Gluten-Free and Celiac Disease Essential Nutrition Guide

In the United States, an estimated 3 million people are affected by celiac disease. This condition occurs when the body reacts to a common dietary protein—gluten—primarily impacting the gastrointestinal system.

The encouraging news is that celiac disease can be effectively managed through nutrition. The cornerstone of treatment is eliminating gluten-containing foods and beverages. However, this can be challenging because gluten is found in many popular products and often hides in ingredient lists and labels.

This article provides essential information to help you understand celiac disease, recognize its signs, and manage it successfully through dietary choices. You’ll discover which foods commonly contain hidden gluten, which ingredients to avoid, and explore a wide variety of naturally gluten-free options that support a healthy, balanced lifestyle.

Bread and salad.

What is Celiac Disease?

Celiac disease is an autoimmune condition that affects the digestive system, making it impossible for the body to tolerate gluten—a protein found in wheat, rye, barley, and triticale. It’s also known by other names, including celiac sprue, gluten intolerance, and gluten-sensitive enteropathy.

This condition often runs in families and can be inherited. It is more commonly seen in individuals with Northern European ancestry. People with celiac disease also have a higher risk of developing other autoimmune disorders, such as thyroid disease, type 1 diabetes, certain rheumatic conditions, and liver diseases.

The reaction occurs when the immune system—specifically in the small intestine—responds to gluten after it’s consumed. This immune response triggers inflammation that damages the intestinal lining, reducing its ability to absorb nutrients. Over time, this malabsorption can lead to malnutrition, even when a person eats a nutrient-rich diet.

Long-term consequences of malnutrition may include anemia, slowed growth, osteoporosis, infertility or miscarriages, nerve damage, seizures, and even intestinal cancers. Both the intestinal inflammation and nutrient deficiencies contribute to a wide range of symptoms that can significantly impact daily life.

How Do I Know If I Have Celiac Disease?

Celiac disease can present with a wide range of symptoms, many of which affect the digestive system. Common signs include abdominal pain, bloating, gas, nausea, vomiting, diarrhea, constipation, canker sores, and even tooth discoloration. Beyond the gut, symptoms may extend to headaches, seizures, itchy or scaly skin, bone or joint pain, menstrual changes, miscarriages, infertility, fatigue, and unintended weight loss. Mental health can also be impacted, with some individuals experiencing irritability, mood changes, or depression.

It’s important to note that celiac disease is different from gluten sensitivity or wheat intolerance—those conditions do not cause damage to the small intestine.

Because celiac disease shares symptoms with other gastrointestinal disorders, diagnosis cannot rely on symptoms alone. Testing typically involves blood work and, in some cases, a biopsy of the small intestine. These tests are most accurate when performed before starting a gluten-free diet, so consult your healthcare provider promptly if you suspect celiac disease.

The good news? Symptoms can be managed—and even prevented—by eliminating gluten. According to the American Gastroenterological Association, “A strict gluten-free diet is the only treatment available for celiac disease” (8). Once gluten is removed from your diet, many symptoms improve within weeks, and intestinal healing often occurs within a few months.

What Can I Eat If I Have Celiac Disease?

Managing celiac disease means committing to a lifelong gluten-free diet. Even small amounts of gluten can trigger symptoms and cause intestinal damage, so avoiding gluten in foods—and even in certain non-food products—is essential.

The challenge? Gluten is found in many everyday foods. It’s naturally present in wheat, rye, barley, and triticale, which are used to make staples like breads, baked goods, cereals, and pasta. Gluten is the protein that gives these foods their structure and texture. For those with celiac disease, the safest choice is to select products clearly labeled “gluten-free” or “without gluten.”

According to the U.S. Food and Drug Administration (FDA), foods labeled “gluten-free” must meet strict standards, containing no more than 20 parts per million of gluten—an amount considered safe for most people with celiac disease.

Beyond obvious sources like bread and pasta, gluten can hide in unexpected places, including:

• Dairy products with fillers

• Prepared soups, sauces, dressings, and gravies

• Processed or cured meats

• Creamed vegetables

• Flavored coffee

• Seasonings on fries or chips

• Soy sauce

• Cereals, granolas, and snack bars made with regular oats or malt extract

• Beer, malt beverages, and some flavored liquors

  
  

Gluten can even appear in non-food items such as lip balm, lipstick, toothpaste, dietary supplements, and certain medications.

Bottom line: Always read labels carefully and when in doubt, verify with the manufacturer.

