What to Expect on the Gluten-Free Diet

To follow the gluten-free diet, you need to eliminate all foods and beverages that contain gluten. Gluten is a protein that's found in the grains wheat, barley, and rye, and some oats. Therefore, you'll need to avoid foods that contain wheat, barley, gluten-containing oats, or rye in order to eat gluten-free. Eating a gluten-free diet can get tricky because gluten-containing ingredients are found in many products. But once you familiarize yourself with labels, you'll become an expert at identifying foods that contain gluten. In addition, there are many whole foods that are healthy and naturally gluten-free, so you'll have plenty of options.

If you're going gluten-free for health reasons—because you have been diagnosed with celiac disease or non-celiac gluten sensitivity—you'll also need to watch for gluten cross-contamination occurring when gluten-free foods come into contact with gluten-containing foods. Any amount of gluten can be damaging to a person with celiac disease.

What to Eat

Following the gluten-free diet is complicated, since food manufacturers use gluten-containing ingredients—usually in the form of wheat or barley—in so many foods.

Wheat is used as the primary ingredient in most conventional baked goods, including: bread, cake, cookies, pasta, crackers, and cereal. Wheat also is used as a thickener in soups and (occasionally) as a thickener in ice cream. Therefore, to eat gluten-free you need to stick to versions of all those foods that are specifically labeled "gluten-free."

Barley isn't found in as many foods as wheat, but it's a sneakier ingredient: manufacturers use barley malt to sweeten some candies and cereals. Barley also is the primary ingredient found in beer. Meanwhile, rye, the third gluten grain, generally is found only in some breads and crackers, most of which also include wheat. It is also found in whiskey.

Oats are naturally gluten-free, but sometimes they can be contaminated by gluten if they are processed in facilities that also process wheat products. Look for oats that are labeled gluten-free to be safe.

The following lists are not exhaustive. When in doubt, always check with the manufacturer.

Bread and Cookies

Bread is a staple in many diets, but just because you can't eat gluten doesn't mean you can't eat bread. There are many gluten-free bread options available in stores. You'll also need to look for rolls, biscuits, muffins, buns, and cookies that are gluten-free.

Pasta

Most pasta contains wheat (semolina, an ingredient you'll see on many pasta labels, is a form of very fine wheat). Therefore, to eat gluten-free, you'll need to purchase only gluten-free pasta. Fortunately, there are many good gluten-free pastas available, with a variety of different ingredients, such as chickpeas, brown rice, quinoa, and corn.

Milk and Other Dairy Products

Most dairy products are gluten-free. However, there are a few important exceptions, including some flavored yogurts and cottage cheese, plus certain types of cheese. Always check the label, and rely on published gluten-free lists.

Meat, Fish, and Poultry

Plain, fresh meat, fish, and poultry is gluten-free. However, you'll need to beware of meat products that are seasoned in-store at the meat counter—liberal use of bread crumbs and marinades containing soy sauce make those a bad bet. Processed meat products such as bacon, ham, sausage, and hot dogs may or may not be gluten-free, so double-check before purchasing.

Eggs

Plain eggs are gluten-free. If you are eating eggs outside of your home, make sure there is no risk of cross-contamination.

Fruits

Fresh fruit may be the perfect gluten-free food, so snack away to your heart's content. In fact, a banana is the perfect gluten-free snack. The vast majority of jarred and canned fruit also is safe on the gluten-free diet.

Vegetables

All fresh vegetables are gluten-free, and many canned and frozen vegetable products are gluten-free (check the ingredients for added ingredients such as pasta). However, when it comes to purchasing beans, stick with a safe brand; because of the way they're grown, beans can be cross-contaminated with gluten grains in harvesting and processing.

Canned Foods

Canned foods such as soups and meat and fish products may or may not be gluten-free. For example, only some canned soups are gluten-free—pasta is a common ingredient in soups, and wheat flour sometimes is used to thicken creamy soups. Always check the label or consult a list of gluten-free options.

Frozen Foods

If you're looking for convenience, you can find gluten-free frozen food choices in the form of frozen gluten-free pizza, frozen gluten-free meat products (such as chicken nuggets and fish sticks), frozen gluten-free veggie burgers, and entire frozen gluten-free meals. Most supermarkets, even the smaller ones, will have something you can eat in the frozen section (although it might be more exotic than the standard meat-and-potatoes frozen meal option).

Condiments

Condiments are tricky on the gluten-free diet. In fact, one hugely popular condiment—conventional soy sauce—is completely off-limits, since it's made mainly with wheat, not soy. Still, it's easy to find gluten-free soy sauce. You also can find gluten-free ketchup, mustard, barbecue sauce, steak sauce, hot sauce, and salad dressing. Some vinegars are safe on the gluten-free diet, while others (particularly malt vinegar) are not. Oils such as olive oil and canola oil generally are perfectly fine.

