What Is Gluten?
Gluten is the name for proteins found in wheat, barley, and rye. Gluten is also added to foods as a thickening agent or to provide texture and flavor.
Gluten has a stretchy quality to it and is the ingredient that gives bread and baked goods their chewy texture. Eating whole grains like wheat, barley, and rye is linked to a lower risk of heart disease, stroke, and diabetes. But gluten can cause health concerns for some.
Some people experience adverse reactions and health risks when eating foods containing gluten. The peptides—amino acids that form the building blocks of proteins—found in gluten are resistant to stomach acids, which can make it hard for some people to digest them. These peptides can cause various symptoms from mild indigestion to more serious health conditions.
Gastrointestinal discomfort or allergy symptoms can develop as a result of eating gluten. Many people have developed celiac disease. Celiac disease is an autoimmune disorder in which the immune system sees gluten as a toxic invader and attacks it, which can cause intestinal damage. People with celiac disease are at a risk of developing more serious disorders if they aren't able to absorb vitamins and minerals very well.
Why Is Gluten Bad for You?
People who are sensitive to gluten in their diet may want to consider avoiding it. But for everyone else, that's not necessary. Gluten doesn't cause problems in most people. It's a natural protein found in many grains.
But there are some conditions that require a strict gluten-free diet.
About 1% of Americans have celiac disease. But most cases go undiagnosed. People with celiac disease experience gastrointestinal symptoms like excessive gas, diarrhea, unexplained weight loss, and nutrient deficiencies. Some people may even have the condition and not have any symptoms that bother them. This is called "silent celiac."
If people with celiac disease continue to eat food with gluten, it can result in damage to their intestinal lining. This affects their digestive system's ability to absorb vitamins and minerals.
People with celiac disease have a higher risk of developing many problems, including:
- Infertility problems
- Emotional problems like depression and anxiety
Children with celiac disease may go through puberty later, experience failure to thrive, or develop learning disabilities or attention-deficit/hyperactivity disorder (ADHD).
The only treatment of celiac disease is to stick to a strict gluten-free diet for life.
The threshold to avoid small intestine damage from celiac disease is 10 milligrams of gluten per day. That's equal to a crumb of regular bread or a penpoint of wheat flour.
Your intestinal lining can heal by sticking to a gluten-free diet, and you may feel a lot better.
Nonceliac gluten sensitivity (NCGS)
Some people diagnosed with irritable bowel syndrome may have gluten sensitivity. It's possible to have difficulty digesting gluten without having autoimmune celiac disease. If you experience gastrointestinal symptoms after eating foods with gluten but have tested negative for celiac, you may have NCGS.
You may have:
NCGS isn't well understood, but it could be related to inflammation. People with it don't have the intestinal damage seen in celiac disease. Symptoms often improve on a gluten-free diet.
This is different from celiac disease or NCGS because people with a wheat allergy aren't reacting to gluten. If you have this allergy, your body produces antibodies to other proteins in wheat. Your doctor may tell you it’s not necessary to avoid gluten-containing foods made from rye and barley.
You may have symptoms like:
Cough or cold-like symptoms like a runny nose
Itching/swelling of the mouth or throat
Antihistamines may help you feel better, especially if you have only a mild reaction to wheat.
Some people have severe reactions and have trouble breathing and can even go into anaphylactic shock. In this case, your doctor may tell you to carry an EpiPen, just in case. Anaphylaxis is a life-threatening condition, so if you need to use your EpiPen, call 9-1-1.
Keeping a food diary can help you determine if your allergy symptoms occur after eating wheat, barley, rye, or oats.
Dermatitis herpetiformis (DH)
This is a very itchy, bumpy skin rash that's triggered by eating gluten. The blister-like bumps usually show up on your elbows, buttocks, knees, and along your hairline. 10%-15% of people with celiac disease also have DH. You may have this skin condition and not have digestive symptoms.
It’s more common in celiac disease, but you can get DH even if you have normal blood tests and intestinal biopsies.
