An Overview of the Gluten-Free Diet

Bowl of fruit

Verywell / Zorica Lakonic

After getting a celiac disease diagnosis, you will be thrust into learning all you can about following gluten-free diet. Gluten—the main protein in kernels of wheat, rye, and barley grains—is what triggers the immune system to attack the lining of the small intestine in people with this condition.

Gluten is in many foods, including those you might not expect, so it can be hard to avoid in order to manage symptoms. It can also find its way into some foods that should be considered safe.

You'll need to know more about food labeling and ingredient names to succeed at the gluten-free diet, and this article can get you started. Read on to learn more about choosing foods, what can happen if you eat gluten when you have celiac disease, and how to set yourself up for gluten-free diet success.

common sources of gluten

Verywell / Brianna Gilmartin

Why Eat Gluten-Free?

Most people who follow a gluten-free diet do so because they're using it to treat a specific health condition. The best-known health condition that responds to a gluten-free diet is celiac disease, which affects about 1% of the global population.

Celiac disease symptoms happen when you are exposed to gluten. This causes the immune system to attack the small intestine. These symptoms may include:

Celiac disease can lead to malnutrition and anemia, a condition in which you don't have enough healthy red blood cells to sufficiently oxygenate your body. It also can lead to osteoporosis, a condition that causes weak and brittle bones, and many other potentially serious health issues.

It's important to get a formal celiac diagnosis if you have concerns. Though you may feel certain you have it based on your symptoms, it's possible that you could instead have a potentially serious condition like ulcerative colitis or Crohn's disease that needs to be treated.

Healthcare providers recommend that people not start eating gluten-free before being tested for celiac disease. That's because you need to be consuming gluten for celiac disease testing to be accurate.

Know, too, that celiac disease is often misdiagnosed. If you are not confident in your provider's assessment, consider seeking a second opinion.

While celiac disease, non-celiac gluten sensitivity, and wheat allergy are the main reasons people follow a gluten-free diet, some do so to help manage chronic fatigue, headaches, and other conditions. These uses are not proven, however.

Gluten-Containing Foods

Any food that contains wheat, barley, or rye contains gluten. A hybrid of wheat and rye, called triticale, also is a gluten source.

Often, gluten is added to foods because manufacturers prize the texture and other characteristics that it adds to their products. For example, wheat bread gets its distinctive texture from gluten, while cakes and pasta stick together instead of crumbling because of the gluten protein.

For someone with celiac disease, this means that you must avoid conventional bread, pasta, cakes, cookies, and most cereal. This broad category of foods high in gluten includes:

  • Beer
  • Biscuits and flour tortillas
  • Breading
  • Breakfast foods (like crepes, waffles, and pancakes)
  • Crackers and croutons

Avoiding gluten doesn't stop there, though. Gluten is an ingredient in many processed food products. In certain soups, gluten grains act as thickeners. Barley malt is often used as a sweetener in candy and cookies. In beer and some forms of liquor, gluten grains are fermented to make alcoholic brews.

Hidden Gluten

Seeing "wheat flour" or another obvious gluten source on a product label is a giveaway that the item is not safe for a gluten-free diet. But gluten can hide under aliases on product labels. And unless you know what they are, they can be easy to miss.

For example, the following ingredients are sources of gluten:

  • Yeast extract in broth
  • Soy sauce solids in seasoned rice
  • Malt vinegar in some varieties of pickles

In addition, foods with no gluten ingredients aren't necessarily gluten-free since they could be subject to gluten cross-contamination in processing.

For example, pure rice cakes processed in the same plant as wheat crackers could pick up trace proteins simply because they are made in the same place—and those trace proteins can be enough to trigger a reaction.

Some people are more sensitive to traces of gluten and must be extra careful. Still, unless a product indicates that steps were taken to produce it without risking cross-contamination, you should assume there is a potential for the food to trigger symptoms.

Gluten can also be found in personal care products like toothpaste and cosmetics, as well as medications.

"Gluten-Free" Labeling

The Food and Drug Administration (FDA) does not require disclosure of gluten on food labels. Manufacturers can disclose it voluntarily under the FDA's gluten-free labeling rules. Today, many do due to consumer interest in such transparency. Some, such as Kraft Foods and Con Agra Foods, have policies of always disclosing ingredients that contain gluten.

To put "gluten-free," "free of gluten," or similar messaging on a product's label and be in compliance with FDA rules, the food must not have any type of wheat, rye, barley, or crossbreeds of those grains. The food can't use an ingredient that comes from these grains unless the gluten is removed to less than 20 parts per million (ppm).

Many companies use bold labeling that has a symbol or states "gluten-free." This makes it easier for people to identify products without looking at the ingredients. However, there is no standard for this, so where and how the designation appears will differ from product to product.

Some manufacturers opt to have their products certified gluten-free by an independent organization like NSF International. They may contain a seal of certification from that group.

How to Start a Gluten-Free Diet

Any change to a diet can be challenging, particularly if it means you need to avoid favorite foods or begin to prepare meals in new ways. But as you become accustomed to what you can eat, you will be able to adapt to new foods while eliminating foods that cause any symptoms.

The growing demand for gluten-free products means they can be found in many mainstream grocery stores. So once you have a list of what you want to buy, you should be able to easily check it off.

