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.1 You should eat only oats known not to be contaminated by wheat, barley, or rye during processing.
  • Avoiding or limiting milk products in the beginning of treatment if they cause or aggravate symptoms. After symptoms improve and the small intestine heals (about 1 to 6 months), you may be able to gradually reintroduce milk products into your diet.
  • 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 such as cheese. But you may need to avoid milk and milk products at the beginning of treatment. And some processed cheeses contain gluten.
  • Flours and foods made with amaranth, arrowroot, buckwheat, corn, flax, millet, 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.

Related Information

References

Citations

  1. Trier JS (2012). Intestinal malabsorption. In NJ Greenberger et al., eds., Current Diagnosis and Treatment: Gastroenterology, Hepatology, and Endoscopy, 2nd ed., pp. 237–257. New York: McGraw-Hill.

Credits

By Healthwise Staff
E. Gregory Thompson, MD - Internal Medicine
Jerry S. Trier, MD - Gastroenterology
Last Revised September 17, 2013

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