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Gluten-Free Diets – The Basics

What is a gluten-free diet?

Gluten is a protein that is found in the grains wheat, barley, and rye. It is also found in any foods that contain these grains. When someone follows a gluten-free diet, they eliminate all sources of gluten from their meal plan.

Who needs to follow a gluten-free diet?

Following a gluten-free diet is the only treatment for celiac disease, an autoimmune disorder. When someone with celiac disease eats food that contains gluten, their body reacts by damaging their small intestine. Uncomfortable symptoms such as abdominal pain, diarrhea, constipation, fatigue, weight loss, anemia (iron deficiency), joint pain, or various other symptoms often occur as a result. The damage to the small intestine also interferes with the body's ability to make use of the nutrients in food.

How are celiac disease and diabetes connected?

About 1% of the total population has celiac disease. But it is more common in people with type 1 diabetes. An estimated 10% of people with type 1 have celiac disease.

There are also many people who are gluten intolerant (also called a gluten sensitivity). When these people eat foods that contain gluten, they experience symptoms similar to those with celiac. However, they test negative for celiac disease and actual damage to their small intestine does not occur. More research about gluten intolerance is needed, but if you experience uncomfortable symptoms when you eat gluten-containing foods, you may fall into this category. Discuss your symptoms with your doctor.

Many people assume that a gluten-free diet is always healthy diet. While there are many nutritious gluten-free foods (such as beans, vegetables, fruit, and nuts), there are also many processed gluten-free foods available now. Remember that a package of gluten-free cookies or buttery crackers is not any better for you than wheat-based cookies or crackers. These are still highly processed foods that are usually high in calories and added sugar. Like any other eating plan, it is still important to choose the most nutritious foods whenever possible.

If you have diabetes, eliminating gluten from your diet “just to try it” may add unnecessary stress and restrictions when meal planning. Unless you have one of these health conditions or your healthcare provider has told you to avoid gluten for another reason, there is no need to complicate meal planning by eliminating it.

What foods are gluten-free?

There are many healthy foods you can include in a gluten-free diet. Vegetables, beans, fruit, milk, many yogurts and cheeses, and healthy fats (vegetable oils, avocados, nuts, seeds, etc.) are all naturally gluten-free. There are also many grains and grain-based foods that you can enjoy:

 
  • Amaranth
  • Arrowroot
  • Beans (kidney, black, soy, navy, pinto, etc.) and lentils
  • Buckwheat
  • Corn, corn bran, pure corn tortillas, and cornstarch
  • Flax
  • Flours made from corn, rice, soy, nut, bean, teff and/or potato flour
  • Kasha
 
  • Millet
  • Polenta
  • Potatoes (sweet potatoes are best) and potato starch
  • Quinoa
  • Rice
  • Sorghum
  • Soy
  • Tapioca
  • Teff

 
All of these grains and flours are safe for people who follow a gluten-free diet. These days, you’ll find many products in the gluten-free aisle at the grocery store such as breads, muffins, pastas, and other snacks. These are usually made with a combination of the gluten-free grains and flours listed above instead of wheat flour.

Which foods are off-limits?

A gluten-free diet completely eliminates wheat, barley, rye, and any foods containing these grains. So, exactly which foods are off limits? Some are more obvious, such as foods typically made with wheat flour: many breads, crackers, cereals, pastas, cous cous, cookies, muffins, cake, pastries, and flour tortillas. But many foods are not as obvious. Below is a basic list of foods and ingredients that are also sources of gluten. See additional resources below to find a more complete list of gluten-containing additives:

 
  • Beer
  • Bulgur
  • Commercially prepared oats, oat bran, and oat fiber
  • Durum wheat
  • Farro
  • Gravy
  • Graham flour
  • Many dressings and sauces
  • Broth in soups and bouillon cubes
  • Breadcrumbs and croutons
  • Some candies
  • Fried foods and any breaded foods
  • Imitation fish
  • Kamut
  • Malt
 
  • Matzo
  • Modified food starch
  • Seasoned chips and other seasoned snack foods
  • Salad dressings
  • Self-basting turkey
  • Semolina
  • Some lunch meats and hot dogs
  • Soy sauce
  • Seasoned rice and pasta mixes
  • Spelt
  • Stuffing
  • Tabbouleh
  • Wheat germ, wheat bran, wheat berries, wheat flour, and white flour

While this may seem like a long list, there are still lots of tasty foods that you can enjoy! In fact, now you can find gluten-free versions of these foods in most grocery stores. Look for gluten-free dressings, broth, soy sauce, oats, beer, and more.

What’s the fuss about oats?

Oats are often contaminated with wheat or barley during processing. These days, there are some companies that process their oats in separate facilities. These oats can be marked as:

  • gluten-free oats
  • pure, uncontaminated oats
  • certified gluten-free oats


Many people with celiac disease are still advised to avoid oats initially. However, eating gluten-free oats can help provide fiber and other important nutrients in your meal plan. Over time, most people with celiac disease can add pure oats back into their plan in small amounts (about 1/2 cup of dry oats or less per day) without any trouble.

Where can I find more information?

Visit the Gluten Free Diets page on diabetes.org. You’ll find lists of foods to avoid and foods that you can still enjoy on a gluten-free diet. You’ll also find gluten-free meal ideas for breakfast, lunch, dinner, and snacks.

Check out this month’s featured book, Gluten-Free Recipes for People with Diabetes. This book is your guide to living a gluten-free (and taste-filled) lifestyle. Complete with recipes, meal plans, strategies, and tips - you’ll find everything you need to start feeling better and eating healthy. You can also find a variety of free gluten-free recipes right here on Recipes for Healthy Living.

There are various foundations and organizations that offer more detailed information about following a gluten-free diet. Many of these organizations focus specifically on celiac disease, and can provide more complete lists of foods and additives to look for in ingredient lists. Local celiac support groups can also be helpful, especially when looking for restaurants in your area that offer gluten-free options.

You might also be interested in this month’s Meal Makeover: Simple Substitutions - Make Your Meal Gluten-Free & Keep it Healthy

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