Gluten-free diet – what to eat and what to avoid?

In healthy, gluten-tolerant individuals, there is no justification for following a gluten-free diet. Moreover, such a diet, if improperly balanced, can be associated with a number of negative effects. These include mineral and vitamin deficiencies, excessive dietary fats and elevated blood glucose and cholesterol levels.

It is worth stressing that a gluten-free diet is not a weight loss diet. An energy deficit is responsible for weight reduction, and the mere presence or absence of gluten does not affect weight loss.

The implementation of a gluten-free diet should only be recommended to people who, for medical reasons, have indications for it, viz:

• celiac disease (visceral disease),
• allergy to wheat,
• non-celiac hypersensitivity to gluten,
• Duhring’s disease.

Importantly, coeliac disease can co-exist with other autoimmune diseases, i.e. for example, type 1 diabetes, autoimmune thyroiditis, inflammatory bowel disease or dermatitis herpetiformis. The occurrence of any of these diseases may also be an indication for a diagnosis of coeliac disease. However, the introduction of such an intervention should be undertaken individually for each patient.

Many people choose to follow a gluten-free diet to improve their wellbeing and alleviate non-specific symptoms, such as migraines, constipation or skin lesions. It should be noted that these are not direct indications for excluding gluten from the diet. If there are many long-term symptoms suggesting hypersensitivity to this protein, it is worth consulting your doctor. The doctor may order diagnostic tests for coeliac disease or other gluten tolerance disorders.

Do not exclude gluten from your diet without consulting your doctor. Following a gluten-free diet prior to diagnostic tests may interfere with their results if there is an intolerance to this protein.

A properly balanced gluten-free diet is nutritious and safe. However, it is not difficult to make dietary mistakes if followed without proper preparation and accuracy. For people with coeliac disease or other indications for gluten elimination, a restrictive diet is key to improving health.

A gluten-free diet should follow the principles of healthy eating and cover the needs for protein, fats, carbohydrates and minerals and vitamins. In case of nutritional deficiencies or inability to balance the diet properly, supplementation should be considered.

Permitted products

Products that are safe on a gluten-free diet are:

• naturally gluten-free cereals (white and brown rice, maize, millet, buckwheat, tapioca, quinoa, amaranth, sorghum, teff) and their preparations (groats, flours, flakes, starches),
• fresh fruit and vegetables,
• pulses (soya, chickpeas, lentils, beans, etc.),
• milk and dairy products (cheese, yoghurt, cottage cheese, cream, kefir, etc.),
• eggs,
• meat, offal and certain meat products,
• fish and seafood,
• nuts, seeds and seeds,
• fats (butter, vegetable oils, margarine),
• coffee beans and tea,
• sugar, honey, jams, agave syrup, maple syrup,
• spices (salt, pepper, herbs, cinnamon, wine vinegar, apple cider vinegar),
• all products that bear the crossed-out whey mark, e.g. bread, pastries, cakes, biscuits, candies, pasta, flours, salty snacks, cereals, spices, baking powder, sauces.

Forbidden products

The basic principle of a gluten-free diet is to exclude products containing wheat and all its varieties (kamut, durum, flatbread, spelt), rye, triticale and barley. Due to the high level of contamination with prohibited cereals, there is also a need to avoid products containing oats (unless it is labelled gluten-free).

Prohibited products include:

• grain products containing gluten (flours, groats, breads, pastries, pizza, pancakes, pasta, confectionery, i.e. cakes, pastries and sweet snacks, i.e. crackers, pretzels, sticks),
• processed meat products (cold cuts, hams, sausages, pâtés) containing e.g. pearl groats, semolina, modified wheat starches, barley malt,
• dairy products and desserts containing e.g. modified starches (derived from gluten cereals),
• breaded products with wheat breadcrumbs, with roux (e.g. vegetables, meats, fish),
• spice mixtures containing gluten in their ingredients.

When shopping, it is important to be cautious and check labels every time, especially for multi-ingredient and highly processed products. Gluten can be hidden even in products that at first glance do not appear to contain it. Be particularly careful with:

• flavoured products (fruit yoghurts, flavoured drinks),
• loose products (instant soups, quiches, puddings, spice mixtures, powdered sauces),
• meat products and delicatessen products,
• ready-made products (soups, frozen foods, sauces, dressings, dips, soya chops, pâtés, etc.).

To be safe, people following a gluten-free diet should primarily choose products marked with the Crossed Whey mark. Permitted food labels are also descriptions on packaging declaring that the product is gluten-free. If you are unsure about the composition of a product, it is better to refrain from buying it.

Many gluten-free products are characterised by a high degree of processing and an abundance of simple sugars and fats. For this reason, a gluten-free diet is not always easily digestible. However, by choosing the right products and heat treatment, the principles of an easily digestible diet can be incorporated.

In people just after the diagnosis of coeliac disease, it is recommended to introduce a gluten-free, easily digestible diet in order to rebuild damaged intestinal villi.

Diet. Alicja Wujkowska 

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translation: Julia Majsiak