Gluten Free Food & Medicine

The gluten free diet avoids protein peptides, foods, ingredients and products that contain gluten. Where does gluten hide? What foods are gluten free?

The gluten free diet eliminates all wheat, barley, and rye. This requires eliminating flours and other products made from or containing these gluten grains.

Wheat

The gluten free diet is free from wheat. The gluten-containing fractions of protein in wheat that are problematic for Celiacs and others affected with Gluten-Related Disorders are gliadins and glutenins.

Other words for wheat include bulgur, durum, einkorn, emmer, graziella ra, kamut, semolina, and spelt.

In case you’ve heard rumors otherwise,

Barley

Barley contains hordeins, the fraction of proteins toxic to Celiacs and others with Gluten Related Disorders.

Other words for barley include bere or beremeal (used in Scotland to make bannock, a quick bread). There are, several words in Middle Eastern languages that mean barley.

Rye

Secalins are the protein fractions in rye that are toxic for Celiacs and others with Gluten-Related Disorders.

Some of the foods words to watch out for are:

  • Couscous (a pasta made from semolina)
  • Farina (a cereal food usually made from semolina)
  • Farro (hulled wheat/spelt used in salads/soups/etc.)
  • Freekeh (cereal from roasted green wheat)
  • Graham (a flour from unbolted whole wheat)
  • Orzo (a pasta made in the shape [and look] of rice grains)
  • Pearl barley (barley with hull and germ removed; used in soups. Etc.)
  • Roux (a mixture made with flour and fat; used as a thickener)
  • Seitan (cooked wheat gluten)
  • Soy sauce (soybeans fermented with roasted grains, usually wheat or barley)

(Gluten free exceptions may exist. Lundberg, for example, makes a “Brown Rice Couscous” labeled gluten free, and several companies make tamari soy sauce labeled gluten free.)

Ingredients that may contain gluten include these:

  • Artificial flavors
  • Malt (from barley)
  • Malt vinegar (fermented from barley)
  • Natural flavors
  • Vegetable [ingredient] (in this context, “vegetable” means “not animal,” as in “vegetable broth,” etc.)

Some ingredients must be gluten free if produced in the USA, but may not be gluten free if produced elsewhere. For example, maltodextrin made in the USA is from corn. Foreign-source maltodextrin may be made from gluten-containing grains. Similarly, xanthan gum made in the USA is from corn. Foreign-source xanthan gum may be made from gluten-containing grains.

Gluten cross-contamination may be a possibility. Cross-contact, for example, can occur in:

  • Beans (USA Grain Standards allow a small quantity of other grains)
  • Non-gluten-containing grains (USA Grain Standards allow a small quantity of other grains)
  • Products that include an advisory statement, for example, “made in a facility that processes wheat.” See gluten free labeling for more information.
  • Products that are not labeled gluten free. See gluten free labeling for more information.
  • See Oats information below.

So what foods can I eat on the gluten free diet?

The simple answer is…everything other than wheat, rye and barley, giving consideration to the ingredient and cross-contact issues noted above.  See also:

Celiac Support Group's Trouble-Shooting Questionnaire provides suggestions for checking a person’s environment for the presence of gluten.

Celiac Support Group's July 1, 2014 blog post discusses What Does A Healthy Gluten Free Diet Look Like?

Celiac Support Group's December 31, 2014 blog post discusses Gluten in Drugs - Action Steps Needed.

Among other frequently asked questions are these:

What about oats?

The protein in oats is called avenin. Celiac Support Group considers that Celiacs and others with Gluten-Related Disorders do best to consume only "purity protocol" oats that are labeled gluten free. This minimizes the otherwise-strong possibility of cross-contact between oats and the gluten-containing grains.

Oats currently labeled gluten-free may be either "purity protocol" oats (gluten-free from farm to fork) or regularly-grown oats that are mechanically sorted to separate out those contaminated by gluten.  If you are eating the latter, you may want to check out the research information links on our Troubleshooting page.

Even purity protocol oats cause symptoms for some people. If you experience digestive issues with any gluten free-labeled oats, you have choices. You can pursue testing for avenin sensitivity, you can try another brand of gluten free-labeled oats, or you can simply stop eating oats, just as you would with any other gluten free product that doesn't agree with you personally.

How does the Gluten Contamination Elimination Diet differ from the Gluten free Diet?

The Gluten Contamination Elimination Diet (GCED) was described in a 2013 study of 17 patients diagnosed as having continuing celiac symptoms or refractory celiac disease.They followed a Gluten Contamination Elimination Diet for 3 to 6 months; 14 of them got better.

The GCED definition was stricter than the Gluten free Diet, to minimize the possibility of cross-contamination. It allowed rice (so it wasn't a paleo diet), but it disallowed all other naturally gluten free flours, grains, and seeds. Processed foods were not allowed. Apples, for instance, had to be fresh, not dried, and nuts purchased in the shell were permitted, but hulled or seasoned nuts were not permitted. Seasonings, condiments, and beverages all were limited.

The original research paper, including a description of the gluten contamination elimination diet (Table 1 in the paper), is referenced at celiac disease.

What about Gluten and Medications?

Learn about and link to the Citizens' Petition to label gluten in medications and Celiac Support Group's Drug Makers Online GF Resource List from our home page

In a separate effort to label gluten in medications, the Gluten In Medications Disclosure Act of 2015 was referred to a committee on 9/29/15.  It died without being referred out of committee.  You can read about the bill and an earlier 2013 legislative effort here:  https://www.govtrack.us/congress/bills/114/hr3648.

Contact us for more information about a Gluten Free Diet.