What Can You Eat On Gluten-Free Diet?

by Marixie Ann Obsioma, MT, undergrad MD on March 20, 2019
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It is not always easy to adjust to a gluten-free diet. But it is not as overwhelming as it may seem if you know the ground rules.

According to a Gallup poll published in August 2018, 21% of Americans are actively attempting to eat gluten-free foods (1). This number dwarfs 1% of the American population with celiac disease, which requires a strict gluten-free diet for survival.

But aside from celiac disease, it has now been accepted that even non-celiac patients can suffer from gluten or wheat sensitivity (2). Experts now recognize three gluten-related conditions – celiac disease, wheat allergy, and gluten sensitivity (3).

The prevalence of these disorders is continuously rising, hence more people are now on the anti-wheat warpath trend. You’ll see the label “gluten-free” from craft beers to animal foods. For those with an autoimmune condition that damages the gastrointestinal tract, switching to a gluten-free diet is critical to prevent complications. For others, though, it is not necessary, and potentially an unhealthy diet.

Whether you are new to this diet or have been following it for years, our discussion here will give you a go-to resource for gluten-free diet details, safe foods, and practices.

What is Gluten?

Gluten is a protein commonly found in grains like wheat, rye, barley, and a cross between rye and wheat known as triticale. It’s also present in sauces like malt vinegar, flour, and soy sauce and in additives such as wheat starch and maltodextrin.

It contains gliadin, glutenin, and several other related but distinct proteins (4).

Gluten is heat-stable. It acts as a binding and extending agent. It is commonly used as an additive in several processed foods for moisture, good texture, and flavor (4).

Gliadin’s peptide sequences are resistant to gastric, intestinal, and pancreatic digestion, thus patients with celiac disease or gluten sensitivity should avoid gluten to prevent adverse health effects (5).

What is a Gluten-Free Diet?

A gluten-free diet excludes all foods containing or contaminated with the protein gluten.

It is the sole treatment for 1-2% of Americans with celiac disease. Its popularity and sales drove upward because of celebrities’ endorsements. A gluten-free diet is also being advertised for weight loss, increased energy, better digestion, and clearer skin (6).

Acclaimed Benefits of A Gluten-Free Diet

1. Relieves Digestive Symptoms

Many people go on a gluten-free diet to manage digestive symptoms. These include diarrhea or constipation, bloating, gas, and fatigue.

Studies have shown that this diet has helped ease digestive problems for patients with celiac disease and gluten sensitivity (7, 8).

One research included 215 patients with celiac disease. They followed a gluten-free diet for half a year. Results showed a significant decrease in the frequency of nausea, diarrhea, stomach pain, and other related symptoms (9).

2. Reduces Chronic Inflammation among Patients with Celiac Disease

Inflammation naturally helps the body treat and heal infections. But chronic inflammation, which usually lasts for weeks or months, may pose serious health risks (10).

Many studies have shown that a gluten-free diet can help reduce markers of inflammation. It treats gut damages caused by gluten-related inflammation in patients with celiac disease (11, 12).

3. Boosts Energy

Patients with celiac disease often feel exhausted or experience “brain fog.” These symptoms are possibly caused by nutrient deficiencies because of the damage in the lining of the gut. One great example is iron deficiency, which may lead to anemia (13, 14).

Switching to a gluten-free diet may help boost your energy levels and stop you from feeling excessively tired and sluggish (15).

One study included more than a thousand patients with celiac disease. Sixty-six percent (66%) of them experienced fatigue. After switching to a gluten-free diet, the number has greatly reduced to 22% (16).

4. Helps in Weight Reduction

People often lose weight after starting a gluten-free diet because unwanted calories are being replaced with fresh fruits, vegetables, and lean proteins.

Who Is It For?

As mentioned repeatedly, a gluten-free diet is mainly advised for patients with celiac disease and gluten sensitivity. This diet is important to manage the signs and symptoms effectively.

  • Celiac Disease. An autoimmune disease that triggers the body to attack the lining of the small intestine. Over time, this will lead to poor absorption of nutrients from food.
  • Gluten Ataxia. An autoimmune disorder that affects nerve tissues causing problems with muscle control and voluntary movements.
  • Non-Celiac Gluten Sensitivity. This condition presents with the same signs and symptoms as a celiac disease even if there is no damage to the gastric tissues. The main mechanism remains to be unknown, but the immune system plays a big role.
  • Wheat Allergy. The immune system sees gluten and other proteins present in wheat as a bacteria or virus. The body creates an antibody against it, prompting an immune response that may cause congestion, difficulty breathing, and other symptoms.

Diet Details

Following a gluten-free diet requires you to pay full attention not just on the ingredients of foods, but also to their nutritional contents.

Here’s a good list of gluten-free foods:

1. Whole Grains

Only a few whole grains have gluten. Others are gluten-free like brown rice, wild rice, quinoa, buckwheat, tapioca, millet, sorghum, teff, arrowroot, amaranth, and oats (17).

It is very important, however, to check food labels when buying whole grains. Gluten-free whole grains can still be contaminated with gluten, especially when processed within the same facility as gluten-containing products (18).

The most common contamination is between oats and wheat as they are often processed within the same facility (19).

Avoid all varieties of wheat, rye, barley, and triticale. These gluten-containing grains are usually present in crackers, bread, cereals, pasta, snack foods, and baked goods (17).

2. Fruits and Vegetables

All fruits and vegetables are naturally gluten-free. However, if processed, they may have gluten-containing ingredients like hydrolyzed wheat protein, malt, maltodextrin, and modified food starch as thickeners or for additional flavor (20). Always double check canned, frozen, dried, and pre-chopped fruits and vegetables.

