Gluten-Free Diet

Gluten is a protein found in many grains. Gluten is present in wheat, rye, and barley. Gluten may cause intestinal injury when ingested by people who are sensitive to gluten.

A tissue sample (biopsy) of the small intestine is usually required for a positive diagnosis of gluten sensitivity. Dietary treatment consists of eliminating foods and food ingredients from wheat, rye, and barley. When these are excluded completely from the diet, most patients regain function of the small intestine.

Strict compliance is important even during symptom-free periods. Gluten sensitive patients must realize that this is a lifelong diet. During the first stages of treatment, some people will also need to restrict dairy products that contain lactose, which is a naturally occurring sugar. Lactose is difficult to absorb when the small intestines are damaged. This is called lactose intolerance.

WHY YOU NEED THIS DIET

Ask your caregiver to explain the conditions that you may have.

  • Celiac disease / nontropical sprue / gluten-sensitive enteropathy.

  • Dermatitis herpetiformis.

SPECIAL NOTES

  • Gluten from wheat, rye, and barley protein interferes with absorbing food in individuals with gluten sensitivity. It is important to read all labels, as gluten may have been added as an incidental ingredient. Words to check for on the label include: flour, starch, durum flour, graham flour, phosphated flour, self-rising flour, semolina, farina, modified food starch, cereal, thickening, fillers, emulsifiers, malt flavoring, hydrolyzed vegetable protein. A Registered Dietician can help you identify possible harmful ingredients in the foods you normally eat.

  • If you are not sure whether an ingredient contains gluten, be sure to check with the manufacturer. Note that some manufacturers may change ingredients without notice. Always read labels.

Since flour and cereal products are quite often used in the preparation of foods, it is important to be aware of the methods of preparation used, as well as the foods themselves. This is especially true when you are dining out.

Starches

  • Allowed: Only those prepared from arrowroot, corn, potato, rice, and bean flours. Rice wafers (*); pure cornmeal tortillas; popcorn; some crackers and chips(*). Hot cereals made from cornmeal; Cream of Rice®. Cold cereals such as puffed rice, Kellogg's Sugar Pops®, Post's Fruity & Chocolate Pebbles®, Van Brode's® Corn Flakes and Crisp Rice, Featherweight's® Corn Flakes; General Mills' Cocoa Puffs®, and Gluten-free Oatmeal. White or sweet potatoes; yams; hominy; rice or wild rice; special gluten-free pasta. Some oriental rice noodles or bean noodles.

  • Avoid: All wheat, and rye cereals; wheat germ, barley, bran, graham, malt, bulgur, and millet (-). NOTE: Avoid cereals containing malt as a flavoring such as Rice Krispies©. Regular noodles, spaghetti, macaroni, most packaged rice mixes(*). All others containing wheat, rye, and/or barley.

Vegetables

  • Allowed: All plain, fresh, frozen, or canned vegetables.

  • Avoid: Creamed vegetables(*), vegetables canned in sauces(*). Any prepared with wheat, rye, or barley.

Fruit

  • Allowed: All fresh, frozen, canned, or dried fruits. Fruit juices.

  • Avoid: Thickened or prepared fruits; some pie fillings(*).

Meat and Meat Substitutes

  • Allowed: Meat, fish, poultry, or eggs prepared without added wheat, rye, or barley; luncheon meat(*), frankfurters(*), and pure meat. All aged cheese, processed cheese products(*). Cottage cheese(+), cream cheese(+). Dried beans and peas; lentils.

  • Avoid: Any meat or meat alternate containing wheat, rye, barley, or gluten stabilizers; Bread-containing products such as Swiss steak, croquettes, and meatloaf. Tuna canned in vegetable broth(*); turkey with HVP injected as part of the basting; any cheese product containing oat gum as an ingredient.

Milk

  • Allowed: Milk. Yogurt made with allowed ingredients(*).

  • Avoid: Commercial chocolate milk which may have cereal added(*). Malted milk.

Soups and Combination Foods

  • Allowed: Homemade broth and soups made with allowed ingredients; some canned or frozen soups are allowed(*). Combination or prepared foods that do not contain gluten(*). Read labels.

  • Avoid: All soups containing wheat, rye, or barley flour. Bouillon and bouillon cubes that contain hydrolyzed vegetable protein (HVP). Combination or prepared foods that do contain gluten(*).

Desserts

  • Allowed: Custard, junket, homemade puddings from cornstarch, rice, and tapioca; some pudding mixes(*). Gelatin desserts, ices, and sherbet(*). Cake, cookies, and other desserts prepared with allowed flours.Some commercial ice creams(*).

