Research indicates that 18 million Americans — more than 1 in 20 — suffer from gluten sensitivity. Are you one of them? If you are experiencing chronic physical or mental health symptoms, it may be time to try a gluten-free diet. I have followed a gluten-free diet on and off for the last decade. Both of my sisters are gluten intolerant and follow gluten-free diets as well. Our all-too-rare family gatherings are both wonderful and challenging as we try to find gluten-free meals that the rest of the family will enjoy, all while accommodating multiple other food allergies and intolerances. Slowly we have found our way, and I’d like to share some of what I’ve learned with you.
Why Go Gluten Free
Some individuals choose to go gluten-free for a short period of time to detox or lose weight. Others commit to a gluten-free diet to heal the gut and relieve inflammatory symptoms. Ingestion of gluten, for those who are gluten-sensitive, may lead to symptoms such as:
- Fatigue, weakness
- Brain fog, trouble concentrating
- Weight gain or loss
- Digestive problems, including diarrhea, constipation, gas, or bloating
- Nausea, abdominal pain and cramping
- Headaches, migraines
- Depression or anxiety
- Joint pain
- Rashes, eczema, acne
- Autoimmune symptoms
The gluten-free diet has gotten a bad rap lately, as so many have jumped on the bandwagon while others remain skeptical and claim it’s just a fad. My view is that if something works for you, who cares what anyone else thinks! I have seen friends and family members vastly improve their health via following a gluten-free diet. I have seen others who soon abandoned it because it didn’t work or it was too hard to stick to. If you are experiencing some of the symptoms above, it’s worth a try. With so many medicines and treatments listing extensive side effects, this is one change you can make without any risk of harm. As long as you continue to eat adequate amounts of food and a balanced diet, there really is no danger in cutting out gluten, and it just may improve your health.
A Word About Celiac
This gluten-free guide is intended for gluten-sensitive individuals, not necessarily those with celiac. Celiac disease may require even stricter gluten avoidance, plus professional follow-up. If you suspect you may have celiac disease, consider getting an endoscopic biopsy before beginning a gluten-free diet. Once you are eating gluten-free, your intestines begin to heal, which means a biopsy at this point could come up negative even if you do have celiac disease. It is important to accurately diagnose celiac, as someone with celiac requires a strict, lifelong gluten-free diet, and those who remain undiagnosed may not take the gluten-free diet seriously, leading to serious health consequences.
How to Get Started on a Gluten Free Diet
If this is your first time eliminating gluten, I’d suggest being extremely strict for the first couple of weeks. Cook all your food at home, if possible, and wash counters, cooking utensils, cutting boards, and pots and pans thoroughly to avoid cross-contamination. The goal is to keep all sources of gluten from entering your body. The reason I recommend this is so that you can clear your body of traces of gluten and see what effect this has on your health. It can take a while for inflammation and antibody production to subside. Some individuals are so sensitive to gluten that they will continue feeling symptoms after exposure to crumbs on a cutting board or flour dust on the counter.
When you first cut out gluten, you’ll probably go through withdrawal or detox type symptoms for the first few days. I usually feel extremely tired, mentally foggy, and generally unwell for the first week or so. You may also experience diarrhea or constipation. Cravings can be quite intense initially. Consider starting your gluten-free diet before a long weekend to give yourself time to adjust before heading back to work. Do your best to stick it out, and you should begin to feel well by the second week. Take a high-quality probiotic to support your body during the transition to gluten free. This can help alleviate any withdrawal effects and help your digestive tract begin to heal from the gluten damage.
It can take 3-6 months to completely clear your system of gluten and allow your body to start to heal. Continue strictly avoiding all gluten until you feel well. If you are still not feeling even a little better after 6 months, it’s likely that gluten is not the culprit and you can resume your normal diet if desired. Most gluten-sensitive individuals will feel positive effects from a gluten-free diet within the first month, so if you can’t commit to 6 months, at least aim for one month strictly gluten-free.
Once you have been feeling consistently well, you can stick to the strict gluten-free diet, or you can experiment a little if you’d like. The amount of gluten it takes to cause a reaction varies between individuals. Some people can cheat once in a while (enjoy a slice of cake at a party, for example) and have no long-term ill effects. Others will need to adhere carefully to the gluten-free diet to avoid a 6-month cascade of inflammatory symptoms. You might find that the trace amount of gluten in your favorite condiment is not a problem, but a piece of pizza causes a significant reaction. You might even find that you tolerate organic wheat but not conventional, or whole wheat better than white. If you reintroduce foods slowly and individually, and only when you are feeling well, you should be able to track any reactions or symptoms you experience. If you suspect a delayed reaction, keep a food and symptom diary whenever you stray from the gluten free diet for any length of time.