Some of the best fresh fruits and vegetables that you can eat while on a gluten-free diet include apples, berries, bananas, citrus fruits, peaches, pears, broccoli, cauliflower, spinach, kale, mushrooms, carrots, onions, bell peppers, green beans, radishes, and more (17).

3. Proteins

Proteins are widely available in both animal and plant-based sources. Most are naturally free from gluten (21). However, gluten-containing ingredients like flour, malt vinegar, and soy sauce are commonly added on protein dishes for flavoring and as fillers.

Focus on gluten-free proteins like beans, peas, lentils, peanuts, tofu, and tempeh. Always buy fresh red meat, poultry, and seafood. Avoid seitan, any breaded meat, fish, or poultry, and proteins marinated with soy sauce (17).

4. Dairy Products

Dairy products, in general, are gluten-free. However, those that are flavored must be double-checked for malt, thickeners, and modified food starch.

You can enjoy milk, butter, cream, cheese, sour cream, and yogurt on your gluten-free diet (17).

5. Drinks and Beverages

There are many types of gluten-free beverages for you to enjoy. However, some drinks are made with barley, malt, and other gluten-containing grains and must be avoided (22).

Focus on water, pure fruit juice, coffee, tea, wine, beers made from sorghum and buckwheat, sports drinks, energy drinks, soda, and lemonade (17). While these are gluten-free, they should still be taken in moderation because of their high sugar and alcohol contents.

6. Fats and Oils

Similar to other products, fats and oils are almost always gluten-free, except for those that contain additives for thickening and additional flavor.

Always look for butter, ghee, olive oil, avocado oil, coconut oil, sesame oil, canola oil, and sunflower oil. Avoid cooking sprays (17).

7. Herbs and Spices

Sauces, spices, and condiments often contain gluten. Ingredients are added to them as stabilizers, emulsifiers, and of course, for flavoring.

Pick your spices, sauces, and condiments carefully. Tamari, coconut aminos, distilled vinegar, white vinegar, and apple cider vinegar are safe options (17).

Are There Risks Involved?

Despite having many health benefits, a gluten-free diet has some downsides too.

Beware of the following risks:

1. Nutritional Deficiency

Due to a problem with gastrointestinal absorption, patients with celiac disease are at risks of different nutritional deficiencies. These include iron, calcium, fiber, zinc, folate, and vitamins b12, A, D, E, and K (23).

Sadly, studies showed that following a strict gluten-free diet alone may not help treat nutritional deficiencies because most people are choosing processed foods labeled as “gluten-free” over fresh fruits and vegetables (24, 25).

More so, most gluten-free versions of foods do not contain fortified vitamins like folate, which is mostly found in bread and is important for the growth of a baby (26).

Vitamin and mineral supplementation can be a very helpful adjunct therapy to a gluten-free diet (27).

2. Constipation

Constipation is one of the most common side-effects of a gluten-free diet because of the exclusion of bread and wheat-based products in your regular meals. Eating fiber is very important to promote healthy bowel movements (24, 28).

If you experience constipation, aim to eat more fiber-rich fruits and vegetables like broccoli, beans, lentils, and berries.

Conclusion

A lot of people can splurge on gluten-containing products without experiencing any negative effects. However, patients with celiac disease and gluten sensitivity must avoid it, as it can cause serious health risks.

While a gluten-free diet may be restricting, there are several healthy and delicious options to choose from.

Just be sure to eat plenty of fresh fruits, vegetables, and lean proteins to keep your stomach happy and healthy.

References:

(1) //news.gallup.com/poll/240515/americans-try-eat-locally-grown-foods.aspx
(2) //www.ncbi.nlm.nih.gov/pubmed/24411520
(3) //www.ncbi.nlm.nih.gov/pubmed/22313950
(4) //www.ncbi.nlm.nih.gov/pubmed/28244676
(5) //www.ncbi.nlm.nih.gov/pubmed/28810029
(6) //www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/gluten-free-diet-weight-loss/
(7) //www.ncbi.nlm.nih.gov/pmc/articles/PMC3482575/
(8) //www.ncbi.nlm.nih.gov/pmc/articles/PMC4017515/
(9) //www.ncbi.nlm.nih.gov/pubmed/15051613
(10) //www.ncbi.nlm.nih.gov/pmc/articles/PMC4579563/
(11) //www.ncbi.nlm.nih.gov/pubmed/15554953
(12) //www.ncbi.nlm.nih.gov/pubmed/12219789
(13) //www.ncbi.nlm.nih.gov/pubmed/28244662
(14) //www.ncbi.nlm.nih.gov/pubmed/26309349
(15) //www.ncbi.nlm.nih.gov/pmc/articles/PMC3482575/
(16) //www.ncbi.nlm.nih.gov/pubmed/22984893
(17) //www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gluten-free-diet/art-20048530
(18) //www.ncbi.nlm.nih.gov/pmc/articles/PMC3257612/
(19) //www.ncbi.nlm.nih.gov/pubmed/21294744
(20) //www.ncbi.nlm.nih.gov/pmc/articles/PMC3257612/
(21) //www.ncbi.nlm.nih.gov/pmc/articles/PMC3257612/
(22) //www.ncbi.nlm.nih.gov/pmc/articles/PMC4125661/
(23) //www.ncbi.nlm.nih.gov/pubmed/17472877
(24) //www.ncbi.nlm.nih.gov/pmc/articles/PMC3257612/
(25) //www.ncbi.nlm.nih.gov/pubmed/27211234
(26) //www.ncbi.nlm.nih.gov/pubmed/25802345
(27) //www.gastrojournal.org/article/S0016-5085(05)00193-9/fulltext
(28) //www.ncbi.nlm.nih.gov/pubmed/15051613


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