Foods to Choose

There's actually quite a long list of reliably safe gluten-free foods. One way to approach the gluten-free diet is to stick to whole foods. This means:

  • All fresh fruits and vegetables are safe to consume on a gluten-free diet. Keep in mind that anything that comes prepackaged might not be.
  • In the meat section, stick to beef, poultry, pork, and seafood that doesn't contain marinades or other added ingredients. Basically, as long as it's plain, it's safe.
  • Rice and quinoa are both good choices to add to your diet. Just be certain to buy plain varieties of these starches, with no added ingredients.
  • Potatoes can also be a good choice, although you'll need to watch how they're prepared.

While these tips can apply to eating at home, it is more difficult when you want to dine out. You will need to look for dishes labeled gluten-free or closely question your server.

The good news is that gluten-free menu labeling has become much more common in recent years, and many restaurants offer gluten-free options for favorites like pasta.

Consider bringing your own food to gatherings where you don't think the food provided will be gluten-free or prepared separately from gluten-containing items.

There are ways to make the process of going gluten-free easier. You can, for example, download a smartphone app to help you identify products and restaurants that cater to those who are gluten-free. You can also check in with your favorite grocery store to see if it maintains lists of gluten-free products or labels the products on their shelves.

Ensuring Good Nutrition

The gluten-free diet may help you consume more fresh, whole foods and their abundant nutrients.

On the other hand, in eliminating many grains, a gluten-free diet also cuts out certain vitamins and minerals. It also may add salt, fat, and sugar.

This can be a concern for anyone, but especially people with conditions like diabetes or heart disease.

You may find it beneficial to consult with a dietitian. They can make sure that what you're eating is providing your body with the nutrition it needs and recommend supplementation, if needed. They can also help you craft meal plans.

Avoiding Trace Amounts

You may be surprised to find that once you've started eating gluten-free, your body will react to even tiny amounts of gluten with the return of old symptoms or even new ones you weren't expecting. This is pretty common after gluten exposure.

Regardless of where you wind up falling on the sensitivity scale, you'll want to limit the chance of an "accidental glutening." Specifically, you'll need to:

  • Decide whether to share a kitchen with people who eat gluten. If so, set it up in a way that prevents you from getting sick.
  • Banish gluten foods and ingredients from your kitchen, or from the part you use.
  • Replace kitchen tools. They may harbor gluten grain residue, even though you've scrubbed them thoroughly.
  • Consider airborne gluten and other sources in your home. This may include shampoos and other products in the bathroom, pet foods, and your craft supplies.
  • Take care when dining out and eating food prepared by a friend or family member.

Summary

People who have celiac disease follow a gluten-free diet so that they avoid intestinal symptoms caused by their body's immune response to the protein gluten. This also helps to reduce the risk of developing a related health condition.

The gluten-free diet requires you to avoid all products made with wheat, rye, barley, or crossbred grains like triticale. It also means avoiding any surprise ingredients made with them or the possibility of cross-contamination of foods, whether during the manufacturing process or at home.

A Word From Verywell

Starting a gluten-free diet may seem intimidating, but it has its benefits. When you eat gluten-free, it also means you become far more aware of what goes into your food and how it's made. This may lead to better health outcomes.

Frequently Asked Questions

  • What is gluten?

    Gluten is a group of seed proteins found in certain cereal grains. These include proteins found in any species of wheat (including durum, einkorn, emmer, farina, farro, graham, Kamut, Khorasan, semolina, spelt, and wheatberries) as well as rye, barley, and triticale.

  • Do I need a gluten-free diet?

    Unless you have celiac disease, gluten intolerance, or a gluten-related disorder, it isn't necessary to adopt a gluten-free diet. There is no scientific support for other uses, and the diet can pose some nutrition challenges.

  • What are the symptoms of gluten intolerance?

    Symptoms of gluten-related disorders are extensive and may include bloating, stomach pain, constipation, diarrhea, nausea, acid reflux, headache, “brain fog,” bone pain, and dermatitis.

  • Where can gluten hide?

    Gluten is hidden in many products, especially packaged and processed foods. Some examples include candies, meat substitutes, pre-seasoned meats, salad dressings, soups, gravies, and soy sauce.

  • What is the best way to eliminate gluten?

    To eliminate gluten from your diet, try to eat more whole foods including fruits, vegetables, nuts, seeds, and gluten-free grains like rice, oats, quinoa, millet, buckwheat, and amaranth. Always read product labels and learn the different terms used to describe wheat.

Was this page helpful?
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Goel G, Tye-Din JA, Qiao SW, et al. Cytokine release and gastrointestinal symptoms after gluten challenge in celiac diseaseSci. Adv. 2019 Aug 7;5(8):eaaw7756. doi:10.1126/sciadv.aaw7756

  2. Green PHR. The role of endoscopy in the diagnosis of celiac diseaseGastroenterol Hepatol (N Y). 2014;10(8):522-524.

  3. Jelsness-jørgensen LP, Bernklev T, Lundin KEA. Fatigue as an Extra-Intestinal Manifestation of Celiac Disease: A Systematic ReviewNutrients. 2018;10(11). doi:10.3390/nu10111652

  4. Celiac Disease Foundation. Testing.

  5. MedlinePlus. Learn about gluten-free diets.

  6. Food and Drug Administration. Food Labeling; Gluten-Free Labeling of Foods.

  7. Beyond Celiac. Gluten-Free Certification.

  8. Johns Hopkins Medicine. Gluten-Free Diet: Is It Right for Me?

  9. Akhondi H, Ross AB. Gluten and associated medical problems. In: StatPearls [Internet].

  10. El Khoury D, Balfour-Ducharme S, Joye IJ. A review on the gluten-free diet: technological and nutritional challengesNutrients. 2018;10(10):1410. doi:10.3390/nu10101410

Additional Reading