Your doctor may prescribe medicine to clear the rash. Still, the only long-term treatment of DH is keeping a strict gluten-free diet.
This is a rare condition in which your immune system attacks the nervous system when you eat gluten. It can be related to celiac or NCGS. People with gluten ataxia often don't have digestive complaints.
Gluten ataxia can affect the part of the brain that controls coordination. You may feel clumsy or lose your balance.
You also may have:
- Trouble using your hands, fingers, arms, and legs
- Tingling in your extremities
- Trouble speaking or moving your eyes
A strict gluten-free diet can help you feel better. It can stop the condition from getting worse, too.
Foods With Gluten
Avoiding gluten entirely can be very tricky at first. It's important to read labels carefully. Grains and ingredients that should be avoided include wheat, rye, barley, brewer's yeast, malt, triticale (a combo of rye and wheat), and oats not labeled "gluten-free."
Foods made from wheat have high amounts of gluten. There are different kinds of wheat:
The following flours are wheat-based, so they're not gluten-free:
- Graham flour
The most common sources of gluten include:
- Bread: This includes all types of bread (unless labeled "gluten-free") such as rolls, buns, bagels, biscuits, and flour tortillas.
- Baked goods: Baked goods like cake, cookies, doughnuts, muffins, and pies contain gluten, as well as pancakes and waffles.
- Pasta: All wheat pasta contains gluten, including spaghetti, fettuccine, macaroni, lasagna, and ravioli.
- Cereal: Not all breakfast cereals contain wheat, but many do, so be sure to check the nutrition labels. Also, be aware that oats are often raised and processed with wheat. Therefore, unless they are labeled gluten-free, oat products will also contain gluten.
- Crackers: Popular snack foods like crackers, pretzels, and some types of chips have gluten.
- Beer: Beer is made from malted barley, which has gluten. Some liquors have added wheat, so be sure to research the ingredients.
- Gravy: Gravies and ready-meals containing gravy contain gluten. Powdered gravy mixes also contain gluten unless specifically labeled "gluten-free."
- Soup: Many canned and boxed soups use wheat flour as a thickening agent. Check nutrition labels to find premade soups without gluten.
What are common gluten-free foods?
As tricky as it can be to avoid gluten, the good news is that many foods are naturally gluten-free. You can still enjoy a healthy, delicious diet with staples like:
Non-processed meats and fish
Fresh fruits and vegetables
Beans and legumes
Grains like rice and corn
Most cheese and dairy
Being on a gluten-free diet doesn't mean that you need to stop eating all grains, which give you healthy carbohydrates, fiber, vitamins, and minerals. Whole grains have even more of these vitamins and minerals.
Gluten-free grains include:
- Corn and corn products like popcorn and cornmeal
- Gluten-free oats
Some widely available foods that don't have gluten are easy substitutes for similar items that do:
- Corn tortillas instead of flour tortillas
- Fresh fruit or gelatin with whipped cream for dessert
- Zucchini noodles topped with spaghetti sauce
- Italian risotto (basmati rice) instead of pasta
- Raw veggies with dips instead of crackers
- Cornstarch for thickening instead of wheat flour
- Gluten-free soups
- Tamari instead of soy sauce (which is made with wheat)
- Flours like almond, tapioca, rice, or corn instead of wheat flour for baked goods
Shopping for Gluten-Free Foods
The market for gluten-free products has boomed in the past few years. Today, you can buy breads, pastas, baked goods, and other items made with gluten-free grains, cauliflower, or other safe ingredients.
Despite this, you'll still have to put in a little extra effort to find safe food—especially when you are first going gluten-free. Here's what to do and what to look out for:
Read the ingredient label. Foods that are labeled "gluten-free" can still contain some wheat starch. The FDA allows a packaged food to be labeled gluten-free if it has been processed to remove gluten and the food contains under 20 parts per million gluten.
