Why do I need to follow a gluten-free diet?

If you have a confirmed diagnosis of celiac disease, your doctor may have told you that you should follow a strict and life-long gluten-free diet. This means avoiding all foods that contain or have come in contact with wheat, barley, or rye ingredients. Research shows that ingesting gluten-containing foods triggers an autoimmune response that can damage your intestinal lining. The damage can lead to a wide variety of symptoms that can affect your overall health, so it is important that you understand how to follow a glutenfree diet. This handout will provide you with the tools you need to live a happy and healthy gluten-free lifestyle.

Gluten-Free Diet

Grains and starches allowed

  • Amaranth
  • Arrowroot
  • Buckwheat
  • Corn
  • Flax
  • Flours made from nuts, beans, and seeds
  • Millet
  • Montina™
  • Potatoes, potato starch, potato flour
  • Quinoa
  • Rice
  • Rice bran
  • Sago flour
  • Sorghum
  • Soy (soya)
  • Tapioca
  • Teff
  • Wild rice

Gluten-Free Flour Recipe

  • 1 cup potato starch
  • 1 cup soya flour
  • ½ cup tapioca flour/ starch
  • ½ teaspoon xanthan gum

Measure and combine above ingredients. One cup is equal to one cup regular flour.

Potato starch must be used, NOT flour. Xanthan gum adds moisture, which is necessary with gluten-free foods.

This flour can be substituted for regular flour to make any gluten recipe such as cookies, cakes, gravy, dumplings, pancakes, etc.

Oats: Oats themselves are naturally gluten-free. Oats are a whole grain so they possess important vitamins, minerals, and fiber that might be lacking in a gluten-free diet. Studies show that pure, uncontaminated oats are tolerable in moderation: 1/2 cup to 1/3 cup dry rolled oats for adults, and 1/4 cup for children. However, commercial oat products can be contaminated with wheat if they are processed or stored in a facility that processes wheat. Look for a certified gluten-free label if you are purchasing an oat product.

Grains to avoid

  • Barley
  • Barley malt/extract
  • Bulgur
  • Couscous
  • Durum
  • Einkorn
  • Emmer
  • Farina
  • Faro
  • Graham flour
  • Kamut
  • Matzo flour/meal
  • Orzo
  • Panko
  • Rye
  • Seitan
  • Semolina
  • Spelt
  • Triticale
  • Udon
  • Wheat
  • Wheat bran
  • Wheat germ
  • Wheat starch

Questionable ingredients

The following is a list of ingredients that are questionable and should not be consumed unless you can verify that they do not contain or are not derived from gluten-containing grains:

  • Brown rice syrup (can be made from barley)
  • Flour or cereal products
  • Hydrolyzed vegetable protein (HVP), hydrolyzed plant protein (HPP), or textured vegetable protein (TVP) from a gluten-containing source
  • Malt vinegar (distilled vinegar is ok)
  • Modified food starch from a gluten-containing source
  • Rice malt
  • Seasonings or “natural flavors”
  • Soy sauce, soy sauce solids, or teriyaki sauce

Frequently overlooked foods that often contain gluten:

  • Breading
  • Brewer’s yeast
  • Broth
  • Brown rice syrup
  • Coating mixtures
  • Communion wafers
  • Croutons
  • Salad dressings
  • Drugs or over-the-counter medications
  • Energy bars (see label)
  • Herbal or nutritional supplements
  • Ice cream or gelato
  • Imitation bacon and seafood
  • Licorice
  • Marinades
  • Playdough (wash hands after use)
  • Processed meats (deli meats, salami, bologna, hot dogs, lunch meats)
  • Roux
  • Sauces, gravies
  • Soup base/bouillon
  • Self-basting poultry
  • Soy sauce, soy sauce solids
  • Thickeners
  • Veggie burgers

Where to shop for gluten-free foods?

In the past, gluten free products were found at specialty stores; luckily this has changed. Most national and regional grocery chains stock gluten-free foods, often in a special aisle or section but often located with other foods.

Regionally in Ohio, gluten-free foods can be found at Costco, Giant Eagle, Kroger, Meijer, Acme, Buehler’s, ALDI , Marc's, Whole Foods, Trader Joe's, Earth Fare, Mustard Seed, and Heinen's.

Shopping tips

  • The perimeter of your supermarket mostly contains naturally gluten-free and nutritious foods like fruits, vegetables, meat, fish, and poultry, and dairy products.
  • If you have access to health food stores, these typically have a good variety of GF items.
  • Don’t be afraid to ask store managers or staff if a particular item is GF!
  • READ LABELS! Avoid items with ingredients in the lists of non-GF ingredients provided here.
  • Look for labels on food packages to ensure they are gluten-free. You can find a variety of GF labels by doing a Google™ image search for “gluten-free labeling.”

A note on gluten-free foods

While there are a lot of gluten-free packaged and convenience foods on the market now, these aren’t necessarily the healthiest choices. Remember, gluten-free doesn’t automatically mean nutritious! These foods can have higher amounts of sugar, fat, and sodium, and lower fiber content. It is important to check the ingredients and make healthy choices. Here are some tips:

  • Choose gluten-free foods that are made from whole grains, like brown rice or quinoa instead of white rice or corn flour.
  • The first ingredient on the label will be the most abundant in the food, so make sure that it is a gluten-free whole grain.
  • If you make a gluten-free pizza or pasta dish, load it up with vegetables and lean protein.
  • Watch out for gluten-free frozen meals – like all frozen meals, they can be loaded with sodium.
  • Save the GF snacks and desserts for special occasions (remember, moderation is key!) Here are a few gluten-free favorites:
    • Tinkyada® gluten-free brown rice pasta (never mushy!)
    • Rudi’s® and Udi’s® gluten-free products (breads, bagels, pizza crust, etc.)
    • Lundberg® rice and quinoa products (most are GF, check label)
    • Bob’s Red Mill® Gluten-Free milled flours (offers a variety of flours for your baking and cooking needs)
    • Bob’s Red Mill® Gluten-Free Whole-Grain Rolled Oats or Gluten Freeda’s® Instant Oatmeal packets
    • Van’s Gluten-Free Foods® (Try the waffles. Many of the products are made with whole-grains.)

