The Gluten-Free Diet
Many believe that the gluten-free diet is simply a quick way to lose weight. This, however, is not true. The gluten-free diet is currently the only treatment for people with celiac disease. People living with non-celiac gluten sensitivity (‘gluten sensitivity’) also benefit from eating gluten-free. Since there are no pills or therapies available, the only way to manage celiac disease is through a strict, 100% gluten-free diet.
So what is gluten anyway? Gluten is a protein found in wheat, barley, rye and the derivatives of these grains, including malt and brewer’s yeast.
A gluten-free diet excludes all products containing these ingredients. Those who are gluten-free can still enjoy a healthy diet filled with fruits, vegetables, meats, poultry, fish, beans, legumes and most dairy products. Such ingredients are naturally gluten-free, and safe for individuals who do not have allergies to these respective food groups.
Download: The Gluten-Free Diet Overview
Download: The Beyond Celiac Getting Started Guide, a comprehensive guide to living with celiac disease
There are a variety of grain, flour and starch alternatives that naturally do not contain gluten and thus can be consumed by those on a gluten-free diet. These include:
All grains are considered “high risk” for cross-contact because they are often grown, milled and manufactured near gluten-containing grains. “Cross-contact” occurs when a gluten-containing food touches a gluten-free food. Eating even tiny amounts of gluten like this can cause damage to the small intestine and prevent nutrients from being absorbed into the bloodstream. Whenever possible, purchase naturally gluten-free grains, flours and starches that are labeled gluten-free and, also, certified gluten-free by a third party.
There’s a lot to learn about living a 100% gluten-free lifestyle. Don’t worry! Beyond Celiac is here to help. Browse our FAQs here.
Just like grains, you should always use caution when it comes to oats. While oats in their natural form do not contain gluten, a small portion of people with celiac disease react to oats in their pure, uncontaminated form. Some research suggests that a protein in oats can trigger a similar response to gluten. Additionally, most mills that process oats also manufacture gluten-containing grains, increasing the risk for cross-contact.
The best advice Beyond Celiac can offer is to take a great deal of care before introducing gluten-free oats into your diet, which includes speaking with your healthcare provider about this dietary change. There is no way to determine if you will react, so proceed with caution. Be sure to use oats that are “pure, uncontaminated,” “gluten-free,” or “certified gluten-free.” Experts believe that up to 50 g of dry gluten-free oats a day are considered safe. Check nutrition labels for portion size. People who develop any new symptoms after adding gluten-free oats to their diet should talk to their dietitian or doctor.
A strict lifelong gluten-free diet is the only treatment available for celiac disease. It can help to alleviate the signs and symptoms of celiac disease, including:
- Dermatitis herpetiformis, an itchy skin rash known as the skin version of celiac disease
- Gastrointestinal distress, such as diarrhea, constipation, gas, bloating and abdominal pain
- Headaches, including migraines
- Iron deficiency anemia
- Joint and muscle pain
- Mood disorders, including depression, anxiety and “brain fog”
- Peripheral neuropathy, which causes tingling in hands and feet
- Osteopenia and osteoporosis
- Unexplained infertility and other reproductive health problems
- Weight gain or weight loss
Three million Americans have celiac disease, and an estimated 18 million Americans have non-celiac gluten sensitivity (‘gluten sensitivity’). Unfortunately, most live unaware and remain undiagnosed or misdiagnosed. In fact, 83% of people with celiac disease don’t know they have it . This means that foods like bread, bagels, pasta, pretzels, cookies, cakes, and crackers are making them sick — sometimes very sick. Left untreated, celiac disease can lead to further complications such as osteoporosis, other autoimmune disorders and even cancer.
Anecdotally, the gluten-free diet benefits many people with various medical reasons to avoid gluten. More research is needed to best understand the relationship between certain conditions and the gluten-free diet. Currently, people who are eating gluten-free include those living with:
- Celiac disease, a serious genetic autoimmune disease that affects 1% of the US population or 3 million Americans
- Gluten sensitivity (sometimes mistakenly referenced as “gluten intolerance”), which has been estimated to affect up to 18 million Americans. The symptoms of gluten sensitivity can be the same as celiac disease, however those with gluten sensitivity do not experience the same intestinal damage. Other foods may play a role in gluten sensitivity. Learn more here.
- Wheat allergies, which can range from a mild reaction (such as hives), or a more serious reaction (such as anaphylaxis).
In order to maximize the health and nutritional benefits of going gluten-free, you should adopt a diet filled with a variety of naturally gluten-free foods such as fruits, vegetables and lean proteins, as well as gluten-free grains. U.S. Food and Drug Administration (FDA) recommendations encourage everyone, including those on a gluten-free diet, to avoid overly processed foods, and keep refined sugar and saturated fat intakes to a minimum.
As with any balanced diet, portion control and moderation are extremely important for people living with celiac disease and eating gluten-free. Daily exercise is also necessary for managing and maintaining a healthy lifestyle.
A gluten-free diet is by no means a cure all. It can be common for some people to struggle with celiac disease symptoms even after going on a gluten-free diet. Keep in mind that it does take time for the body to heal. If you are still having symptoms over time, it is important to talk to your doctor about them. Your doctor and a registered dietitian knowledgeable of celiac disease can help you to determine if you are accidentally eating gluten or if something else may be the cause of your symptoms.
Most importantly, a gluten-free diet cannot replace a formal consultation, diagnosis or recommendation from a physician or trained healthcare professional . Dietitians knowledgeable in celiac disease and the gluten-free diet play a critical role in the management of this autoimmune condition.
Sticking to a gluten-free diet can be tough. But with the right education and an optimistic approach, you and your family can live a full and healthy gluten-free life.