The Gluten-Free Diet Decoded

The gluten-free diet is recommended for people with celiac disease, a chronic digestive health condition in which the small intestine becomes damaged when gluten is present. People with non-celiac gluten sensitivity or gluten intolerance may also try a gluten-free diet to manage their symptoms. Keep reading to learn about gluten, what a gluten-free diet looks like, and whether it’s the right choice.

What is a gluten-free diet?

A gluten-free diet eliminates all dietary sources of gluten, a protein naturally found in wheat-containing foods, as well as rye and barley. Here are some examples of foods that naturally contain gluten you should avoid on a gluten-free diet:

• Wheat-based flours (including anything battered and deep-fried, pre-boxed pancake or muffin mixes, and similar)
• Wheat-based cereals
• Wheat-based breads and bagels
• Wheat-based crackers
• Wheat-based cookies and cakes
• Condiments with wheat, including soy sauce and some salad dressings with malt.

Some foods are naturally gluten-free, like oats, but are processed in close proximity to other gluten-containing cereals. Most people who follow a strict gluten-free diet must be cautious about buying these foods; some may avoid eating them entirely. A registered dietitian trained in gluten-free eating can help you find foods that are appropriate for you to eat and help you feel your best.

Who is the gluten-free diet for?

The gluten-free diet is recommended for people with celiac disease, an autoimmune digestive condition in which the small intestine becomes damaged when gluten proteins are present. If you have celiac disease, you’ll need to avoid all dietary gluten sources and follow a gluten-free lifestyle indefinitely, and fortunately, there are thousands of gluten-free products you can enjoy.

If you suspect you are sensitive to gluten, sometimes called an intolerance, you may feel better after reducing your gluten intake. Some gluten intolerance symptoms include bloating, constipation or diarrhea, and brain fog. Gluten sensitivity is less severe than celiac disease and doesn’t have the same damaging effects on your small intestine. Follow up with your doctor if you suspect you have a gluten sensitivity.

What are the benefits of a gluten-free diet?

If you have celiac disease and eat gluten, your body will initiate an autoimmune response that can lead to cramps, stomach pain, bloating, and more severe complications such as villous atrophy, the erosion of small fingerlike projections in your small intestine that aids with absorption. If left unaddressed, this can increase the risk of nutritional deficiencies over time. A gluten-free diet should improve your digestive health and help you feel your best.

The benefits of this diet include:

• Alleviated symptoms of celiac disease
• Reduced symptoms of non-celiac gluten sensitivity
• Improved symptoms of dermatitis herpetiformis
• Reduced risk of additional autoimmune diseases

Are there any potential drawbacks of this diet?

Although it’s medically necessary for people with celiac disease to eliminate gluten, removing all wheat products can limit their choices of fiber-rich grains, a major fiber source for Americans. Awareness of this potential drawback is important as fiber is essential for digestive health, preventing cancers, lowering cholesterol levels, and controlling blood sugar.

To ensure you meet your daily requirements, which are about 25–30 g of fiber for most adults, add fiber-rich ingredients to your meals and snacks as often as possible. These include beans, legumes, fruits, vegetables, nuts, and seeds. Some gluten-free grains that contain higher levels of fiber include quinoa, amaranth, and wild rice.

Most wheat products in North America are also fortified with nutrients like iron. By omitting these foods, you may need to eat more iron-rich foods to satisfy your daily requirements. Iron-rich foods include red meat (choose lean cuts), beans, legumes, nuts, seeds, shellfish, and dark leafy greens.

A non-nutritional drawback of a gluten-free diet is that it can be difficult to follow when dining out. Most restaurants offer gluten-free meals, but they’re never guaranteed. It’s a good practice to review menus online before heading out to ensure there are gluten-free options you enjoy. At social gatherings, you may need to bring extra snacks or inform your hosts of your dietary requirements.

List of gluten-free foods

Gluten-free foods include:

• Fruits
• Vegetables
• Meat and poultry (as long as it’s unbreaded)
• Fish (also unbreaded)
• Natural dairy products and alternatives (cheese, butter, cottage cheese, gluten-free yogurt, dairy-free milk)*
• Eggs
• Seafood
• Nuts
• Seeds
• Potatoes
• Legumes (lentils, chickpeas, black beans)
• Grains (buckwheat, quinoa, rice, millet, corn flour, sorghum, teff, amaranth)

*May need to check for added ingredients or flavorings that may contain gluten.

Reading food labels

Most gluten-free products will have a certified 'gluten-free' label on the front of the package. Sometimes, the short form 'GF' is used instead. A similar identifying tag is used for restaurant menu items, but if you’re ever unsure, you can ask your server for details.

Wheat-based products will contain gluten and should be avoided. Always check the ingredients or use an app to ensure the products you are interested in are gluten-free before purchasing. Popular apps include 'Find Me Gluten Free' or 'The Gluten Free Scanner' app. They are available for Android and Apple devices.

Gluten reaction management

If you accidentally eat wheat or other gluten-containing foods, you may experience a gluten reaction. Depending on your sensitivity, you may experience side effects immediately or after a few hours. Symptoms may include diarrhea, cramping, and bloating. Avoid eating gluten again and eat bland gluten-free foods to allow your digestive system to settle.

Is the gluten-free diet right for me?

If you have celiac disease, you will need to follow a gluten-free diet forever. Fortunately, many resources, apps, and easy-to-identify gluten-free products make it easier to follow a gluten-free lifestyle.

Eliminating wheat and other gluten-containing grains can make meeting your daily fiber goals more challenging. To boost your fiber and nutrient intake, add more fruits and vegetables to meals, use nuts and seeds to garnish soups and salads, and enjoy beans throughout the week. If you have any nutrition concerns, contact a registered dietitian.