Reading labels

On August 2, 2013, FDA issued a final rule defining “gluten-free” for food labeling with a compliance date of August 5th, 2014. This meant that food products bearing a gluten-free claim labeled on or after that date must meet the rule's requirements. This allows consumers, especially those living with celiac disease, to be confident that items labeled “gluten-free” meet a defined standard for gluten content. Additionally, on June 25, 2014, FDA issued a guide for small food businesses to help them comply with the final rule's requirements. For more information and FAQs regarding these changes please see:

Tips while dining out

  • It is more useful to ask if a food has any ingredient that is derived from or processed with wheat, barley, or rye, than to ask, “Is this food gluten-free?”
  • Salads can be tricky – make sure croutons never came in contact with the salad, and check ingredients of salad dressings.
  • Soups are often times thickened with flour, and can be another tricky menu selection.
  • The following words on a menu may signify a gluten-containing item: hollandaise sauce, slurry, dredge, stock, chowder, torte, “cream of,” flourless cake, white sauce, mousse, and crème brûlée. Question the following cooking methods: braised, stewed, roasted, broiled, broasted, and grilled.
  • Foods that are deep fried need to be fried in a separate fryer dedicated to GF foods – ask your server how the food is fried (i.e., French fries, onion rings, fried chicken, hash browns, and tortillas and tortilla chips).
  • Burgers (including veggie burgers) can often contain fillers that contain gluten – please check.
  • Be courteous, but remind your server or chef that you have strict dietary needs. If it is helpful, you may be able to order restaurant cards that explain GF requirements to cooks. The cards might look like this:

To my server and/or chef:

Please note: I have celiac disease and therefore have special dietary restrictions. I strictly cannot eat foods containing or that have come in contact with wheat, barley, rye, and oats (unless oats are certified gluten-free) or else I will become very sick. The foods I must avoid are:

  • Gluten
  • Wheat
  • Flour
  • Bread, breading, bread crumbs, or batter
  • Pasta
  • Beer or malt beverage

If you are uncertain whether or not a particular food is gluten-free, please tell me before serving it to me. Thank you for your help.


Menu ItemDescription
Au gratinBrowned topping of bread crumbs or grated cheese
BechamelWhite sauce made with a roux and milk for thickening
Beurre manieMixture of butter and flour used to thicken sauces
Cordon bleuChicken or veal and ham and cheese; breaded and sauteed
EncrustedFlour or bread crumbs used to combine food items
DustLight shake over of dry ingredients, which may include flour
FarfelMinced noodle dough used for soup
FricasseeMeat or poultry stew thickened with flour
FritterFood dipped or mixed with batter and fried
GnocchiDumplings made from a flour or potato/egg paste
Pan gravySauce made from meat juices with flour added
MarinadeSoy sauce may be an ingredient
MeuniereSprinkled with flour and browned in butter
RaspingsVery thinly shredded stale bread
RouxButter and flour paste used to thicken sauces and soups
ScallopiniThinly sliced meat cooked in fat to tenderize or coated in flour and fried
Soy sauceSauce made from fermented soy beans and may be roasted in wheat or barley
Teriyaki sauceContains soy sauce
TempuraShrimp, seafood, and vegetables battered and fried in a flour-based batter
VelouteSauce thickened with flour and used for soups, stews, and fricassee
Welsh rarebitCheese sauce made with ale or beer and served on toast or crackers


The following is a list of vitamin and mineral supplement brands with mostly all GF products. Please read all ingredient labels to ensure products are gluten-free.

  • Freeda® Vitamins
  • Nature Made®
  • Solgar®
  • Twin Lab®
  • Whole Foods 365® Vitamins

These ingredients in supplements are gluten-free:

  • Cellulose
  • Medicinal alcohol
  • Caramel (usually derived from burnt sugar)
  • Lactose

Ingredients in supplements which are more likely to contain gluten:

  • Starch
  • Dusting powder
  • Pregelatinized starch
  • Flour

Ingredients in supplements which are less likely to contain gluten:

  • Sodium starch glycolate
  • Caramel coloring
  • Maltodextrin


The following alcoholic beverages do not contain gluten and are therefore safe on a gluten-free diet:

  • Distilled alcoholic beverages (i.e., gin, rum, vodka, whisky)
  • Wines and pure liqueurs
  • Gluten-free beer– These are now available but check label to ensure that it is certified GF

Alcoholic beverages that do contain gluten because they were fermented from gluten-containing grains:

  • Wine coolers
  • Most beers (unless specified as GF)
  • Ales
  • Lagers

Last reviewed by a Cleveland Clinic medical professional on 10/01/2017.


  • Ediger TR, Hill ID. Celiac disease. Pediatr Rev. 2014;35:409-15.
  • Barakauskas VE, Lam GY, Estey MP. Digesting all the options: Laboratory testing for celiac disease. Crit Rev Clin Lab Sci. 2014;51:358-78.
  • Celiac Disease Foundation. Guidelines For A Gluten-Free Lifestyle. Woodland Hills, CA: Celiac Disease Foundation, 2009. Print.

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