The primary treatment for celiac disease and gluten sensitivity is to strictly avoid eating foods that contain gluten. NYU Langone physicians work closely with registered dietitians to help create a healthy and satisfying gluten-free diet that fits your lifestyle.
According to recent guidelines created by the U. S. Food and Drug Administration, foods and products that are labeled “gluten free” must contain less than 20 parts per million gluten, meaning the product contains less than 0.002 percent gluten. For people who have celiac disease, avoiding these foods and products allows the intestines to heal and to absorb the nutrients needed to stay healthy.
People with celiac disease need to commit to a strict, lifelong, gluten-free diet to manage the condition safely and effectively. Ingesting even tiny amounts of gluten may cause symptoms and intestinal damage.
It is also important to replenish nutrients and vitamins lost over time, such as calcium, vitamin D, folate, and iron. They may be at low levels in people with celiac disease, so a physician may recommend prescription or over-the-counter supplements. Always check supplement labels to ensure they are gluten-free.
For those with gluten sensitivity, the degree of intolerance can vary. Often, avoiding gluten relieves digestive and other symptoms of the condition. Exposure to gluten, however, does not result in intestinal damage. People with gluten sensitivity may not have to be as vigilant about avoiding products with gluten as those who have celiac disease.
For those with gluten sensitivity and irritable bowel syndrome, or IBS, eating foods low in certain carbohydrates may relieve some symptoms. For instance, FODMAPs—which stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—are a group of carbohydrates that may cause symptoms in people with gluten sensitivity or IBS. Foods containing high levels of these carbohydrates include certain fruits, onions, and beans, among others. Following a diet low in FODMAPs may alleviate symptoms.
Gluten-free diets have become popular even among people who don’t have celiac disease, gluten sensitivity, or a wheat allergy. Some people report feeling better and having more energy on a low gluten or gluten-free eating plan. NYU Langone experts recommend talking to a gastroenterologist before making any major changes in your diet.
NYU Langone dietitians can provide a comprehensive list of foods and products that are safe for people with celiac disease, as well as those that should be avoided. People with celiac disease should avoid all foods containing wheat, barley, and rye, as well as those with other grain-based ingredients, such as bulgur, farina, and semolina flour.
Many processed or packaged foods and beverages also contain gluten, such as beer, pasta, pies, cookies, candies, cakes, cereals, crackers, and salad dressings. A dietitian can explain what ingredients to watch for on food and product labels to avoid accidentally eating gluten.
An important concern when adhering to a strict gluten-free diet is cross-contamination. This can occur when a gluten-free food is manufactured on a machine used for products containing gluten. Some labels warn of this possibility, but not all do. In these situations, it may be best to avoid the food or contact the manufacturer for clarification.
Cross-contamination can also occur at home, especially if there are several people living there. Replacing toasters, cutting boards made of porous materials, and wooden kitchen tools can help prevent inadvertent gluten exposure. Our dietitians and gastroenterologists can help people adjust to these new dietary changes.
Fortunately, many foods are naturally gluten free. These include unprocessed meat, fish, poultry, eggs, beans, seeds, raw nuts, fruits, vegetables, and most dairy products. Our gastroenterologists and dietitians can offer advice on how to shop for these foods to ensure they’re not mixed with grains or other products that contain gluten.
Gluten is present not only in foods but also in commonly used products such as cosmetics—including lipstick and lip balm—as well as toothpaste, deodorant, and medications. Some mouthwashes and toothpastes also contain gluten. In general, if a product meets the gluten-free guidelines, it will be indicated on the label. However, if a product does contain gluten, it may not be so easy to determine, as many ingredients containing gluten have unfamiliar names. Our experts can help you identify which products are safe.