Going gluten-free is more than a lifestyle change for people with celiac disease and those who can’t tolerate this type of protein. It’s a treatment in and of itself, but giving up gluten completely is easier said than done.
In this article, we shall take you through a quick rundown on how to go gluten-free, including what to consume and what’s a no-no.
What is Gluten?
Gluten is a class of proteins, called glutelins and prolamins, which are found aplenty in four cereal grains — rye, wheat, barley, and oats. By extension, gluten is also contained in hybrids of those grains (triticale, spelt, etc.), as well as products such as malt beers, bread, and sandwiches.
Gluten has characteristic viscous and glue-like properties, which makes flour elastic and sticky when blended with water. This helps the dough rise and maintains its shape, giving bread and other gluten products their crunchy, tasty and chewy texture. For these reasons, glutens are widely used in making a variety of foods, as a base for tablets and other medications, and lots of non-food applications.
Sadly, some people are sensitive or intolerant to gluten, meaning they develop unpleasant symptoms when they consume foods containing gluten. Note, however, that a true wheat allergy and gluten intolerance are not the same.
A wheat allergy is a negative immune response to the presence of wheat, and usually affects your antibodies. There is no such thing as a “gluten allergy” – only an allergy to wheat, or intolerance to gluten, which is far less understood than a wheat allergy.
Wheat is one of the top 8 causes of food allergies, according to the American College of Allergy, Asthma & Immunology (ACAAI). Others include soy, shellfish, fish, tree nuts, peanuts, milk, and eggs.
If you are allergic to wheat, and you consume it, you may experience a buffet of mild to serious symptoms, including nasal congestion, rash, hives, throat irritation, diarrhea, itchy, watery or bloodshot eyes, shortness of breath, nausea, and vomiting. These symptoms may flare up within minutes of eating gluten or start up to 2 hours later. It can lead to anaphylaxis.
The only life-threatening is anaphylaxis, which is rare and characterized by severe shortness of breath or difficulty breathing. Despite this, wheat allergy doesn’t cause intestinal damage. Interestingly, you may be allergic to wheat, but not allergic to other cereal grains like rye or barley. In either case, if you’ve wheat allergies, your doctor may prescribe an EpiPen, and of course, you must avoid gluten-containing foods made with wheat (although you might be able to eat wheat -free food).
Gluten intolerance is another common condition in which the patient develops a mild to serious reaction to gluten. Unlike wheat allergies, gluten intolerance means that your body rejects, fights or can’t digest gluten. And the resulting attack against it may cause intestinal damage, but separate from the villi-damaging celiac disease.
Celiac disease, which used to be more commonly known as gluten-sensitive enteropathy or celiac sprue, is the most serious form of an intolerance to gluten that affects roughly one percent of Americans. It’s an autoimmune digestive condition in which the patient’s immune system reacts unusually to gluten. Again, this is a separate condition from a wheat allergy, or an intolerance to gluten.
When an individual with celiac disease eats gluten, their immune system launches an attack on the small intestine’s villi, small fingerlike projections responsible for absorbing nutrients from food. This can lead to severe malnutrition, as well as other serious health issues, including permanent gastrointestinal damage, infertility, and pre-term pregnancy.
Children and adults with celiac disease often manifest different symptoms. There can be hundreds of unique symptoms of this disease.
Pediatric celiac disease, the condition in children, causes more often intestinal symptoms that may include constipation, diarrhea, bloating and gas, abdominal pain, vomiting or nausea, and pale, smelly stool. It may also cause stunted growth, short stature, failure to thrive in toddlers, late puberty in teens, weight loss, dental problems, mood disorders in adolescents, and irritability.
Celiac adults may also experience intestinal symptoms but they are usually less common and infrequent. About 50 percent of adults with celiac disease are likely to experience non-gastrointestinal symptoms, including joint pain/aches, canker mouth sores, anxiety & depression, iron-deficiency anemia, chronic fatigue, headaches or migraines, infertility, irregular periods, and osteoporosis (less dense, porous bones).
Recognizing and diagnosing celiac disease in adults can be quite tricky because symptoms are numerous, and tend to vary from person to person. That’s why ongoing testing is recommended if you have noticed some of the symptoms. Read more about celiac disease symptoms, risks, and how to get tested.