Chips and Snack Foods

Gluten-free snackers should take heart: most potato chips are considered gluten-free, as are the majority of corn and tortilla chips. Beware of other snack foods, such as pita chips (made with wheat-containing pita bread) and wheat-containing crackers. Here's a detailed rundown of gluten-free snack options.

Nuts

Nuts are naturally gluten-free. However, if they are processed in a facility that also processes gluten-containing foods, there may be a risk of cross-contamination. To find safely gluten-free nuts, look for the "May contain" statement on the ingredients label. If the label includes the statement "May contain wheat," then the nuts should be avoided.

Ice Cream

When it comes to gluten-free ice cream, you have plenty of choices, including some that may surprise you (you actually can find gluten-free cookie dough ice cream and gluten-free brownie bite ice cream). To be safe, read ingredient labels carefully and stick with known "gluten-free" brands. Also, when getting ice cream at a restaurant or ice cream shop, follow these rules to avoid cross-contamination. Frozen yogurt shops also offer a bonanza of gluten-free froyo options.

Non-Alcoholic Beverages

The vast majority of sodas, sports drinks, energy drinks, and juices are gluten-free. In addition, most coffee and many types of flavored teas (both hot tea and iced tea) are safe on the gluten-free diet. You can't go wrong with 100% juice drinks (plain orange juice or apple juice always are safe options), but you're unlikely to get into trouble by venturing outside your gluten-free beverage comfort zone, either.

Alcoholic Beverages

Many people who are new to the gluten-free diet don't realize that beer isn't gluten-free (it's made with barley). Not to worry: there are plenty of good gluten-free beers on the market. Wine and hard cider also are gluten-free, as are most rum and tequila. When it comes to vodka, gin, whiskey, bourbon, and other hard liquor, if they are made from gluten-containing grains, you should avoid them. Some vodka is naturally gluten-free because it is made from potatoes or another gluten-free source.

Protein Shakes and Supplements

When looking for a multivitamin, aim to purchase one that is labeled gluten-free. Gluten-free protein powders are also available for purchase.

Recommended Timing

Once you've been diagnosed with celiac disease or non-celiac sensitivity, you'll need to follow a gluten-free diet. Before you rush out to buy all kinds of specialty items, keep in mind that there are many nutritious and delicious foods that are naturally gluten-free.

Filling your body with whole foods will provide you with energy and help your body heal: Fresh fruits and vegetables; fresh, lean cuts of meat, poultry, and fish; gluten-free grains, nuts, seeds; and plain low-fat dairy products. Some people with celiac disease also have lactose intolerance. If you're one of them, you may have to omit dairy, at least at first.

Resources and Tips

Advice on implementing the gluten-free diet abounds, but it's often about duplicating your old favorite foods. Instead, you might want to approach this significant change in the way you eat as a great opportunity to clean up your diet and find some new, healthier favorite foods.

• Shop the perimeter of the grocery store, where you find the fresh fruits, vegetables, meats and fish, and dairy products.
• Experiment with fresh spices you'll find in the produce department, and avoid spice mixtures that may contain gluten ingredients.
• When you eat out, stick with restaurants that offer gluten-free menus or have gluten-free options.

Modifications

Most people who follow the gluten-free diet eliminate only gluten-containing foods. However, some people also are intolerant to milk-based dairy products, and so must eat a gluten-free, dairy-free diet. Others choose to follow other variations of the gluten-free diet, including: the low-FODMAP diet, the low-carb diet, and the paleo diet.

Here is some information on these variations of the gluten-free diet:

• Gluten-free, dairy-free diet. Many people who are diagnosed with celiac disease initially find they are lactose-intolerant due to celiac-related intestinal damage. Ultimately, the gluten-free diet helps to heal that damage, and people with celiac regain their tolerance to milk products. But in the meantime, many need to omit milk-based products from their diets, including milk, cream, yogurt, cheese, cottage cheese, and ice cream. Learn more about living dairy-free.
• Gluten-free, corn-free diet and/or gluten-free, soy-free diet. Some people who follow the gluten-free diet find they are sensitive to additional grains and legumes, including corn and soy. Eliminating either corn or soy (or both) can be challenging, since many gluten-free products feature either corn or soy ingredients. However, some food product manufacturers—especially those catering to health-conscious consumers—make products that are free of gluten, dairy, and soy. In addition, some companies that cater to people with food allergies (such as Enjoy Life) make products that are free of all four of those ingredients: gluten, dairy, soy, and corn.
• Gluten-free low-FODMAP diet. The low-FODMAP diet, which eliminates gluten grains, may help to reduce symptoms of irritable bowel syndrome. FODMAP stands for "fermentable oligosaccharides, disaccharides, monosaccharides, and polyols," all of which are types of carbohydrates. Consuming these types of carbohydrates (including gluten grains, which are high in one particular type of FODMAP) may cause digestive symptoms such as bloating, diarrhea, or abdominal pain. Some people find they're sensitive to one type of FODMAP, but not to all of them. If you need to eliminate FODMAPs, there are plenty of great low-FODMAP recipes available.