What Is the Gluten-Free Diet?

gluten free diet

Verywell / Debbie Burkhoff

The gluten-free diet eliminates foods that contain gluten, which is a protein found in the grains wheat, barley, and rye, and some oats. (Oats are, by nature, gluten-free. However, they nearly always become contaminated during processing or distribution with other gluten-containing grains. If tolerated, up to about a ½ cup of dry gluten-free oats per day may be included in the diet.) Many of the foods and beverages commonly consumed—such as bread, cereal, crackers, and even beer—contain these grains, which places them off-limits for those who are gluten-free.

People who have celiac disease and non-celiac gluten sensitivity need to follow the gluten-free diet because of their health conditions. In addition, the diet has gained in popularity in recent years, with some (including celebrities) claiming it aids in weight loss or cures acne.

However, there's no medical evidence for most of those claims, and experts agree that the gluten-free diet is only necessary for those with celiac disease or gluten sensitivity. The diet can be restrictive, since it eliminates many common foods and foods you may be used to eating. It also can be tricky since some foods that you do not expect to contain gluten do, such as canned soups and ice cream. But once you get educated and acclimated, you'll see that it can be a well balanced, healthy diet.

"The gluten-free diet is a medically necessary way of eating for people with celiac disease and non-celiac gluten sensitivity. Most experts agree that this diet should only be used when medically necessary, since restricting a food group increases the risk for nutrient imbalances."

Willow Jarosh, MS, RD

Background

Gluten, a sticky, stretchy form of protein, is a key component in wheat—gluten is a large part of what makes bread soft and stretchy and cakes light and springy. In fact, over the centuries, farmers have bred wheat to include more gluten, since the protein is so important in baking.

However, some people react very badly to gluten. The gluten-free diet first was developed for people who have been diagnosed with celiac disease, which is an autoimmune disorder. When you have celiac disease, consuming a food that contains gluten causes your immune system to kick into overdrive and attack the lining of your small intestine. Left untreated, celiac disease can cause nutritional deficiencies, osteoporosis, and even cancer in very rare cases.

People with celiac disease may exhibit certain symptoms. The most common include diarrhea and/or constipation, fatigue, stomach pain, and bloating, but a small majority of people may not have any symptoms.

Although there are several drugs for celiac disease in development, the only current treatment for the condition is a gluten-free diet. Once those with celiac disease begin eating gluten-free, their symptoms tend to abate and their small intestines begin to heal.

Non-celiac gluten sensitivity, the other condition in which a gluten-free diet is required, only was identified by medical researchers in the 1980s, and there's still no medical test for it. People with non-celiac gluten sensitivity do not have celiac disease (their doctors rule out celiac disease before diagnosing them with gluten sensitivity). However, they experience many of the same symptoms as people with celiac disease, including digestive issues such as diarrhea or constipation, fatigue, headaches, and bloating.

Despite these symptoms, doctors believe that people with non-celiac gluten sensitivity do not incur long-term damage to their bodies by eating gluten-containing foods. Following the gluten-free diet clears up their symptoms, while eating foods with gluten in them (either accidentally or on purpose) causes those symptoms to return. You may have non-celiac gluten sensitivity if you feel better on a gluten-free diet, even though there's no way to test for it.

Many people who don't have celiac disease or non-celiac gluten sensitivity follow a gluten-free diet. In some cases, their doctors have recommended that they follow the diet. For example, women struggling with infertility may be told to go gluten-free; there's one medical study published in 2011 showing that women who can't conceive are more likely to have undiagnosed celiac disease. In addition, there was a medical research study published in 2008 that indicated a gluten-free vegan diet may help to lower inflammation levels and protect joints in people who have rheumatoid arthritis.

However, there's also a group of people who advocate the gluten-free diet as a cure for almost any health issue, which it most definitely is not. In particular, multiple celebrities—including Kourtney Kardashian and Gwyneth Paltrow—have endorsed the gluten-free diet. Some see the diet as effective in weight loss, even though there's little medical evidence it can help you lose weight.

In fact, many people with celiac disease find they gain weight when they go gluten-free, since their small intestines begin to heal and they're suddenly absorbing nutrients again.

