My intention in writing this post is to give an introduction to the world of eating gluten free. Really to get you started as efficiently as possible. If you desire a deeper dive, please check out the hyperlinks and additional resources (or schedule a consult to learn more!).

What is gluten?

Gluten is a protein that triggers immune reactions in people with celiac disease (CD), people with non-celiac gluten sensitivity (NCGS), and people with irritable bowel syndrome (IBS).

The protein gluten is actually made of two smaller proteins—gliadin and glutenin. Those two proteins, when hydrated (mixed with water), create a stretchy substance that holds and binds foods (e.g., bread) together. Gluten is the reason you can roll pizza dough so thin you can literally see through it (called a “gluten window”).

Side note: this is why many gluten-free breads are so crumbly!

What grains contain gluten?

Gluten is naturally present in the grains wheat, rye, barley, and triticale (a cross between wheat and rye). Gluten is also naturally present in the “ancient grains” spelt, farro, and kamut.

What are grains?

Grains are seeds. If you plant a wheat berry in the ground, it will grow into wheat grass. Then, that wheat grass will eventually mature into stalks of wheat. And each wheat stalk will produce many more seeds.

Grains are starchy seeds. While sunflower seeds and pumpkin seeds contain more fat (and protein) than carbs, grains are mostly carbohydrate.

Let’s look at the USDA’s MyPlate for further understanding.

While nuts and seeds are housed in the Protein Foods group, Grains are so special they get their own category!

What foods contain gluten?

While some people eat whole (unprocessed) wheat berries, most of us consume gluten as foods made from wheat flour (a processed food ingredient).

The process (pun intended) is straightforward. 

The farmer takes a handful of wheat berries. And mills (grinds) those starchy seeds into a fine dust called flour. Then, you use that flour (whole wheat or all purpose) to bake bread, muffins, cookies, cakes, crackers, etc.

But it’s not all sweet and starchy.

You can use flour (combined with butter, forming a roux) to make gravy, thicken soups, and bind meatballs.

Where is gluten “hiding” in processed foods?

The food industry uses all parts of wheat, including wheat derivatives. Check out this list of wheat derivatives by Sacchetto. The food industry uses ingredients that you (likely) never use in your home kitchen.

Here are some common ingredients derived from wheat (thus, contain gluten).

• Malt (from barley) – used in corn flakes and crisp rice cereal
• Malt vinegar (from barley) – used in salad dressing, marinades, barbecue sauces
• Modified food starch – found in deli meats, salad dressings
• Vital wheat gluten – found in meat substitutes
• Hydrolyzed wheat protein – added to broth and stock

One of my biggest surprises when going gluten free was learning most soy sauce contains gluten! (Tip: look for tamari, a gluten-free soy sauce)

For a full list of hidden sources of gluten, check out this post by the Gluten Intolerance Group: 38 Foods Where Gluten May Be “Hidden.”

How to tell if a packaged food is gluten-free

There are three ways to tell if a package of food is gluten-free.

It has a Gluten-Free label

If the packaging claims a food is gluten-free, then it is most likely safe to eat. The Food and Drug Administration (FDA) only allows companies to label foods “gluten-free” if they contain less than 20 parts per million (ppm) of gluten. However, I encouage you to still check the ingredients list, just to be safe (I know several restaurants who accidentally put a “gluten-free” icon next to a farro salad).

Wheat is missing from the Allergen Listing

Some packaging includes list of common allergens present in the product. These common allergens include wheat, milk, egg, nuts, and soy. If the packaging says “contains wheat,” it is not gluten-free. However, please note that a lack of allergen labeling does not mean that the product is gluten-free (as companies are not required to list barley and rye, but both contain gluten). Remember to check the ingredients list for other hidden sources of gluten.

Ingredients List has no wheat (or derivatives)

The following ingredients contain gluten.

• Wheat
• Barley
• Rye
• Triticale (a cross between wheat and rye)
• Spelt (ancient wheat)
• Farro (ancient wheat)
• Kamut (ancient wheat)
• Bulgar (cracked wheat)
• Semolina (coarsely milled durum wheat, used mainly for making pasta)
• Couscous (a type of pasta)
• Orzo (a type of pasta)
• Farina (wheat breakfast porridge; cream of wheat)
• Graham flour (coarse-ground whole wheat flour)
• Matzo meal (ground up matzo; unleavened wheat bread)
• Malt
• Brewer’s yeast
• Oats (unless specifically labeled gluten-free, see below for details)

If you’ve never read food labels, you soon will (it’s the only way to check if a packaged food contains gluten). Don’t worry about doing it perfectly the first time. The more you read labels, the better you will get!

