Diet & Nutrition

Gluten-Free Diet 101: A Complete Scientific Guide

Bonnie Taub-Dix, RDN
Ashley Welch
By  and Medically Reviewed by 
Reviewed:
Medically Reviewed
gluten free diet ingredients
Gluten is a protein that gives bread its sponginess. For certain people, including those with celiac, gluten poses health risks.Adobe Stock

Many diets become popular thanks to celebrity endorsements — think Kanye West on paleo, or Jennifer Aniston doing intermittent fasting — or because of commercial success, as with WW and the South Beach Diet. But others, like the gluten-free diet, have entered the mainstream, in part, from a legitimate medical need.

A diet without gluten is used to help alleviate symptoms of celiac disease, an autoimmune condition that affects nutrient absorption and prevents the digestion of gluten.

But many people go gluten-free despite not having celiac disease or other similar health conditions that necessitate eliminating gluten. People who follow a gluten-free diet for nonmedical reasons may be seeking weight loss, better focus, increased energy, or a less-bloated belly, all potential benefits touted commonly by wellness influencers.
There’s no question that the gluten-free diet has become popular for nonmedical reasons. Indeed, the number of people on the gluten-free diet who do not have celiac disease is almost double the number of people diagnosed with celiac disease. Research shows about 2.7 million people in the United States follow a gluten-free diet without having celiac.

The demand for gluten-free foods in the United States is also significant, with sales of gluten-free products totaling more than $15.5 billion in 2016.

That number is expected to reach more than $17 billion by 2027.

If you don’t have a medical need to eliminate gluten, is this diet beneficial for you?

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For this variation, stir together a quick whole-wheat pancake batter with buttermilk and that not-so-secret pancake ingredient — olive oil, whch adds fruity, herbaceous notes to the pancakes. Or feel free to swap in melted butter or a neutral oil for a more traditional take.

contains  Wheat, Dairy, Eggs
3.7 out of 33 reviews

SERVES

4

CALORIES PER SERVING

412

AUTHOR

The Feedfeed

PREP TIME

10 min

COOK TIME

10 min

TOTAL TIME

20 min

Ingredients

1 cup whole wheat flour
1 tbsp granulated sugar
1 tsp baking powder
1/2 tsp baking soda
1/4 tsp fine sea salt
1 cup buttermilk
2 tbsp extra-virgin olive oil
1 large egg
1/2 tsp vanilla extract
Nonstick spray
4 medium ripe bananas, sliced 1/2-inch thick
Butter, for serving
Fresh fruit, for serving
Maple syrup, for serving

Directions

1

For step-by-step directions to make this recipe, visit The Feedfeed.

Nutrition Facts

Amount per serving

calories

412

total fat

10g

saturated fat

2g

protein

9g

carbohydrates

78g

fiber

7g

sugar

41.2g

added sugar

16.3g

sodium

379mg

TAGS:

Wheat, Dairy, Eggs, Gluten-free, Vegetarian, High-Fiber, Family-Friendly, Breakfast

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What Is Gluten?

First things first: Gluten is a protein. Mary Ellen Phipps, MPH, RDN, owner of Milk and Honey Nutrition in Houston, says gluten is found in wheat, including spelt, kamut, farro, durum, bulgur, and semolina; barley; rye; and triticale.

Oats are naturally gluten-free, but they may also be cross-contaminated with gluten if they were processed in a facility with gluten-containing foods.

Most beers, certain condiments, and other processed foods may also contain gluten byproducts.

While whole grains are healthy, they can cause uncomfortable symptoms, including bloating and fatigue, in some people. In those with celiac disease, they can lead to more severe issues, like malnutrition and intestinal damage.

Common Questions & Answers

What can you eat on a gluten-free diet?
Foods that are safe to eat on a gluten-free diet include fruits and vegetables; most dairy products, including milk, cheese, and butter; potatoes; rice and rice noodles; meat and fish (as long as they’re not breaded or battered); and gluten-free flours.
Can you lose weight on a gluten-free diet?
There is a lack of scientific evidence proving that a gluten-free diet leads to weight loss. But in some cases, you may make healthier choices on a gluten-free diet because you’re paying more attention to food labels, thereby helping you lose weight.
Do eggs have gluten? What about potatoes?
Both eggs and potatoes are naturally gluten-free. Nonetheless, both foods are at high risk for cross-contact with foods containing gluten, especially when prepared at a restaurant. 
What are some gluten-free breakfast ideas?
Some examples of breakfasts without gluten are: gluten-free cereal, cottage cheese and fruit, omelets with onions and peppers, grits, scrambled or hard boiled eggs with corn tortillas, and gluten-free pancakes, oats, or waffles.
What does gluten do to someone with celiac disease?
In people with celiac disease, eating gluten triggers an immune response in the small intestine, which over time damages its lining. This prevents the intestine from absorbing nutrients properly and can lead to gastrointestinal symptoms like diarrhea and bloating, fatigue, weight loss, and anemia.