  • Avoid: Cakes, cookies, doughnuts, pastries, etc., prepared with wheat, rye, and/or barley flour. Some commercial ice creams(*), ice cream flavors which contain cookies, crumbs, or cheesecake(*); ice cream cones. All commercially prepared mixes for cakes, cookies, and other desserts(*); bread pudding; puddings thickened with flour.

Sweets

  • Allowed: Sugar, honey, syrup(*), molasses, jelly, jam, plain hard candy, marshmallows, gumdrops, homemade candies free from wheat, rye, or barley. Coconut.

  • Avoid: Commercial candies containing wheat, rye, or barley(*). Almond Roca is dusted with wheat flour. Chocolate-coated nuts, which are often rolled in flour.

Fats and Oils

  • Allowed: Butter, margarine, vegetable oil, sour cream(+), whipping cream, shortening, lard, cream, mayonnaise(*). Some commercial salad dressings(*). Peanut butter.

  • Avoid: Some commercial salad dressings(*).

Beverages

  • Allowed: Coffee (regular or decaffeinated), tea, herbal tea (read label to be sure that no wheat flour has been added). Carbonated beverages; some root beers(*).

  • Avoid: Cereal beverages such as Postum® or Ovaltine® ; beer (unless Gluten free), ale, malted milk; some root beers, wine, and sake.

Condiments

  • Allowed: Salt, pepper, herbs, spices, extracts, food colorings; monosodium glutamate (MSG); cider, rice, and wine vinegar; bicarbonate of soda; baking powder; Chun King® soy sauce; nuts, coconut, chocolate, and pure cocoa powder.

  • Avoid: Some curry powder (*), some dry seasoning mixes (*), some gravy extracts (*), some meat sauces (*), some catsup (*), some prepared mustard (*), horseradish (*), some soy sauce (*), chip dips (*), some chewing gum (*). Yeast extract (contains barley). Caramel color (may contain malt).

Flour and thickening agents

Allowed: Arrowroot starch (A), Corn bran (B), Corn flour (B,C,D), Corn germ (B), Cornmeal (B,C,D), Corn starch (A), Potato flour (B,C,E), Potato starch flour (B,C,E), Rice bran (B), Rice flours: Plain, brown (B,C,D,E) Sweet (A,B,C,F). Rice polish (B,C,G), Soy flour (B,C,G), Tapioca starch (A).

ARE GOOD FOR:

(A) Good thickening agent

(B) Good when combined with other flours

(C) Best combined with milk and eggs in baked products

(D) Best in grainy-textured products

(E) Produces drier product than other flours

(F) Produces moister product than other flours

(G) Adds distinct flavor to product; use in moderation.

(*) Check labels and investigate any questionable ingredients.

(-) Additional research is needed before this product can be recommended.

(+) Check vegetable gum used.

* These amounts indicate the minimum number of servings needed from the basic food groups to provide a variety of nutrients essential to good health. The word "maximum" is used if amounts of certain foods eaten must be controlled. Combination foods may count as full or partial servings from the food groups. Dark green, leafy, or orange vegetables are recommended 3 or 4 times weekly to provide vitamin A. A good source of vitamin C is recommended daily.

NOTE: Brand names are used for clarification only, and do not constitute an endorsement. Also, ingredients may be changed by the manufacturer without notice. Always read labels.

SAMPLE MEAL PLAN

Breakfast

  • Fruit or juice.

  • Cereal (from allowed grains).

  • Toast (from allowed grains).

  • Heart-healthy tub margarine

  • Jam or jelly.

  • Milk beverage.

Lunch

  • Meat or meat substitute.

  • Gluten-free bread.

  • Vegetable or salad.

  • Heart-healthy margarine.

  • Fruit or dessert.

  • Milk beverage.

Dinner

  • Meat or meat substitute.

  • Potato or rice.

  • Salad with dressing or soup.

  • Gluten-free bread.

  • Vegetable.

  • Fruit or dessert.

  • Heart-healthy margarine.

  • Beverage.

SAMPLE MENU

Breakfast

  • Orange juice.

  • Banana.

  • Rice or corn cereal.

  • Toast (gluten-free bread).

  • Heart-healthy tub margarine.

  • Jam.

  • Milk.

  • Coffee or tea.

Lunch

  • Chicken salad sandwich (with gluten-free bread and mayonnaise).

  • Sliced tomatoes.

  • Heart-healthy tub margarine.

  • Apple.

  • Milk.

  • Coffee or tea.

Dinner

  • Roast beef.

  • Baked potato.

  • Broccoli.

  • Lettuce salad with gluten-free dressing.

  • Gluten-free bread.

  • Custard.

  • Heart-healthy margarine.

  • Coffee or tea.

These meal plans are provided as samples. Your daily meal plans will vary.