How It Works

As you know, gluten is found in the grains wheat, barley, and rye. The gluten-free diet works by eliminating all foods with gluten in them. This may sound simple: just skip the bread, cookies, and wheat-based cereal. But the gluten-free diet is far more complicated than just skipping those obvious foods. That's because gluten grains—particularly wheat—are extremely common in all processed foods.

Wheat is used to thicken soups and to help ferment soy sauce. Barley—the second-most-common gluten grain—is found in sweeteners used in cereals and in candy, and also in beer and malted alcoholic beverages.

To successfully follow the gluten-free diet, you need to know where gluten lurks and avoid all those foods. You'll need to learn to read labels on food products and recognize gluten-containing ingredients, and you'll need to be cautious in restaurants and when enjoying a meal at a friend or relative's home.

It's also not enough to simply eliminate all foods with gluten. You'll need to be cautious about gluten cross-contamination. That's because even a tiny crumb can contain enough gluten to cause symptoms and even ongoing celiac disease-related intestinal damage in some cases.For example, choose a granola bar like 88 Acres Cinnamon Maple Seed + Oat Bars that contain certified gluten-free oats. Additionally, look for products made in certified gluten-free facilities, such as the gluten-free soy protein powder from Bob's Red Mill.

However, you don't need to fear giving up bread, baked goods, and beer—there are good gluten-free versions of all these foods available in most larger supermarkets. In addition, there are tons of foods that are naturally gluten-free, such as gluten-free grains, corn, nuts, seeds, legumes, fruits, vegetables, cheese, dairy, eggs, and meats like chicken, turkey, and pork. In addition, many restaurants—even fast food outlets—feature gluten-free options or even an entirely gluten-free menu.

Pros and Cons

A gluten-free diet is essential for people who have celiac disease and non-celiac sensitivity. Removing gluten from the diet prevents the death of villi in the intestine. In addition to being medically necessary, the gluten-free diet—when planned appropriately—is nutrient-dense. There are many foods that are naturally gluten-free.

Although intestinal healing may take some time for people with celiac disease, many find they feel better within a short time of starting the gluten-free diet. For people with non-celiac gluten sensitivity, their symptoms may abate even more quickly—within a few days in some cases.

When followed properly according to medical advice, the gluten-free diet is safe. However, people who are following the gluten-free diet need to be mindful of several nutrients, including fiber and some B vitamins, since certain common gluten-free foods (such as tapioca flour) are scarce in these nutrients. People who have celiac disease or those that need to eat gluten-free should consult with a dietitian to learn more about naturally nutrient-dense gluten-free foods to ensure they are getting everything they need.

One of the cons of the gluten-free diet is that it can be overwhelming in the beginning. Once you are equipped with education on how to identify gluten-free foods, you'll find that the diet gets easier.

Eating gluten-free requires planning that other diets do not require. Gluten-free products may also be more expensive than their conventional counterparts. But many restaurants have gluten-free options, and eating gluten-free is more convenient now than it has ever been.

How It Compares

The gluten-free diet is unusual in the overall diet community in that it first was developed as a treatment for a specific illness (celiac disease). Although many people follow the gluten-free diet for other reasons, doctors don't recommend it. Still, there are other diets that incorporate the gluten-free diet into their overall approach. They include:

  • The Low-FODMAP diet, used to treat irritable bowel syndrome, calls for you to reduce or eliminate wheat, barley, and rye, all of which are high in FODMAPs, a type of carbohydrate that research shows can lead to uncomfortable digestive symptoms.
  • The paleo diet, which asks followers to eat only the foods that would have been available before the dawn of agriculture, eliminates all grains, not just wheat, barley, and rye. The paleo diet also skips all dairy products and legumes, food groups that are allowed on the gluten-free diet.
  • The Atkins diet relies mainly on gluten-free foods, especially in its beginning stages. It does allow some foods with gluten grain-based ingredients in later stages. However, Atkins is one of the most gluten-free-friendly weight-loss diets.
  • The South Beach diet also calls for people to mainly eat gluten-free. However, South Beach does not require you to be as carefully gluten-free as you need to be if you have celiac or gluten sensitivity.
  • The Whole30 diet is an elimination diet that might help you to discover a sensitivity to gluten (or to another food). The diet, which forbids all grains, is intended to be a short-term program to help improve your health, rather than to help you lose weight.

