The Gluten-Free Diet – A Beginner’s Guide
Gluten-free diets are very popular these days, and you have probably already heard a lot about gluten and its potential side-effects.
Some people – around 1% – have celiac disease (sometimes mistakenly referred to as gluten intolerance or sensitivity, which are different conditions) while others discover at some point of their lives that they are sensitive to gluten and feel better without it.
Is a gluten-free diet a good idea for you? Can it benefit you in the long term?
What can you eat and what should you avoid on a gluten-free diet?
What is gluten exactly? How does it affect some people’s health? Why are some people sensitive to it and should you be concerned?
Let’s find out the answers to these questions – and many more.
What Is Gluten And Why Are Some People Sensitive To It?
Gluten is a mix of two different proteins, glutenin and gliadin, found in some grains, such as wheat, rye, barley and triticale (a newer variety that’s a cross between wheat and rye).
It is the substance that allows the foods containing it to hold their shape, and gives them their chewiness. It’s also the reason why bread raises.
Not all grains contain gluten, though – there are plenty of them who are gluten-free. Examples include rice, quinoa, millet, buckwheat, to name a few.
It is estimated that 1% of the population has celiac disease, and unfortunately many people remain undiagnosed, as not all people who have celiac have gastrointestinal symptoms. Up to 80% of the people who are affected might be completely unaware they have it (1, 2).
Additionally, the number of people affected by celiac disease in the States who aren’t properly diagnosed is on the rise (3).
In people who have celiac, their immune system will react to gluten and damage the small intestine. The damage affects the villi, which are small, tubular projections that make up the lining of the small intestine, and, as a result, nutrient absorption is worsened.
This is sometimes accompanied by pronounced GI symptoms, such as bloating, pain, gas, diarrhea, but might also provoke a wide array of general symptoms (fatigue, headaches, anemia), where the cause is difficult to pinpoint. Additionally, due to the worsened absorption of food, patients could develop nutrient deficiencies.
Keep in mind that celiac disease is an autoimmune disease that can develop at any point in your life. Just because it was ruled out when you were in your 30s, doesn’t mean that you cannot develop it in your 40s, or later in life.
Now, there’s something else that is important to consider – and that has been a controversial subject in the past few years: even people who don’t have celiac disease can have a gluten sensitivity or intolerance, ranging from mild to severe.
While there isn’t a clear, well-established definition of what gluten sensitivity is, it is generally considered that people who have it will suffer from adverse reactions to gluten, sometimes due to the lack of enzymes for gluten digestion (4).
Non-celiac gluten sensitivity (NCGS) is estimated to be much more common than celiac disease, but because of the fact that there isn’t a clear definition yet, there aren’t any conclusive studies on its prevalence in the general population.
There isn’t any specific test for NCGS, so if you react negatively to gluten but your doctor has ruled out celiac, you might want to remove all sources of gluten from your diet to see if this helps. If it doesn’t, you’re unlikely to be sensitive to gluten and would need to continue searching for the cause of your problems.
There are also people who are allergic to whey, who might or might not be sensitive to gluten at the same time; most patients who have an allergy to whey are children and outgrow it before puberty.
As with all allergies, a wheat allergy is an immune reaction to an allergen, or the substance that provokes it. The symptoms are those of an allergic reaction: a skin rash, difficulty breathing, headache, and in more severe cases, an anaphylactic shock (requiring an immediate trip to the ER) (5).
Who Can Benefit From A Gluten-free Diet?
First of all, for people who have celiac disease, it is essential to avoid gluten.
If you suspect you might have celiac disease, you should get it diagnosed by a healthcare professional. Some of the symptoms of celiac disease include:
- intestinal discomfort, pain, bloating, gas
- diarrhea or constipation
- nausea and vomiting.
Nevertheless, many of the symptoms of celiac disease are not GI-specific. A wide array of symptoms might be present, especially in adults, such as fatigue, headaches, depression, joint pain, anemia, osteoporosis, infertility, and irregular menstrual periods.
