A Gluten Free Diet

What is Gluten?

Gluten is a general name for a protein found in wheat, barley, and rye. It is most commonly encountered in baked goods (e.g. breads, pies, cakes, and cookies) as well as cereals and pasta. It is also often an additive in many processed food items.

Practical steps to beginning a Gluten free diet

Start by examining the foods already in your kitchen. You may already be enjoying many naturally gluten-free products and foods such as detailed below. Then, examine all of your packaged food with labels. Read the ingredient lists carefully to identify sources of hidden gluten (see table). If you discover gluten in the product, get rid of it, or place it in a separate part of your pantry so others in your household can enjoy them.

Gluten-Free Foods

Naturally Gluten-Free Foods You CAN Eat

  • Produce

    • Fresh Fruits & Vegetables
    • Canned Fruits & Vegetables (read label for additives)
    • Frozen Fruits & Vegetables (no sauce)

    Meats and Protein Substitutes

    • Fresh 100% Beef, Pork, Poultry, Fish & Seafood, & Eggs
    • Tofu
    • Hummus
    • Beans, Legumes, Nuts, Nut Butters (e.g. peanut butter)

    Dairy

    • Unflavored Milk (whole, low fat, skim, evaporated or condensed)
    • Cheese (Cream Cheese, Cottage Cheese, Aged Cheese)
    • Ice Cream (read label- avoid cookie dough, cakes, and brownies)
    • Plain Yogurt (read labels with fruit yogurt)
    • Sour Cream
    • Cream, Buttermilk, Half and Half
    • Whipping Cream

    Cereals and Grains

    • Cream of Rice
    • Grits
    • Puffed Rice (gluten-free dry cereals)
    • Plain Brown or White Rice
    • 100% Corn Tacos/Tortillas
    • Cornmeal
    • Hominy

    Condiments

    • Jams, Jellies, and Marmalades
    • Mayonnaise
    • Mustard, Ketchup
    • Pickles, Olives, Relish
    • Most Salad dressings (read label)
    • Distilled Vinegars
    • Honey
    • Maple Syrup

    Fats and Oils

    • Vegetable, Canola and Olive oil
    • Shortening, Lard
    • Vegetable Spray
    • Butter/Margarine

    Beverages

    • 100% Fruit Juice
    • Coffee, Tea, Cocoa
    • Soda (except Root-Beer)
    • Gluten-free beer
    • Wine and all distilled liquors
Gluten-Free Grains & Flours

Naturally Gluten-Free Grains and Flours You CAN Eat

Amaranth, Cornmeal, Potato Starch, Soy, Arrowroot Cornstarch Quinoa Tapioca, Buckwheat, Flax, Rice and rice bran, Teff, Bean, nut, and seed flours, Millet, Sago, Yam, Cassava, Montina, Sorghum, Yucca

Bean flours can be used as a substitute in baked goods. They are higher in protein than rice flours and because of this work well in baked goods to give them the proper texture and consistency. Plus they are nutritious, and generally have a "nuttier" taste.
Chickpea flour has a mild, sweet taste, and can be substituted for regular flour in a 1:1 ratio. No additional changes to the recipe are usually needed. This ingredient tends to work well in cookies, muffins, cakes, and quick breads.

Lentil flour has a stronger flavor than chickpea flour and works well as a substitute in bread and pasta recipes.
Mesquite flour is made by grinding the dried bean pods of the mesquite tree. This flour is high in protein as well as calcium, iron, zinc, and magnesium. Its nutty, sweet flavor is good in an assortment of various baked goods.

