Eating gluten-free can be quite difficult as gluten often shows up in unexpected places such as food marketed as “gluten-free”. This is a guide on how to minimize your risk. Note that if you aren’t that sensitive to gluten, then you may not need to take all of the extreme measures outlined in this guide; you may be able to tolerate restaurant food and the various gluten-free options at your local supermarket.
Reading food labels
Always read the label!
Don’t just assume that something is gluten-free. Sometimes wheat shows up in bizarre places such as:
- Soy sauce. Almost all soy sauce is made from wheat (and soy).
- Salad dressing.
- Cough drops.
- Filler in meats like salami and hot dogs.
- Glucose/sugar in toffees, caramels, and Diana sauce is sometimes made from wheat.
What to look for
- Quickly scan the front of the packaging to see if there are claims about gluten-free. If you don’t see anything right away, flip to the back side and find the ingredients list.
- Look for the words “Contains: …” or “May contain: …” near the ingredients list. Wheat or gluten may show up in this list. Save time by reading this first.
- Continue reading because you need to look at the ingredients too. Assume that these ingredients contain gluten:
- Wheat / gluten
- Barley, rye, triticale, and oats* (oats don’t contain gluten but are usually contaminated)
- Sauce, soy sauce, oyster sauce
- Malt, malted anything
- Spelt, kamut, farro, durum, bulgar, semolina (wheat middlings)
- “Flour”, unless the type of flour is specified.
- Brewer’s yeast.
- Hydrolyzed (vegetable) protein?: This is sometimes made from wheat. There are mixed opinions as to whether or not this is safe.
- Yeast extract, natural flavors, rice syrup (?). In rare cases these are made from barley, which contains gluten.
Gluten free is sometimes a lie
Many celiacs report that they have problems with foods that say gluten free on the packaging. There are various theories and viewpoints:
- In some countries, a food can be labelled gluten free if the measured level of gluten is below 20 parts per million. However, some people still react to very low levels.
- It actually contains gluten. A Melbourne study found that 2.7% of “gluten-free” foods tested were not compliant with the Australian standard of no detectable gluten.
- You are reacting to something else in the food.
Certain foods are naturally gluten-free
Meat, fruit, vegetables, milk, etc. are naturally gluten-free and are good choices.
Watch out however as some processed meats are not gluten-free. Prepared meats (e.g. hot dogs, salami) may contain gluten/wheat ingredients.
These foods don’t contain gluten
- Buckwheat
- Rice
- Glutinous rice. This is just a misleading name for sticky rice.
- Corn
- Sweetbread is a misleading culinary name for the thymus or pancreas of an animal.
- MSG (monosodium glutamate)
Cooking
Cooking everything that you eat is a safe option. However, you still need to be careful about:
- Non-stick pans: These can harbour gluten, so you’ll need to get a new one. Another option is to bake your food and to use a fresh layer of aluminium foil every time.
- Plastic and wood cooking utensils: These can also harbour cross-contamination, so use metal utensils instead. However, don’t use colanders/strainers (metal or not) that are being used for wheat (e.g. pasta) as colanders have nooks and crannies that are difficult to clean wheat out of. Get your own set of utensils and keep them in your own space. Also get your own chopping board.
- People you live with: If you tell other people not to use your cooking utensils, they may do it anyways for their convenience. It’s something to watch out for so try to clearly communicate that they should not do that. For foods like butter, roommates/family members may use a knife with bread crumbs to scoop those foods so they can be a source of contamination.
- Toasters. If a toaster has been used before on wheat products, don’t use it. You can use a toaster oven (with a fresh sheet of aluminium foil) as a toaster; or, buy a new toaster for yourself.
Making eating more convenient
When cooking for yourself, here are some easy cooking tips:
- Bake meat/fish on a bed of vegetables such as onions, mushrooms, eggplant, etc. The clean-up is easy because you can use a fresh sheet of aluminium foil that you throw away afterwards.
- Cook large batches of food at once.
- Juice is a slightly more convenient method of eating fruit.
However, I’m not going to lie to you: getting accustomed to the inconvenience of constantly cooking is a huge adjustment. I would point out though that this is what humanity did before microwave dinners and restaurants.
If you want to buy pre-made food, here’s where you should look:
- Certain chains such as Trader Joe’s and Whole Foods are better at getting their suppliers to label their food products well.
- Most supermarkets now have gluten-free sections. However, be prepared to pay the ‘gluten-free tax’.
- Gluten-free bread is typically found in freezer sections.
- Gluten-free pasta will be found beside regular pasta.
