A gluten-free diet (GFD) is an eating plan devoid of gluten-containing foods. People with gluten intolerance and people who want to eliminate this protein for a healthier life experience adopt a gluten-free diet plan. Many people experience unpleasant reactions after consuming gluten, including bloating, skin eruptions and digestive issues. Some reactions are a result of celiac disease: a genetic health condition in which the body has an autoimmune response to gluten, attacking the small intestine. Sticking to a gluten-free diet may be more favorable for overall wellness and better digestive health.
What Is Gluten?
Gluten is the primary storage protein of wheat grains. It is comprised of hundreds of distinct proteins, mainly gliadin and glutenin. It is also found in other grains like rye, barley and spelt.
What Is a Gluten-Free Diet?
A gluten-free diet is a daily menu typically containing foods and drinks that don’t have wheat-related proteins – specifically gluten. Some people opt to go completely carb-free when approaching a diet devoid of gluten since so many carbohydrate-containing foods are made using wheat, barley, or rye. People with celiac disease need to follow a gluten-free diet to relieve the symptoms associated with gluten intolerance. Prolonged exposure to gluten in people with celiac disease can result in more aggravated symptoms or other health conditions.
A gluten-free diet is linked to health benefits such as weight loss, increased energy, and overall wellness. As a result, many people with no medical aversions to gluten begin eating foods devoid of gluten.[2, 3]
First Steps to Going Gluten-Free
Deciding to go gluten-free isn’t as easy as just jumping on a gluten-free diet. Knowing that those delicious pieces of bread served at restaurants are now off-limits can be hard to digest, so-to-speak. Understanding how to read food labels, and even supplement and vitamin labels can feel like a chore, but people get the hang of it quickly, and the benefits are worth it. Some people opt to start with a vegetarian or vegan diet to ease into a stricter gluten-free lifestyle. Here are ten steps to start you on your gluten-free journey:
- Consult your healthcare provider to make sure this diet is right for you.
- Get excited about going gluten-free, whether it’s voluntary or mandatory: visualize the benefits.
- Start a list of delicious gluten-free groceries.
- Look up delicious gluten-free recipes.
- Go through your pantry, fridge, medicine cabinet, and toiletries and check labels for gluten-related ingredients.
- Give away or dispose of items that aren’t gluten-free.
- If you live with others who are not avoiding gluten in their diet, create an individual space for your new lifestyle.
- Replace food items, supplements, and vitamins with healthy, gluten-free substitutes.
- Find fellow gluten-free dieters for on-going support, discussion, and diet ideas. Online support groups can be a great resource.
- Start enjoying your new, gluten-free life.
What Should You Eat on a Gluten-Free Diet?
Many people think a gluten-free diet means limited or even unpleasant food options. With the gluten-free substitutes available today, however, anyone can enjoy a nutrient-rich, satisfying meal. Here are some common items that you can add to your gluten-free foods list:
- Fresh fruits and vegetables
- Meat, fish, poultry, and eggs
- Nuts and seeds
- Dairy products
Previously thought to be a gluten-intolerant ingredient, oats are safe for consumption by people with an aversion to gluten. Oats contain a protein called avenin that is non-toxic and well-tolerated by people with celiac disease. Although oats are not associated with gluten-containing grains, they may have been in contact with wheat, barley, or rye during manufacturing. A quick check on the label can tell you if the source guarantees against cross-contamination.
You can also buy gluten-free versions of foods such as bread, flour, crackers, and cereals. These products are made with rice and other gluten-free flours. Keep in mind that these processed foods may be higher in sugar and calories and lower in fiber than the foods they replace. These items can also be more expensive.
Which Foods and Ingredients Contain Gluten?
You can enjoy a wonderful, varied diet without the use of gluten in food. A great way to start planning your menu at home, or ordering from the menu at a restaurant, is by knowing which foods contain gluten. Some food products and even restaurants offer gluten-free food substitutes or meals. Usually, these options are labeled openly as being "gluten-free." However, if you’re not entirely sure, look for these ingredients, or ask your server if your meal contains these items. Here are some gluten-containing ingredients and additives to avoid:
- Barley (this includes malt, malt flavoring, and malt vinegar)
- Triticale (a grain that is a cross between wheat and rye)
- Durum flour
- Graham flour
It takes an adjustment and even a bit of mourning when you realize that there are foods you will no longer be able to eat. With the increase of gluten-free dieters, however, manufacturers and nutritionists are getting closer to providing and recommending tasty alternatives. Here are some foods that typically contain gluten and, unless there is a gluten-free substitute, need to be avoided:
- Cereal products
- Stuffings and dressings
- Cakes, cookies, and other baked goods
Other foods that may contain gluten:
- Soy sauce
- Energy bars
- Salad dressing
- Teriyaki sauce
- Brown rice syrup
- Sauces and gravy
- Thickeners (roux)
- Imitation seafood
- Imitation meat
- Processed lunch meat
- Soup bases, broth, and bouillon
- Panko (Japanese breadcrumbs)
- Seasoned rice mixes
- Breading and coating mixes
- Self-basting poultry
Are Medicines, Vitamins, and Supplements Gluten-Free?
