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Purpose: This diet is designed to provide adequate nutrition while eliminating foods that contain gliadin, which is the alcohol-soluble extract of gluten, a protein found in barley, oats, rye, wheat, and wheat derivatives. The dietary guidelines below are intended for people with celiac sprue (also known variously as "celiac disease," "celiac syndrome," "gluten-induced enteropathy," "gluten-induced sprue," "idiopathic steatorrhea," and "nontropical sprue") and/or dermatitis herpetiformis (DH or Duhring's disease), for whom a gluten-free diet will help to prevent such complications as abdominal cramping and bloating, diarrhea, fatigue, excess intestinal gas, and weight loss. People with celiac sprue and/or DH must follow a gluten-free diet for life.
General Guidelines for a Gluten-Free Diet
If you are restricted to following a gluten-free diet, you must be careful in the selection of both the foods you prepare at home and the foods you buy and order when away from home. For preparing food at home you may find specialty cookbooks for a gluten-free diet helpful. Dietsite recommends Against the Grain: The Slightly Eccentric Guide to Living Well Without Gluten or Wheat, by Jax Peters Lowell; Wheat-Free Recipes & Menus: Delicious Dining Without Wheat or Gluten, by Carol Fenster, Ph.D; and More from the Gluten-Free Gourmet: Delicious Dining Without Wheat, by Betty Hagman. Remember that gluten-free products do not contain preservatives; be sure to store all gluten-free foods in your refrigerator or freezer.
For tips and information on reading food products' ingredient labels and on avoiding gluten when dining out, see the following sections. For detailed information on foods that do and do not contain gluten, refer to Foods for a Gluten-Free Diet
Reading Labels
If you must avoid gluten, you can still eat a variety of foods. In fact, by experimenting with a range of gluten-free products, you will be better able to provide your body with the nutrients it needs both safely and enjoyably. In addition to shopping for gluten-free products at your local supermarket or health-food store, you can order foods directly from the manufacturer or through the Gluten-Free Food Vendor Directory
However you choose to do your shopping, you will need to be very careful not only about reading food labels but also about verifying the ingredients of any medications you purchase. The tips and information below may be helpful:
- In addition to avoiding all foods that list barley, oats, rye, wheat, or wheat derivatives in the ingredients, avoid products containing gluten stabilizers, hydrolyzed vegetable protein (HVP), and texturized vegetable protein (TVP).
- Ingredients marked as additives, cereals and cereal grains, colorings, emulsifiers, excipients, flavorings, hydrolized plant protein (HPP), malts, preservatives, starches (including modified starch or modified food starch), vegetable gum, and vinegar may be derivatives of gluten-containing grains.
- If an ingredient list does not appear on a food product's label, contact the manufacturer for detailed information (the manufacturer's name and address must appear on the label). There are no laws requiring that a product label indicate the inclusion of food sources that contain gluten, and food manufacturers and processors may change a product's formula without announcement. When in doubt about the contents of any commercial product, do not use the product until you have obtained the necessary ingredient information from the manufacturer. Most food manufacturers will provide information about their products upon request.
- Before you take any medication, check with your pharmacist or the product manufacturer to make sure that the medication is gluten-free. All medications have fillers or dispersing agents, some of which may include wheat starch.
Dining Out
Restaurant menus almost never provide explicit information about the inclusion of gluten in dishes. If you must avoid gluten, order very carefully. Always ask your waiter to list the ingredients in dishes, and follow these guidelines:
- Ask your waiter specifically whether the dishes that you are interested in contain any of the following ingredients: barley, bran, bulgur, cereal additives or products, durham, emulsifiers, flour, graham, HVP or TVP, malt or malt flavoring, millet, oats, rye, starch (modified starch or modified food starch), wheat, wheat germ, vegetable gum.
- Inquire about the methods of preparation as well as about the foods themselves. Flour and cereal products that contain gluten are often used in the preparation of dishes. Order meat, poultry, or fish, for example, only if the dish is prepared without breading, gravy, or sauce.
- Beware of food that is grilled; a restaurant's grill may be contaminated with gluten from other foods.
- Beware of fried foods; the grease in which a restaurant fries food may be contaminated with gluten from other foods.
Foods for a Gluten-Free Diet
The table below provides detailed dietary guidelines for following a gluten-free diet.
