• 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 possible—with a little practice and help from a registered dietitian—to still eat a well-balanced, satisfying diet.

    Gluten-Free Eating Guide

    The 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 Category Foods Recommended Foods to Question * Foods to Avoid
    Grains and Starchy Vegetables
    • Amaranth
    • Arrowroot
    • Buckwheat
    • Bean flours (garbanzo, fava, romano)
    • Cassava
    • Corn
    • Flax
    • Kasha
    • Hominy
    • Indian rice grass
    • Job’s tears
    • Mesquite flour
    • Millet
    • Montina
    • Nut flours and meals
    • Pea flour
    • Potatoes, potato flour/starch
    • Quinoa
    • All forms of rice (eg, white, brown, jasmine, wild)
    • Sago
    • Sorghum
    • Soy 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 wafer
    • French fries
    • Matzo
    • Rice mixes, rice pilaf
    • Barley
    • Bulgur
    • Chapatti flour
    • Couscous
    • Cracked wheat
    • Dinkel
    • Durum
    • Einkorn
    • Emmer
    • Farina
    • Faro
    • Fu
    • Gluten, gluten flour
    • Graham flour
    • Hydrolyzed wheat protein
    • Kamut
    • Malt
    • Matzo flour/meal
    • Oats (most commercial brands) **
    • Orzo
    • Panko
    • Rye
    • Seitan
    • Semolina
    • Spelt
    • Triticale
    • Udon
    • Wheat (wheat flour, wheat bran, wheat germ, other wheat products)
    Vegetables
    • All plain fresh, frozen, and canned vegetables
    • Vegetables in sauce
    • Breaded vegetables
    Fruits
    • All plain fresh, frozen, and canned fruits
    • Dried fruits (may be dusted with flour)
    • Thickened fruits
    Milk
    • Milk, buttermilk, and cream
    • Plain cheese, cream cheese, cottage cheese
    • Yogurt
    • Cheese sauces and spreads
    • Flavored cheese
    • Malted milk
    Meats and Beans
    • All plain, fresh meat, poultry, and fish
    • Eggs
    • Legumes
    • Nuts, nut butters (eg, peanut butter)
    • Seeds
    • Tofu
    • Cold cuts, hot dogs, salami, sausage
    • Imitation seafood
    • Flavored tofu
    • Meat marinades and flavorings
    • Seasoned nuts
    • Poultry basted or injected with broth
    • Breaded meat, poultry, or fish
    Oils
    • Vegetable oils (eg, canola and olive)
    • Margarine (choose trans-free margarines)
    • Mayonnaise
    Sweets and Snack Foods
    • Cakes, cookies, and pastries made from gluten-free flours
    • Corn and rice tortillas
    • Egg custards
    • Gelatin desserts
    • Plain popcorn
    • Plain rice cakes or rice crackers
    • Plain corn chips or corn crackers
    • Whipped toppings
    • Candy
    • Ice cream, sherbet, sorbet, and popsicles
    • Potato chips
    • Seasoned or flavored snack chips
    • Chocolate bars and candy that contain barley malt flavoring or wheat flour
    • Ice cream made with gluten-containing ingredients (eg, cookie dough, brownies)
    • Ice cream cones
    • Icing and frosting
    Beverages
    • Distilled alcoholic beverages (eg, rum, gin, whiskey, vodka, wine, and pure liqueurs)
    • Coffee
    • Juices
    • Soft drinks
    • Tea
    • Cocoa drinks
    • Flavored alcoholic beverages (eg, ciders and coolers)
    • Flavored teas and coffees
    • Non-dairy soy, rice, potato, and nut beverages
    • Undistilled alcoholic beverages (eg, beer, ale, lager)
    Other (Condiments, Baking Ingredients, Soups, Sauces, and Gravies)
    • Aspartame
    • Baking soda
    • Butter, lard, and shortening
    • Carob chips and carob powder
    • Corn syrup, maple syrup, and sugar (brown, white, and confectioner’s)
    • Cream of tartar
    • Homemade broths
    • Honey
    • Jams, jellies, marmalade
    • Ketchup
    • Mustard
    • Pure cocoa, baking chocolate, and chocolate chips
    • Plain pickles and relish
    • Pure herbs and spices
    • Pure black pepper
    • Salt
    • Vanilla
    • Vinegars (eg, apple, balsamic, cider, distilled white, grape, wine, spirit)
    • Yeast
    • Baking powder
    • Bouillon cubes
    • Brown rice syrup
    • Gravy and sauces
    • Soups and broths
    • Salad dressings
    • Worcestershire sauce
    • Malt vinegar
    • Soy sauce
    • Teriyaki 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 doctor.

    Shopping for Gluten-Free Foods

    When shopping for foods, it is 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 Diet

    • Focus 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 Association http://www.eatright.org/

    Celiac Disease Foundation http://www.celiac.org/

    CANADIAN RESOURCES

    Canadian Celiac Association http://www.celiac.ca/

    Canadian Dietetic Association http://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 January 3, 2010.

    The gluten-free diet. Canadian Celiac Association website. Available at: http://www.celiac.ca/EnglishCCA/egfdiet2.html#allowed . Accessed January 3, 2010.

    Gluten-free diet guide for families. Children’s Digestive Health and Disease Foundation website. Available at: http://www.cdhnf.org/user-assets/documents/pdf/GlutenFreeDietGuideWeb.pdf . Accessed January 3, 2010.

    Raymond N, Heap J, Case S. The gluten-free diet: an update for health professionals. University of Virginia Health System website. Available at: http://www.healthsystem.virginia.edu/internet/digestive-health/nutritionarticles/Sept0601.pdf . Published September 2006. Accessed January 3, 2010.

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