So you've decided you need to follow a wheat-free diet — either because of a medical diagnosis or simply because you feel bloated and out-of-sorts after eating the grain. Life without wheat may be more comfortable for your stomach, but what on earth can you eat when you ditch it?
What's the Problem With Wheat?
Wheat contains a group of proteins called gluten, which some digestive systems can't handle. Celiac disease is the name given to the autoimmune condition in which the body is permanently intolerant to gluten. According to the National Celiac Association, if you have undiagnosed or untreated celiac disease, the finger-like villi that line the walls of the small intestine become flattened and unable to absorb nutrients properly.
Full-blown celiac disease is a serious condition, and if you have it you'll need to cut out gluten forever to avoid feeling poorly. You won't be able to eat wheat again at some time in the future.
Another type of intolerance, known as non-celiac gluten sensitivity, or just plain gluten sensitivity/ intolerance is a more mild version of celiac disease, and it may get better. Unlike celiac disease it does not involve damage to the small intestines.
The National Celiac Association says symptoms of gluten sensitivity can range from mild to more severe and include diarrhea, vomiting and migraines. Following a wheat-free diet can reduce or eliminate these symptoms.
A Little Bit of Perspective
Perhaps because low carb and wheat-free diets have incorrectly become synonymous with "healthy", lots more people think they have a problem with gluten than actually do.
The perception versus reality of gluten intolerance is neatly summed up by an August 2015 study published in the journal Digestion. The aim of the study was to find out how many people from a group who believed they were gluten intolerant actually were. The results? Of the 392 people who claimed they couldn't digest gluten, only 6.6 percent tested positive for celiac disease. Just 6.9 percent more were found to have non-celiac gluten sensitivity.
Based on this, 86.5 percent of those who believe they are sensitive to gluten can actually consume it without any health issues.
More likely, if you find you get uncomfortable after eating foods like bread or pasta, it will be because of the carbohydrate content overall rather than because of wheat or gluten specifically. Among the several reasons why carbs can cause bloating, fermentation by bowel bacteria of specific carb fractions is a common explanation.
Read more: The 10 Worst Foods for Bloating
If you do need to cut out gluten or follow a wheat-free diet, the good news is that there are still plenty of things for you to eat and your diet can still be healthy and balanced if you take care.
Eating a Wheat-Free Diet
Just cutting out wheat is an easier task than cutting out every trace of gluten. If you are banishing all gluten from your diet, you will also need to avoid every trace of barley, rye and triticale (a cross between rye and wheat) as they also contain the protein. You'll need to be stricter with celiac disease than with a milder intolerance.
According to the Mayo Clinic bulgur, durum, einkorn, emmer, farro, kamut and spelt are all forms of wheat, so make sure to avoid products with these listed on the label. All of the following flours are also from wheat:
- Enriched flour, with extra vitamins and minerals
- Farina, usually used to make hot cereals
- Graham flour, a whole grain wheat flour
- Self-rising flour
- Semolina, used in pasta and couscous
Prepackaged foods that contain wheat, barley, rye or triticale and derivatives must be labeled with the name of the grain in the ingredient list, which is very helpful.
But as well as the more obvious "grain" foods like bread, pasta, breakfast cereals, cakes, cookies and crackers, the Mayo Clinic says any or all of the following may contain wheat or gluten, unless they're labeled as specifically gluten free:
- Beer, ale, porter, stout (usually contain barley)
- French fries
- Gravies, soups and bouillon
- Imitation meat or seafood
- Malt, malt flavoring and other malt products (barley)
- Hot dogs and processed lunch meats
- Salad dressings
- Sauces, including soy sauce (wheat)
- Potato and tortilla chips
- Self-basting poultry
Read more: 9 Foods You Didn't Know Contain Gluten
What You Can Eat
There are many naturally wheat and gluten-free foods that are part of a healthy balanced diet. The Office of Disease Prevention and Health Promotion recommends that for good health we eat a range of fruits and vegetables, low fat dairy products, oils and proteins (seafood, lean meats and poultry, soy products, eggs, beans and peas, nuts and seeds), all of which are safe for celiacs and people with non-celiac gluten sensitivity.
Grains — half of which should be whole grain — should also be part of a healthy diet. And though it's trickier if you have to avoid wheat and gluten, there are plenty of safe choices.
Check out this list of gluten-free grains as recommended by the Mayo Clinic:
- Corn — cornmeal, hominy, grits and polenta labeled gluten-free
- Gluten-free flours — rice, soy, corn, potato and bean flours
- Rice, including wild rice
- Tapioca (cassava root)
Oats aren’t straightforward. According to the Gluten Free Watchdog, if you have celiac disease, you may want to avoid them altogether. They don't naturally contain gluten, but may be contaminated with traces of wheat or barley during processing. Oats should be OK with a mild intolerance though, especially if the food carries a gluten-free statement.
Read more: List of Wheat-Free Bread and Cereal
Getting Enough Nutrients
A December 2016 study in Clinical Nutrition found that gluten-free diets commonly did not contain adequate amounts of vitamins and minerals, in particular vitamin D, vitamin B12, folate, iron, magnesium, calcium and zinc.
Gluten-free diets were also found to provide less healthy fiber, more cholesterol-raising saturated fat and to have a higher glycemic index and glycemic load. In fact, a June 2015 study in the American Journal of Clinical Nutrition found that diets with a high glycemic load were associated with more weight gain.
Part of the problem is relying on processed gluten-free foods. Research in the February 2018 issue of the Journal of Human Nutrition and Dietetics found high fat and sugar levels occurred more commonly in gluten-free bread and flour products than wheat-containing ones. High salt was also more common in gluten-free products, which also tended to be lower in protein and fiber, too. Gluten-free foods are pricier as well.
This research reinforces that if you don't actually need to cut out gluten or eat a wheat-free diet, it's easier, cheaper and generally healthier not to do so. If it's essential you do go gluten free, try not to rely on commercially-made alternatives too much.
Is This an Emergency?
- National Celiac Association:"What is Celiac Disease"
- Digestion: " Non-Celiac Gluten Sensitivity among Patients Perceiving Gluten-Related Symptoms"
- Mayo Clinic: "Gluten-Free Diet"
- Office of Disease Prevention and Health Promotion: "Dietary Guidelines 2015-2020: Key Recommendations: Components of Healthy Eating Patterns"
- Gluten Free Watchdog: "Gluten Free Watchdog Updated Position Statement on Oats"
- Clinical Nutrition: "Non-Celiac Gluten Sensitivity Among Patients Perceiving Gluten-Related Symptoms"
- American Journal of Clinical Nutrition:"Changes in Intake of Protein Foods, Carbohydrate Amount and Quality, and Long-Term Weight Change: Results From 3 Prospective Cohorts"
- Journal of Human Nutrition and Dietetics: "An Investigation Into the Nutritional Composition and Cost of Gluten-Free Versus Regular Food Products in the UK"