Note: For specific information on serving sizes for the foods listed in the table below, refer to the U.S. FDA food pyramid (U.S. Food and Drug Administration). To substitute ethnic foods, see the ethnic food pyramids
Guidelines for a Gluten-Free Diet
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Food Groups
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Gluten-Free Foods
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Foods Containing Gluten
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Breads & Grains
6-11 servings daily
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Breads or bread products (bread crumbs, dressings, etc.) made from the following flours:
- Bean
- Buckwheat
- Carob
- Chickpea (gram)
- Corn
- Kasha
- Maize or waxy-maize
- Masa
- Millet
- Pea
- Potato
- Quinoa
- Rice
- Sago
- Soba (made from pure buckwheat)
- Sorghum (milo)
- Soy
- Sweet chestnut
- Teff
- Yam
Breads or bread products (bread crumbs, dressings, etc.) made from the following starches
- Arrowroot
- Corn
- Potato
- Tapioca
Breads or bread products (bread crumbs, dressings, etc.) made from "gluten-free" mixes.
Note: Gluten-free bread products taste better when warmed or toasted.
Corn or rice cereals containing malt flavoring derived from:
- Corn
- Cornmeal
- Grits
- Hominy
- Kasha (buckwheat)
- Cream of rice
- Puffed rice
Rice of all types (including wild & flaked rice), rice crackers, rice noodles, rice spaghetti, rice wafers
Note: Enriched converted rice may contain a barley additive.
Pastas made with the following flours:
- Corn
- Maize or waxy maize
- Potato
- Rice
- Soy
Oriental bean noodles
Pure-cornmeal chips & tortillas
Polenta
Popcorn (air-popped or popped in oil)
Yeast
Brand-name recommendations:
- Aproten hot cereal, rusk, pasta
- Soya crackers
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Bread or bread products (bread crumbs, dressings, etc.) made from:
- Bread flour
- Brown flour
- "Low-gluten" flour
Breads or bread products (bread crumbs, dressings, etc.) containing or made from flours containing any of the following grains:
- Amaranth
- Barley
- Couscous
- Durum
- Far
- Graham
- Granary
- Kamut
- Oats
- Mir
- Rye
- Semolina
- Spelt
- Triticale
- Wheat or wheat starch
- Wholemeal
Cereals containing malt or malt flavoring derived from:
- Barley
- Barley malt
- Barley-malt syrup
Any foods containing:
- Bran
- Bulgur
- Einkorn wheat
- Malt (including malt extract, flavoring, syrup, or vinegar)
- Vegetable or wheat starch
- Wheat germ
Most crackers, rusk, zweibeck, & pretzels
Matzo
Biscuits, cornbread, muffins, pancakes, & waffles made form commercial mixes
Dumplings, macaroni, noodles, & spaghetti made from wheat flour
Udon (wheat noodles)
Farina
Tabbouleh
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Fruit
2-4 servings daily
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All fruits (dried, fresh, frozen)
Pure fruit juices
Olives
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Canned fruit in heavy syrup
Ocean Spray Cranberry Juice
Thickened fruit sauces
Some commercial fruit-pie fillings
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Vegetables
3-5 servings daily
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All fresh vegetables (including pickles)
All canned or frozen vegetables not containing ingredients made with gluten
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Most breaded or creamed vegetables
Most commercially prepared vegetables
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Milk & Dairy
2-3 servings daily
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All milk (including condensed, dry, & evaporated)
Homemade chocolate milk made with cocoa powder
All aged cheeses, such as Cheddar, Edam, Parmesan, & Swiss
Pasteurized cottage & cream cheeses that do not contain preservatives or vegetable gum
Yogurt not containing cereal
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Malted & instant milk drinks
Commercial chocolate milk or chocolate drinks containing cereal additives
Blue & Roquefort cheese
Processed cheeses, cheese foods, & cheese spreads containing gluten stabilizers
Ice cream
Note: Some ice creams contain wheat flour; contact the manufacturer for complete ingredient information.
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Meat & Other Protein Sources 2-3 servings
or 6 oz daily
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Fresh fish & shellfish, meat, poultry
Pure-meat cold cuts
Meat products (canned meats, hot dogs, sausages) made without fillers
Alfalfa
Eggs
Lentils
Tofu-soya curd
Beans (dried or fresh) of the following kinds:
- Adzuki
- Carob
- Fava
- Garbonzo
- Hyacinth
- Mung
- Romano
- Soya
- Tepary
- Urad
Nuts of the following kinds:
- Acorns
- Almonds
- Chestnuts
- Hazelnuts
- Peanuts (peanut butter)
- Walnuts
Peas (dried or fresh) of the following kinds:
- Cowpeas
- Pigeon
- Sweet
- Urad dal
Seeds of the following kinds:
- Mustard
- Poppy
- Safflower
- Sesame
- Sunflower
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Any meat prepared with barley, oats, rye, wheat, or gluten stabilizers
Breaded meat, fish, shellfish, poultry (croquettes, patties, loaves)
Any canned meats, cold cuts, hot dogs, sandwich spreads, & sausages that contain fillers
Meat with added HVP (as in some turkey bastings)
Freeze-dried meals
Canned baked beans
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Soups
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Homemade soups not containing barley, oats, rye, or wheat in any form
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Soups containing barley, oats, rye, or wheat in any form
Note: Most canned soups and soup mixes contain gluten.
