The Gluten-Free Diet
What is Gluten?
Gluten is a protein found in wheat, rye and barley. It is also found in grains closely related to wheat, including spelt, triticale, and kamut. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine, where nutrients are absorbed.
Reasons People Choose a Gluten-Free Diet
People may avoid gluten for a variety of reasons, including celiac disease; wheat allergy; gluten-sensitivity or gluten-intolerance without celiac disease; as a treatment for autism or autoimmune diseases; or simply because they feel better without it. Sometimes an entire household will go gluten-free when one family member is diagnosed with celiac disease.
Get Tested BEFORE You Go On a Gluten-Free Diet
To be tested for celiac disease, you need to be on a diet that contains a typical amount of gluten. Otherwise, the test results may produce a false negative. If you have any of the symptoms of celiac disease, or fall into a high risk category for other reasons, you should ask your doctor about getting tested. See Celiac Disease for further information.
Naturally Gluten-Free Foods
Most foods are gluten-free in their natural state: fruit, vegetables, nuts, legumes, eggs, dairy products, corn, rice, soy, meat, fish and poultry are all naturally gluten-free. However, when food manufacturers add multiple ingredients, flavorings, stabilizers, coatings, etc., gluten can end up in the final processed product. Learn how to read labels and always check the list of ingredients.
Oats
Oats are naturally gluten-free. However, almost all commercially grown oats are cross-contaminated with wheat in the fields, and in storage, transportation and packaging facilities. Specially grown and processed gluten-free oats are now available for celiacs, though a very small percentage of celiacs cannot tolerate even the gluten-free oats.
Gluten is Everywhere
The Western diet is heavily dependant on wheat products: it is the primary ingredient in pizza, cookies, cake, crackers, pasta, pancakes, bread and pastries. Beer contains gluten because it is made of malted barley. Most breakfast cereals contain malt syrup, made from barley. Gluten can appear in soy sauce, seasonings, sauces, candy, processed meats, soups, dressings, energy bars, supplements, cosmetics (yes, you do eat a little lipstick), medicines and communion wafers. Young children may also ingest gluten from art supplies, including playdough.
Cross-Contamination
Even microscopic amounts of gluten can trigger the autoimmune reaction, and cause short-term symptoms and long-term health damage in many celiacs. As a result, celiacs must avoid cross-contamination that may result from sources such as a shared toaster, cutting board, condiments or a butter dish. Dining out at restaurants or a friend's house can be challenging.
Booming Market in Gluten-Free Products
"Gluten-Free" is one of the Top Ten trends in food retail. There are thousands of gluten-free products in every food category on the market, and more coming out every month, many at your local grocery store. You can eat gluten-free pizza and drink gluten-free beer. Restaurants increasingly are offering gluten-free menu options.
Getting Started on a Gluten-Free Diet
Browse the resources below and arm yourself with some basic information about gluten ingredients, how to read labels and avoid cross-contamination; scan the gluten-free recipe books at the library, bookstore and online (though the cookbooks you already own have plenty of naturally gluten-free recipes); and enjoy exploring alternative grains and new recipes, including those from other cultures that rely less on wheat products.
Resources for the Gluten-Free Diet
Gluten-Free Living
This site has a wonderful online primer on the gluten-free diet, ingredients, labeling laws, eating out, etc. The staff at this magazine does its own research on the food industry and has current and accurate information.
Celiac Disease Foundation
CDF has online resources, plus a download for their "Quick Start Diet Guide," and ordering information for a booklet "Guidelines for a Gluten-Free Lifestyle." Check out this excellent series of Practical Gastroenterology journal articles on the gluten-free diet with topics such as cost, heart health, vegetarianism, whole grains, medications, kids and dining out.
On Celiac.com you will find lists for Safe and Unsafe ingredients that are helpful, plus countless other articles and tips.
Dietitian and author Shelly Case has a web site with extensive resources and articles on maintaining a nutritious gluten-free diet, plus news items and current topics.