The Gluten-Free Diet: A Beginner's Guide

The Gluten-Free Diet: A Beginner's Guide

By Ryan Raman, MS, RD and Rachael Ajmera, MS, RD

The protein gluten is found in items like wheat products, beer, and pasta. It may cause digestive symptoms in some people, including those with celiac disease.

A gluten-free diet involves excluding foods that contain the protein gluten like wheat and rye products. Most studies on gluten-free diets have involved people with celiac disease. However, gluten in the diet can affect other health conditions like non-celiac gluten sensitivity (NCGS).

Wheat allergy occurs when your body creates antibodies to wheat proteins causing a potentially serious anaphylactic reaction. It’s important to see a health professional who’s experienced with gastrointestinal issues to help reach the correct diagnosis.


What is gluten

Gluten is a family of proteins found in wheat, barley, rye, and spelt. Its name comes from the Latin word for glue. It gives flour a sticky consistency when it’s mixed with water.

This glue-like property helps gluten create a sticky network that gives bread the ability to rise when baked. It also gives bread a chewy and satisfying texture. Some people have uncomfortable gastrointestinal symptoms after eating foods that contain gluten. Severe reactions can occur in people diagnosed with celiac disease.

Celiac disease is an autoimmune disorder in which the body mistakenly attacks itself after exposure to gluten. Celiac disease affects at least 1% of the population in the Western world and can damage the intestines.

If eating gluten makes you feel uncomfortable, a doctor may recommend screening for celiac disease.


Why some people should avoid gluten

Most people can eat gluten without experiencing any side effects, but people with celiac disease cannot tolerate it.

People with other disorders like non-celiac gluten sensitivity (NCGS) and wheat allergy frequently avoid gluten too.


Celiac disease

In celiac disease, the body mistakes gluten for a foreign threat. To remove this perceived threat, the body overreacts and attacks the gluten proteins.

This attack also damages surrounding areas, like the gut wall. Not only can this lead to nutrient deficiencies and severe digestive issues, but it can also increase the risk of many harmful diseases.

People with celiac disease often experience symptoms such as:

  • • bloating
  • • diarrhea or constipation
  • • sharp stomach pain
  • • skin rashes
  • • stomach discomfort
  •  weight loss

Interestingly, some people with celiac disease do not experience digestive symptoms. Instead, they may experience other symptoms like:

  • • anemia
  • • depression
  • • fatigue

These symptoms are common in many other medical conditions, making celiac disease difficult to diagnose. 


Non-celiac gluten sensitivity (NCGS)

NCGS is believed to affect around 0.6%–13% of people. People diagnosed as having NCGS do not test positive for celiac disease or wheat allergy, but they still feel uncomfortable after eating gluten. Symptoms of NCGS are similar to those of celiac disease.

NCGS can be complicated to identify because there are currently no specific lab or tissue tests to diagnose it conclusively.

There have been a few very small studies where people who did not have celiac disease or wheat allergy were given gluten-free or gluten-containing test foods. The participants did not know which test foods they were eating.

When asked to describe symptoms after each challenge, most of the participants were unable to correctly identify gluten-containing test foods. Researchers point out that other triggers besides gluten may be involved.


Gluten ataxia

Similar to celiac disease, gluten ataxia is an autoimmune disorder. This disorder causes the body’s immune system to attack the nervous system in response to gluten ingestion. This can cause a range of neurological symptoms. In particular, gluten ataxia can cause balance, coordination, and motor control issues.

According to one review, gluten ataxia typically affects individuals over age 50 years and accounts for approximately 15% of all ataxia diagnoses. Ataxias are a group of disorders that affect balance and coordination.

A gluten-free diet is recommended to help reduce symptoms of gluten ataxia and prevent further damage to the nervous system. 


Wheat allergies

Wheat allergy is a type of allergic reaction that occurs in response to one or more wheat proteins.

It can cause symptoms like:

  • • difficulty breathing
  • • headache
  • • hives
  • • nasal congestion
  • • swelling or irritation of the mouth or throat

In severe cases, it can also cause anaphylaxis, an allergic reaction that can be life threatening.

Wheat allergy is most common in children, but approximately 65% of children with wheat allergy outgrow it by the age 12.

Though people with wheat allergy do not necessarily need to avoid gluten specifically, they may need to avoid certain gluten-containing foods. This includes wheat products like bread, pasta, and baked goods.


What to avoid

Completely avoiding gluten can be challenging, as it’s found in many common ingredients that are added to foods and beverages.

Wheat is the main source of gluten in the diet. Wheat-based products include:

  • • durum
  • • kamut
  • • semolina
  • • spelt
  • • wheat bran
  • • wheat flour

Other gluten sources include:

  • • barley
  • • brewer's yeast
  • • malt
  • • rye
  • • triticale, a hybrid crop that combines wheat and rye

Many gluten-free products are now widely available, but it is important to read the ingredient section of the food label on most of the foods you buy.

Labels may include additional statements like “processed in a facility that also processes wheat-based foods.” Oats are naturally gluten-free but may be processed with other wheat-containing foods, contaminating them.


What to eat and drink

Gluten-free diets can be expensive and may lack important nutrients if not properly planned. There are plenty of gluten-free options that will allow you to enjoy healthy and delicious meals. It can be very helpful to work with a registered dietitian to make sure you are meeting all your nutritional needs.

The follow items are naturally gluten-free:

  • • Beverages: most beverages, except for beer (unless it’s labeled gluten-free)
  • • Dairy: unflavored dairy products, including plain milk, yogurt, and cheese
  • • Eggs: whole eggs, egg whites, egg yolks
  • • Fruits: berries, melons, pineapples, bananas, oranges, pears, peaches, etc.
  • • Grains: quinoa, rice, buckwheat, tapioca, sorghum, corn, millet, amaranth, arrowroot, teff, oats (if they’re labeled gluten-free) • Herbs and spices: black pepper, turmeric, oregano, thyme, rosemary, parsley, cilantro, etc.
  • • Meat, fish, and poultry: all types, except battered or coated meats
  • • Nuts and seeds: almonds, walnuts, pistachios, cashews, hemp seeds, chia seeds, flaxseeds, etc.
  • • Spreads and oils: vegetable oils, olive oil, coconut oil, butter, margarine, etc.
  • • Starches and flours: potato flour, cornstarch, corn flour, chickpea flour, soy flour, almond meal or flour, coconut flour, tapioca flour
  • • Vegetables: broccoli, tomatoes, onions, peppers, mushrooms, asparagus, carrots, potatoes, etc.

If you're ever unsure if an item contains gluten, it's best to read the nutrition label carefully. 




Download the full issue of the March-April 2024 Healthy Options News Digest here.


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