Non-celiac gluten sensitivity (NCGS) is a milder form of gluten intolerance but it may still cause several health problems and intestinal damage. As scientists pointed out in a 2015 systematic review, NCGS is fairly common, affecting between 0.5 and 15 percent of the U.S. population. Again, people with NCGS neither have celiac disease nor are they “allergic” to gluten. Research is still ongoing to determine the exact cause and risk factors. Some speculate that it is an intolerance to the proteins in wheat (ATIs), or an issue with FODMAPs, not gluten itself. The most prevalent symptoms of non-celiac gluten sensitivity are brain fog (a chronic form of mental fatigue), recurrent headaches, stomach pain, bloating and gas, and general fatigue.
What You Should Know About Going Gluten-free
Before you learn how to go gluten-free, it’s important to understand why. When you go on a gluten-free diet, you essentially give up eating barley, rye, wheat, oats, and anything else that may contain gluten. And there are several plausible reasons to do this.
First of all, a strict, lifelong zero-gluten diet is the chief treatment for celiac disease. As mentioned, eating gluten when you have the disorder will cause the small intestine to become inflamed and unable to absorb nutrients.
Generally, it may help prevent health complications and long-term effects linked to celiac disease, such as infertility, thyroid conditions, pregnancy complications, type 1 diabetes, and dental problems, to name a few. A gluten-free diet may also help reduce, control or eliminate symptoms for people with gluten sensitivity and other non-celiac gluten intolerances.
Some individuals choose to live a gluten-free lifestyle because they think it may help them control chronic fatigue, migraines, depression, anxiety, and headaches. Others believe this diet may play a role in their weight loss ambitions. However, that there’s little to no research to prove these claims.
Whereas going gluten-free isn’t a choice for some people, it’s important that you get tested first. Here are the top reasons why this makes health and logic sense:
You may have celiac disease.
If you have experience characteristic symptoms of celiac disease, it’s crucial that you swear off gluten immediately. However, if you do away with gluten prior to getting tested, you will most likely return a false negative result. That’s why you need to get tested before you eliminate gluten from your diet. The longer you wait, the more likely you will develop celiac disease complications. People with untreated celiac disease are four times at risk of developing cancers and lymphoma of the small intestine, and 20x at risk of chronic pancreatitis. Other complications of undiagnosed celiac sprue include infertility, iron-deficiency anemia, gallbladder diseases, lactose intolerance, and atherosclerotic heart disease, and other autoimmune disorders.
You have a family history of celiac disease.
If you have a first-degree relative (kid, brother, sister, parent, etc.) with celiac disease, your chances of developing it may be as high as 20 percent. The trouble is celiac disease can develop at any age. That’s why you should get tested routinely if it runs in your family.
You may have a food intolerance.
Celiac disease and most food intolerances have an overlap in symptoms. For instance, diarrhea, bloating, constipation, fatigue, and abdominal pain are both common in people with celiac disease and lactose intolerance. Unfortunately, a gluten-free diet may not be of much help to someone with lactose intolerance — in fact, it may make it worse. A conclusive test is, therefore, critical to eliminate guesswork.
Going gluten-free on a hunch or by choice means that you are voluntarily locking out many potential sources of vitamins, minerals, and other nutrients.
A growing number of people ask how to go gluten-free, but never ask why they should do that in the first place. This can be troublesome because gluten is an important part of a balanced diet. Most fortified wheat products like cereals, bread, and sandwiches are usually loaded with B vitamins (more commonly called folic acid or folate). When you cut them out from your diet, this can be a big problem for you, especially if you are pregnant or planning to become pregnant. Folic acid is needed during pregnancy to prevent birth defects. Whole grains are also rich in dietary fiber, which the digestive system requires to do its job properly.
The diet of an average person in the US is already deficient in fiber, and this can become much worse when you eliminate whole grains. Fiber also plays a key role in gut microbiome health and has anti-inflammatory and antioxidant properties. A gluten-free diet may lack essential vitamins and nutrients such as phosphorus, calcium, riboflavin, thiamine, niacin, zinc, iron, and folic acid. People on a gluten-free diet are choosy and are more likely to suffer from nutritional deficiencies, making them susceptible to type-2 diabetes, weight gain, and other health ills.
