24 Foods to Eat (and What to Avoid) If You're Going Gluten-Free for Celiac Disease

A gluten-free diet is the primary treatment for celiac disease, a chronic immune disorder triggered by the consumption of gluten, a protein naturally present in wheat, barley, and rye. When people with celiac disease eat foods with gluten, the immune system attacks the small intestine, causing inflammation and damage that affects digestion, absorption, and nutrition.

The only way to stop the inflammation and damage to the intestinal lining is to stop consuming gluten. Getting a celiac diagnosis is a relief for many, but figuring out what you can and can’t eat on a gluten-free diet is distressing.

In this article, you will learn more about celiac disease, why you need to follow a gluten-free diet, and guidance on how to make safe and nutritious food choices. 

Understanding Celiac Disease and Gluten Sensitivity

It’s estimated that about 1% of the world’s population has celiac disease. You’re more likely to have the chronic digestive disorder if it runs in your family. 

Scientists have identified specific genetic variants that increase the risk of celiac disease. The variants are part of the human leukocyte (HLA) antigen complex that helps the immune system differentiate between the proteins made by the body and those that come from outside invaders. The genetic variants associated with celiac disease recognize a segment of protein found in gluten, also known as gliadin—as a foreign invader.

If you have celiac disease, consuming gluten triggers an inflammatory process that targets the lining of the small intestine, causing gastrointestinal symptoms like abdominal pain, gas, bloating, and diarrhea. It’s possible to have celiac disease and not have typical symptoms. Instead, you may have health issues like iron deficiency anemia, osteoporosis, or ataxia (clumsy movements due to poor muscle control). These conditions and symptoms are common signs of nutritional deficiencies. 

When you continue to consume gluten with celiac disease, the inflammatory process damages the intestinal lining, leading to malabsorption and malnutrition. A strict gluten-free diet is one way to prevent further damage and alleviate the symptoms it causes.

Though celiac disease and gluten sensitivity are sometimes used interchangeably, they aren’t the same. According to Megan Hilbert, MS, RDN, a registered dietitian specializing in gut health at Top Nutrition Coaching, gluten sensitivity or non-celiac gluten sensitivity (NCGS) “is not an autoimmune condition and is clinically recognized as less severe than celiac, but patients report similar relief as those diagnosed with celiac once they stop eating gluten. Nonceliac gluten sensitivity also cannot be diagnosed through a blood test or biopsy, whereas celiac disease can.”

Additionally, having an allergy to wheat doesn’t mean you have celiac disease. Though both involve immune-mediated reactions, a wheat allergy may cause other symptoms like hives or difficulty breathing.

Naturally Gluten-Free Foods

Learning the underlying cause of your digestive issues is a relief, but you may have a hard time wrapping your head around your new diet that eliminates all foods made with wheat, barley, and rye and no more bread, pasta, or pizza. But you can create healthy, balanced meals without gluten. “Most foods, thankfully, are naturally gluten-free in their whole food form,” says Hilbert. 

Like any meal plan, when following a gluten-free diet you need to include a variety of nutrient-rich foods to ensure proper nutrition. Creating meals that center around these naturally gluten-free foods is a good place to start on your gluten-free diet. 

Gluten-Free Grains and Alternatives

A gluten-free diet means avoiding all foods that contain wheat, barley, and rye. Wheat and wheat flour are staple grains in the American diet, but you have many gluten-free alternatives you can use in place of wheat. Gluten-free grains include:

• Amaranth
• Buckwheat groats
• Millet
• Quinoa
• Rice
• Sorghum
• Tapioca
• Teff

If you're a fan of oats, be sure to look for certified gluten-free oats. "Oats are naturally gluten-free, but are often processed in facilities with gluten-containing foods,” says Hilbert.

Use these gluten-free grains to make cereal, soup, and side dishes. They can also be ground into gluten-free flour to make pasta, bread, or baked goods. Corn, potatoes, soy, beans, and almonds aren’t grains but are used to make gluten-free flour. 

Gluten-free flours don’t have the same taste or balance of proteins and starch as wheat flour. For this reason, and may need to experiment with different flours to create gluten-free versions of your favorite foods like pasta, bread, and baked goods. Single-ingredient gluten-free flours are great for making pasta and pancakes, but you may want to use a mix of gluten-free flours when baking.

