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Patient education: Gluten-free diet (The Basics)

Patient education: Gluten-free diet (The Basics)

What is a gluten-free diet? — A gluten-free diet is a diet that doesn't contain any gluten. Gluten is a protein that is found in wheat, rye, barley, and (sometimes) oats. Many foods, such as breads, pasta, pizza, cereals, and crackers, have gluten in them. People who are on a gluten-free diet should not eat any foods with gluten.

Who should be on a gluten-free diet? — People with a condition called celiac disease should be on a gluten-free diet. Celiac disease is a condition that affects the body's ability to break down certain foods. People with celiac disease get sick if they eat foods with gluten, so need to be on a completely gluten-free diet for their whole life.

If you think you have celiac disease, do not cut gluten from your diet before talking with a doctor or nurse. That's because the tests for celiac disease involve looking at how your body reacts to gluten.

Many people without celiac disease also choose to eat a gluten-free diet. They might have heard that this diet can help them lose weight or feel better. It's true that a gluten-free diet that includes plenty of vegetables, fruits, and protein can be healthy. But it also sometimes keeps people from getting all the nutrition they need. Also, some gluten-free products have a lot of sugar and calories. This can make it harder for some people to stay at a healthy weight. If you do not have celiac disease but are interested in trying a gluten-free diet for other reasons, talk with your doctor or nurse.

How do I get started? — To get started, you will work with a dietitian (food expert) or other professional who has experience with a gluten-free diet. They will:

Teach you which foods are safe to eat and which foods you should avoid

Help you plan balanced meals so that you get the nutrition you need

Give you gluten-free recipes

Help you find gluten-free substitutes for your favorite foods (such as pasta or cookies)

You can get advice and help from other people, too. Ask your doctor or nurse if there is a local support group for people with celiac disease. You can also get information online from trustworthy sources like www.celiac.org, www.nationalceliac.org, and www.gikids.org.

It can be hard to learn how to manage a gluten-free diet, especially at first. But it usually gets easier with practice and time. Having support from other people in your life can help, too.

Which foods can I eat? — Foods that are gluten free and generally safe for people with celiac disease include the following (table 1):

Rice, corn, potatoes, quinoa, millet, buckwheat, and soybeans

Special flours, pasta, and other products labeled "gluten free"

Fruits and vegetables

Meat, fish, and eggs

Wine and distilled alcoholic drinks, such as rum, tequila, vodka, and whiskey

Milk, cheese, and other dairy foods are also gluten free. But many people with celiac disease have trouble digesting these foods, especially at first. Doctors usually recommend that people with celiac disease avoid eating dairy products, at least for a short time, while their intestines are healing.

Which foods should I avoid? — You need to avoid all foods made from or with wheat, rye, and barley (table 2). Ask your doctor or dietitian if you can eat oats.

You should also avoid other types of foods that contain or might contain gluten, unless they are specifically labeled "gluten free." These include:

Flour, breads, pizza, crackers, muffins, and baking mixes

Pasta, pastries, and cereals

Some sauces, spreads, spices, condiments, and salad dressings

Processed meats and vegetarian meat substitutes

Beers, ales, lagers, and malt vinegars

To know exactly which foods you can eat, you will have to read ingredient labels on food packaging. For people with celiac disease, even tiny amounts of gluten can be harmful. So it's important to read labels carefully, even on things like oil sprays used for baking or pan cooking.

Foods that are labeled "gluten free" or say they are made or processed in a "gluten-free facility" are safe to eat. Foods that contain any type of wheat, rye, or barley are not safe to eat. If you are unsure whether a food is gluten free, call the company. Their phone number should be on the package or on their website.

People with celiac disease can still take most types of medicines. But some prescription and over-the-counter medicines and supplements might contain a small amount of gluten. Check with your doctor, nurse, or pharmacist if you are not sure if something is safe to take.

Will I need to take vitamins? — You might. Celiac disease can keep your digestive system from normally absorbing the nutrients in foods. To get all the nutrients you need, your doctor or nurse might recommend that you take certain vitamins.

Can I eat out? — Yes. Many restaurants now have gluten-free menus or foods. If you eat out, it's important to always let the restaurant know you can't have anything that contains gluten or has been in contact with gluten. That way, they can be extra careful when they prepare your food.

What if my child is on a gluten-free diet? — If your child is on a gluten-free diet, let their caregivers, teachers, and school know. Tell them which foods your child can and can't eat. As your child gets older, they can learn how to read labels and know what foods are safe to eat.

More on this topic

Patient education: Celiac disease (The Basics)
Patient education: Vitamin supplements (The Basics)

Patient education: Celiac disease in adults (Beyond the Basics)
Patient education: Celiac disease in children (Beyond the Basics)

This topic retrieved from UpToDate on: Mar 03, 2022.
This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms ©2022 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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