Celiac disease - nutritional considerations

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Celiac sprue - foods to avoid

Gluten-free diet; Gluten sensitive enteropathy - diet; Celiac sprue - diet

Staples of the gluten-free diet include:

• Cereals made without wheat or barley malt
• Fruits and vegetables
• Meat, poultry, and fish (not breaded or made with regular gravies)
• Milk-based items
• Oats (may be okay for some people with celiac disease, but work closely with your doctor or nutritionist)
• Potatoes, rice, corn, beans

You can eat foods such as pasta, bread, pancakes, and pastries made with alternative grains (rice, buckwheat, tapioca, potato, or corn flours and starches).

You can buy these products through local and national food companies, or you can make them from scratch using alternative flours and grains.

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Other food items you may use for cooking include:

• Potatoes, rice flax, millet
• Legumes, nuts, seeds, cassava
• Tapioca sorghum

The gluten-free diet involves removing all foods, drinks, and medications made from gluten. This means not eating anything made with barley, rye, and wheat. All items made with all-purpose, white, or wheat flour are prohibited.

Obvious sources of gluten include:

• Breaded foods
• Breads, bagels, croissants, buns
• Cakes, donuts, and pies
• Cereals (most)
• Cold cuts, hot dogs, salami, or sausage
• Crackers and many snacks bought at the store, such as potato chips and tortilla chips
• Gravy
• Pancakes and waffles
• Pasta and pizza
• Soups (most)
• Stuffing

Less obvious foods that must be eliminated include:

• Beer
• Candies (some)
• Communion breads
• Croutons
• Marinades, sauces, soy and teriyaki sauces
• Salad dressings (some)
• Self-basting turkey

There is a risk of cross-contamination. Items that are naturally gluten-free may become contaminated if they are made on the same production line as, or moved together in the same place as foods containing gluten.

Eating at restaurants, work, school, and social gatherings can be challenging. Call ahead and plan. It is important to read labels before buying or eating, due to the widespread use of wheat and barley in foods.

Despite its challenges, maintaining a healthy, balanced diet is possible with education and planning.

Review Date: 01/20/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).