To learn how to understand and use the Nutrition Facts Label, check out this FDA website (they’re in charge of label laws).

Be aware of cross-contamination

Sometimes foods that are naturally gluten-free get contaminated with gluten during processing or preparation. There are three levels of contamination.

1. “May contain wheat” – is the most likely to be contaminated
2. “Made on the same equipment as wheat” – is likely to be contaminated
3. “Made in a facility that also processes wheat” – is not ideal, but less risky than the above

Look at it this way, if your household is not 100% gluten-free (i.e., if you live with gluten eaters) then your kitchen is a “shared facility.”

Oats (contaminated by processing)

Take oats, for example.

While oats do not contain gluten, they are typically processed on machinery that also processes wheat. 

Picture it. 

As the oats are shuttled down a conveyer belt previously used to transport wheat, the oats get coated with tiny bits of gluten. (Tip: look for certified gluten-free oats).

Other common sources of cross-contamination happen at home.

The toaster (contaminated by mixed-use)

If you’ve ever used your toaster for wheat bread, that toaster is now contaminated. Each time you put a slice of gluten-free bread in that toaster, that slide of gluten-free bread gets coated with minuscule (but powerfully immunogenic) flecks of gluten from toast of the past.

Condiments (contaminated by “double dipping”)

I watch this happening all the time. My husband puts his knife in the mayonnaise, spreads the mayo on his bread, then double-dips to get a second helping of mayo for the second slide, contaminating the whole jar in the process.

Beware of gluten in body care products

Yes, gluten can also be hiding in your shampoo and body lotion. Check the ingredients list for things like “hydrolyzed wheat peptides.”

C.O. Bigelow uses hydrolyzed wheat protein to make their Lavender Peppermint Shampoo. If you use this shampoo, you get exposed to gluten through your skin!

How careful do I have to be?

As careful as you can.

Even small amounts of gluten can trigger an immune reaction.

Just like you can’t “kinda sorta” be pregnant, you can’t “kinda sorta” be gluten-free. You either are or are not.

Learn more about how important it is to be 100% gluten-free by listening to the Root Cause Medicine Podcast #60: How Gluten Impacts Your Autoimmune Disease with Dr. Tom O’Bryan.

How long do I have to be gluten-free?

It depends.

Some people can “get over” gluten.

Others can never eat it again.

The stricter you are, the more likely your immune system will extinguish/forget to react.

Every time your immune system sees gluten, it increases antibody levels (I always picture Mario Brothers “re-upping” and earning an extra life).

But you don’t have to take my word for it. Check out this episode of the Doctor’s Farmacy where Dr. Mark Hyman discusses Is Gluten-Free A Fad Or Is Gluten A Real Threat To Our Health? with dietitian Maggie Ward.

What can I eat?

Finally, the most important part of this whole post. Here’s what you CAN eat.

For optimal health, we should all eat a variety of whole foods (30 plants per week!) in as close to their original form as possible. To reduce toxic burden, choose organic as much as possible. To reduce inflammation, it’s also important to minimize packaged and processed foods.

Below is a list of healthy, whole foods that should make up the base of your gluten free diet (and a few extras to help flavor and sweeten your meals).

If you have any questions — any questions at all — please reach out to your registered dietitian for guidance.

Resources

Organizations who specialize in Gluten-Free

• FDA gluten-free labeling guidelines
• Beyond Celiac
• Gluten Intolerance Group
• Celiac.org
• Gluten Free Living
• Gluten Free Watchdog

Gluten-Free Recipes

• National Celiac Association’s gluten-free recipe search tool
• Beyond Celiac’s (searchable) gluten-free recipes
• Academy of Culinary Nutrition’s Top 50 Gluten-Free Blogs

Podcasts

• Root Cause Medicine Podcast #60: How Gluten Impacts Your Autoimmune Disease with Dr. Tom O’Bryan
• Doctor’s Farmacy Podcast #32: Is Gluten-Free A Fad Or Is Gluten A Real Threat To Our Health? with dietitian Maggie Ward

Journal Articles

• Fasano A. All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. F1000Res. 2020;9:F1000 Faculty Rev-69. Published 2020 Jan 31. doi:10.12688/f1000research.20510.1

Other Articles

• Gluten Intolerance Group: 38 Foods Where Gluten May Be “Hidden”
• Food and Drug Administration (FDA): How to Understand and Use the Nutrition Facts Label