To diagnose it, your doctor will likely prescribe the following tests:
- a blood test to check for the presence of specific antibodies
- biopsy of a sample from your small intestine
In order to diagnose celiac properly, you shouldn’t limit gluten before you get tested – otherwise, you might get a false negative.
Additionally, there are people who have gluten sensitivity without meeting the diagnostic criteria for celiac disease. They might have specific gastrointestinal symptoms that range from mild and barely noticeable to severe, and, through elimination and reintroduction, they might discover that they feel better when they do not consume any gluten.
Some people might have a sensitivity or an allergy to whey, while not being specifically sensitive to gluten. They would benefit from a wheat-free diet.
Some people who have IBS (irritable bowel syndrome) might see their symptoms worsen when they eat foods containing either whey or gluten (6, 7). If that’s your case, it would be sensitive to remove gluten and/or whey from your diet.
Moreover, many people thrive on a low-carb or on a ketogenic diet. While these aren’t strictly gluten-free diets by definition, if you’re following them, you will most likely remove all major sources of gluten from your diet, such as bread, pasta, baked goods, etc., as they are all high in carbs.
Both the keto and low-carb diets rely on ingredients and foods that naturally do not contain any gluten; nevertheless, if you actually have celiac disease, you might want to make sure there isn’t any possible cross-contamination.
If you’re not tolerating carbs very well, and not just food containing gluten, it might be a good idea to look into these diets – you’d be eating both low-carb and gluten-free, and might discover that’s exactly what your body needs at this point of your life.
What Is The Gluten-free Diet Exactly?
Thankfully, there are many foods that are naturally gluten-free, so you’ll definitely have plenty of choices. If you’re starting a gluten-free diet (or any kind of diet, really), it’s always better to concentrate on all the great food that you can have, instead of the things you should limit.
What Are The Allowed Foods?
Foods that are naturally gluten-free include:
- Meat, poultry, and fish
- Fats and oils
- Herbs and spices
- Many types of grains, such as quinoa, millet, rice, buckwheat, corn, teff
Additionally, although processed food isn’t optional for your health, there are a lot of gluten-free processed foods that you can eat.
In order to make sure that particular food doesn’t contain gluten, you should read the label to make sure it doesn’t contain any gluten source, such as wheat, rye, malt, barley, or triticale.
If you have a sensitivity to gluten, simply avoiding foods that contain any of these ingredients will likely be sufficient for you to keep your symptoms in check.
Nevertheless, if you have celiac disease, this might not be enough of a precaution, as some foods might be cross-contaminated if they’re produced in the same facility where foods containing gluten are processed.
If you have doubts about possible cross-contamination, your best bet is to check whether the item has been labeled as gluten-free and to stick to these.
Given that the interest in gluten-free diets has been steadily on the rise in the past few years, there are more and more gluten-free products, so you’ll have lots of choices.
Additionally, you can even have gluten-free wheat, rye and barley products, such as gluten-free bread, pasta, flour, cookies, and so on.
So what are the sources of gluten in our diet? What should you avoid?
What Foods Should You Avoid?
If you’re following a gluten-free diet, you should be avoiding any foods that are made of, or that contain the following:
- Wheat (including all wheat-based products, such as flour, wheat bran, wheat germ, durum, semolina, spelt and kamut)
- Barley and malt
- Brewer’s yeast
Foods made of these grains include:
- Bread – all types of bread, including bagels, baguettes, scones, hamburger buns, etc.
- Baked goods – both sweet and savoury – muffins, cookies; cakes, pies, croissants, crackers, pretzels
- Pasta and noodles made of wheat – you can still have pasta made of rice, sweet potato, corn, quinoa or konjac
- Couscous – unless labeled gluten-free
- Most cereals and oats – oats are gluten-free but are often cross-contaminated with gluten; most cereals contain gluten, but you can have corn and rice cereals. For both oats and cereals your best bet is to look for a gluten-free label
- Some sauces and marinades – always check the label and look for gluten-free options or make the sauces and marinades yourself
- Most soups, unless homemade without any flour or other gluten-containing products
- French fries
- Most deep-fried foods that have a crunchy coating – the coating usually contains bread crumbs or flour
- Some vegetable proteins – if you see “hydrolyzed vegetable protein” on a label, it might mean that it contains gluten.