- Sometimes conventional foods happen to be gluten-free: breaded chicken (rarely), shepherd’s pie (sometimes), mashed potatoes, some steamers, Indian (sometimes), pad thai (sometimes), hash browns, fries, chili, etc.
- Junk food is often gluten-free: ice cream (most), candy (sometimes), soda, chips (many flavours), Doritos (most flavours), etc.
As mentioned previously, you may get ‘glutened’ by food that is supposedly gluten-free. The convenient route isn’t always perfectly safe. Some people will repeatedly eat from restaurants and brands that haven’t failed them in the past.
Cooking from friends and family
This is a risk. Some people don’t take basic precautions such as reading ingredient labels. Some people may not understand that bread contains gluten (or that a few crumbs of bread is not ok).
Eating out at restaurants
In general, eating out at a restaurant is a bigger risk than eating gluten-free food purchased at a supermarket. The Melbourne paper discussed earlier found that 9% of restaurant food in Melbourne had detectable levels of gluten versus 2.7% of foods labelled gluten-free. This may partly be due to restaurant workers who are insensitive because they believe that gluten-free is a fad; one chef even intentionally serves gluten to gluten-free customers.
If you really want to eat out, here are some pointers:
Major chain restaurants
Many restaurant chains list their gluten-free choices on their website. They often have “gluten-friendly”/gluten-free options due to the gluten-free trend. However, cross contamination may be an issue. Almost all chains are honest and upfront about cross contamination being a risk.
“Find me Gluten Free” smartphone app
The “Find me Gluten Free” app makes it easy to find restaurants near you. However, simply going to these restaurants will not guarantee you a gluten-free experience.
Vietnamese
Pho is generally gluten-free. Watch out for beef balls as they sometimes contain gluten.
If a dish has grilled meat (e.g. rice or vermicelli with meat), you are taking your chances with cross contamination from the grill.
Poutine, New York Fries, fries, etc.
While traditional gravy uses wheat as a thickener, many poutine restaurants have gluten-free options.
Ask if the fries are cooked in a deep fryer that also cooks wheat or breaded/battered items. Some burger chains such as Five Guys do not have breaded items that would be cooked in their deep fryer.
Burritos, authentic Mexican, Chipotle Mexican Grill
You can avoid the wheat in the burrito wrap by getting a bowl instead. At Chipotle, you can minimize your risk by asking the worker to change gloves and to grab lettuce and cheese from the bag it comes from (rather than the containers on the line counter).
Japanese
Japanese restaurants generally have good gluten-free options. Sashimi and rice are the lowest risk options.
Bring your own gluten-free soy sauce as almost all soy sauce is made from wheat. Carry it in a small bottle or buy packets of soy sauce.
Usually wasabi isn’t made from wheat, but sometimes it is. If you don’t bring your own wasabi, you should ask if it is gluten-free.
Avoid:
- Unagi / eel. This will have sauce on it, which typically contains wheat.
- Imitation crab meat. It usually contains wheat flour.
- Sushi and nigri may sometimes have wasabi in them. You can order sashimi instead.
- Tempura. The batter typically contains wheat. Some rolls contain tempura bits.
- Spicy ___ may contain tempura bits. The spicy mayonnaise may contain gluten.
Watch out for:
- Masago (egg) may contain wheat ingredients. The pan used to cook it (if it is made in-house) may introduce cross-contamination.
- Salad dressing may contain wheat.
- There may be cross contamination when the sushi is made because the chef’s knife and hands may come into contact with tempura bits, unagi sauce, etc.
- Sushi rice typically contains vinegar. It is possible that a restaurant uses malt vinegar (which contains gluten) or another gluten-containing vinegar instead of traditional rice vinegar. Some celiacs avoid distilled vinegar (because it is often distilled from wheat), although most sources say that distilled vinegar is safe.
- Some teas contain barley or malt.
Chinese
These are generally a trap and have no gluten-free options. Almost everything contains wheat or soy sauce. Examples of gluten-free menu items:
- Congee with basic ingredients – lean pork, thousand-year duck egg, meat that hasn’t been marinated, seafood (excluding crab meat and some fish balls), etc. Some congee ingredients may contain wheat.
- Chicken (sometimes). Do not eat chicken with brown skin- it has been marinated in soy sauce. Ask if the chicken has been marinated; if so, the marinade may contain soy sauce or wheat.
- Bowl of rice.
Social situations that involve food
Sorry I don’t have a great answer for you. Eating nothing while other people eat is somewhat awkward. You can order a drink such as brand-name soda (they are generally gluten-free and you can easily look up their ingredients online).
If your friends are trying to decide where to eat, be proactive in suggesting various restaurants where you can eat. You can keep a list of safe choices on your smartphone as a reference. If you will be eating at somebody’s house, you can bring your own food.
