Gluten-Free Diet

Gluten-Free Diet

Definition

A gluten-free diet is a diet that excludes the protein gluten. Gluten is found in grains such as wheat, barley, rye, and a cross between wheat and rye called triticale.

A gluten-free diet is essential for managing signs and symptoms of celiac disease and other medical conditions associated with gluten. A gluten-free diet is, however, popular among people without gluten-related medical conditions. The claimed benefits of the diet are improved health, weight loss and increased energy.

Most clinical studies regarding gluten-free diets have been conducted with people who have celiac disease. Therefore, there is little clinical evidence about the health benefits of a gluten-free diet in the general population.

Removing gluten from your diet likely changes your overall intake of fiber, vitamins and other nutrients. Therefore, regardless of your reasons for following a gluten-free diet, it's important to know how it can affect your overall nutritional needs.

Your doctor or a dietitian can help you make appropriate dietary choices to maintain a well-balanced diet.

Celiac disease - is a condition in which gluten triggers immune system activity that damages the lining of the small intestine. Over time this damage prevents the absorption of nutrients from food. Celiac disease is an autoimmune disorder.

Non-celiac gluten sensitivity - causes some signs and symptoms associated with celiac disease — including abdominal pain, bloating, diarrhea, constipation, "foggy brain," rash or headache — even though there is no damage to the tissues of the small intestine. Studies show that the immune system plays a role, but the process isn't well-understood.

Gluten ataxia - an autoimmune disorder, affects certain nerve tissues and causes problems with muscle control and voluntary muscle movement.

Wheat allergy- like other food allergies, is the result of the immune system mistaking gluten or some other protein found in wheat as a disease-causing agent, such as a virus or bacteria. The immune system creates an antibody to the protein, prompting an immune system response that may result in congestion, breathing difficulties and other symptoms.

Claims about the general health benefits of a gluten-free diet are the motivation for other people to avoid wheat and other grains with gluten. Very little clinical research has been conducted, however, about the benefits of the diet for people who do not have a gluten-related medical condition.

Diet details

Following a gluten-free diet requires paying careful attention to both the ingredients of foods and their nutritional content.

Many naturally gluten-free foods can be a part of a healthy diet:

Fruits and vegetables

Beans, seeds and nuts in their natural, unprocessed forms

Eggs

Lean, nonprocessed meats, fish and poultry

Most low-fat dairy products

Grains, starches or flours that you can include in a gluten-free diet include:

Amaranth

Arrowroot

Buckwheat

Corn and cornmeal

Flax

Gluten-free flours (rice, soy, corn, potato, bean)

Hominy (corn)

Millet

Quinoa

RiceSorghum

Soy

Tapioca (cassava root)

Teff

Grains not allowed

Avoid all foods and drinks containing the following:

Wheat

Barley

Rye

Triticale (a cross between wheat and rye)

Oats (in some cases)

While oats are naturally gluten-free, they may be contaminated during production with wheat, barley or rye. Oats and oat products labeled gluten-free have not been cross-contaminated. Some people with celiac disease, however, cannot tolerate the gluten-free labeled oats.

Wheat terms to know

There are different varieties of wheat, all of which contain wheat gluten:

Durum

Einkorn

Emmer

Kamut

Spelt

Wheat flours have different names based on how the wheat is milled or the flour is processed. All of the following flours have gluten:

Enriched flour with added vitamins and minerals

Farina, milled wheat usually used in hot cereals

Graham flour, a course whole-wheat flour

Self-rising flour, also called phosphate flour

Semolina, the part of milled wheat used in pasta and couscous

Gluten-free food labels

When you are buying processed foods, you need to read labels to determine if they contain gluten. Foods that contain wheat, barley, rye or triticale — or an ingredient derived from them — must be labeled with the name of the grain in the label's content list.

Foods that are labeled gluten-free, according to the Food and Drug Administration rules, must have fewer than 20 parts per million of gluten. Foods with these labels may include:

In general, avoid the following foods unless they're labeled as gluten-free or made with corn, rice, soy or other gluten-free grain:

Beer, ale, porter, stout (usually barley)

Breads

Bulgur

Cakes and pies

Candies

Cereals

Communion wafers

Cookies and crackers

Croutons

French fries

Gravies

Imitation meat or seafood

Malt, malt flavoring and other malt products (barley)

Matzo

Pastas

Hot dogs and processed luncheon meats

Salad dressings

Sauces, including soy sauce

Seasoned rice mixes

Seasoned snack foods, such as potato and tortilla chips

Self-basting poultry

Soups, bouillon or soup mixes

Vegetables in sauce

Medications and supplements

Prescription and over-the-counter medications may use wheat gluten as a binding agent. Talk to your doctor or pharmacists about the drugs you're taking. Dietary supplements that contain wheat gluten must have "wheat" stated on the label.

Results

Keeping a strict gluten-free diet is a lifelong necessity for people with celiac disease. Following the diet and avoiding cross-contamination results in fewer symptoms and complications of the disease.

For some people with non-celiac gluten sensitivity, the condition may not be lifelong. Some research suggests that you may follow the diet for a certain period, such as one or two years and then retest your sensitivity to gluten. For other people with non-celiac gluten sensitivity, the diet may be a lifelong treatment.

Few clinical studies have looked at the benefits of the diet among the general population — people without celiac disease or non-celiac gluten sensitivity. There is not enough clinical evidence to determine the accuracy of the following claims about the diet's results:

Weight loss

Overall improved health

Improved gastrointestinal health

Improved athletic performance

Risks

The foods not included in a gluten-free diet provide important vitamins and other nutrients. For example, whole-grain breads and other products are natural or enriched sources of the following:

Iron

Calcium

Fiber

Thiamin

Riboflavin

Niacin

Folate

Therefore, following a gluten-free diet will likely change your nutrient intake. Some gluten-free breads and cereals have significantly varied nutrient levels than the products they are replacing. Some gluten-free foods also have higher fat and sugar contents than the gluten-containing food being replaced. It's important to read labels, not only for gluten content but also for overall nutrient levels, salt, calories from fats and calories from sugars.

You can talk to your doctor or dietitian about foods that would provide healthy, nutrient-rich alternatives.