Gluten is a protein found in many things including over-the-counter medication, herbal and nutritional supplements, vitamin and mineral supplements, and even communion wafers. Ask your healthcare provider if your medication contains gluten, and check labels on supplements to make sure they are made with high-quality natural ingredients that don’t include gluten.
Is a Gluten-Free Diet Healthy?
A healthy, gluten-free diet encourages a higher intake of fruits, vegetables, and other healthier food choices to make up for any nutrition lost from wheat proteins.
Going gluten-free is necessary for people with gluten intolerance issues such as celiac disease and non-celiac gluten sensitivity. Over time, people with celiac disease who are on a gluten-free diet see a significant reduction in symptoms or experience no symptoms at all. For many people, damage done to the intestines by celiac disease is eventually repaired after following a gluten-free diet.
A rise in popularity to go gluten-free has prompted the development of healthier and more nutritional substitutions. A healthy, gluten-free diet encourages a higher intake of fruits, vegetables, and other healthier food choices to make up for any nutrition lost from wheat proteins. A diet rich in these foods in and of itself encourages better digestion and a healthier GI tract.
Since humans only started eating wheat about 10,000 years ago, scientists speculate that it’s harder for the body to digest and absorb. However, it is not certain if this is still true as there are bacteria in the mouth that help digest gluten. Nonetheless, a gluten-rich diet has been linked to poor digestion.
Gluten can also cause degradation to the thyroid with continued use, and affect the brain – one of the reasons avoiding gluten has been linked to a reduction in headaches. Sticking to a plant-based, gluten-free diet that provides the proper nutrients may help support overall health.
Gluten Intolerance: Celiac Disease, NCGS, & Wheat Allergy
Celiac disease, non-celiac gluten sensitivity (NCGS) and allergies to wheat are all conditions that result from gluten intolerance and are often confused as the same condition. One thing they have in common is that they can all be cared for by adopting a gluten-free diet.
Celiac disease (CD) is an autoimmune disorder. People with CD are genetically predisposed to this condition which is activated through gluten consumption and specific stress-related triggers like trauma and surgery.
When people with celiac disease eat gluten, the cells that line the small intestine flatten, resulting in a reduced ability to absorb nutrients. Celiac disease can materialize on the skin in the form of blisters or a rash called dermatitis herpetiformis. The only way to alleviate celiac disease is to completely eliminate every form of gluten from their diet.[9, 10]
Non-Celiac Gluten Sensitivity
Non-celiac gluten sensitivity (NCGS), also called gluten sensitivity, is similar to celiac disease, but it is not categorized as an immune or autoimmune condition. It also does not adversely affect the intestine, does not cause skin issues, and is not known to be genetic. Therefore, if these factors are not present, it is unlikely that celiac disease is causing your gluten sensitivity.
It is difficult to establish if it is, in fact, gluten that is causing a reaction in people with NCGS or another element since gluten-containing grains are made up of several different components. There are no tests currently available to identify NCGS, except by avoiding gluten in the diet. If symptoms subside, it is then safe to assume that you are sensitive to gluten.
A wheat allergy is an immune response to one or more of the several hundred protein strains found in wheat. The symptoms of a wheat allergy are also similar to celiac disease and Non-Celiac Gluten Sensitivity. However, a wheat allergy is the only one out of the three conditions that can result in anaphylactic shock, which often requires the immediate administration of epinephrine into the body.
People who have a wheat allergy do not necessarily have a gluten intolerance and may continue to enjoy gluten-rich foods as long as they don’t contain wheat. They do however need to remain on a wheat-free diet and may benefit from other allergy-prone foods.[12, 13]
Gluten-Free Diet Benefits
Many people who have switched to a gluten-free diet, whether they are gluten-intolerant or not, experience several health benefits. Weight loss is one of the claims linked to avoiding gluten, but there’s no direct evidence stating that this is true. Many testimonials, however, state that weight loss was experienced after switching to a GFD. This weight loss may be the result of eating a diet containing fewer carbohydrates.