Which Health Issues Can a Gluten-Free Diet Help Manage?

Medically speaking, not all gluten-related issues are created equal. There can be confusion around two common gluten-related conditions in particular: celiac disease and nonceliac gluten sensitivity.

Let’s take a look at the differences between the two, and how the gluten-free diet may benefit both, along with some other medical conditions.

Celiac Disease

Celiac disease is an autoimmune disorder that affects an estimated two million people in the United States.

It's likely that even more people have the condition because it is known to be underdiagnosed.

In people with celiac disease, ingesting gluten causes damage to the lining of the small intestine, which can cause long-term problems with digestion and a host of unpleasant symptoms along with fatigue.

Symptoms of celiac disease vary from person to person, but they can include diarrhea, constipation, gas, nausea, and abdominal pain, as well as symptoms outside the digestive system, such as osteoporosis, anemia, headaches, and joint pain.

Other people may not have any outward symptoms at all, but are still at risk for long-term health issues.

Regardless of whether you have symptoms, the best way to find out if you have celiac disease is through a blood test, a biopsy, or sometimes both. Make sure to get tested before going gluten-free, as doing so could affect your test results.

Nonceliac Gluten Sensitivity

Nonceliac gluten sensitivity (NCGS) can be difficult to diagnose because it mimics symptoms of many other digestive disorders, and because most symptoms in scientific studies are self-reported by participants.

Symptoms of NCGS vary from person to person, but they may include brain fog, depression, bloating, abdominal pain, diarrhea, fatigue, and joint pain.

Diagnosing NCGS remains tricky because of the reliance on self-reported data and the lack of ways to clinically test for it, but one indicator of NCGS includes having symptoms but testing negative for celiac disease.

Gluten Ataxia

Gluten ataxia is rare and falls under the spectrum of gluten-related conditions. It affects the brain rather than the digestive system, and the damage it causes is irreversible. According to research, in some people, gluten triggers an autoimmune attack on the cerebellum — the area of the brain responsible for functions like balance and coordination, which can cause ataxia.

Symptoms of ataxia vary, but may include difficulty using arms and legs, trouble speaking, vision issues, and poor coordination and balance.

Gluten ataxia usually shows up around age 50, and many patients will have neurological symptoms but no digestive symptoms.

Wheat Allergy

Sometimes confused with celiac disease, a wheat allergy is triggered by food containing wheat. Several proteins in wheat cause this type of reaction, whereas people with celiac disease react only to gluten (one specific protein in wheat, barley, and rye).

Wheat allergies are most common in children, and more than 65 percent of people affected will outgrow the allergy by the time they are 12 years old.

Symptoms can include a rash, hives, stomachache, runny nose, and anaphylaxis, and the primary treatment is to avoid foods and products containing wheat, which can but doesn’t always include foods with gluten.

For example, rye and barley contain gluten but are not wheat, so those with a wheat allergy may be able to eat these grains as long as they haven’t been cross-contaminated with wheat.

Be sure to read ingredient labels carefully to avoid wheat in all of its forms.

Potential Health Benefits of the Gluten-Free Diet

In addition to celiac, NCGS, gluten ataxia, and wheat allergy, some studies suggest a gluten-free diet may play a role in treating the following conditions (though more research is needed):

  • Irritable Bowel Syndrome One study of 140 IBS patients found that following a gluten-free diet for 12 weeks led to significant improvement of gastrointestinal symptoms.

  • Schizophrenia A research review of nine studies found that six of them demonstrated beneficial effects of a gluten-free diet for people with schizophrenia, including improved functioning and decreased symptoms severity.

  • Fibromyalgia One small study of 20 women with fibromyalgia and gluten sensitivity found that all of the study participants reported improved symptoms while following a gluten-free diet. Fifteen of the women experienced dramatic improvement in chronic widespread pain, indicating remission from their disease.

  • Endometriosis A study of 207 women with endometriosis found 75 percent reported a significant change in painful symptoms after following a gluten-free diet for 12 months.

Always get approval from your doctor before trying a gluten-free diet to help with any medical condition.

