Allergies: Symptoms, Reaction, Treatment & Management
The Gluten-Free Diet: A Beginner's Guide With Meal Plan
A gluten-free diet involves excluding foods that contain the protein gluten, which is found in wheat, barley, rye, and spelt. This diet can include foods like fruits, vegetables, meats, and gluten-free products.
Gluten is a protein that gives flour a sticky consistency when it's mixed with water. It's also associated with the rise and chewy texture of bread. The term "gluten" is derived from the Latin word for glue.
Gluten is commonly found in products such as bread, pasta, and baked goods.
A healthcare professional may recommend a gluten-free diet if you experience uncomfortable gastrointestinal symptoms after eating foods that contain gluten.
In some cases, you may need to completely avoid gluten if you have certain health conditions or are allergic to products that commonly contain gluten.
Keep reading to learn more about eating a gluten-free diet, including a sample menu.
Most people can eat gluten without experiencing any side effects. However, some people who have gluten-related disorders may need to avoid it. These disorders include:
If you have a wheat allergy, you may not necessarily need to avoid gluten specifically, but you'll need to avoid certain gluten-containing foods, including wheat-based products like bread, pasta, and baked goods.
Talk with a healthcare professional if you experience any of the following symptoms after eating foods that contain gluten:
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 may include:
Other common gluten sources include:
Many gluten-free products are now widely available, but it's important to read the ingredient section of the food label on most of the foods you buy.
Labels may include additional statements such as "processed in a facility that also processes wheat-based foods." Oats are naturally gluten-free but may contain traces of gluten if they are processed in the same factory as wheat-based foods.
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.
The following items are naturally gluten-free:
If you're unsure whether an item contains gluten, read the nutrition label carefully. It could also be helpful to work with a registered dietitian to ensure that you're meeting all your nutritional needs.
Feel free to swap suggestions according to your liking or add extra meals and snacks to fit your needs. Heartbeet Kitchen offers some excellent recipes for gluten-free snacks and entrees.
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Most people with gluten-related disorders such as celiac disease try a gluten-free diet to help treat digestive problems such as:
Some research suggests that eating a gluten-free diet may also have other benefits for people with celiac disease and other gluten-related disorders, including:
It's important to note that this diet is only necessary for those with celiac disease or other gluten-related disorders, and it may not be appropriate for everyone.
Can you lose weight by going gluten-free?You may experience some weight loss when you begin following a gluten-free diet.
This may be due to eliminating foods such as cookies, cakes, and other snack foods. However, some weight loss may occur as a result of the restrictive nature of the diet or a lack of planned balanced meals.
Gluten-free options are not always healthier or more nutritious than other foods. Certain gluten-free products, such as cakes, pastries, and snacks, may be high in calories and contain few beneficial nutrients.
This diet should not be considered a weight loss diet.
A gluten-free diet may have several downsides for people who have a gluten-related disorder, as well as for those who have not received a diagnosis that requires the elimination of gluten.
Risk of a nutritional deficiency
Some research suggests that gluten-free diets are more likely to be deficient in important nutrients such as:
This may be because many gluten-free versions of foods are not fortified with these nutrients. Gluten-free diets are also typically higher in saturated fats, sodium, and carbohydrates than their gluten-containing counterparts.
A registered dietitian can help you plan balanced meals that meet your nutritional needs. They may recommend that you take vitamin and mineral supplements if you have trouble getting enough of these nutrients from food.
Constipation
According to a 2021 study, people who follow a gluten-free diet may also be more likely to experience constipation.
A fiber-rich diet may help promote healthy bowel movements. But gluten-free diets eliminate many popular sources of fiber, such as bread, bran, and other wheat-based products.
Some gluten-free substitutes for wheat-based products are also low in fiber.
Cost
Following a gluten-free diet can be difficult if you're on a tight budget.
A 2024 study found that gluten-free pastas and breads sold in U.S. Grocery store chains were about 2.7 and 4.6 times more expensive, respectively, than their gluten-containing counterparts.
This is because gluten-free products cost manufacturers more money to make. For example, gluten-free foods must pass stricter testing and avoid cross contamination.
When following a gluten-free diet, you may be able to save money by:
Difficulties when socializing
A 2021 review suggests that following a gluten-free diet could make it more difficult for people to socialize and engage in gatherings. This could lead to feelings of isolation, loneliness, and unhappiness.
Following a strict gluten-free diet may also make traveling and eating at restaurants more challenging. As a result, people who eat a gluten-free diet are more likely to stay home to eat.
