Answers to the Most Common Questions About the Gluten-Free Diet

By Donna Barnett, MA, RDN, CDN

Over the past decade or so gluten-free diets have become increasingly popular, both for medical necessity and by personal preference. Some reports suggest that more than 3 million people in the U.S. follow a gluten-free diet, however the prevalence of celiac disease in the general population is much lower, about 1 in every 133 people. This blog post explores some of the main questions that people have about gluten, celiac disease, and gluten-free diets.

What is gluten?

It is a group of proteins found in wheat, barley, rye, and hybrid grains. Gluten is very elastic: picture pizza dough⁠—the gluten is what makes it so stretchy. It’s a really useful ingredient in breads, pastas, cereals, and other processed grain products.

Who needs a gluten-free diet?

Children and adults who have been diagnosed with celiac disease by a gastroenterologist should follow a 100% gluten-free diet. The diet is currently the only treatment for this disease. The usual American diet may include a tablespoon or more of gluten each day, but someone with celiac disease can react to as little as 1/8th of a teaspoon.

Is it beneficial for people who do not have celiac disease to follow a gluten-free diet?

Many people feel that eating a gluten-free diet is healthier, but that is not necessarily the case. Gluten-free snack foods and baked items are often high in sugar and or fat to make up for the lack of gluten. Many also have additives and preservatives to maintain structure of the food. Additionally, gluten-free cereal grains are not required to be fortified with vitamins and minerals in the same way that gluten containing grains are. For many children with a limited diet, fortified gluten-containing cereals, breads and flours provide a large amount of their recommended daily allowance for iron, folic acid, and other B vitamins. Removing this food source could put them at risk for inadequate intake.

There are a number of recent research studies that link non-celiac gluten sensitivity with functional abdominal symptoms that can actually be triggered by things other than gluten. This body of research suggests that certain carbohydrates naturally present in gluten containing grains (wheat, barley, rye and hybrid grains) may cause symptoms as opposed to the gluten itself. If you are considering a gluten-free diet for your child or yourself, you may first want to discuss with your doctor or dietitian whether an alternative diet recommendation would be more appropriate in the absence of celiac disease.

What should you eat on a gluten-free diet?

  • 3-5 servings per day of a variety of certified gluten-free grains.
  • 5-7 servings of fresh produce per day
  • 3-4 servings of dairy products per day
  • 2 servings of lean protein per day
  • Ask your provider or registered dietitian if a gluten-free multivitamin is needed.

What are some tips for success on a gluten-free diet?

  • Evaluate the ingredients of all items that can be eaten or might come in contact with your mouth.
  • Learn to identify hidden sources of gluten. Gluten can hide in instant coffee, spice mixes, sauces, chips, gum, candy, soda, sports drinks, medications, cosmetics, toothpaste, lotion, and craft supplies.
  • Be aware that processed products may contain gluten as fillers, stabilizers, and flavoring agents. Review the ingredients carefully, and look for a gluten-free label if choosing a processed product.
  • Avoid cross contamination by cleaning hands and surfaces well and often.
  • Prepare for social events ahead of time by bringing a gluten-free treat to a birthday party, or calling a restaurant to find out what accommodations can be made.
  • Precook and freeze quick gluten-free meals for busy days.
  • Have gluten-free snacks on hand for school, after school activities, and during travel.

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