Pro Tips for Living Gluten-Free with Celiac Disease

Avoiding gluten goes beyond skipping wheat, rye, barley, and triticale. Here are practical tips to help you stay safe and enjoy a healthy, varied diet.

Watch Out for Cross-Contamination

Even trace amounts of gluten can trigger symptoms, so be mindful of cross-contact. Gluten can transfer through shared utensils, cutting boards, containers, and even toasters used for regular bread. When dining out, choose restaurants with gluten-free menus and let your server know you have celiac disease. The same caution applies at social gatherings or when eating at someone’s home.

Ingredients to Avoid

Gluten often hides in packaged and prepared foods. Check labels carefully for these common culprits:

• Flours such as durum, emmer, kamut, semolina, and spelt

• Food starches and thickeners

• Hydrolyzed vegetable protein

• Malt flavoring, extract, or vinegar

• Brewer’s yeast

• Certain preservatives and stabilizers

  
  

If you’re unsure, contact the manufacturer for clarification.

Naturally Gluten-Free Foods to Enjoy

The good news? There’s a wide variety of safe, nutritious options:

• Fresh, frozen, or canned fruits and vegetables (without sauces)

• Fresh fish, poultry, and meat

• Eggs

• Plain dairy products

• Nuts and seeds

• Rice and rice flour

• Gluten-free grains like amaranth, buckwheat, quinoa, and teff*

• Flours made from cassava, coconut, corn, potatoes, or tapioca

• Oats labeled “gluten-free”**

• Soybeans and edamame (but avoid soy sauce)

  
  

*Choose fortified gluten-free grains for added vitamins and minerals.

**Oats can be cross-contaminated during processing, so always look for a gluten-free label.

Shopping Tips

Many grocery stores have dedicated gluten-free sections. Check the freezer aisle for gluten-free baked goods made with alternative flours. Avoid bulk bins, as these can increase the risk of cross-contamination.

A Word From Victoria

The good news is celiac disease can be effectively managed by eliminating gluten from your diet. While gluten is common in many pre-made, processed, and packaged foods, the availability of gluten-free alternatives continues to grow. Even better, understanding which foods are naturally gluten-free gives you the confidence to make informed choices, reduce the risk of symptoms, and enjoy a healthy, balanced lifestyle.

Ready to start working with a professional who’s invested in seeing you thrive, despite celiac disease? Book an appointment with me today!

References

(1) U.S. Food and Drug Administration (2022, March 7). Gluten-Free Labeling of Foods. https://www.fda.gov/food/food-labeling-nutrition/gluten-free-labeling-foods

(2) U.S. Food and Drug Administration. (2018, July 16). Gluten and Food Labeling. https://www.fda.gov/food/nutrition-education-resources-materials/gluten-and-food-labeling

(3) Harvard Health Publishing. (2023, April 7). Celiac disease (non-tropical sprue). https://www.health.harvard.edu/a_to_z/celiac-disease-non-tropical-sprue-a-to-z

(4) National Institute of Diabetes and Digestive and Kidney Diseases. (2020, October). Definition & Facts for Celiac Disease. U.S. Department of Health and Human Services, National Institutes of Health. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/definition-facts

(5) National Institute of Diabetes and Digestive and Kidney Diseases. (2020, October). Treatment for Celiac Disease. U.S. Department of Health and Human Services, National Institutes of Health. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/treatment

(6) National Institute of Diabetes and Digestive and Kidney Diseases. (2020, October). Symptoms & Causes of Celiac Disease. U.S. Department of Health and Human Services, National Institutes of Health. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/symptoms-causes

(7) National Institute of Diabetes and Digestive and Kidney Diseases. (2020, October). Diagnosis of Celiac Disease. U.S. Department of Health and Human Services, National Institutes of Health. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/diagnosis

(8) Adelsberg, R. (2021, March). Gluten-free diet: nutritional value. American Gastroenterological Association, AGA GI Patient Center.  https://patient.gastro.org/gluten-free-nutritious-diet/

(9) Celiac Disease Foundation. (n.d.). Sources of gluten. https://celiac.org/gluten-free-living/what-is-gluten/sources-of-gluten/

(10) National Institute of Diabetes and Digestive and Kidney Diseases. (2020, October). Eating, Diet, & Nutrition for Celiac Disease. U.S. Department of Health and Human Services, National Institutes of Health. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/eating-diet-nutrition

(11) Celiac Disease Foundation. (n.d.). Gluten-Free Foods. https://celiac.org/gluten-free-living/gluten-free-foods/