Gluten helps create bread that’s soft and airy and cookies that are moist and chewy. When baking, mixing gluten-free flour creates a better balance of proteins and starch so baked goods have a texture and flavor that more closely resembles those made with wheat flour. Look for a recipe or ready-made gluten-free all-purpose flour that allows a 1-to-1 substitute for wheat flour in recipes. 

Gluten-Free Food Labeling

Like any balanced meal plan, your gluten-free diet should center around foods that are naturally gluten-free, like fruits, vegetables, lean sources of protein, healthy fats, and gluten-free grains. But your gluten-free diet must also fit your lifestyle and budget. Use food labels to find ready-made items that are gluten-free.

“One of the best ways to do this is to read the ‘contains’ allergen statement on the bottom of the food label below the ingredients list. If wheat is listed in the ‘contains’ statement, that is not a product that is gluten-free,” says Hilbert.

If wheat isn’t listed in the ‘contains’ statement, take a look at the ingredients list to make sure the food is gluten-free. Avoid any food that lists barley (listed as malt, malt extract, or malt vinegar), rye (listed as rye or triticale), or oats (that aren't certified gluten-free).

Foods to Avoid

You must avoid any foods that contain wheat, barley, or rye on a gluten-free diet. In general, this means avoiding most baked goods, baking mixes, cereals, and pasta. Gluten is also found in beer, flavored liquors, and malt beverages.

Unless the food label says gluten-free, you need to do your own detective work to determine if a food is safe for you to eat. If you find any of the following in the ingredients list of a food item, avoid it:

• Durum
• Semolina
• Spelt
• Malt
• Malt extract
• Malt vinegar
• Distilled vinegar
• Brewer’s yeast
• Triticale
• Hydrolyzed vegetable protein
• Hydrolyzed plant protein
• Modified food starch
• Natural flavoring
• Caramel color
• Dextrin 
• Maltodextrin
• Yeast extract

You also want to avoid any foods with ambiguous ingredients like natural flavorings or seasonings. If you’re not sure if the food has gluten or not, don’t eat it or contact the manufacturer to find out if the item contains gluten.

Dining Out and Cross-Contamination

You can eat out on a gluten-free diet, but pre-dining research can help you find restaurants that cater to your needs. Search online for restaurants that have a gluten-free menu or take a look at the menu of a local restaurant to look for gluten-free options. If you can’t find any concrete answers online, call the restaurant and ask. 

You can also use apps like Find Me Gluten-Free to locate restaurants that offer gluten-free items, suggests Hilbert.

Once at the restaurant, tell the staff you have celiac disease or NCGS. “Letting them know that you can become very ill if you eat gluten can help them understand the necessity to make sure your food is gluten-free,” says Hilbert. Ask about their gluten-free options, the ingredients used, and how food is prepared. 

Hilbert recommends avoiding complex dishes with coatings, sauce, or fried items and inquiring about spice mixes, thickeners, and marinades and if they contain flour, soy sauce, or teriyaki.  

Managing a Gluten-Free Lifestyle

Going gluten-free for celiac disease requires effort and attention. You may struggle in the beginning, but once you understand what you can and can’t eat, you can easily manage your gluten-free lifestyle.

Your healthcare provider can help you get started on your gluten-free diet, but you should consult with a registered dietitian for individualized guidance. A registered dietitian can also help you create a meal plan that suits your tastes, budget, and eating habits.

Planning ahead is essential when you need to follow a gluten-free diet. Creating a weekly meal plan is a good place to start. Knowing what you’re going to eat ahead of time helps you avoid grab-and-go foods that may not fit your gluten-free lifestyle.

Use your menu to create a grocery list and do some meal prepping to get a jumpstart on the week, such as washing and cutting vegetables, cooking grains, and marinating meats. You can also batch-cook and freeze meals so they’re ready to go. 

Eating a gluten-free diet can affect your emotional and social well-being. You may avoid social events or going out to restaurants because of your special diet needs, but once you've figured out what you can (and cannot) eat, you can find strategies to safely eat in public settings.

Learning the gluten-free lifestyle takes time and you’re going to have ups and downs. Find a local or an online gluten-free support group to connect with people you can relate to and learn from.