Eating, Diet, & Nutrition for Celiac Disease

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How will I need to change my diet if I have celiac disease?

If you have celiac disease, you will need to remove foods and drinks that contain gluten from your diet. Following a gluten-free diet can relieve celiac disease symptoms and heal damage to the small intestine. People with celiac disease need to follow a gluten-free diet for life to prevent symptoms and intestinal damage from coming back. Your doctor or a registered dietitian can guide you on what to eat and drink to maintain a balanced diet.

If you or your child has been diagnosed with celiac disease, you may find support groups helpful as you learn about and adjust to a gluten-free lifestyle. Your doctor or a registered dietitian may be able to recommend support groups and other reliable sources of information.

What foods and drinks contain gluten?

Gluten occurs naturally in certain grains, including

  • wheat and types of wheat, such as durum, emmer, semolina, and spelt
  • barley, which may be found in malt, malt extract, malt vinegar, and brewer’s yeast
  • rye
  • triticale, a cross between wheat and rye

Gluten is found in foods that contain ingredients made from these grains, including baked goods, baking mixes, breads, cereals, and pastas. Drinks such as beer, lagers, ale, flavored liquors, and malt beverages may also contain gluten.

Many food ingredients and additives—such as colorings, flavorings, starches, and thickeners—are made from grains that contain gluten. These ingredients are added to many processed foods, including foods that are boxed, canned, frozen, packaged, or prepared. Therefore, gluten may be found in a variety of foods, including candy, condiments, hot dogs and sausages, ice cream, salad dressing, and soups.

Cross-contact

Cross-contact occurs when foods or products that contain gluten come into contact with gluten-free foods. Cross-contact can spread gluten to gluten-free foods, making the gluten-free foods unsafe for people with celiac disease to consume. Cross-contact can occur at any time, including when foods are grown, processed, stored, prepared, or served.

How can I identify and avoid foods and drinks that contain gluten?

A registered dietitian can help you learn to identify and avoid foods and drinks that contain gluten when you shop, prepare foods at home, or eat out.

For example, when you shop and eat at home

  • carefully read food labels to check for grains that contain gluten—such as wheat, barley, and rye—and ingredients or additives made from those grains.
  • check for gluten-free food labeling.
  • don't eat foods if you aren’t sure whether they contain gluten. If possible, contact the company that makes the food or visit the company’s website for more information.
  • store and prepare your gluten-free foods separately from other family members’ foods that contain gluten to prevent cross-contact.

When you eat out at restaurants or social gatherings

  • before you go out to eat, search online for restaurants that offer a gluten-free menu.
  • review restaurant menus online or call ahead to make sure a restaurant can accommodate you safely.
  • at the restaurant, let the server know that you have celiac disease. Ask about food ingredients, how food is prepared, and whether a gluten-free menu is available. Ask to talk with the chef if you would like more details about the menu.
  • when attending social gatherings, let the host know you have celiac disease and find out if gluten-free foods will be available. If not, or if you are unsure, bring gluten-free foods that are safe for you to eat.

What should I eat if I have celiac disease?

If you have celiac disease, you will need to follow a gluten-free diet. Your doctor and a registered dietitian can help you plan a healthy, balanced diet to make sure that you get the nutrients you need.

Gluten-free foods

Many foods, such as meat, fish, fruits, vegetables, rice, and potatoes, without additives or some seasonings, are naturally gluten-free. Flour made from gluten-free foods, such as potatoes, rice, corn, soy, nuts, cassava, amaranth, quinoa, buckwheat, or beans are safe to eat.

You can also buy packaged gluten-free foods, such as gluten-free types of baked goods, bread, and pasta. These foods are available from many grocery stores, restaurants, and at specialty food companies. Packaged gluten-free foods tend to cost more than the same foods that have gluten, and restaurants may charge more for gluten-free types of foods.

Talk with your doctor or a registered dietitian about whether you should include oats in your diet and how much. Research suggests that most people with celiac disease can safely eat moderate amounts of oats. If you do eat oats, make sure they are gluten-free. Cross-contact between oats and grains that contain gluten is common and can make oats unsafe for people with celiac disease.

Gluten-free foods.Many foods are naturally gluten-free.

Gluten-free labeling

The U.S. Food and Drug Administration (FDA) requires that foods labeled “gluten-free” meet specific standards. One requirement is that foods with the terms “gluten-free,” “no gluten,” “free of gluten,” or “without gluten” on the label must contain less than 20 parts per million of gluten. This amount of gluten is too small to cause problems in most people with celiac disease.

The FDA rule does not apply to foods regulated by the U.S. Department of Agriculture, including meat, poultry, and some egg products. The rule also does not apply to most alcoholic beverages, which are regulated by the U.S. Department of the Treasury.

Should I start a gluten-free diet before I talk with my doctor?

No. If you think you might have celiac disease, you should talk with your doctor about testing to diagnose celiac disease before you begin a gluten-free diet. If you avoid gluten before you have testing, the test results may not be accurate.

Also, if you start avoiding gluten without advice from a doctor or a registered dietitian, your diet may not provide enough of the nutrients you need, such as fiber, iron, and calcium. Some packaged gluten-free foods may be higher in fat and sugar than the same foods that contain gluten. If you are diagnosed with celiac disease, your doctor and dietitian can help you plan a healthy gluten-free diet.

If you don’t have celiac disease or another health problem related to gluten, your doctor may not recommend a gluten-free diet. In recent years, more people without celiac disease have begun avoiding gluten, believing that a gluten-free diet is healthier or could help them lose weight. However, researchers have found no evidence that a gluten-free diet promotes better health or weight loss for the general population.8

Reference

[8] Gaesser GA, Angadi SS. Navigating the gluten-free boom. Journal of the American Academy of Physician Assistants. 2015;28(8):10. doi: 10.1097/01.JAA.0000469434.67572.a4

Last Reviewed October 2020
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.