Celiac Disease: Eating a Gluten-Free Diet
Celiac disease is a problem some people have with foods that contain gluten. Gluten is a type of protein found in the grains wheat, barley, rye, and triticale (a wheat-rye cross). When a person with celiac disease eats gluten, it triggers an immune response that is not normal. This damages the small intestine.
Symptoms of celiac disease can include gas, bloating, diarrhea, weight loss, fatigue, weakness, and vomiting. Stools may be bulky, loose, and more frequent. The damage to the intestine also makes it hard for your body to absorb vitamins, minerals, and other nutrients. This can lead to anemia or osteoporosis or both.
This information can help you learn more about how to eat so you can manage your symptoms, prevent long-term problems, and still get the nutrition you need.
- Untreated celiac disease can make it hard for you to get the nutrients you need. Eating a variety of healthy foods that do not have gluten can help you keep your weight up and stay strong.
- The main treatment for celiac disease is to avoid eating any foods that contain gluten. Even the smallest amount of gluten is harmful and can cause symptoms in some people.
- Even if you don't have symptoms, you still need to avoid gluten totally to prevent damage to the intestines and long-term problems.
- Some people with celiac disease need to avoid cow's milk and milk products when they first begin treatment. Most people can slowly add dairy foods back into their diet as the intestine heals. But they will still need to avoid foods with gluten for the rest of their lives.
If you have questions about following a gluten-free eating plan for celiac disease, talk to your doctor or dietitian.
How to eat when you have celiac disease
Eating a gluten-free diet isn't easy. But if you take your time to read labels and ask questions, you can stay on a gluten-free eating plan.
Foods to avoid
Do not eat any foods that contain gluten. These include foods made with wheat, barley, rye, or triticale (a wheat-rye cross). Common foods that contain gluten include:
- Breakfast cereals made with wheat, barley, or rye, or that have the term "malt" or "malted" in their names. Malt is made from barley.
Avoid all beer products unless they say they are gluten-free. Beers with and without alcohol—including lagers, ales, and stouts—contain gluten unless they specifically say they are gluten-free.
Avoid oats, at least at first. Oats may cause symptoms in some people, perhaps as a result of contamination with wheat, barley, or rye during processing. But many people who have celiac disease can eat moderate amounts of oats without having symptoms. Health professionals vary in their long-term recommendations regarding eating foods with oats. But most agree it is safe to eat oats labeled as gluten-free.
Carefully read food labels. The U.S. Food and Drug Administration (FDA) says that if a food sold in the U.S. is labeled gluten-free, then it must contain less than 20 parts per million (ppm) of gluten. Look for hidden gluten. Foods such as ice cream, salad dressing, candy, canned and frozen soups and vegetables, and other processed foods may have hidden gluten.
Foods you can eat
On a gluten-free eating plan, you can still have:
- Eggs and dairy products. Some milk products may make your symptoms worse. If you have questions about milk products, ask your doctor. Read ingredient labels carefully. Some processed cheeses contain gluten.
- Flours and foods made with amaranth, arrowroot, beans, buckwheat, corn, cornmeal, flax, millet, potatoes, gluten-free nut and oat bran, quinoa, rice, sorghum, soybeans, tapioca, or teff.
- Fresh, frozen, or canned unprocessed meats. (Examples of processed meats to avoid are hot dogs, salami, and deli meat.) Read labels for additives that may contain gluten.
- Fresh, frozen, dried, or canned fruits and vegetables, if they do not have thickeners or other additives that contain gluten.
- Certain alcohol drinks, including wine, liquor (including whiskey and brandy), liqueurs, and ciders.
When you eat out, look for restaurants that serve gluten-free food. You might ask if the chef is familiar with cooking without any gluten. Also look for grocery stores that sell gluten-free pizza and other foods. The Internet can be another source of information on gluten-free foods.