Foods to Avoid on a Gluten-Free Diet
If you have celiac disease, gluten intolerance or gluten sensitivity, you must understand which foods have gluten and eliminate them entirely from your diet.Given that gluten is found in a laundry list of foods and products, however, avoiding it completely can be quite tricky, if not daunting. To add insult to injury, gluten is present as a common ingredient included in many food products, ranging from pastry to malt beverages and everything in between In light of that, it’s best to see a physician, dietician, gastrologist, or a nutritionist before you embark on your gluten-free journey.
Off-limit foods that contain gluten include:
Malt: This is a germinated cereal grain that has been dry-processed via malting. It’s typically used as a flavoring ingredient in baby foods, pastry, breakfast cereals, baked foods, malt vinegar, ciders, and flour.
Rye: This is a popular grass grain. It’s used to make a variety of food and food products, including crispbread, bread, flour, and some liquors.
Barley: This is another gluten-rich cereal grain that is predominantly used a natural sweetener, food grain or as an ingredient for making some whiskeys, brewing beers, and other beverages.
Triticale: This is a hybrid cereal grain between rye and wheat. It also contains a significant amount of gluten, which is why it is commonly used to make muffins, cakes, crispbreads, and biscuits.
Wheat: Perhaps the largest source of gluten, wheat-based foods are almost ubiquitous. Also, avoid wheat varieties like semolina, Kamut, durum, spelt, triticale, and much more.
In addition to rye, barley, wheat, and triticale, it is important to eliminate from your diet food products whose ingredients may contain gluten. These include:
Brewer’s yeast: Store-bought brewer’s yeast is a byproduct of the beer-making process, and may contain gluten from barley. Unless labeled gluten-free, avoid it.
Drinks and beverages: Most flavored alcoholic beverages (FABs) and beers are made from barley, and therefore, contain gluten.
Pastries: Unless indicated as gluten-free, baked stuff like pastries, bread crumbs, pizza, muffins, cakes, biscuits, cookies, etc. are a big no-no.
Sauces and dressings: Salad dressing, condiments, marinades, teriyaki sauce, soy sauce, hoisin sauce, and an assortment of other sauces may contain gluten starch as the base.
Cereals: The vast majority of breakfast cereals are made with ingredients that contain gluten. Unless indicated as gluten-free, don’t eat them.
Bread: All types of bread made with rye, wheat, or barley should be avoided like the plague.
Snacks: From pretzels and graham crackers to flavored chips and popcorn, most snack foods have gluten. Check the label first.
Pasta: Avoid wheat-based pasta.
Oatmeals: Oats are gluten-free in their pure form. However, oat products can be contaminated with gluten during processing.
These are just a few food and food products you should keep at bay when you are on a gluten-free diet.
Some broths, couscous, soups, seitan, battered foods, candies, medicine, multivitamin supplements, rice mixes, gravies, licorice, and sweeteners may also contain gluten (unless labeled otherwise).
What to Eat on a Gluten-free Diet
To effectively do away with gluten from your diet, it’s best to always read labels of foodstuff you purchase. Ideally, however, the most effective way to avoid gluten is to consume single-ingredient whole foods. With that in mind, here are commonly available foods that you should prefer because they are naturally devoid of gluten:
Veggies and fruits: For people who follow a strict gluten-free diet, fruits and vegetables serve a two-prong advantage: they are naturally gluten-free and loaded with vitamins, as well.
Eggs: No part of the whole unprocessed egg contains gluten.
Seeds and nuts: Peanuts, flax seeds, cashew nuts, and all other types of nuts and seeds are naturally free from gluten. Good thing, some like pine nuts, chestnuts, sunflower seeds, and almonds are rich in fiber. As stated earlier, this is a big issue for people on a gluten-free diet.
Spices and herbs: All natural spices and herbs have no gluten in them.
Oils and spreads: All butter and vegetable oils are safe for people with gluten allergies, sensitivity, and intolerance.
Some flours: Go for flour and starches derived from tapioca, coconut, maize, almond, soy, chickpeas, corn, and potatoes.
Grains: Eat naturally gluten-free grains such as teff, arrowroot, amaranth, millet, sorghum, tapioca, corn, maize, buckwheat, rice, and quinoa. Only eat oats labeled gluten-free.
Dairy: Cheeses, plain yogurt, plain milk, butter, and other plain dairy products are gluten-free. It’s worth mentioning, however, that flavored dairy items include gluten-containing ingredients.