Grains to AVOID Eating

Gluten Containing Grains to AVOID Eating

  • Barley (including barley malt, malt flavoring, and malt extract)
  • Rye
  • Wheat in all forms (including wheat bran, wheat germ, and wheat starch) in all forms (including wheat bran, wheat germ, and wheat starch)
    • Wheat can also be called by its species name: Durhum, Einkorn, Emmer (also known as Farro), Khorasan wheat (also known as Kamut), Spelt, or Triticale (a hybrid grain of wheat and rye)
    • Semolina (a type of flourmeal most often made from durham wheat; though note that this can be made from rice or corn)
    • Atta flour
    • Pastas/noodles made from wheat (e.g. couscous, orzo, udon)
    • Cereals made from wheat (e.g. bulgur and farina)
    • Special flours/meal made from wheat (e.g. Graham flour and matzo flour)

What about Oats?

Oats are currently felt to be safe for most celiacs, as long as processed in a facility where there is no risk of cross-contamination with wheat. Note: a minority of celiac patients may be intolerant to the protein (Avenin) in oats, which is similar to gluten. You should try to avoid the consumption of oats initially or only consume oats that are clearly labeled gluten-free.

Hidden Sources of Gluten

  • Ales, beer and lagers
  • Breading and meat coating mixes
  • Communion wafers
  • Croutons and stuffing
  • Sauces, marinades, gravies, and thickening agents (such as roux)
  • Imitation seafood/bacon/meat (such as seitan)
  • Soy sauce (unless made in the Tamari-style and labeled gluten free
  • Dry roasted nuts
Gluten in additives

Products that may contain gluten in additives

Brown rice syrup (if made with barley enzymes), Envelope glue, Mineral Supplements, Supplements (herbal, vitamin, mineral), Broth and soup bases, Flavorings, Prescription Medicines, Toothpaste, Candy, Luncheon Meats, Self-basting poultry, Processed cheese, Vitamin Supplements, Dairy Substitutes, Lipstick, gloss and balms.

Gluten Free Chapsticks and Lip Balms

Consuming Nutrient-Dense Gluten-Free Foods:

Celiac disease can cause vitamin and mineral deficiencies due to decreased intestinal absorption. Blood work will be done evaluate for specific vitamin and mineral deficiencies. While on a gluten-free diet, trying to incorporate foods rich in calcium, iron, folate, and Vitamin B12 along with keeping an overall well-balanced diet will help avoid these nutrient deficiencies.

  • Calcium rich foods: Milk, yogurt, cheese, ice cream, sardines, salmon, broccoli, spinach, almonds, figs, calcium fortified soy milk and orange juice
  • Iron rich foods: Meat, fish, poultry, nuts, seeds, legumes, dried fruit, eggs, amaranth, and quinoa
  • Folate rich foods: Broccoli, asparagus, orange juice, liver, legumes, bean flour, flax, peanuts, walnuts, sesame and sunflower seeds
  • Vitamin B12 rich foods: Liver, eggs, milk, meat, poultry, fish, and seafood

Shopping Tips

Remember to begin a gluten-free diet with an open mind and positive attitude. Spend your first few weeks at the grocery store when you have time to read food labels and take your time browsing the isles.

Upon your first visit to the grocery store, shop the perimeter of the store where the naturally gluten-free items will be found. Start with the produce section where you do not need to worry about label reading. Then make your way into the fresh meat, poultry, seafood section where these food items will again be generally gluten-free. Take caution when purchasing your deli meats as these may contain gluten and you should ask for gluten-free products. You then can visit the dairy and egg section before finally, venturing into the inner isles and looking for processed foods/dry staples that do not contain gluten or are labeled gluten-free

Reading Product Labels

Read food labels carefully to guarantee the safety of the food. Any ingredient used in the product must be listed on the label. If you have any doubts, check with the manufacturer of the food.

Wheat is one of the 8 most common allergens that must be listed on a food label. If a protein derived from wheat is used as an ingredient (even in small amounts in such things as colorings or seasonings), it must be noted on the allergy statement. If you see wheat on the allergen list then you know it must be avoided. However, if the food does not contain wheat, it may not mean it is gluten-free because oats, rye and barely are not required to be listed under the allergen statement. Therefore, always read the label carefully, and remember to check them every time you purchase an item, as ingredients in a product can change at any time.