Stews containing noodles
Bouillon or broth containing HVP
Miso
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Fats & Oils
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Butter, lard, margarine, & salad dressings not containing emulsifiers, gluten stabilizers, or HVP
Note: Some margarines contain flour as an additive.
Cream, sour cream, & whipping cream made with gluten-free flours (see list above) or cornstarch
Cooking oils of the following kinds:
- Corn
- Hydrogenated
- Olive
- Peanut
- Safflower
- Sunflower
- Vegetable
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Most commercial salad dressings
Nondairy cream substitutes & some nondairy creamers
Fat substitutes (Olestra, Oatrim, Replace)
Canola oil & vegetable oils that do not list the full ingredients & sources
Cooking sprays that contain grain alcohol
Suet (in packets)
Note: May contain wheat flour.
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Snacks & Desserts
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Desserts not containing barley, oats, rye, or wheat in any form, such as:
- Fruit ices
- Gelatin
- Most ice creams
- Junket
- Most sherbets
Homemade puddings:
Note: Homemade puddings may be thickened with cornstarch, which does not contain gluten.
Puddings made from mixes not containing gluten stabilizers or wheat flour
Chocolate, chocolate syrup, cocoa, coconut, hard candy, honey, jam, jelly, marshmallows, pure molasses, meringue, sugar
Some chewing gum
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Cakes, cookies, donuts, pastries, & pies prepared with barley, oat, rye, or wheat in any form
Cakes, cookies, & puddings made from commercial mixes
Chocolate products made with gluten stabilizers
Homemade puddings thickened with wheat flour
Ice cream or sherbet containing gluten stabilizers
Ice cream cones
Jell-O Brand pudding
Some commercial candies
Note: Almond Roca, for example, is dusted with wheat flour.
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Beverages
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Pure tea, hot cocoa, or coffee (instant & decaffeinated)
Note: For flavored coffees, contact the manufacturer for complete ingredient information.
Carbonated beverages (except some root beers)
Pure fruit juices (including apple cider)
Drink mixers, and alcohol of the following kinds:
- Brandy
- Champagne
- Cognac
- Grappa
- Mead (honey wine)
- Ouzo
- Potato vodka
- Most rums (light rums are recommended)
- Sake
- Tequila not containing dyes or additives
- White wine made in the United States
Note: Alcohol manufacturers may change their ingredients; be sure to read the label and check with the manufacturer for a full list of ingredients.
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Coffee, tea, or coffee substitutes containing gluten additives
Herbal teas containing malted barley
Hot cocoa or hot chocolate made from commercial mixes
Ovaltine
Postum
Lemon or orange barley water
Hawaiian Punch
Most root beers
Some ginger beers & cloudy lemonades
Alcohol of the following kinds:
- Beer (ale, lager, stout)
- Gin
- Vodka made from grain
- Corn whiskey (made with a grain mash)
- Whiskey (including bourbon, Scotch, & Canadian blends)
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Baking Products, Condiments, & Seasonings
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Black pepper, salt
All herbs
Pure spices
Balsamic, rice, & wine vinegars
Baking powder
Note: Must not contain wheat flour; check ingredient list.
Bicarbonate of soda
Cornstarch
Corn syrup
Food coloring
Gravies & sauces made with gluten-free flours (see "Breads & Grains") or cornstarch
Some ketchups & mustards
Pure mayonnaise
Monosodium glutamate (MSG)
Note: Avoid completely if you are sensitive to MSG.
Soy sauces that do not contain wheat or barley (try Lachoy or Chun King brands)
Cream of tartar
Flavorings not containing alcohol
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Most white pepper
Ground spices
Note: Wheat flour is commonly included to prevent clumping.
Vinegar distilled from grain (white vinegar)
Some curry powders & mixes
Mustard powder
Note: May contain wheat flour.
Some dry seasonings, gravy & stock cubes, & extracts
Gravies & sauces prepared with flour containing gluten (see "Breads & Grains")
Mayonnaise containing gluten stabilizers or wheat flour
Sauces:
- Fish
- Some meat sauces
- Most soy sauces (Shoyhu)
- Steak
- Teriyaki
- Worcestershire
Most dips
Vanilla & other flavorings containing alcohol
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