If you’re missing the more starchy side dishes, you can still have rice and potatoes, including sweet potatoes. Alternatively, you might wish to consider other options (that are also lower in carbs than rice or potatoes), such as steamed, sautéed or fresh vegetables, salads, and avocado.
What Beverages Can You Have?
The healthiest option out there, regardless of the specific diet you’re following, is, of course, water. Sparkling water is another excellent alternative. Homemade tea is another great choice.
On top of that, most beverages are gluten-free, with one major exception – beer, which contains gluten. There are some gluten-free beers, but it’s a good idea to proceed with caution (or have a different type of alcoholic drink, such as wine or liquor).
Most sodas are gluten-free, too, as well as 100% fruit juices, although they both contain lots of sugar, so if you’re striving for better health, do consider limiting them.
Coffee is naturally gluten-free, too, but might be cross-contaminated, so people who have celiac should ideally brew their coffee at home, and buy coffee from trusted sources.
Effects And Benefits Of The Gluten-free Diet
For people who have celiac disease or non-celiac gluten sensitivity, following a gluten-free diet will have an immediate positive effect on their health.
Removing the substance that makes your body overreact and damage itself, or give you a wide array of horrible symptoms, will give you relief and will make you feel better – both short- and long-term.
If you’re sensitive to gluten or to wheat, the first step of making yourself feel better and enjoying better health is identifying the cause of your symptoms (i.e. gluten and/or whey) and removing it from your diet.
Many people don’t actually know that they have a gluten sensitivity, because the symptoms can be very unspecific. Once they eliminate gluten from their diet, they start feeling better, and vice-versa, they feel worse and develop symptoms if they eat gluten again. The best way to figure all of this out is via trial and error – if you feel better on a gluten-free diet, then it’d be sensible to stick to it in the long run.
Additionally, patients with brain disorders such as autism, epilepsy, and schizophrenia sometimes respond well to a gluten-free diet and see an improvement of their symptoms. If you, or someone close to you, suffers from these, a gluten-free diet might be worth considering.
Although more studies are necessary in order to reach a conclusion, it is theorized that there is a strong connection between autoimmune diseases and gluten sensitivity.
Patients with autoimmune thyroid conditions, type 1 diabetes, multiple sclerosis, and psoriasis among others might discover that they have fewer flare-ups and that their symptoms are less severe on a gluten-free diet (8, 9, 10, 11).
Another obvious benefit of a gluten-free diet is not eating empty calories in the form of bread, pasta, cakes and the like. Most foods that contain gluten are refined and processed, and such serve a purpose of filling you up, but do not provide much nutrition beyond that.
So if you want to feel at your best, it might be a good idea to substitute bread, pasta, and desserts with more wholesome and nutritious alternatives. Skipping the bread and eating a larger serving of vegetables instead would be a great start, and also removing pasta from your diet.
What Should You Do If You Eat Something That Contains Gluten?
Unfortunately, there isn’t an antidote to gluten, so if you have a strong gluten sensitivity or celiac disease, you’d simply need to wait it out, and get some rest.
You might experience both GI and non-GI symptoms, ranging from bloating to fatigue and brain fog, and the severity will range based on the exposure and on your specific condition.
Give your body time to recover, accept that you might not feel at your best for a while, be gentle to yourself, and move on.
To prevent that from happening, always make sure to communicate clearly your diet restrictions and sensitivities, both in restaurants and when someone else is cooking for you. Nobody wants to poison you when you visit friends or family or are eating out, so communication is key. Do not take chances and always stick to food that is safe to eat.