Some people with celiac disease gain weight as their symptoms improve. Other benefits that have been associated with a gluten-free diet include a better mood, more energy, and a reduction in headaches.
Are There Any Risks or Side-Effects of a Gluten-Free Diet?
Although there are several benefits associated with a gluten-free diet, there are some things to consider.
- A lower intake of fiber may increase the chances of constipation
- More rice consumption can lead to greater exposure to toxic chemicals
- Increased risk of nutritional deficiencies
- Gluten-free foods may have a higher cost
People who decide to practice a gluten-free diet may experience some issues associated with their new menu. If you don’t include a healthy amount of fruits and vegetables, you may experience a decline in nutrient intake or may become constipated due to a lack of fiber from wheat and grains.
Many people on a GFD tend to consume more rice, more than any other gluten-free grain. This particular grain has higher trace elements of chemical toxins like arsenic and mercury than other grains, so consuming grains other than rice is recommended.
The use of amaranth, quinoa, teff, buckwheat, and sorghum as a replacement for wheat has yielded promising results regarding better nutritional value for GFD users.
There has been speculation regarding the lack of nutrients present in a gluten-free diet, namely iron, calcium, fiber, vitamin D, and vitamin B. Developing a deficiency in these micronutrients should be considered when approaching a gluten-free diet. Due to the popularity of avoiding gluten, however, more nutrient-rich, gluten-free substitutions are available.
The use of amaranth, quinoa, teff, buckwheat, and sorghum as a replacement for wheat has yielded promising results regarding better nutritional value for GFD users. Newer nutritional products that use these substitutes are usually labeled “gluten-free” and can be expensive, so look for alternatives that naturally carry higher levels of vitamins and nutrients for a less expensive shopping trip.
Ready to Go Gluten-Free?
If you feel that you would benefit from a gluten-free diet, try reaching out to others who are eating only gluten-free foods. This approach is a great way to get a first-case account of how this eating lifestyle works for them and may be beneficial for you. If you do decide to go gluten-free, make sure you have enough nutritional supplements in place to avoid a vitamin or mineral deficiency. Additionally, embrace healthy alternatives when it comes to gluten-free food: A plant-based diet is a healthy and positive choice to consider no matter what diet you choose for overall wellness.
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- "Learn about gluten-free diets." U.S National Library of Medicine. Medlineplus. 2016. Accessd Feb 19. 2018.
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- Sainsbury K, et al. "Maintenance of a gluten free diet in coeliac disease: The roles of self-regulation, habit, psychological resources, motivation, support, and goal priority." Appetite. 2018;125, 356-366. Accessed 19 Feb. 2018.
- Gilissen L, et al. "Why oats are safe and healthy for celiac disease patients." Med Sci (Basel). 2016; 4(4). pii: E21. Accessed 19 Feb. 2018.
- Fernandez-Feo M, et al. "The cultivable human oral gluten-degrading microbiome and its potential implications in coeliac disease and gluten sensitivity." Clin Microbiol Infect. 2013;19(9), E386-94. Accessed 19 Feb. 2018.
- Naiyer AJ, et al. "Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction." Thyroid. 2008;18(11), 1171-8. Accessed 19 Feb. 2018.
- Bascuñán KA, et al. "The 5 W’s of a gluten challenge for gluten-related disorders." Nutr Rev. 2018;76(2), 79-87. Accessed 19 Feb. 2018.
- Green PH, et al. "Celiac disease." J Allergy Clin Immunol. 2015;135(5),1099-106; quiz 1107. Accessed 20 Feb. 2018.
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- Elli L, et al. "Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity." World J Gastroenterol. 2015;21(23), 7110-9. Accessed 20 Feb. 2018.
- Aziz I, et al. "The rise and fall of gluten!" Proc Nutr Soc. 2015 Aug;74(3), 221-6. Accessed 20 Feb. 2018.
- Ortiz C , et al. "[Celiac disease, non celiac gluten sensitivity and wheat allergy: comparison of 3 different diseases triggered by the same food]." Rev Chil Pediatr. 2017;88(3):, 417-423. Accessed 5 March 2018.
- Punshon T, et al. "Essential micronutrient and toxic trace element concentrations in gluten containing and gluten-free foods." Food Chem. 2018;252, 258-264. Accessed 5 March. 2018.
- Vici G, et al. "Gluten free diet and nutrient deficiencies: A review." Clin Nutr. 2016;35(6), 1236-1241. Accessed 5 March 2018.
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†Results may vary. Information and statements made are for education purposes and are not intended to replace the advice of your doctor. If you have a severe medical condition or health concern, see your physician.