Some key words on labels that may indicate the presence of gluten are:

  • Hydrolyzed Vegetable Protein (HVP) – unless made from soy or corn
  • Flour or Cereal products – unless made with pure rice flour, corn flour, potato flour, or soy flour
  • Vegetable Protein – unless made from soy or corn
  • Malt or Malt Flavoring – unless derived from corn
  • Modified Starch or Modified Food Starch – unless arrowroot, corn potato, tapioca, waxy maize or maize is used
  • Vegetable Gum – unless made from carob bean, locust bean, cellulose, guar, gum arabic, gum aracia, gum tragacanth, xantham or vegetable starch
  • Soy Sauce or Soy Sauce Solids – unless you know they do not contain wheat
  • Stabilizer
  • Starch
  • Flavoring
  • Emulsifier
  • Hydrolyzed
  • Plant Protein
Cross Contamination

BE AWARE of Cross Contamination

When living with other family members that are not on a gluten-free diet or you are dining out, you must be aware of cross-contamination.

  • Toaster ovens seem to be the biggest culprit for cross-contamination of gluten-containing foods. Be sure to clean your toaster oven well in between uses or purchase two toasters to have at home to avoid cross-contamination.
  • Cutting boards, colanders, pots, and pans can also be a source of cross-contamination. Be sure to clean all cookware in between uses. Be sure to clean all surfaces and utensils well before preparing gluten-free meals or snacks. Remember, if you are cooking gluten-containing pasta be sure to clean the strainer well in between. Consider buying a dedicated set of these items for use only with gluten-free cooking.
  • Having two separate jars of condiments, such as peanut butter, jelly, mayonnaise, etc, labeling one as "gluten-free" can help avoid cross-contamination. You can also purchase "squeezable" bottles of condiments
  • When baking with gluten containing flours, make sure to cover gluten-free foods. Flour dust can float in the air for hours and then settle on gluten-free foods, contaminating them.
  • When dining out be sure to ask how foods are prepared or even call ahead after reviewing the menu to ask questions. See our Tips on Dining Out for further advice.
Medications, Vitamins and Supplements

When it comes to being on a gluten-free diet, you need to think of all things that are ingested including medications, both over-the-counter and prescription. Check with the manufacturer or pharmacist to be sure the medication does not contain gluten. You can find a list of gluten-free drugs at www.glutenfreedrugs.com. Always read labels.

Below are some commonly used gluten-free over-the-counter medications:

  • Advil
  • Allegra
  • Colace
  • Ibuprofen
  • Sudafed
  • Aleve
  • Aspirin
  • Excedrin
  • Extra Strength Motrin
  • Tylenol
  • Align
  • Claritin
  • Imodium
  • Pepto Bismol
  • Zyrtec

Local Stores That Sell Gluten-Free Products:

  • Stop & Shop Grocery Stores
  • Shaw's Grocery Stores
  • Big Y World Class Markets
  • It's Only Natural Market-Middletown, CT (860) 346-1786
  • Aleia's Bakery-Old Saybrook, CT (860) 399-8063
  • Thyme and Season Natural Foods Market – Hamden, CT (203) 407-8128
  • Trader Joe's
  • Food Works-Guilford, CT (203) 458-9778
  • Whole Foods Market

Where can I find more information and support?

Here are some websites with information about celiac disease, as well as links to useful references, support groups and more.

If you have been newly diagnosed with celiac disease within the past 12 months, they are eligible to request a FREE Gluten-Free Care Package from the University of Chicago.

Celiac Support Association: www.csaceliacs.org
Has a wealth of information explaining the disease, support groups, links to gluten-free product lists, news, recipes and more!

Celiac Disease Foundation: www.celiac.org
Has information about the disease, diet, lifestyle, how to read labels, what to & not to eat, awareness events, research studies, and more!

National Foundation for Celiac Awareness: www.celiaccentral.org