Fish, poultry, and meats: All poultry, fish, and meats are naturally gluten-free. However, avoid coated, smothered or battered meats because the batter or coating may contain gluten.
How to Check for Gluten on a Label
You have lots of food options when it comes to a gluten-free diet, allowing you to whip up a variety of sumptuous and healthy recipes. What happens if you aren’t sure if a food or food product is gluten-free? This is exactly why reading food labels is one of the best tips for how to go gluten free. Here’s how to check for gluten on food labels:
First, check if the label explicitly says “gluten-free”. This is the outright way to know if a food item is indeed gluten-free. Some labels may indicate the food product is wheat-free, but might still contain from other sources. Unfortunately, the FDA doesn’t require manufacturers to declare gluten but only wheat.
Second, check the food label for obvious ingredients that contain gluten. Rye, barley, and wheat are the big 3 suspects. Some ingredient labels may use their Latin names — Secale cereale for rye, Hordeum vulgare for barley, and Triticum vulgare for wheat. But they aren’t the only culprit ingredients.
Watch out for rye flour, seitan, oatmeal, modified wheat starch, matzo, malted milk, malt vinegar, malt syrup, graham flour, faro/farro, durum, Bulgur, brewer’s yeast, Kamut, wheat starch, wheat germ, triticale, spelt, semolina, and hydrolyzed wheat protein.
Thirdly, check for non-obvious ingredients that may contain gluten. These include unfamiliar ingredients like Fu (mostly found in Asian dishes), Farina, Emmer, Einkorn, and Atta.
Furthermore, make sure to read carefully through the allergen listing. If part of the food label, it includes potential allergens like dairy, soy, peanuts, tree nuts, egg, fish, and wheat. If the allergen list doesn’t contain wheat, don’t rule out gluten. After all, rye, oats, triticale, and barley are not among the top 8 allergens supposed to be listed. Find out more information on how to read food labels for gluten.
Eating Out on a Gluten-free Diet
Learning how to go gluten free is much more than reading food labels. It’s all about scrutinizing everything that goes into your body, whether you’re at home, in school, at work, or eating out. Your workplace may offer free meals, or host mixers, parties or corporate events where food is served. Some coworkers may prepare potluck to share. Where do you fit in the equation as someone with celiac disease? The chances are good that you’ll be left out, and some companies don’t allow people to bring food to their workplaces. How to go gluten free without disrupting your workplace dynamics and eating out?
Inform your boss/manager/supervisor. There’s no reason to suffer alone or feel isolated at work. Talk to your bosses, and let them know about your condition and how it may affect you at work. This article we wrote earlier tackles several issues on how to go gluten free at work.
Keep your friends and coworkers in the loop. When your colleagues and friends learn that you’re on a gluten-free diet, they will more probably bring/order food items or pick restaurants with gluten-free menu items when you eat out.
Plan, plan, plan. If you traveling on a work or business trip, ensure that you research beforehand restaurants to eat out at, and places to shop. If not possible, plan head to create a diet centered on single-ingredient whole foods like fruits, veggies, and lean meats.
Call restaurants ahead of your reservation. The best way to eat out safely is to reach out to the restaurant staff well ahead of time and explain your strict requirements. They will tell you about their gluten-free options so you can make your choice early enough.
More importantly, check their menu online, and ask questions but politely. Perhaps the first question is to inquire if they actually have a gluten-free menu. Don’t forget to ask if the restaurant staff has been trained on the subject matter. Some other questions to ask may include: are you aware of what gluten and gluten-free means? What menu items can be made gluten-free? At the end of the day, be understanding and prepared to chow down on something that may not be your favorite dish.
Gluten-Free (GF) Certifications
It can be tough for someone with celiac disease to find truly gluten-free food items, which is where GF certifications come in. As defined and required by the law, foods that have a “GF” or “Gluten-free Certification” seal on its packaging label must have lower than 20 ppm (parts per million) of gluten. According to the Food & Drugs Administration (FDA), this is the threshold of food that can be eaten without causing symptoms of celiac disease.
Manufacturers that put GF Certification logo on the products must have their respective food items independently verified and tested for purity, integrity, and quality.
