that are fried or breaded

    Fresh fruits and vegetables

    Many packaged foods

    Beans

    Oats (check with your healthcare provider)

    Tofu

    Communion wafers

    Gluten-free communion wafers

    Avoiding Accidental Exposure to Gluten

    Staying gluten-free means always being aware. Even if you are very careful, mistakes can happen. The food you eat can’t come into contact with gluten. Your meals must be made with utensils that have not touched foods that contain gluten. Shared knives, cutting boards, toasters, and storage containers are risks for gluten exposure. Shared condiments may have crumbs that contain gluten. At restaurants, parties, and other places where you eat food prepared by others, ask how the food was made. Gluten can also be found in some non-food items. Some medications contain gluten. So do some vitamin supplements. Ask your pharmacist before taking a medication or supplement. Also, some shampoos, lotions, makeup, glues, soaps, and other products contain gluten. It can be possible to ingest some gluten when using these projects. This is called cross-contamination. For example, this can happen if you use a lotion that has gluten and then touch food you eat. Also note that Play-Doh and similar products have gluten. Any adult or child with celiac disease should wash their hands after handling these.

    Coping with Gluten-Free Living

    Living gluten-free can be hard. While there are many gluten-free foods now that you can buy, it is still a big change for many people. You may be upset that you can’t eat your favorite foods, eat freely at restaurants, parties, or over the holidays. Household members may also be upset by the strict controls over food. If you face problems like these, think about joining a celiac disease support group. Support groups offer tips on how to make a gluten-free lifestyle easier on you and the people you live with. You can find ways to involve the people in your household. There are many ways to make gluten-free group meals. See “More Resources” below for help in finding a group.

    Bring safe foods that you enjoy to parties and school or work events. This can help you avoid the urge to grab something you shouldn’t eat.

    Following Up with Your Health Care Provider

    You should see your health care provider at least once a year for a celiac checkup. A simple blood test can show if your celiac disease is under control. If you are having symptoms, your health care provider can help you find sources of gluten you may have missed.

    More Resources

    To learn more about managing celiac disease, try these resources:

    • Celiac Disease Foundation: www.celiac.org

    • Academy of Nutrition and Dietetics: www.eatright.org

    • National Digestive Diseases Information Clearinghouse: www.digestive.niddk.nih.gov