Celiac Disease: Following a Gluten-Free Diet

why do I need to follow a gluten-free diet?

If you have a confirmed diagnosis of celiac disease, your doctor may have told you that you should follow a strict and life-long gluten-free diet. This means avoiding all foods that contain or have come in contact with wheat, barley, or rye ingredients. Research shows that ingesting gluten-containing foods triggers an autoimmune response that can damage your intestinal lining. The damage can lead to a wide variety of symptoms that can affect your overall health, so it is important that you understand how to follow a gluten-free diet. This handout will provide you with the tools you need to live a happy and healthy gluten-free lifestyle.

Gluten-Free Diet

Grains and starches allowed

  • Amaranth
  • Arrowroot
  • Buckwheat
  • Corn
  • Flax
  • Flours made from nuts, beans, and seeds
  • Millet
  • Montina™
  • Potatoes, potato starch, potato flour
  • Quinoa
  • Rice
  • Rice bran
  • Sago flour
  • Sorghum
  • Soy (soya)
  • Tapioca
  • Teff
  • Wild rice

Gluten-Free Flour Recipe

  • 1 cup potato starch
  • 1 cup soya flour
  • ½ cup tapioca flour/ starch
  • ½ teaspoon xanthan gum

Mix and measure out one cup to equal one cup of regular flour.

Potato starch must be used, NOT flour. Xanthan gum adds moisture, which is necessary with gluten-free foods.

This flour can be substituted for regular flour to make any gluten recipe such as cookies, cakes, gravy, dumplings, pancakes, etc.

Oats: Oats themselves are naturally gluten-free. Oats are a whole grain so they possess important vitamins, minerals, and fiber that might be lacking in a gluten-free diet. Studies show that pure, uncontaminated oats are tolerable in moderation: 1/2 cup to 1/3 cup dry rolled oats for adults, and 1/4 cup for children. However, commercial oat products can be contaminated with wheat if they are processed or stored in a facility that processes wheat. Look for a certified gluten-free label if you are purchasing an oat product.

Grains to avoid

  • Barley
  • Barley malt/extract
  • Bulgur
  • Couscous
  • Durum
  • Einkorn
  • Emmer
  • Farina
  • Faro
  • Graham flour
  • Kamut
  • Matzo flour/meal
  • Orzo
  • Panko
  • Rye
  • Seitan
  • Semolina
  • Spelt
  • Triticale
  • Udon
  • Wheat
  • Wheat bran
  • Wheat germ
  • Wheat starch

Questionable ingredients

The following is a list of ingredients that are questionable and should not be consumed unless you can verify that they do not contain or are not derived from gluten-containing grains:

  • Brown rice syrup (can be made from barley)
  • Flour or cereal products
  • Hydrolyzed vegetable protein (HVP), hydrolyzed plant protein (HPP), or textured vegetable protein (TVP) from a gluten-containing source
  • Malt vinegar (distilled vinegar is ok)
  • Modified food starch from a gluten-containing source
  • Rice malt
  • Seasonings or “natural flavors”
  • Soy sauce, soy sauce solids, or teriyaki sauce

    Frequently overlooked foods that often contain gluten:

    • Breading
    • Brewer’s yeast
    • Broth
    • Brown rice syrup
    • Coating mixtures
    • Communion wafers
    • Croutons
    • Salad dressings
    • Drugs or over-the-counter medications
    • Energy bars (see label)
    • Herbal or nutritional supplements
    • Ice cream or gelato
    • Imitation bacon and seafood
    • Licorice
    • Marinades
    • Playdough (wash hands after use)
    • Processed meats (deli meats, salami, bologna, hot dogs, lunch meats)
    • Roux
    • Sauces, gravies
    • Soup base/bouillon
    • Self-basting poultry
    • Soy sauce, soy sauce solids
    • Thickeners
    • Veggie burgers

    Where to shop for gluten-free foods

    In the past, gluten free products were found at specialty stores; luckily this has changed. Most national and regional grocery chains stock gluten-free foods, often in a special aisle or section but often located with other foods.

    Regionally in Ohio, gluten-free foods can be found at Costco, Giant Eagle, Kroger, Meijer, Acme, Buehler’s, ALDI , Marc’s, Whole Foods, Trader Joe’s, Earth Fare, Mustard Seed, and Heinen’s.

    Shopping tips

    • The perimeter of your supermarket mostly contains naturally gluten-free and nutritious foods like fruits, vegetables, meat, fish, and poultry, and dairy products.
    • If you have access to health food stores, these typically have a good variety of GF items.
    • Don’t be afraid to ask store managers or staff if a particular item is GF!
    • READ LABELS! Avoid items with ingredients in the lists of non-GF ingredients provided here.
    • Look for labels on food packages to ensure they are gluten-free. You can find a variety of GF labels by doing a Google™ image search for “gluten-free labeling.”

    A note on gluten-free foods

    While there are a lot of gluten-free packaged and convenience foods on the market now, these aren’t necessarily the healthiest choices. Remember, gluten-free doesn’t automatically mean nutritious! These foods can have higher amounts of sugar, fat, and sodium, and lower fiber content. It is important to check the ingredients and make healthy choices. Here are some tips:

    • Choose gluten-free foods that are made from whole grains, like brown rice or quinoa instead of white rice or corn flour.
    • The first ingredient on the label will be the most abundant in the food, so make sure that it is a gluten-free whole grain.
    • If you make a gluten-free pizza or pasta dish, load it up with vegetables and lean protein.
    • Watch out for gluten-free frozen meals – like all frozen meals, they can be loaded with sodium.
    • Save the GF snacks and desserts for special occasions (remember, moderation is key!) Here are a few gluten-free favorites:

    Reading labels

    On August 2, 2013, FDA issued a final rule defining “gluten-free” for food labeling with a compliance date of August 5th, 2014. This meant that food products bearing a gluten-free claim labeled on or after that date must meet the rule’s requirements. This allows consumers, especially those living with celiac disease, to be confident that items labeled “gluten-free” meet a defined standard for gluten content. Additionally, on June 25, 2014, FDA issued a guide for small food businesses to help them comply with the final rule’s requirements.

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