Alcohol
- The distillation process used to make distilled alcohols such as vodka should result in a gluten-free product. However, there are some anecdotal reports of people who have problems with alcohol distilled from grains. Whiskey is often distilled from wheat, rye, and barley. Bourbon is sometimes distilled from a mash that includes wheat (this results in wheated bourbon). Grain vodkas, as the name suggests, are distilled from grains such as wheat.
- Wine may contain traces of gluten from fining agents, the barrel it was aged in (wheat flour is often used to seal them), or added colours and flavours.
- Beer is made from wheat. Some people find that they react to beers marketed as gluten-free.
- The Verywell fit website has many articles as to which alcohols are and aren’t gluten-free, as well as information as to why you may be reacting to particular alcohols.
Other
If you have a wheat allergy, watch out for shampoos that contain gluten.
Chapstick, lipstick and makeup may contain gluten. See Appendix A at the end of this post for more information on how to find gluten-free replacements.
Toothpaste, mouthwash, and postage may also potentially contain gluten.
Retainers apparently can contain gluten since gluten is occasionally an ingredient in plastics.
Medications, supplements, and pills can contain gluten. Unfortunately it may be difficult to figure it out. You can try asking your gastroenterologist or pharmacist.
You may not need to eat gluten-free for IBS and GI issues
Wheat contains gluten and FODMAPs, which are short-chain carbohydrates that are poorly absorbed by the small intestine. (FODMAP stands for Fermentable Oligo-, Di-, Mono-saccharides And Polyols.) A gluten-free diet can reduce GI symptoms simply because a wheat-free diet avoids the FODMAPs in wheat. For people with GI issues, a more effective approach may be to adopt a low-FODMAP diet instead of a gluten-free diet.
If you suffer from IBS, another option is hypnotherapy. Yes, I’m talking about hypnosis. Simone Peters, Peter Gibson, and their colleagues have researched the crazy things that IBS patients try to heal themselves. Surprisingly, it works for most IBS patients without the many inconveniences of a low-FODMAP diet. The news outlet ABC from Australia has a great segment on hypnotherapy for IBS. The hypnosis process is wacky; even Simone Peters admits that she wasn’t expecting to get into hypnotherapy when she entered the world of academia.
Note that if you go off of a gluten-free diet and find that you experience brain fog or depression, there is some evidence that gluten is the culprit (although there are strong placebo effects for brain fog and depression). Peters and Gibson have performed a small pilot study where they found a link between gluten and these patient-reported issues. See Figure 2 in this paper for a visualization of the data.
Research links:
- Gluten study #1: This trial led the researchers to believe that a gluten-free diet improves IBS symptoms.
- Gluten study #2: This trial found that FODMAPs, not gluten, was the problem in IBS.
- Gluten study #3: After study #2, some patients continued on their gluten-free diet because it made them feel better. This study looked into that phenomenon and found that some patients did get more depressed when they ate gluten. The placebo treatment also caused symptoms, although the gluten treatment induced more negative effects than the placebo. Unfortunately, this trial was not very large.
- Hypnotherapy: This (small) trial compared hypnosis to a low-FODMAP diet and found similar effectiveness.
Low-FODMAP diet resources:
- Reddit: r/FODMAPs
- Getting started handout
- Chipotle Mexican Grill’s carnitas are an option
- The Monash University website has lots of free recipes. They also have a smartphone app (commercial) to help you figure out the levels of FODMAPs in your food.
- Example meal plan (vegetarian).
If you still get ‘glutened’ (and want to avoid it)…
If you are reacting to restaurant food or “gluten-free” food, then stop doing that. Cook all of your food from scratch.
If that still doesn’t work, one route is to adopt an extremely strict diet to minimize cross-contamination. An academic paper provides some detail on one clinic’s recommended diet for avoiding cross contamination:
Products allowed/disallowed in the Gluten Contamination Elimination Diet (GCED), targeting the elimination of gluten cross-contamination
| Allowed | Not allowed | |
|---|---|---|
| Grains | Plain, unflavored, brown and white rice | Millet, sorghum, buckwheat or other inherently gluten-free grains, seeds, or flours |
| Fruits/Vegetables | All fresh fruits/vegetables | Frozen, canned or dried |
| Proteins | Fresh meats | Lunch meats |
| Fresh fish | Ham, bacon | |
| Eggs | Other processed, self-basted or cured meat products | |
| Dried beans | ||
| Unseasoned nuts in the shell | ||
| Dairy | Butter, yogurt (unflavored), milk (unflavored), aged cheeses | Seasoned or flavored dairy products |
| Processed cheeses | ||
| Condiments | Oils, vinegar, honey, salt | Flavored and malt vinegars |
| Beverages | 100% fruit/vegetable | |
| Gluten-free supplemental formulas | ||
| Gatorade, milk, water |
These findings are mirrored by other researchers who have found that supposedly gluten-free flours often contain levels of gluten that are likely toxic for celiacs. Italian researchers found that 5 of 15 flours tested had over 30mg / 100g (300 ppm) of gluten.
