What Is the Gluten-Free Diet?

gluten-free ingredients

Janine Lamontagne 

In This Article

The gluten-free diet eliminates foods that contain gluten, which is a protein found in the grains wheat, barley, and rye. Many of the foods and beverages commonly consumed—such as bread, cereal, crackers, and even beer—contain these grains, which places them off-limits for those who are gluten-free.

People who have celiac disease and non-celiac gluten sensitivity need to follow the gluten-free diet because of their health conditions. In addition, the diet has gained in popularity in recent years, with some (including celebrities) claiming it aids in weight loss or cures acne.

However, there's no medical evidence for most of those claims, and experts agree that the gluten-free diet only is medically necessary for those with celiac or gluten sensitivity. The diet is very restrictive, since it eliminates so many common foods. It also can be very difficult to follow, since foods you might not expect to contain gluten—such as canned soups and ice cream—sometimes do contain it as an ingredient.

"The gluten-free diet is a medically necessary way of eating for people with celiac disease and non-celiac gluten sensitivity. Most experts agree that this diet should only be used when medically necessary, since restricting a food group increases the risk for nutrient imbalances."

Willow Jarosh, MS, RD

Background

Gluten, a sticky, stretchy form of protein, is a key component in wheat—gluten is a large part of what makes bread soft and stretchy and cakes light and springy. In fact, over the centuries, farmers have bred wheat to include more gluten, since the protein is so important in baking.

However, some people react very badly to gluten. The gluten-free diet first was developed for people who have been diagnosed with celiac disease, which is an autoimmune disorder. When you have celiac disease, consuming a food that contains gluten causes your immune system to kick into overdrive and attack the lining of your small intestine. Left untreated, celiac disease can cause nutritional deficiencies, osteoporosis, and even cancer in very rare cases.

Celiac has a huge number of potential symptoms, many of which don't involve your digestive tract at all, but the most common ones include: diarrhea and/or constipation, fatigue, stomach pain, and bloating. Although there are several drugs for celiac disease in development, the only current treatment for the condition is a gluten-free diet. Once those with celiac disease begin eating gluten-free, their symptoms tend to abate and their small intestines begin to heal.

Non-celiac gluten sensitivity, the other condition in which a gluten-free diet is required, only was identified by medical researchers in the 1980s, and there's still no medical test for it. People with non-celiac gluten sensitivity do not have celiac disease (their doctors rule out celiac disease before diagnosing them with gluten sensitivity). However, they experience many of the same symptoms as people with celiac disease, including: digestive issues such as diarrhea or constipation, fatigue, headaches, and bloating.

Despite these symptoms, doctors believe that people with non-celiac gluten sensitivity do not incur long-term damage to their bodies by eating gluten-containing foods. Following the gluten-free diet clears up their symptoms, while eating foods with gluten in them (either accidentally or on purpose during a "cheat day") causes those symptoms to return. You may have non-celiac gluten sensitivity if you feel better on a gluten-free diet, even though there's no way to test for it.

Many people who don't have celiac disease or non-celiac gluten sensitivity follow the gluten-free diet. In some cases, their doctors have recommended they follow the diet. For example, women struggling with infertility may be told to go gluten-free; there's one medical study published in 2011 showing that women who can't conceive are more likely to have undiagnosed celiac disease. In addition, there was a medical research study published in 2008 that indicated a gluten-free vegan diet may help to lower inflammation levels and protect joints in people who have rheumatoid arthritis.

However, there's also a group of people who advocate the gluten-free diet as a cure for almost any health issue, which it most definitely is not. In particular, multiple celebrities—including Kourtney Karsashian and Gwyneth Paltrow—have endorsed the gluten-free diet. Some see the diet as effective in weight loss, even though there's little medical evidence it can help you lose weight.

In fact, many people with celiac disease find they gain weight when they go gluten-free, since their small intestines begin to heal and they're suddenly absorbing nutrients again.

How It Works

As you know, gluten is found in the grains wheat, barley, and rye. The gluten-free diet works by eliminating all foods with gluten in them. This may sound simple: just skip the bread, cookies, and wheat-based cereal. But the gluten-free diet is far more complicated than just skipping those obvious foods. That's because gluten grains—particularly wheat—are extremely common in all processed foods.

Wheat is used to thicken soups and to help ferment soy sauce. Barley—the second most-common gluten grain—is found in sweeteners used in cereals and in candy, and also in beer and malted alcoholic beverages.

To successfully follow the gluten-free diet, you need to know where gluten lurks and avoid all those foods. You'll need to learn to read labels on food products and recognize gluten-containing ingredients, and you'll need to be cautious in restaurants and when enjoying a meal at a friend or relative's home.

It's also not enough to simply eliminate all foods with gluten. You'll need to be cautious about gluten cross-contamination. That's because even a tiny crumb can contain enough gluten to cause symptoms and even ongoing celiac disease-related intestinal damage in some cases.

However, you don't need to fear giving up bread, baked goods and beer—there are good gluten-free versions of all these foods available in most larger supermarkets. In addition, many restaurants—even fast food outlets—feature gluten-free options or even an entire gluten-free menu.

Pros and Cons

The gluten-free diet is essential for people who have celiac disease or non-celiac gluten sensitivity. Although intestinal healing may take some time for people with celiac disease, many find they feel better within a short time of starting the gluten-free diet. For people with non-celiac gluten sensitivity, their symptoms may abate even more quickly—within a few days in some cases.

When followed properly according to medical advice, the gluten-free diet is safe. However, people who are following the gluten-free diet need to watch their levels of several important nutrients, including fiber and some B vitamins, since gluten-free foods often are lacking in these nutrients. Some people who are eating gluten-free may find they need to consult a dietitian who is skilled in the gluten-free diet to make sure they're not missing key parts of a healthy diet.

