Gluten-Free 101: What You Need to Know

If you’ve recently been told you need to follow a gluten-free diet for health reasons, it is very important to completely eliminate gluten from your diet. This is a lifestyle change that will take time and practice to become “normal.” Here are important tips to get you started, or to refresh your knowledge:

• Educate Yourself About Gluten
  • Gluten is a protein found in the grains wheat, barley, rye, and triticale. Gluten is commonly found in foods like bread, baked goods, crackers, pasta, cereals (though gluten-free versions are widely available).
  • Surprisingly, gluten is also found in caramels, licorice, soy sauce, barbecue sauce and salad dressings.
  • Oats, formerly not recommended for those with celiac disease, are actually gluten-free. However, most commercial oats are contaminated with gluten from cross-contact with wheat, barley, or rye during harvesting and processing. Only eat products containing oats if they are labeled gluten-free. Some individuals with celiac disease feel they cannot tolerate oats. Please discuss with your physician or dietitian if you experience symptoms when eating oats.
  • Read more on sources of gluten and gluten-free foods.
• Read Food Labels
  • Step 1: Look for the words “gluten-free” on package labels.
    • The FDA does not require gluten-free food packages to display a gluten-free symbol or trademark, only the words “gluten-free.”
    • Avoid products labeled “No gluten-containing ingredients.” Companies may use this term when they do not test for the presence of gluten in their product. Even if a product uses no gluten-containing ingredients, gluten may be in the final product from cross-contact with other products or ingredients during manufacturing.
  • Step 2: Read the product ingredients list, especially if the product is not labeled “gluten-free.”
    • Check the allergen warning on the ingredients list for “wheat.” The allergen warning is found underneath the ingredients list.
      • If the allergen warning lists wheat, then it is not safe for consumption.
      • Barley and rye are not included in allergen labeling, but if found in the ingredients list, the product is not safe for consumption.
    • Only consume a product containing oats if it is labeled “gluten-free.” Oat products must be labeled “gluten-free” to be safe for consumption. Per the FDA, they do not need to have a label or symbol that states they are “certified” gluten-free.
    • Gluten-containing ingredients to avoid: malt, malt flavor, malt extract, malt vinegar, brewer’s yeast, and ingredients with the words “wheat,” “barley,” or “rye” in the name or in parentheses after the name. Examples of ingredients to avoid: dextrin (wheat), wheat starch, malt extract (barley).
    • Gluten-free ingredients you don’t need to avoid: caramel color, maltodextrin, and maltose (these are all made from corn), dextrose, glucose syrup (these are gluten-free even if made from wheat due to their extensive processing), distilled vinegar (this is gluten-free even if made from wheat because the distillation process removes gluten), artificial flavor, food starch/modified food starch (unless the ingredients list or allergen warning states “contains wheat” and the product is not labeled gluten-free).
    • Ingredients you should check: yeast extract, natural flavors, rice syrup. If the product is labeled “gluten-free,” you do not need to check. If the product is not labeled “gluten-free,” it is possible these ingredients could contain small amounts of barley, though unlikely. Call the food manufacturer to inquire about the source of the ingredient. To consume wheat grass or barley grass products,make sure they are labeled gluten-free to ensure no cross-contact between the seed (gluten-containing part) and the grass (gluten-free part) of the plant.
    • Special rules for USDA foods:
      • USDA foods include produce (fruits and vegetables), meat, poultry, seafood, and eggs. The USDA is a separate agency from the FDA, so these foods are not required to be labeled for allergens.
      • While the majority of USDA foods follow the FDA gluten-free labeling rules, these are the ingredients to avoid when no allergen information is included on the label: food starch, dextrin, spices, seasonings, flavoring.
  • Step 3: Read the manufacturer’s warning if the product is not labeled “gluten-free.”
    • Avoid grain-based products (rice, corn, and other cereal grains) that are labeled “may contain” or “made on shared equipment” with wheat/gluten that are not labeled “gluten-free.”
      • A recent study found that grain-based products with naturally gluten-free ingredients that were not labeled “gluten-free” were more likely to contain gluten from cross-contact via manufacturing. Examples include cereals and baked goods.
      • Non-grain-based products that were naturally gluten-free but did not include a gluten-free label had no higher risk of cross-contact.
    • The absence of a “may contain wheat/gluten” or “made on shared equipment with wheat/gluten” warning does NOT mean the product is gluten-free. This warning is not required by the FDA. This is why it’s best to choose grain-based products that are labeled “gluten-free.”
• Prevent Cross-Contact
  • It is very important to avoid consuming even small amounts of gluten from cross-contact with gluten-containing foods during food preparation and cooking. One eighth of one teaspoon, or just 1/50^th of a slice of bread, contains enough gluten to cause intestinal damage in most people with celiac disease.
  • Learn more about preventing cross-contact both at home and when dining out.
• Make Other Lifestyle Changes
  • Check your medications and supplements
    • For medications, avoid these ingredients if no allergen information is given: food starch, dextrose, dextrin.
    • Call the manufacturer when in doubt. Check out http://glutenfreedrugs.com for a continually updated list of many common medications.
  • Know what alcohol is gluten-free
    • Distilled liquor is safe for consumption regardless of source because the distillation process removes all gluten from wheat, barley, or rye.
    • Wine is naturally gluten-free.
    • Avoid anything malted (hard lemonade, mixed drinks, beer). “Malted” means made with barley, and gluten will remain in the final product.
    • Avoid gluten-removed products – these are not considered safe for consumption by people with celiac disease.
  • Always be prepared
    • You will benefit from calling ahead to restaurants and parties, and keeping gluten-free snacks on hand at all times. You are more likely to accidentally or purposefully eat gluten when frustrated, rushed, or hungry. Preparation is an important part of maintaining a gluten-free lifestyle.
  • When in doubt, go without
    • If you are unsure if a food is gluten-free, it’s best to go without. Examples include if a food product doesn’t have an ingredient label, or you can’t ask questions about how a food was prepared.

Click here for more information about sources of gluten.

Click here for more information about foods that are safe to eat.