Foods to Avoid When Going Gluten Free
If you’re thinking of giving up gluten, it’s pretty obvious that you’ll need to cut out bread and pasta. But there are tons of foods with hidden gluten that you’ll also need to avoid. Foods that often or always contain gluten include:
- Bread, including whole or sliced loaves, bagels, rolls, flour tortillas, crackers
- Baked goods, including cookies, cakes, pastries, muffins, quick breads
- Pasta, including spaghetti, macaroni, couscous, farro
- Meatballs, stuffing, stuffed mushrooms, and other foods made with breadcrumbs
- Hot or cold breakfast cereals
- Condiments such as soy sauce, teriyaki sauce, salad dressing, malt vinegar, and seasonings
- Soups (often thickened with flour)
- Deli meat, sausages, hot dogs
- Vegetarian meat substitutes, including veggie burgers, seitan, tempeh, bacon bits, imitation seafood
This is not an exhaustive list. If a food is not labeled “gluten free,” read ingredient labels carefully and avoid anything containing enriched flour, wheat, barley, bulgur, rye, triticale, kamut, spelt, semolina, brewer’s yeast, or malt. Some additional ingredients may be derived from wheat, such as modified food starch, dextrin, caramel color, hydrolyzed proteins, maltodextrin, and vinegar, but these will usually be labeled as such. The safest (and healthiest!) choice is to stick with whole foods, as it’s easy to miss something in a long list of ingredients.
Oats themselves do not contain gluten but are often grown, harvested, or processed alongside wheat, so cross-contamination is a concern. Additionally, some gluten-sensitive people react to the proteins in oats as well, as they are similar to gluten. It is best to avoid oats at first, and then later try adding in small amounts of oats that are labeled “gluten-free” and watch for any reaction.
So What Can I Eat on a Gluten Free Diet?
Lots of things! Numerous foods are naturally gluten-free, and many others have been created to accommodate a growing population of gluten-free consumers. Preparing food yourself from scratch gives you the most control over ingredients, but store-bought foods labeled “gluten free” are safe. Your gluten-free choices include:
- Meat, Fish
- Beans, Tofu
- Nuts, Seeds
- Anything Labeled Gluten Free (frozen dinners, baked goods, cereals, and crackers)
When searching for recipes, you do not have to limit yourself to the term “gluten free recipes.” Paleo recipes are extremely popular right now and the Paleo diet is completely gluten free. Also look for international recipes, as many Mexican, Brazilian, Asian, and Indian dishes are gluten free.
Alternatives to Your Favorite Gluten Foods
Alternatives to Pasta: You can substitute rice or quinoa for pasta in most recipes. If you’re craving actual noodles, try gluten-free pasta, usually made of rice, corn, and/or quinoa flour. A gluten-free pasta containing quinoa usually has a texture most similar to regular (wheat) pasta, while rice pasta tends to be a bit gummy for my liking. A healthier alternative to gluten-free pasta is zucchini noodles. Simply use a vegetable peeler or spiralizer to create long, thin strands of zucchini. This same technique works with sweet potatoes, beets, and other root vegetables. Spaghetti squash can replace pasta as well. Scrape the strands out of a cooked spaghetti squash and top with your favorite sauce, pesto, or chopped herbs.
Alternatives to Bread: I have tried numerous gluten-free breads and to be honest, I don’t like any of them. I find them to be dense and unappealing. Instead, I prefer to substitute foods that are naturally gluten-free. Corn tortillas often fill in nicely. Large leaves of lettuce or halved bell peppers can hold sandwich fillings. Two cucumber slices with meat, cheese, or hummus between them make fun mini sandwiches. Gluten-free quick breads and muffins tend to be more palatable than gluten-free yeast breads, and good recipes abound on the Internet.
Other Gluten Free Grains and Starches: Many grains are gluten-free. Corn and rice are popular options. When buying corn flour, cornmeal, or products made from corn, always opt for organic, since non-organic corn is likely to be genetically modified. Rice, particularly brown rice, is a healthy staple, but try to avoid relying solely on this grain, as it can often contain high levels of arsenic, cadmium, mercury, tungsten, and other heavy metals, even if it’s labeled organic. While the amounts of heavy metals are not high enough to recommend avoiding rice altogether, eating it daily could become problematic. Switch it up and try other gluten-free grains such as amaranth, teff, millet, quinoa, buckwheat, arrowroot, cassava, sorghum, or tapioca. Starchy or high-carbohydrate foods such as potatoes, sweet potatoes, and beans are also gluten-free.
Gluten Free Dining
Dining out has become much easier for those on gluten-free diets as awareness of this dietary choice has spread. Many restaurants have gluten-free menus or can advise you as to which menu options are safe. Always ask your waiter for ingredients and cooking methods of any menu choices not labeled gluten free. There are few, if any, restaurant foods that are always gluten-free everywhere, as often menu items are coated with flour, fried alongside gluten foods, topped with breadcrumbs, or covered in sauces containing gluten. Cross-contamination with cooking utensils and pans can even be a concern for very sensitive individuals. That being said, some options tend to be safer than others, and these include steamed vegetables, salads (no croutons and only oil and vinegar for dressing), grilled meat or fish (without sauce), and plain white or brown rice.
Stay tuned for more posts about going gluten-free, tips and advice, and gluten-free recipes!
By Ali Wetherbee