In addition, the gluten-free diet is quite difficult to follow in the real world, since so many common foods contain gluten. People who follow the diet carefully often find it's difficult to eat out at a restaurant or to enjoy a meal with friends, at least without significant research and preparation in advance. Eating gluten-free is not convenient and frequently requires planning that other diets do not require. Gluten-free products also are more expensive than their conventional counterparts.

Common Myths and Questions

Is the gluten-free diet important to follow if I have celiac disease or non-celiac gluten sensitivity?

Yes, it's critical. If you have been diagnosed with celiac disease or non-celiac gluten sensitivity, you must follow the gluten-free diet for life. Although research is ongoing, there's no cure for celiac disease, and the only treatment is the gluten-free diet.

Will the gluten-free diet help me improve my health if I don't have celiac disease or non-celiac gluten sensitivity?

Probably not. There are a few conditions, including infertility and rheumatoid arthritis, where medical research indicates a gluten-free diet may help. Research into other conditions, including mental health conditions and some autoimmune diseases, has not been as promising. So in most cases you're unlikely to see a true benefit from cutting gluten out of your diet.

Will going gluten-free help me lose weight?

Again, probably not. Some people do find they can lose some pounds while eating gluten-free. But their weight loss may occur more because they've eliminated so many types of foods—and therefore eliminated so many opportunities to snack and eat generally—than because they aren't eating gluten any longer.

Does following the gluten-free diet mean I have to give up bread?

No, definitely not! It does mean you'll need to eat only gluten-free bread, though (and gluten-free rolls and gluten-free crackers, too). Gluten-free bread has garnered a fairly bad (and occasionally well-deserved) reputation over the years for being crumbly and dry, but these days gluten-free bread products taste and feel almost like the wheat-containing breads they're intended to replace.

Does following the gluten-free diet mean I have to give up all grains?

Again, not at all. There are many, many common (and more exotic) gluten-free grains you can eat. Rice is gluten-free, for example, and corn is gluten-free as well. Quinoa, teff, tapioca, and sorghum all are gluten-free. Some people do eat low-carb/low grain in addition to following the gluten-free diet, but you don't need to be low-carb in order to be gluten-free.

Can I eat out if I'm following the gluten-free diet?

Yes, definitely: many restaurants offer gluten-free menus. Even in restaurants that don't have a specific gluten-free menu, it's usually possible to speak to the chef or the manager to arrange something you can eat. Ethnic restaurants such as Mexican, Japanese, Thai, or even Italian eateries often are good options.

Can I cheat on the diet?

People who have celiac disease or non-celiac gluten sensitivity should not cheat on gluten-free the diet. In those with celiac, even a tiny bit of gluten—too small for you to see—is enough to cause intestinal damage. And it may surprise you to learn that your symptoms may return with a vengeance if you cheat (or if you eat gluten-containing foods accidentally). So all things considered, it's definitely not worth it to cheat.

How It Compares

The gluten-free diet is unusual in the overall diet community in that it first was developed as a treatment for a specific illness (celiac disease). Although many people follow the gluten-free diet for other reasons, doctors don't recommend it. Still, there are other diets that incorporate the gluten-free diet into their overall approach. They include:

  • The Low-FODMAP diet, used to treat irritable bowel syndrome, calls for you to reduce or eliminate wheat, barley, and rye, all of which are high in FODMAPs, a type of carbohydrate that research shows can lead to uncomfortable digestive symptoms.
  • The paleo diet, which asks followers to eat only the foods that would have been available before the dawn of agriculture, eliminates all grains, not just wheat, barley, and rye. The paleo diet also skips all dairy products and legumes, food groups that are allowed on the gluten-free diet.
  • The Atkins diet relies mainly on gluten-free foods, especially in its beginning stages. It does allow some foods with gluten grain-based ingredients in later stages. However, Atkins is one of the most gluten-free-friendly weight loss diets.
  • The South Beach diet also calls for dieters to mainly eat gluten-free. However, South Beach does not require you to be as carefully gluten-free as you need to be if you have celiac or gluten sensitivity.
  • The Whole30 diet is an elimination diet that might help you to discover a sensitivity to gluten (or to another food). The diet, which forbids all grains, is intended to be a short-term program to help improve your health, rather than to help you lose weight.

    Getting Started

    Starting the gluten-free diet can be intimidating—there's a significant amount to learn in a very short time, and you're probably in a rush to get going so you can feel better. Your best bet is to start with a comprehensive gluten-free food list, and to stick only with processed food products that are specifically labeled "gluten-free."

    It's also common for people to focus on foods they can't eat, as opposed to foods they can eat while gluten-free, and even to even mourn their old gluten-containing favorites. But the truth is, you don't need to mourn; you'll almost certainly find good gluten-free versions for your favorite processed foods, and great gluten-free recipes to recreate most other dishes.

    A Word from Verywell

    The gluten-free diet isn't for everyone—it's intended specifically to treat celiac disease and non-celiac gluten sensitivity. If you have one of those two conditions, it's very important to stick to the gluten-free diet strictly. If your dietary goal is to lose weight or become more healthy generally, you're better off trying a diet that's specifically intended to deliver those results.

    The gluten-free diet isn't an easy diet to follow, simply because gluten grains (wheat, barley, and rye) are so common in the foods we eat. It's easy to make mistakes, especially when you're first starting the diet. But you're likely to find that eating gluten-free becomes second nature over time, and that your celiac or gluten sensitivity symptoms improve or disappear entirely as a result.

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