Celiac disease is an autoimmune condition that affects the small intestine.
The condition is triggered by the ingestion of gluten, a family of proteins in wheat, rye, barley, spelt, and kamut.
Fortunately, you can treat celiac disease by avoiding gluten in your diet.
This article explains what to eat and avoid with celiac disease and provides a sample gluten-free celiac disease diet.
What is celiac disease?
Celiac disease is caused by an immune response to gluten, which causes inflammation and damage to the small intestine.
Gluten is what helps bread rise and gives bread, pasta, pizza crust, and other wheat products their shape and appealing texture.
Celiac disease a genetic disorder that affects about 0.5–1% of the population (1).
The inflammation in response to gluten damages the absorptive surface area of the small intestine.
Consequently, this destruction decreases the absorption of many vitamins and minerals, which can lead to nutrient deficiencies, unintended weight loss, lactose intolerance, and congenital sucrase-isomaltase deficiency (CSID).
Other symptoms of celiac disease include (1):
- muscle weakness
Other people with celiac disease may not show any of these symptoms but may develop iron deficiency anemia or osteoporosis from the malabsorption of vitamins and minerals (2).
Unlike celiac disease, gluten sensitivity and gluten intolerance do not cause damage to the lining of the small intestine.
However, gluten sensitivity or intolerance can cause many of the same symptoms as celiac disease in response to gluten exposure.
For people without celiac disease, gluten sensitivity, or gluten intolerance, there is no health benefit to following a gluten-free diet, including for people with rheumatoid or psoriatic arthritis (2, 3).
Celiac disease diet
Currently, the only treatment for celiac disease is a gluten-free diet.
Foods with gluten to avoid
Gluten is found in wheat, rye, barley, spelt, and kamut.
These gluten-containing grains are commonly used to make products like bread, pasta, crackers, snack foods, cakes, and other baked goods.
Be sure to read the ingredient list of foods as it’s not always so obvious which foods are gluten-free.
Here are some foods that may contain gluten:
- Fruits and vegetables: those canned or frozen with sauces
- Processed meats: salami, bacon, hot dogs, and lunch meats
- Dairy products: flavored milk and yogurt, ice cream, and cheese sauces and spreads
- Beverages: flavored coffee and certain beers
- Condiments: barbecue sauce, ketchup, mayonnaise, mustard, and salad dressings
Check the label of these products and others that are unsure of to make sure the ingredient label doesn’t contain wheat, rye, barley, malt, spelt, or kamut.
While it’s voluntary for food manufacturers to state whether their product contains gluten, the Food and Drug Administration (FDA) requires that the labels of most packaged food in the United States disclose when they contain wheat (4).
Gluten-free foods to eat
Some products label their products as “gluten-free, “no gluten,” free of gluten”, and “without gluten.”
These products must contain less than 20 parts per million (ppm) of gluten, which is the lowest level that can be reliably detected (5).
However, just because a food product doesn’t carry a gluten-free claim, that doesn’t mean it contains gluten.
Foods that are naturally gluten-free include:
- Fruits: apples, bananas, berries, melons, peaches, pears, etc.
- Vegetables: asparagus, broccoli, cauliflower, kale, mushrooms, onions, etc.
- Starchy vegetables: corn, potatoes, and squash
- Whole grains: quinoa, brown rice, wild rice, millet, amaranth, teff, arrowroot, and popcorn.
- Meats: fresh beef, pork, lamb, and bison
- Poultry: fresh chicken, turkey, and chicken eggs
- Seafood: fresh fish, scallops, and shellfish
- Dairy: butter, cheese, cottage cheese, milk, and yogurt
- Legumes, nuts, and seeds: almonds, beans, lentils, peas, sunflower seeds, etc.
- Oils and fats: avocado oil, canola oil, coconut oil, olive oil, and nut butter like peanut butter
- Beverages: black coffee, fruit juice, lemonade, sports drinks, soda, tea, water, and some alcoholic beverages
Oats and other naturally gluten-free grains like rice do not inherently contain gluten but they could be processed together with wheat and be contaminated with gluten as a result.
Therefore, you should avoid gluten-free grains not labeled as “gluten-free” but labeled “may contain,” or “made on shared equipment with” wheat or gluten.
One-day sample celiac disease diet
Here is a one-day sample celiac disease diet plan:
Breakfast: Baby spinach omelet, a banana, and black coffee.
Snack: Cottage cheese with sliced peaches
Lunch: Homemade burrito bowl made with black beans, rice, corn, pico de gallo, guacamole, and queso.
Snack: Hummus with veggies for dipping and almonds.
Dinner: Baked salmon, risotto, and asparagus.
Avoiding foods that contain gluten is not enough.
You must also ensure that you or the person preparing your food avoids cross-contact, which occurs when a gluten-free food is exposed to a gluten-containing food.
Many people find cross-contact the most difficult part of following a gluten-free diet since even just a crumb of gluten can trigger an autoimmune response in people with celiac disease.
Here are some tips to avoid cross-contact:
- Avoid using the same toaster, grill, or griddle to prepare gluten-free foods that are also used to make gluten-containing foods.
- Tightly cover your food when using a convection oven and thoroughly clean the oven between uses.
- Use separate sponges and dishrags to clean gluten-free cookware.
- Have separate condiments like peanut butter, jelly, and mayonnaise to avoid cross-contact from utensils.
- Store your gluten-free items on the top shelf of your pantry and refrigerator in a dedicated area.
Also, keep in mind that gluten a protein — not a type of bacteria — so it cannot be “killed off” using heat.
Avoid using the same boiling water or frying oil to make gluten-free foods that were also used to make gluten-containing foods.
The bottom line
Celiac disease is an autoimmune disease that causes inflammation in the small intestine in response to the ingestion of gluten.
Following a gluten-free diet is the only treatment for celiac disease.
While many foods are naturally gluten-free, it’s always best practice to read the ingredient label.
You must also avoid cross-contact at home, in restaurants, and other foodservice locations.