It's important to remember that you can still socialize while following a gluten-free diet — it simply requires a little extra preparation.
If you're eating out, consider calling the restaurant beforehand to see whether gluten-free options are available. If you're going to a social gathering, consider eating ahead of time or bringing your own food.
A gluten-free diet involves completely avoiding the protein gluten, which is often found in pasta, baked goods, and other wheat-based foods.
While a gluten-free diet can be restrictive, there are plenty of nutritious and delicious options available.
You can consider eating more fruits, vegetables, lean protein, dairy foods, and healthy fats to promote overall health and prevent nutrient deficiencies.
If you're unsure about how to plan balanced meals, consider speaking with a healthcare professional or a registered dietitian. They could help you develop a meal plan and recommend any supplements you may need to ensure that you get enough essential nutrients.
Can A Gluten-Free Diet Ease IBS Symptoms?
This is a timely question. We seem to be in the midst of a gluten-free frenzy, or is this merely another food fad? It seems like just yesterday that celiac disease was considered to be an uncommon disorder.Dr. William F. Balistreri
We now understand that this disorder may affect one percent of the population, over two million individuals in the United States alone.Dr. William F. Balistreri
This has led to a proliferation of gluten-free products with sales estimated to be over six billion dollars per year. However, many individuals adhere to a gluten-free diet not because they have celiac disease but because they believe they are sensitive to gluten.Dr. William F. Balistreri
In fact, experts have coined the term non-celiac gluten sensitivity. For those individuals who suffer irritable bowel syndrome or IBS. Symptoms that are relieved by a gluten-free diet. Their symptoms return if gluten is ingested.Dr. William F. Balistreri
It's unclear how common this disorder may be. However, estimates are that six to seven percent of adults in the United States have non-celiac gluten sensitivity.Dr. William F. Balistreri
It's also unclear as to the mechanism and whether the restriction of gluten truly alters the natural history.Dr. William F. Balistreri
There are, however, a few recent studies which suggest that indeed a gluten-free diet can relieve symptoms of IBS. The first was a double blind study conducted in Australia.Dr. William F. Balistreri
Individuals with IBS symptoms who were shown not to have celiac disease were given either a gluten-free baked product or identical product which contained gluten. Those who ingested gluten over a period of time reported significantly more and severe symptoms.Dr. William F. Balistreri
Conversely, those ingesting the gluten-free products had less bloating, abdominal pain, fatigue and other symptoms.Dr. William F. Balistreri
Another study published this month in the Journal of Gastroenterology also reported that a controlled diet of a gluten-free substance reduced symptoms in patients with diarrhea predominant IBS.Dr. William F. Balistreri
I look forward to additional studies because there are several unanswered questions. Number one, is any improvement truly related to the avoidance of gluten or is it due to the placebo effect of eating what is perceived as a healthy or healthier diet?Dr. William F. Balistreri
And number two, is the effect related to gluten elimination or the restriction of wheat? Clearly, this distinction is important since the natural history of celiac disease versus that of gluten sensitivity is quite different.Dr. William F. Balistreri
In addition, it is neither simple nor inexpensive to restrict gluten from the diet since items such as pizza, bread, pasta make up a significant proportion of the daily intake.Dr. William F. Balistreri
The bottom line—gluten restriction may prove to be an option for certain individuals with IBS. However, we strongly recommend that you speak with your physician and that celiac disease is excluded prior to choosing a gluten-free diet.","publisher":"Medscape Video"} ]]>
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Dr. William F. Balistreri
This is a timely question. We seem to be in the midst of a gluten-free frenzy, or is this merely another food fad? It seems like just yesterday that celiac disease was considered to be an uncommon disorder.Dr. William F. Balistreri
We now understand that this disorder may affect one percent of the population, over two million individuals in the United States alone.Dr. William F. Balistreri
This has led to a proliferation of gluten-free products with sales estimated to be over six billion dollars per year. However, many individuals adhere to a gluten-free diet not because they have celiac disease but because they believe they are sensitive to gluten.Dr. William F. Balistreri
In fact, experts have coined the term non-celiac gluten sensitivity. For those individuals who suffer irritable bowel syndrome or IBS. Symptoms that are relieved by a gluten-free diet. Their symptoms return if gluten is ingested.Dr. William F. Balistreri
It's unclear how common this disorder may be. However, estimates are that six to seven percent of adults in the United States have non-celiac gluten sensitivity.Dr. William F. Balistreri