A highly unconventional alternative
Another option is to adopt a diet of only fatty meat- see my primer here. This isn’t as crazy as it sounds as the Inuit have done it for generations while individuals of other races (e.g. arctic explorers) have also been able to live on just meat. Today, many people without serious health conditions (e.g. celiac disease) simply do this diet to lose weight; it may not be as restrictive as it first appears.
Potential advantages:
- It is more “convenient”. Such a diet makes shopping incredibly simple and greatly reduces food preparation time. Because the diet is a big change, it probably isn’t worth the effort unless you’ve learned your lesson about eating out and you are tired of cooking.
- Possible health benefits. There are various anecdotal reports of better health (Meat Heals is a collection of highly-biased anecdotes). Most people lose weight on the diet even though calories are not restricted. The Paleomedicina clinic reports the reversal of serious autoimmune conditions such as Type 1 diabetes (case study #1 and #2).
- If you don’t tolerate foods other than gluten/wheat, this diet will eliminate it. It has the benefits of an elimination diet.
Disadvantages
- The initial adaptation phase can be quite difficult for some people. It can lead to low blood sugar, which can cause you to pass out (e.g. while driving). If you do try this diet, carry some carbs with you.
- Social stigma.
- Bad for your social life.
My personal experience
I don’t actually do the meat-only diet. I just eat mostly meat (especially fatty cuts and offal) with some fruit. No salt or seasonings. I don’t really know of anybody who eats only fruit and meat (and there is zero science on it)… so I am hesitant to recommend my way of eating. However, I would note that my current diet is technically more restrictive than the GCED diet but I don’t find it difficult to follow at all. I actually greatly prefer it over my previous diet (where I would eat out and buy frozen dinners). Surprisingly, I enjoy my meals more and now enjoy eating again. I spend less time cooking and shopping for groceries so in that sense it is more convenient.
Closing thoughts
If you can tolerate small amounts of gluten and your doctor agrees that it won’t cause long-term damage, then that’s great. Enjoy your life! (Note that if you have celiac disease, you may wish to have follow-up testing to verify that you are actually in good health.)
However, if you highly sensitive, then you may have to deal with constantly getting glutened accidentally because gluten is everywhere. That’s just how it is. I am sorry to tell you that. If you tire of the paranoia (or the inconvenience of preparing everything you eat), you can explore the alternative options such as the GCED diet or the fatty-meat-only diet discussed earlier.
Resources
Reddit is a good place for peer support, recipe ideas, etc.: r/glutenfree and r/celiac
If you don’t know how to cook, learn some basic cooking skills.
Options for those who are highly sensitive and tired of getting glutened:
- The GCED diet is summarized in Table 1 of the study paper.
- My primer on meat-only diets.
Appendix A: Makeup
Amazon.com: Simply search for the type of the product + “gluten free”.
Sephora: Like Amazon, you can search their website or app for the type of product + “gluten free”.
Gluten-free brands:
- Red Apple Lipstick – see their website here. They also have a list of problematic makeup ingredients on their website.
- Afterglow Cosmetics – their website has a webpage specifically discussing gluten-free makeup and why all of their products are gluten-free (the founder’s family has celiac disease).
- Monave – their website states that they use gluten-free ingredients in a dedicated gluten-free facility, with the exception of their oatmeal soap. The owner is a celiac.
- Gabriel Cosmetics (incl. Zuzu Luxe, Clean Kids Naturally) – their FAQ states that their products are gluten-free and that most (but not all) of their product lines are certified gluten-free.
- Ecco Bella – their FAQ claims that their products are gluten-free, though it doesn’t provide information on cross contamination or shared equipment.
- Eos – their FAQ states that their products are gluten-free. No information on cross contamination or shared equipment.
Sort of gluten-free, but not 100% safe?:
- ELF cosmetics – No ingredients that contain gluten, but does sometimes use shared equipment according to VeryWellHealth.
- Bare Minerals – Their website states that many of their products don’t use ingredients derived from barley, oats, rye, spelt or wheat. However, they cannot confirm that their products are free from any traces of gluten. See their FAQ.
- Bite Beauty – Their FAQ contains a list of their gluten-free products. No information on cross contamination or shared facilities.