Eliminating gluten may improve athletic performance in some individuals, but the diet isn’t recommended for every athlete, so don’t follow it before getting your doctor’s approval.

Risks and Who Should Avoid a Gluten-Free Diet

There’s no shortage of claims about the gluten-free diet, but sometimes not eating gluten for a nonmedical reason can have unintended consequences. One unwelcome side effect of a gluten-free diet is an increased risk for nutrient deficiencies, including iron, calcium, zinc, vitamin B12, vitamin D, and folate.

Excess fat in the blood and coronary artery disease are additional risks of the gluten-free diet.

And while not a health risk, foods specifically processed to be gluten-free tend to be more expensive than their gluten-containing counterparts.

Phipps adds that your body can have trouble readjusting if you swear off gluten and suddenly reintroduce it back into your diet.

If you’ve gone gluten-free and fit into one of the following categories, you may want to consider gradually welcoming the protein back into your diet.

People Without Allergies or Intolerances

“Don’t mistake the hype around the gluten-free diet as proof that it’s an effective or safe weight loss tool,” says Phipps. "There is no scientific evidence that avoiding gluten will lead to weight loss."

Some people who go on a gluten-free diet will lose weight, but usually it’s because they’re paying closer attention to nutrition labels and what’s in their food.

Because there are so many processed gluten-free foods packed with unhealthy fats and added sugar, you may even gain weight on a gluten-free diet.

People on Low-Carb Diets

“The most common misconception around gluten-free diets is that they are synonymous with carb-free diets,” says Phipps. That’s simply not true.

Bananas, for example, are naturally gluten-free but still contain carbs. A medium-size banana contains 26 grams (g) of carbs.

Although there are no hard and fast rules, a standard low-carb diet limits carbs to between 20 to 57 g of carbs daily.

Most vegetables and dairy products are also naturally gluten-free, and still contain carbs. Gluten-free products eliminate grains such as wheat, rye, and barley, but their gluten-free counterparts — gluten-free rice, quinoa, and corn — may have just as many carbs.

So if you’re trying to scale back your carb intake, going gluten-free won’t necessarily accomplish that goal.
The bottom line: Don’t self-diagnose a gluten intolerance of any sort. Because of the potential risks, going gluten-free isn’t a good choice without a medical diagnosis, and you’re best off speaking with a doctor if you’re experiencing symptoms.

Getting Started on the Gluten-Free Diet

If you and your healthcare provider have determined that going gluten-free is right for you, the first steps include reading food labels carefully, getting rid of gluten-containing products, and restocking your pantry and fridge with gluten-free options. Working with a registered dietitian who is knowledgeable about celiac disease and a gluten-free diet can help make the transition to this eating style easier. Know that for people with celiac disease, no amount of gluten is safe to consume. You can’t go on and off a gluten-free diet or have a cheat day. Even without symptoms, gluten will damage the villi in the intestines of those with celiac.

Check for the “Certified Gluten-Free” seal on food packages, and read the ingredient list on food labels. Foods regulated by the U.S. Food and Drug Administration (FDA) may be gluten-free but aren’t required to be labeled as such.

Several foods, such as rice, are naturally gluten-free, so knowing those foods is important, too.

Other tips from the Celiac Disease Foundation on how to tell if packaged food is free of gluten include checking a list of allergens, identifying any obvious sources of gluten (wheat, barley, rye), and looking into hidden ingredients or those you haven’t heard of before.

A Detailed Food List for the Gluten-Free Diet

With your healthcare team’s okay, follow this list of foods with and without gluten to address your health concern.

What to Avoid

Gluten-containing grains:

  • Wheat
  • Barley
  • Bulgur
  • Cross-contaminated oats (check the label to ensure the food is gluten-free)
  • Rye
  • Seitan

Pure wheat and all its forms. This includes, but is not limited to:

  • Wheat starch
  • Wheat bran
  • Wheat germ
  • Couscous
  • Cracked wheat
  • Farro
  • Semolina
  • Spelt

Beverages:

  • Most beer (unless clearly marked gluten-free)
  • Malt beverages

Other unexpected items:

  • Barley malt
  • Some chicken, beef, and vegetable broths
  • Malt vinegar
  • Some salad dressings
  • Veggie burgers
  • Frozen meals
  • Condiments
  • Soba noodles

What to Eat

Naturally gluten-free foods:

  • Fruits
  • Vegetables
  • Meat
  • Poultry
  • Seafood
  • Dairy
  • Beans
  • Legumes
  • Nuts

Naturally gluten-free grains, seeds, and starches:

Beverages:

  • Water
  • Sparkling water
  • Soda
  • Juice
  • Sports drinks
  • Wine
  • Most hard liquor
  • Gluten-free beer

A 7-Day Sample Gluten-Free Diet Meal Plan

To get an idea of what eating a gluten-free diet looks like, check out this seven-day sample meal plan from Kendra Weekley, RD, and David Gardinier, RD, registered dietitians with Cleveland Clinic’s Center for Human Nutrition.