Getting Started

Starting the gluten-free diet can be intimidating—there's a significant amount to learn in a very short time, and you're probably in a rush to get going so you can feel better. Your best bet is to start with a comprehensive gluten-free food list, and to stick only with processed food products that are specifically labeled "gluten-free."

It's also common for people to focus on foods they can't eat, as opposed to foods they can eat while gluten-free, and even to even mourn their old gluten-containing favorites. But the truth is, you don't need to mourn; you'll almost certainly find good gluten-free versions for your favorite processed foods, and great gluten-free recipes to recreate most other dishes. A great way to start is to look through some gluten-free cookbooks for inspiration.

A Word from Verywell

The gluten-free diet isn't for everyone—it's intended specifically to treat celiac disease and non-celiac gluten sensitivity. If you have one of those two conditions, it's very important to stick to the gluten-free diet strictly. If your dietary goal is to lose weight or become more healthy generally, you're better off trying a diet that's specifically intended to deliver those results.

The gluten-free diet can be overwhelming when you are first getting started, but you're likely to find that eating gluten-free becomes second nature over time and that there are plenty of delicious and nutritious foods to choose from.

Frequently Asked Questions

  • Is the gluten-free diet important to follow if I have celiac disease or non-celiac gluten sensitivity?

    Yes, it's critical. If you have been diagnosed with celiac disease or non-celiac gluten sensitivity, you must follow a gluten-free diet for life. Although research is ongoing, there's no cure for celiac disease, and the only treatment is the gluten-free diet.

  • Will the gluten-free diet help me improve my health if I don't have celiac disease or non-celiac gluten sensitivity?

    Probably not. There are a few conditions, including infertility and rheumatoid arthritis, where medical research indicates a gluten-free diet may help. Research into other conditions, including mental health conditions and some autoimmune diseases, has not been as promising. So in most cases, you're unlikely to see a true benefit from cutting gluten out of your diet.

  • Will going gluten-free help me lose weight?

    Again, probably not. Some people do find they can lose some pounds as a side effect of eating gluten-free. But their weight loss may occur more because they've eliminated so many types of foods—and therefore eliminated so many opportunities to snack and eat generally—than because they aren't eating gluten any longer.

  • Does following the gluten-free diet mean I have to give up bread?

    No, definitely not! It does mean you'll need to eat only gluten-free bread, though (and gluten-free rolls and gluten-free crackers, too). Gluten-free bread has garnered a fairly bad (and occasionally well-deserved) reputation over the years for being crumbly and dry, but these days gluten-free bread products taste and feel almost like the wheat-containing bread they're intended to replace.

  • Does following the gluten-free diet mean I have to give up all grains?

    Again, not at all. There are many, many common (and more exotic) gluten-free grains you can eat. Rice is gluten-free, for example, and corn is gluten-free as well. Quinoa, teff, tapioca, and sorghum all are gluten-free. Some people do eat low-carb/low grain in addition to following the gluten-free diet, but you don't need to be low-carb in order to be gluten-free.

  • Can I eat out if I'm following the gluten-free diet?

    Yes, definitely: many restaurants offer gluten-free menus. Even in restaurants that don't have a specific gluten-free menu, it's usually possible to speak to the chef or the manager to arrange something you can eat. Ethnic restaurants such as Mexican, Japanese, Thai, or even Italian eateries often are good options. Also, remember that cross-contamination is a possibility. One hundred percent gluten free foods need to be made in a separate part of the kitchen, using separate cooking tools and utensils.

  • Can I stray from the diet?

    People who have celiac disease or non-celiac gluten sensitivity should not stray from the gluten-free diet. In those with celiac disease, even a tiny bit of gluten—too small for you to see—is enough to cause intestinal damage and uncomfortable symptoms.

8 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Jane Anderson
Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet.