Gluten-Free Diet for Celiac Disease

Topic Overview

People who have celiac disease must be on a gluten-free diet. Even a small amount of gluten may cause symptoms of bloating, gas, and diarrhea.

The basics of a gluten-free diet include:

• Avoiding all foods that contain wheat, rye, triticale, and barley gluten. Bread, bagels, pasta, pizza, malted breakfast cereals, and crackers are all examples of foods that contain gluten. Although some foods are labeled wheat-free, this doesn't mean that they are gluten-free.
• Avoiding oats, at least initially. Oats may cause symptoms in some people, perhaps as a result of contamination with wheat, barley, or rye during processing. But many people who have celiac disease can eat moderate amounts of oats without having symptoms. Health professionals vary in their long-term recommendations regarding eating foods with oats. But most agree it is best that people newly diagnosed with celiac disease not eat oats until the condition is well controlled with a gluten-free diet. Then, up to 2 oz (50 g) of oats may be eaten daily as long as no new symptoms arise.^{footnote 1} You should eat only oats known not to be contaminated by wheat, barley, or rye during processing.
• Avoiding all beer products unless they are gluten-free. Beers with and without alcohol, including lagers, ales, and stouts, contain gluten unless the label specifically says they are gluten-free.
• Reading ingredient labels carefully and being aware of types of hidden gluten. Gluten can be in things like medicines, vitamins and other nutritional supplements, lipstick and lip balm, and various food additives. Products whose labels have the phrase "modified food starch" or "hydrolyzed vegetable protein" may contain gluten.

The U.S. Food and Drug Administration (FDA) says that if a food sold in the U.S. is labeled free of gluten, then it must contain less than 20 parts per million (ppm) of gluten.

On a gluten-free diet, you can still have:

• Eggs and dairy products. Some milk products may make your symptoms worse. If you have questions about milk products, ask your doctor. Read ingredient labels carefully. Some processed cheeses contain gluten.
• Flours and foods made with amaranth, arrowroot, beans, buckwheat, corn, cornmeal, flax, millet, pure uncontaminated nut and oat bran, potatoes, quinoa, rice, sorghum, soybeans, tapioca, or teff.
• Fresh, frozen, and canned meats. Read labels for additives that may contain gluten.
• Fresh, frozen, dried, or canned fruits and vegetables if they do not contain thickening agents or other additives containing gluten.
• Certain alcoholic beverages, including wine, liquor (including whiskey and brandy), liqueurs, and ciders.