Note that this meal plan is provided as guidance and inspiration and should not replace the advice of your doctor or dietitian. Consult with your healthcare team if you have any questions or concerns regarding if this meal plan is right for you.

Day 1

Breakfast: Omelet with peppers and onions

Lunch: Split pea lentil soup with a side of potato wedges

Snack: Sliced apple with peanut butter

Dinner: Crustless shepherd’s pie and a side of roasted asparagus

Day 2

Breakfast: Eggs, bacon, and hash browns with a side of strawberries

Lunch: Southwest chicken bowl with brown rice and broccoli

Snack: Gluten-free trail mix

Dinner: Three-bean chili with gluten-free corn muffins

Day 3

Breakfast: Peanut butter–banana smoothie

Lunch: Asian chopped salad with a side of fresh blueberries

Snack: Roasted pumpkin seeds

Dinner: Fish tacos on gluten-free corn tortillas with sliced avocado

Day 4

Breakfast: Greek yogurt topped with strawberries and banana slices

Lunch: Gluten-free pita wrap with deli turkey and cheddar cheese paired with a side salad (hold the croutons!)

Snack: Oat energy bites made with gluten-free oatmeal

Dinner: Baked lemon chicken with zucchini, yellow squash, and sweet potato

Day 5

Breakfast: Gluten-free oatmeal with banana slices and almond butter

Lunch: Egg roll in a bowl with gluten-free soy sauce, paired with a mandarin orange

Snack: Low fat string cheese and a peach

Dinner: Grilled salmon fillet with veggie kabobs on a bed of steamed rice

Day 6

Breakfast: Gluten-free buckwheat pancakes topped with chopped walnuts and raspberries

Lunch: Cold quinoa salad with black beans, red onion, shredded carrots, diced tomato and feta cheese, side of gluten-free crackers

Snack: Hummus and cucumber slices

Dinner: Chickpea pasta with marinara sauce, meatballs, and broccoli

Day 7

Breakfast: Overnight gluten-free oats with blueberries, almond milk, and slivered almonds

Lunch: BBQ chicken tacos in a gluten-free tortilla with coleslaw on top

Snack: Low-fat cottage cheese and pears

Dinner: Turkey burgers on a gluten-free bun with sweet potato fries and a side salad

Resources We Love

Favorite Orgs for Info on Celiac Disease

Celiac Disease Foundation

The Celiac Disease Foundation (CDF) is a nonprofit that funds research, patient and provider education, and advocacy initiatives. The website provides resources on gluten-free living, including recipes, meal plans, and information on federal health benefits you may be entitled to. There are also handy lists of gluten-free foods, gluten in medicine, vitamins, and supplements, and even gluten-free candy.

Beyond Celiac

This patient advocacy organization is on a mission to create a world where people with celiac disease can live healthy lives without social stigma and fear of exposure to gluten. On Beyond Celiac’s website, you will find resources for people newly diagnosed, information for parents of children with celiac disease, and a guide on going gluten-free in college. You can also learn about the latest research news and clinical trials aimed at developing new treatments for celiac disease.

Favorite App for Following a Gluten-Free Diet

Eat! Gluten Free

This app from the Celiac Disease Foundation provides a database of gluten-free products and recipes. Simply use the search function to check if your favorite foods are available in gluten-free varieties. You can also search gluten-free foods by location and see what’s new and available in your area. Eat! Gluten Free is available for free on the App Store and Google Play Store.

Favorite Blogs for Gluten-Free Recipes

Gluten-Free Goddess

Looking for some tasty gluten-free recipes? The Gluten-Free Goddess has you covered! Authored by Karina Allrich, this easy-to-navigate blog offers tons of meal ideas for breakfast, lunch, dinner, and snacks while following a gluten-free diet.

Backing Backwards

Created by food writer and former pastry chef Daniela Dewar, Baking Backwards is a vegetarian baking blog devoted to recipes for sweet and savory gluten-free treats. Chocolate chip quinoa cookies, marbled cheesecake mousse cups, and minty hot fudge cream cakes are just some of the mouth-watering recipes you’ll find that are all safe to eat on a gluten-free diet.

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