Food manufacturers and processors that cater to the burgeoning group of gluten-free customers are increasingly seeking GF certifications for their items. This offers two-prong benefit: it acts as a seal of validation that gluten-free consumers are looking for when choosing ingredients and food items to consume. It also helps cultivate a connection between consumers and gluten-free brands.
Independent 3rd-party certification labs go above and beyond 20 ppm standard set by the FDA. They not only test and certified the plants and facilities where food is processed, but also check for trace levels of gluten in food items.
Currently, there are 3 major institutions that offer GF certification for restaurants, manufacturers and other key players who cater to the gluten-free market. These are the NSF International, the Allergen Control Group/Canadian Celiac Association (ACG/CCA), and the Gluten Intolerance Group’s Gluten-Free Certification Organization (GFCO).
Gluten-Free Certification Program (GFCP) of the ACG/CCA has a number of standards and criteria that manufacturers of gluten-free products for the Canadian and the US market must meet. In the United States, the ACG/CCA requires that food test below 10 parts per million of gluten, but the cut-off is 20 ppm for Canadian products.
CFCO is a GF certification program created by the GIG (Gluten Intolerance Group). It’s the leading gluten-free certification organization, testing both processing factories/facilities and products. For a food product to be certified as GF by CFCO, it must contain less than 10 parts per million of gluten. In fact, CFCO-certified food items read zero ppm.
NSF is another 3rd-party testing and certification organization that caters to different markets, especially in North America. Its certification process tests both products and facilities to make sure they test less than 15 parts per million of gluten.
Generally, gluten-free certification is a multi-step process that includes inspection of the facility, product testing, and complete evaluation of the ingredients. Most GF certification organizations carry out random inspections and testing to ensure that manufacturers adhere to their strict guidelines.
Wondering how to go gluten-free? You’re not alone — nearly 2.7 million are estimated to be on the diet, according to a recent report. The truth of the matter, however, is that going on a gluten-free is a gigantic commitment that’s often expensive and frustrating. In a nutshell: it may not be worth the trouble if you aren’t allergic, sensitive or intolerant to gluten.
If you believe you may have gluten sensitivity or celiac disease, consult with your doctor. He or she will likely have you tested for celiac disease (CD), which is a chronic disorder that may cause severe intestinal damage if not treated early. It occurs when your immune system mistakenly sees gluten (a type of protein found in rye, wheat & barley) as a foreign substance, launching an immune attack on the lining of your small intestine. Even if you have symptoms of CD, don’t go gluten-free without first being screened for the condition. You might have a different condition that can’t be treated with a gluten-free diet.
Remember celiac disease runs in families and can develop at any age. Following a gluten-free lifestyle for several years may make it harder to accurately diagnose the condition. However you look at it, you must get tested first before you hop onto the gluten-free bandwagon.
Finding out what foods contain gluten is the first step in learning how to go gluten free. Unsurprisingly, you must avoid obvious sources of gluten, namely wheat, barley, triticale, and rye. Also, stay away from brewer’s years, malt, and food products based on rye, wheat, barley, and their hybrids. This means avoiding bread, pasta, cereals, baked goods, snacks, sauces, and other foods like couscous.
The good news is that a gluten-free diet has a ton of food options to eat. Best non-gluten foods include meats, fish, herbs & spices, nuts, seeds, veggie oils, fruits & vegetables, grains like quinoa, plain dairy products, eggs, and starches.
If you aren’t sure if your food of choice has gluten or not, the best course of action is to read the ingredients label. If it’s labeled “gluten-free,” that is a no-brainer. Check the food label for obvious ingredients like rye, wheat, and barley, as well as their derivatives like durum, spelt, triticale, seitan, and wheat germs, just to mention a few.
Furthermore, don’t forget to look at the allergen list, which indicates if any of the top 8 allergens are present in the food item. If the lists show that wheat is one of the allergens, you are better off going for another item.
For people with celiac disease, going gluten-free is a lifelong commitment, which means it can affect your social, workplace, and other aspects of your life, including eating out.
Talk to your managers, inform your friends, and keep your coworkers in the loop about your condition, and going gluten-free will help. Creating more awareness at work will likely help shape your company culture towards a more gluten-free-friendly workplace.
The same goes for when you are eating out at a restaurant. It’s best that you call or communicate with staff ahead of time to discuss gluten-free menu options, and ask important questions.