Gluten-free diet for celiac disease

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, 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 does not 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.1 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 (56.7 g) of oats may be eaten daily as long as no new symptoms arise.2 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 2 to 6 months), you may be able to gradually reintroduce milk products into your diet.
  • Avoiding all beer products, alcoholic and nonalcoholic, including lagers, ales, and stouts.
  • 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.

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.
  • Flours and starches made from rice, corn, buckwheat, potatoes, soybeans, or tapioca.
  • 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.

Citations

  1. Haboubi NY, et al. (2006). Coeliac disease and oats: A systematic review. Postgraduate Medical Journal, 82(972): 672–678.
  2. Farrell RJ, Kelly CP (2002). Celiac sprue. New England Journal of Medicine, 346(3): 180–188.

Last Updated: June 23, 2008

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