An Overview of the Gluten-Free Diet

After a diagnosis of celiac disease, you will need to go on a 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 this condition, so it must be avoided to manage symptoms.

Gluten is in many foods (including many in which you wouldn't expect to find it) and it's extremely difficult to avoid. In fact, the learning curve on a gluten-free diet is equal to or greater than the learning curves on almost any other type of diet. You will get the hang of it eventually, but you'll learn more about food labeling and ingredient names than you ever thought you would need to know in the process.

You'll also make mistakes as you learn how to eat gluten-free and may even experience them decades into following the diet.

Do your best to educate yourself about gluten-containing foods to set your gluten-free diet up for success.

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. When gluten triggers the immune system to attack the small intestine, celiac disease symptoms follow, which can lead to malnutrition, anemia, osteoporosis, and many other potentially serious health consequences.

Doctors 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. It can be important to know for sure whether you have celiac so that you can watch for related health conditions that might occur.

People with celiac disease must be gluten-free for life in order to alleviate symptoms and significantly reduce the risk of related conditions. Even tiny amounts of gluten can keep immune systems in overdrive and prevent intestines from healing.

Gluten-Containing Foods

Any food that contains wheat, barley, or rye contains gluten, meaning you must avoid conventional bread, pasta, cakes, cookies, and most cereal. Gluten-containing grains are commonly used in foods because they have characteristics that are prized by food manufacturers. For example, wheat bread gets its distinctive, pleasing elasticity and texture from gluten, while cakes and pasta stick together instead of crumbling because of the gluten protein.

However, bread, cereal, and pasta represent only the tip of the gluten iceberg—gluten is an ingredient in many, possibly even the majority of processed food products. In certain soups, gluten grains act as thickeners, allowing manufacturers and cooks at home to use less expensive ingredients such as cream. Barley malt, meanwhile, is frequently used as a sweetener in candy and cookies. And in beer and some forms of liquor, gluten grains are fermented to make alcoholic brews.

Labeling and Hidden Gluten

The problem is that gluten can hide under various ingredient names on a food label. A can of soup may list "starch" that includes hidden gluten. Candy listing "natural flavors" may also contain gluten. It's seemingly everywhere and you'll need to figure out where it hides in order to avoid it.

The U.S. Food and Drug Administration (FDA) does not require disclosure of gluten on food labels, although manufacturers can disclose it voluntarily under the FDA's gluten-free labeling rules.

To use the FDA's "gluten-free" label, a food must not have any type of wheat, rye, barley, or crossbreeds of those grains. The food can't use an ingredient derived from those grains unless it has been processed to remove gluten to less than 20 parts per million (ppm).

Many companies do choose to make it easy for people to identify their gluten-free products without looking at the ingredients. They'll use bold labeling that states "gluten-free" or a symbol that defines the food as such. The growing popularity of the diet has ensured that all kinds of gluten-free products can be found in many mainstream grocery stores. You can also purchase foods specifically certified gluten-free by an independent organization, which may have standards that are even stricter than the FDA.

Other manufacturers, like Kraft Foods and Con Agra Foods, have policies of always disclosing ingredients that contain gluten in their food labels. In those cases, a gluten-containing starch would be labeled in the ingredients list as "starch (wheat)," while a gluten-containing natural flavor might read "flavoring (barley)."

It's important to note that foods with no gluten ingredients aren't necessarily gluten-free since they could be subject to gluten cross-contamination in processing.

How to Start a Gluten-Free Diet

Given all of this, eating gluten-free might seem a bit intimidating. Sticking entirely to naturally gluten-free whole foods such as fresh fruits, vegetables, meats, poultry, and fish can be a good way to start out.

In addition to helping you avoid rookie mistakes while your body adjusts to going gluten-free, this approach will also help you isolate the cause of any symptoms later on if you add more foods to your diet. Furthermore, it may help you consume more needed nutrients since packaged goods have fewer vitamins and minerals than fresh, whole foods.

Foods to Choose

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 and find new dishes you enjoy.

There's actually quite a long list of reliably safe gluten-free foods. If you choose to embark on this diet by sticking to whole foods:

  • All the fresh fruits and vegetables are safe to consume on a gluten-free diet (although anything that comes pre-packaged 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 as a starch to add to your diet, just be certain to buy plain varieties with no added ingredients.
  • Potatoes can also be a good choice, although you'll need to watch how they're prepared.

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.

While these rules 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 (GF) labeling on menus has become much more common in recent years, and many restaurants offer gluten-free options for favorites like pasta.

Also consider bringing your own food to gatherings where you don't think the food provided will be gluten-free enough for you.

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 a replay of old symptoms or even new ones you weren't expecting. Such symptoms may include digestive upset and fatigue. Unfortunately, this is pretty common after a gluten exposure and can take several days or more to feel like yourself again.

The sources of trace amounts can be hidden gluten ingredients or cross-contamination in food processing or in the kitchen.

Some people are more sensitive to traces of gluten and must be extra careful. Regardless of where you wind up falling on the sensitivity scale, you'll need to do some homework when you first go gluten-free to minimize the chance of an "accidental glutening." Specifically, you'll need to:

  • Decide whether to share a kitchen with household members who eat gluten and (if the decision is yes) set up that shared kitchen in a way that prevents you from getting sick.
  • Banish gluten foods and ingredients from your kitchen (or from the part of the kitchen only you will be using, if applicable).
  • Replace kitchen tools since they're likely to harbor gluten grain residue (even though you've scrubbed them thoroughly).
  • Make the rest of your home gluten-free, including your bathroom (shampoo, conditioner, toothpaste, and makeup), your workshop (drywall and craft supplies can contain gluten), and your medicine cabinet.
  • Exercise some serious caution when dining out and eating food prepared by a friend or family member.

A Word From Verywell

Overall, starting a gluten-free diet and consistently eating gluten-free will force you to become far more aware of what goes into your food and how it's made. But the benefit of better health should make all that extra study worthwhile.

Was this page helpful?
Article 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. Celiac Disease Foundation. Testing.

  2. Saturni L, Ferretti G, Bacchetti T. The gluten-free diet: safety and nutritional quality. Nutrients. 2010;2(1):16-34. doi:10.3390/nu2010016

  3. Dewar DH, Donnelly SC, Mclaughlin SD, Johnson MW, Ellis HJ, Ciclitira PJ. Celiac disease: management of persistent symptoms in patients on a gluten-free diet. World J Gastroenterol. 2012;18(12):1348-56. doi:10.3748/wjg.v18.i12.1348

Additional Reading
Related Articles