Are There Any Risks Associated With The Gluten-free Diet?
If you’re being smart about your gluten-free diet and plan it well, there aren’t any risks associated with it. If you’re getting your fiber and all essential micronutrients from foods that are naturally gluten-free, then you don’t risk any significant nutrient deficiencies.
Gluten-free junk food won’t be any healthier than its gluten-containing equivalent, nutritionally speaking, just because it doesn’t contain gluten. It will just help you keep your symptoms in check if you’re sensitive or intolerant to gluten.
However, if you stick to mostly whole, unprocessed foods that do not contain gluten, the diet will be easy for you and is perfectly sustainable in the long run.
Of course, if you are at a healthy weight and simply remove all the calories that were coming from bread, pasta, and the like, and do not substitute them with anything else, you might end up undereating and feeling hungry, so you’d need to make sure that you’re covering your nutritional needs with something else.
What Diets Are Naturally Gluten-free?
Most diets where you limit either carbs or grains (or both) are naturally gluten-free. Here are some examples:
If you’re following a keto or a paleo diet, for example, you have already eliminated all major sources of gluten from your diet.
If you’re sensitive to gluten (or have celiac) you should still check labels, but if you’re consuming whole, natural foods, such as meat, veggies and some fruits, you are almost certainly not eating any gluten (except if there is some cross-contamination from other foods).
The Keto Diet Vs. A Gluten-free Diet
The keto diet will be gluten-free by default unless you’re doing dirty keto and eating gluten-containing foods from time to time.
On top of being gluten-free, it will be very low in carbs (20-25 g net carbs per day) and likely higher in fats, to compensate for the lack of carbs, as well as adequate in protein, to make it a sustainable long-term diet.
A keto diet plan is much more structured and strict than a gluten-free diet because you need to track macros and calories, and be very mindful of your food choices (i.e. not just avoid a list of foods, but also make sure that whatever you’re eating fits well in your macros).
Many people do keto for weight loss, and report amazing results; the gluten-free diet might or might not lead to weight loss, depending on your food choices, activity level, and overall calorie consumption and needs. If you just substitute traditional bread with gluten-free bread, you’re not going to see any major changes.
If, however, you decide to change your diet and introduce healthier alternatives to foods that contain gluten, you might see a very positive change, both in terms of general health and of weight loss.
The Paleo Diet Vs. A Gluten-free Diet
The paleo diet is less strict than keto, in the sense that you don’t need to count macros and calories on it, and don’t need to limit carbs to such a low threshold. Some people decide to track on paleo and also decide to do both keto and paleo at the same time, or low-carb paleo.
The paleo diet itself is very flexible and can be adapted to plenty of different lifestyles and preferences. It’s also naturally gluten-free, as it is a no-grains type of diet.
It is not necessarily a low-carb type of diet, but it’s usually much lower in carbs than the standard American diet, as all major carb sources are removed.
A gluten-free diet, on the other hand, can mean plenty of different things in terms of nutrition and macros, so if you’re striving to become healthier, you might wish to combine it with paleo or with keto and see how you feel about these.
The major premise of the paleo diet is that you’d be eating meat, eggs, vegetables, and seasonal fruits. These are all excellent food choices that are naturally gluten-free.
If you feel better without gluten in your life, and have managed to identify it as a cause, that’s a big step towards feeling better in the long run, and not experiencing nasty gluten-related symptoms. A gluten-free diet is not difficult to manage if you don’t get fixated on what you cannot have, but instead concentrate on all the amazing foods that you can eat.
Gluten-free processed food might be expensive, especially compared to its gluten-containing counterparts. That’s why we recommend basing your diet mostly on whole food, that is both naturally gluten-free, and full of important nutrients – vegetables, meat, fish, eggs, and fruits are all great options. This low-carb food list is also gluten-free.
What are your thoughts on gluten and gluten-free diets? Are you sensitive to gluten? How did you find out about it? Share your comments with us in the comment section below!