Remember "wheat-free" does not mean gluten-free. There still could be rye, barley, or another gluten-containing ingredient in the food. These ingredients are not "major" allergens, so you will have to look closely at the ingredient labels to find them.
This is where technology can help. There are phone apps that scan barcodes and can alert you if a food is gluten-safe. Not every item is in every app so consider downloading more than one. The apps are especially handy when you're newly diagnosed and may feel overwhelmed by the diet.
Cross-contamination. Another thing to look out for are products labeled as "made on shared equipment" or "may contain" wheat or gluten. This means it's possible that there's some gluten in the product.
Hidden gluten. Read labels on all packaged and processed foods. Gluten can be found in many dressings, sauces, gravies, and candy. For instance, you may be surprised to learn that soy sauce and licorice both contain wheat.
Different varieties of wheat. There are several types of wheat to watch for when you're shopping for gluten-free foods, and all of them have gluten:
- Kamut spelt
Farina, graham flour, and semolina are all wheat products.
Find an alternative. If you're not sure whether a product is correctly labeled, find something else. For instance, a product may be labeled as gluten-free, but wheat is listed as an ingredient.
Gluten-free food should be consumed in moderation. A study of gluten-free foods targeted at children found that 88% of the products didn't offer many health benefits, and 79% of them were high in sugar.
Gluten-free bakery products are also high in fat, sugar, salt, and refined carbohydrates.
How to save money on gluten-free foods
Living gluten-free can be expensive, especially if you choose food that's not naturally gluten-free like pastas, baked goods, and convenience foods. Here's how to slash your food bill:
- Search for coupons online.
- Make your own baked goods using gluten-free mixes or from scratch.
- Rely on naturally gluten-free foods for most of your diet.
You may be able to deduct some of the cost of gluten-free food as a medical expense. Here are some of the steps you must take:
- Itemize your federal returns.
- Get a doctor's official diagnosis and a prescription for gluten-free food.
- Save your receipts for gluten-free foods.
- Calculate the difference between the costs of regular food versus your food.
- File the correct form: 1040; schedule A.
If you have questions, talk to your tax preparer and take a look at IRS publication 502 on medical deductions.
Avoiding Gluten at Restaurants
Eating out can be one of the biggest challenges for someone living gluten-free. You often scan menus for "What can I eat?" rather than "What do I want to eat?" Make a plan and do your research before you head to the restaurant to bring back the joy of dining out.
It's best to avoid any of the following when dining out gluten-free at restaurants:
- Breaded items
- Wheat flour
- Broths and soups
- Soy sauce
- Spice mixes
- Flour dusting
- Salad dressings
- Battered foods
- Fried foods
- Vegetables prepared in pasta water
Many cuisines are known to have gluten-free dishes including:
Most of the time, fast-food restaurants won't have gluten-friendly options available and won't have the appropriate staff to make changes. So dining at a non-fast-food establishment is your best bet.
Let your fingers do the research. Do an internet search for "gluten-free restaurants near me." You might be surprised to find out that there are some dedicated gluten-free eateries in your area. You can take a look at restaurant menus online to check if they have options for you.
- Some dishes may have a symbol noting they're gluten-free.
- Many restaurants have dedicated gluten-free menus.
- Call ahead to find out if any options you like can be made gluten-free.
Download apps. There are apps available to download on your phone that list restaurants that cater to those living gluten-free. They are especially helpful when you're traveling.
Get social. Facebook and other social media can be a great tool. Do a search for groups that bring together people in your general area who share tips on the best places to shop and eat out. There are other groups that talk about restaurant options while traveling to different cities, share recipes, and more.
At the restaurant. Tell your server you must avoid gluten. Be prepared to briefly tell them what that means. Here are some easy requests and questions to ask:
- Hold the croutons on salads and garnishes like fried onion strings
- Ask that your food not be dusted with flour before cooking
- Ask if the grill and other cooking surfaces are cleaned before preparing gluten-free options
- Find out if oil in fryers is changed before preparing gluten-free french fries
If you aren't getting answers that make you comfortable, ask to speak to the manager or chef.
