QUICK START GUIDE FOR CELIAC DISEASE
Here is a simple overview of the Gluten-Free (GF) diet. Not all areas of the diet are as clear-cut as portrayed by this Guide.
This is intended to be used as a general reference tool for the newly diagnosed celiac and those with Dermatitis
Herpetiformis (DH). Understanding these dietary requirements will enable the newly diagnosed celiac to read labels of food
products and determine if a product is safe to eat.
Celiac disease (CD) is a lifelong, genetic disorder affecting children and adults. Dermatitis Herpetiformis (DH) is the skin
manifestation of Celiac disease. When people with CD/DH eat foods that contain gluten, it creates an autoimmune
reaction that causes damage to the villi, tiny hair-like projections in the small intestine. This does not allow food to be
properly absorbed. Even small amounts of gluten in foods can affect those with CD/DH and cause health problems.
Damage can occur to the small bowel even when there are no symptoms present. Gluten is the generic name for certain
types of proteins contained in the common cereal grains wheat, barley, rye and their derivatives.
Research indicates that pure, uncontaminated oats consumed in moderation (up to ½ cup dry oats daily) are tolerated
by most celiacs. Gluten-free oats are currently available in the United States. Consult your physician or dietician before
including oats in your diet and for regular monitoring.
Rice, corn (maize), soy, potato, tapioca, beans, garfava, sorghum, quinoa, millet, buckwheat, arrowroot, amaranth, teff,
Montina®, flax, and nut flours.
The key to understanding the GF diet is to become a good ingredient label reader. The following ingredients should not be
consumed. They are derived from prohibited grains: barley, rye, triticale, wheat (durum, graham, kamut, semolina, spelt),
malt, malt flavoring, malt vinegar (generally made from barley—verify the source).
Distilled alcoholic beverages and vinegars are gluten-free. Distilled products do not contain any harmful gluten peptides.
Research indicates that the gluten peptide is too large to carry over in the distillation process. This process leaves the
resultant liquid gluten-free. Wines and hard liquor/distilled beverages are gluten-free. Beers, ales, lagers and malt
vinegars that are made from gluten-containing grains are NOT distilled and therefore are not gluten-free. Gluten-free beers
are now available in the United States.
Frequently overlooked foods that may contain gluten and need to be verified: brown rice syrup, breading and coating mixes,
croutons, energy bars, flour or cereal products, imitation bacon, imitation seafood, marinades, panko (Japanese bread
crumbs), pastas, processed luncheon meats, sauces, gravies, self-basting poultry, soy sauce or soy sauce solids, soup
bases, stuffings, dressings, thickeners (roux), communion wafers, herbal supplements, drugs and over-the-counter
medications, nutritional supplements, vitamins and mineral supplements
Play-dough: a potential problem if hands are put on or in the mouth while playing with Play-dough. Hands should be washed
immediately after use.
A label that declares a complete list of ingredients is safest. Labels must be read every time foods are purchased.
Manufacturers can change ingredients at any time. As of 2006, wheat used in products will be identified on the label.
You may verify ingredients by calling or writing a food manufacturer and specifying the ingredient and the lot number of the
food in question. State your needs clearly—be patient, persistent and polite.
If In Doubt Go Without!
When unable to verify ingredients or the ingredient list is unavailable – DO NOT EAT IT. Regardless of the amount eaten,
it is not worth triggering your immune system and the damage to the small intestine that occurs every time gluten is
consumed, whether symptoms are present or not. A person with Celiac disease may have additional food sensitivity not
related to gluten.
Wheat Free Is Not Gluten-Free
Products labeled wheat-free are not necessarily gluten-free. They may still contain spelt, rye or barley-based ingredients
that are not GF.
When preparing gluten-free foods they must not come in contact with food containing gluten. Contamination can occur if
foods are prepared on common surfaces, or with utensils that are not thoroughly cleaned after preparing gluten-containing
foods. Using a common toaster for GF bread and regular bread is a major source of contamination. Flour sifters should
not be shared with gluten-containing flours. Deep fried foods cooked in oil shared with breaded products should not be
consumed. Spreadable condiments in shared containers may also be a source of contamination. When a person dips
into a condiment a second time with the knife used for spreading, the condiment becomes contaminated with crumbs
(e.g. mustard, mayonnaise, jam, peanut butter or margarine).
Wheat flour can stay airborne for many hours in a bakery (or at home) and contaminate exposed preparation surfaces and
utensils or uncovered gluten-free products. Likewise, foods not produced in a gluten-free environment have the potential to
be contaminated with gluten. This may occur when machinery or equipment is inadequately cleaned after producing glutencontaining
foods. Food manufacturers are required to abide by Good Manufacturing Practices outlined in the FDA Code of
Federal Regulations to reduce the risk of contamination in manufacturing. Let common sense be your guide.
Not all adverse reactions are due to Celiac Disease
Lactose intolerance, food sensitivities or allergies to soy, corn, other foods or even the stomach flu, are common causes of
symptoms similar to Celiac disease. Newly diagnosed celiacs may have trouble digesting certain foods, especially fatty
ones, until the small intestine has had a chance to heal and start absorbing normally. If necessary, keep a diary of foods
eaten. Read labels, remember what you ate, and listen to your body.
Attitude is Everything
Like anything new, it takes time to adjust to the GF diet. It is natural to mourn old food habits for a short time. Stay
focused on all the foods you can eat. Fresh fruits and vegetables are delicious and healthy. Fresh poultry, fish, meat and
legumes provide protein and are naturally GF. Most dairy foods can also be enjoyed providing you are not lactose intolerant.
GF substitutes for foods commonly made with wheat are available at health food stores and from GF food manufacturers,
as well as many mainstream markets. Try GF waffles for breakfast; a sandwich on GF bread for lunch; and rice, corn or
quinoa pasta for dinner. Your new way of eating is very satisfying!
The GF diet is a life-long commitment and should not be started before being properly diagnosed with CD/DH. Starting the
diet without complete testing is not recommended and makes diagnosis difficult. Tests to confirm CD could be inaccurate if
a person were on a GF diet for a long period of time. For a valid diagnosis gluten needs to be reintroduced. Celiac disease
is an inherited autoimmune disease. Screening of family members is recommended. Consult your doctor for testing.
Information in this brochure is in agreement with gluten-free dietary guidelines of the American Dietetic Association, 2006.
This Guide was developed by nutrition experts and published by Celiac Disease Foundation (CDF) and Gluten Intolerance
Group® (GIG®) to assist persons newly diagnosed with Celiac disease and/or Dermatitis Herpetiformis with preliminary
gluten-free choices. Both organizations offer patient support and educational activities and materials. CDF and GIG®are
501(c)(3) nonprofit corporations. Contact us for additional information:
Celiac Disease Foundation
13251 Ventura Blvd Ste 1
Studio City, CA 91604
818-990-2354 • FAX: 818-990-2379
Gluten Intolerance Group®
31214 124th Ave SE
Auburn, WA 98092
253-833-6655 • FAX: 253-833-6675
Website: http://www.gluten.netCeliac Disease. Read more here.
QUICK START GUIDE FOR CELIAC DISEASE