It's also unclear as to the mechanism and whether the restriction of gluten truly alters the natural history.Dr. William F. Balistreri
There are, however, a few recent studies which suggest that indeed a gluten-free diet can relieve symptoms of IBS. The first was a double blind study conducted in Australia.Dr. William F. Balistreri
Individuals with IBS symptoms who were shown not to have celiac disease were given either a gluten-free baked product or identical product which contained gluten. Those who ingested gluten over a period of time reported significantly more and severe symptoms.Dr. William F. Balistreri
Conversely, those ingesting the gluten-free products had less bloating, abdominal pain, fatigue and other symptoms.Dr. William F. Balistreri
Another study published this month in the Journal of Gastroenterology also reported that a controlled diet of a gluten-free substance reduced symptoms in patients with diarrhea predominant IBS.Dr. William F. Balistreri
I look forward to additional studies because there are several unanswered questions. Number one, is any improvement truly related to the avoidance of gluten or is it due to the placebo effect of eating what is perceived as a healthy or healthier diet?Dr. William F. Balistreri
And number two, is the effect related to gluten elimination or the restriction of wheat? Clearly, this distinction is important since the natural history of celiac disease versus that of gluten sensitivity is quite different.Dr. William F. Balistreri
In addition, it is neither simple nor inexpensive to restrict gluten from the diet since items such as pizza, bread, pasta make up a significant proportion of the daily intake.Dr. William F. Balistreri
The bottom line—gluten restriction may prove to be an option for certain individuals with IBS. However, we strongly recommend that you speak with your physician and that celiac disease is excluded prior to choosing a gluten-free diet.Does Gluten Cause Inflammation?
Gluten may cause inflammation in people who are sensitive to it. This can lead to gastrointestinal symptoms like stomach pain, bloating, and vomiting. In people with celiac disease, it can also lead to longer-term complications such as anemia, osteoporosis, and neurological problems.
If you have celiac disease or gluten intolerance, you should avoid foods that contain certain grains, including what, barely, and rye. Many popular foods, including baked goods, cereals, and pizza, are commonly made with these grains.
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How Gluten Causes Inflammation Gluten is mostly made up of gliadin and glutenin proteins and is part of the prolamin superfamily of proteins. In people who are susceptible, these proteins trigger an inflammatory response from the immune system. Inflammation occurs when the immune system releases certain substances in response to injury or infection. In people with celiac disease (a gluten-related immune disorder), the body responds to gluten as if it were a virus. This can lead to chronic or long-term inflammation, which can cause damage to the digestive system and other parts of the body. In people who are sensitive to gluten but don't have celiac disease, it may be that gluten proteins, combined with other components of wheat, trigger an inflammatory immune response. Who Is at Risk for Inflammation from Gluten? Several conditions are related to gluten. Symptoms are similar, but there are distinct differences among them. Celiac Disease Celiac disease is a serious autoimmune disorder that affects about 1% of the world's population. In celiac disease, the body sees gluten as a foreign invader. It produces antibodies that, while attempting to attack gluten, end up attacking healthy tissue, especially in the small intestines. That makes it hard to absorb nutrients from food. Symptoms can include: Diarrhea, constipation Stomach pain, bloating, vomiting Migraines, joint pain Chronic fatigue In addition to malnutrition, long-term complications may include: Anemia (a low number of healthy red blood cells) Infertility Neurological conditions Osteoporosis (chronic bone-thinning) Skin problems Development of other autoimmune diseases Some people have a genetic or environmental predisposition to have issues with gluten. For example, the risk of having celiac disease is higher if you carry certain variants of the HLA-DQA1 and HLA-DQB1 genes. These genes are part of a family of genes that help the immune system know the difference between foreign invaders and the body's own proteins. Gluten Sensitivity People with gluten sensitivity also have a bad reaction to gluten. They might have some of the symptoms of celiac disease. However, gluten sensitivity doesn't involve the high levels of antibodies and damage to the intestines seen in celiac disease. A sensitivity to gluten is not a true allergy. Other names for gluten sensitivity are non-celiac gluten sensitivity (NCGS) and gluten intolerance. People with gluten sensitivity should consider a gluten-free diet. Many things can lead to similar abdominal symptoms, and it's not always gluten. Poorly digested carbs that ferment in the gut (FODMAPS, short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) can produce the same symptoms. So can some food allergies. Wheat Allergy A wheat allergy is a type of food allergy in which your immune