It's always a good idea to carry gluten-free snacks so you're not tempted to eat something unsafe.
Here are some easy and nutritious gluten-free snacks to try:
Hummus cucumber sandwiches:
- Slice up a cucumber.
- Spread a little hummus on one slice.
- Top with another slice of cucumber.
Ants on a log:
- Take a celery stick.
- Fill it with peanut butter.
- Add some raisins on top.
- Open, drain, and pat dry a can of chickpeas.
- Toss with olive oil and salt.
- Spread out on a baking sheet.
- Roast at 400 F (204 C) for 20-30 minutes, shaking the pan every 10 minutes.
- Remove from the oven.
- Toss with your favorite spices or fresh herbs, such as chili powder, cumin, rosemary, or thyme.
- Pop some popcorn.
- Pour it into a large bowl.
- Drizzle with melted butter.
- Sprinkle in some furikake or shredded seaweed.
- Add some bite-sized rice crackers.
- Stir well.
Some other gluten-free snacks are:
- Tortilla chips and guacamole
- Rice cakes
- Fresh fruit
- Fruit leather
- Cottage cheese
- Cheese sticks
You can also make your own trail mix with your favorite nuts, seeds, and unsweetened dried fruits.
Hidden Sources of Gluten
Some foods and drinks have gluten, but they might fly under your radar.
Most beverages are gluten-free. But there are important exceptions:
Be aware that any beverage with malt is usually made from barley malt and is off-limits. Don't add malt to a milkshake and be wary of things like wine coolers, which sometimes have added malt.
Sauces and condiments
Check labels of any sauces or condiments you use. Some common ones that contain gluten include:
- Teriyaki or other sauces made with soy sauce
- Malt vinegar
- Creamy sauces thickened with a roux (flour and butter)
When you get the munchies, be careful what you reach for. Some snacks have hidden gluten.
- Corn, potato, and rice chips with added flavorings
- Candies like licorice and malt balls
- Granolas/trail mixes made with wheat or non-gluten-free oats
- Some energy bars
- Ice cream with added things like cookie dough
Because gluten is a bonding agent, it's also used in some products that aren't food, including:
- Cosmetics such as lipstick, lip gloss, and lip balm
- Dental products
- Vitamins and nutritional supplements
- Drugs and medications
- Toy dough
Regular communion wafers are usually made from wheat. Check with your church to see if gluten-free wafers are available.
Complications of Going Gluten-Free
Gluten-free diets have become popular with people who don't have gluten sensitivity or celiac disease. They may believe that:
- A gluten-free diet will help you lose weight.
- Your overall health improves.
- You'll have better gastrointestinal health.
- Your athletic performance will improve.
But there's no research to support these claims. Complications of going gluten-free may include:
Fewer nutrients. You may wonder whether gluten-free alternatives are healthier. Some studies show that people who are on a gluten-free diet tend to gain weight. These foods also often have fewer nutrients such as iron, calcium, and fiber and more sugar and fat.
Higher costs. Before committing to gluten-free foods, think about the cost. Most gluten-free foods have a higher price tag than what they replace. The expenses of a gluten-free diet can be significant.
Switching to a gluten-free diet can be a big adjustment, but it's a critical change to make if you've been diagnosed with celiac disease or any other kind of gluten allergy or sensitivity. The more you get used to doing what you need to do to eat safely—like learning to carefully read restaurant menus, better understanding nutritional labels, and finding gluten-free alternatives that you enjoy—the easier it gets.
Why is gluten bad for your gut?
It's not—unless you have a condition related to eating gluten. In celiac disease, your body unleashes an autoimmune reaction to gluten and damages the lining of the small intestine. In NCGS, digestive symptoms can be similar, but the intestinal lining isn't damaged.
What are the first signs of being gluten-intolerant?
Gluten intolerance is when you get sick after eating foods with gluten. Symptoms vary. But you may feel gassy, bloated, belly pain, or have bowel issues.