system overacts to wheat. This can cause symptoms such as hives, sneezing, or runny nose. You might also have gastrointestinal symptoms similar to gluten sensitivity and celiac disease. Less commonly, a wheat allergy can cause anaphylaxis, a severe, life-threatening allergic reaction. Many foods contain both gluten and wheat. Because the symptoms can overlap, it can be difficult to tell whether you're reacting to gluten or wheat. However, an allergy test can confirm whether you have a wheat allergy. Dermatitis Herpetiformis Dermatitis herpetiformis is an autoimmune disease triggered by gluten. It causes skin symptoms, including an itchy, inflamed, blistering rash. It can also cause gastrointestinal symptoms similar to celiac disease. Most people who develop dermatitis herpetiformis also have celiac disease. A skin biopsy can determine whether you have it. Symptoms of Inflammation Not everyone experiences a reaction to gluten in the same way. If you have gluten sensitivity, you'll probably feel symptoms soon after eating gluten. For those with celiac disease, it may take 48 to 72 hours for symptoms to start. After you eat something with gluten, you may experience inflammation-related symptoms such as: Bloating, gassiness Abdominal discomfort or pain Diarrhea, constipation Weight loss Other Symptoms of Gluten Intolerance Gluten intolerance and celiac disease can also cause problems related to malabsorption of nutrients. These might include: Anemia Skin rash Bone weakness Hair loss Mouth ulcers Infertility Failure to thrive and delayed puberty in children Some people report brain fog (feeling mentally drained) from gluten. Diagnosis Diagnosis of celiac disease is reached through blood tests and endoscopy (a tube with a camera is inserted down the throat to look for the damage caused by the condition) with biopsy (a sample is removed and examined by a pathologist in the lab). There are no good tests available that can diagnose gluten sensitivity. Your healthcare provider may first want to rule out celiac disease with an antibody test. Other possible causes of your symptoms such as wheat allergy, irritable bowel syndrome, and inflammatory bowel disease will also need to be ruled out. If your healthcare provider is unble to find the cause of your symptoms, they may suggest going on a gluten-free diet for six weeks or longer. If your symptoms improve, that may be enough for a gluten sensitivity diagnosis. Prevention and Treatment Treatment for celiac disease and gluten intolerance is similar, but people with celiac disease generally require stricter diets and additional therapies you may not need if you have gluten intolerance. Avoiding foods that contain gluten: Eliminating gluten from your diet can prevent the inflammatory response. This is especially crucial for people with celiac disease since inflammation damages the intestines and other healthy tissues. Treating underlying nutritional deficiencies: People with celiac can have deficiencies in nutrients like iron, calcium, and vitamins D and B12 and may have to take supplements to help correct these. Managing other health conditions: It is common for people with an autoimmune condition like celiac disease to develop other autoimmune conditions. It's important to see your healthcare provider regularly and seek treatment for any new symptoms you develop. There's no cure for celiac disease. If you have celiac disease, a strict, lifelong gluten-free diet is the main therapy. People with dermatitis herpetiformis or gluten sensitivity also benefit from avoiding gluten. For some people with gluten sensitivity, the diet may not have to be as strict or lifelong. If you're allergic to wheat, you should avoid it, but you can have other grains that contain gluten. Complications People with celiac disease can develop serious complications when their symptoms are not well-controlled. These include: Malabsorption: When the body can't get the nutrients it needs from the foods you eat. Lactose intolerance: People with untreated celiac disease are more likely to develop lactose intolerance, which causes problems digesting dairy products. Osteoporosis: Poor calcium absorption can lead to brittle bones and an increased risk of fractures. Neurological problems: People with celiac disease may have non-GI symptoms such as headache and brain fog. Infertility: There is some evidence that untreated celiac disease may impair fertility. Heart problems: Celiac disease can increase the risk of coronary heart disease and other cardiovascular conditions. Cancer: People with celiac disease have a small increase in the risk of certain cancers such as small bowel cancer, small bowel lymphoma, and Hodgkin lymphoma. Diabetes/hyperglycemia: Around 6% of people with celiac disease also have type 1 diabetes. Low fiber intake: People on a gluten-free diet may not get enough fiber, which can cause persistent, celiac-like symptoms. Summary If you have celiac disease, gluten causes severe inflammation and damage to the intestines. You must avoid gluten to control inflammation and the potential for serious complications. If you have gluten sensitivity, you might have many of the same symptoms as someone with celiac disease but without the damage to the intestines. Avoiding gluten can help you avoid a bad reaction.
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