What is a gluten-free diet?

A gluten-free diet is a diet that excludes foods containing gluten.

Gluten is a protein found in wheat (including spelt, durum and atta), rye, barley and oats.

This means gluten is found in a wide variety of foods, including:

• flour
• bread and baked goods
• cereals
• pasta
• processed foods, including seasonings, sauces and stock cubes
• takeaway foods
• beer and malted drinks

What problems can gluten cause?

In people with coeliac disease, eating gluten causes damage to the lining of the small bowel and can lead to serious health problems. It's important for both children and adults with coeliac disease to follow a strict, lifelong gluten-free diet to minimise the risk of complications.

Learn more about coeliac disease.

Some people notice unpleasant symptoms after eating gluten — such as abdominal pain and bloating — and self-diagnose a gluten sensitivity or intolerance. If you have these symptoms, it's important to see your doctor to rule out a serious medical cause, such as coeliac disease.

Who should follow a gluten-free diet?

The only way to manage medically diagnosed coeliac disease is to follow a strict, lifelong gluten-free diet. This is because your sensitivity to gluten will never disappear. Gluten will cause damage to your small bowel every time you eat it, even in tiny amounts.

Your doctor may advise you to follow a gluten-free diet for other reasons — for example, if you have wheat allergy, irritable bowel syndrome or ‘non-coeliac gluten sensitivity'. This refers to a range of symptoms attributed to eating gluten, such as dermatitis herpetiformis. Their cause and treatment, however, is not well understood.

It's a good idea to seek guidance from a dietitian about following a gluten-free diet, especially if you have other health conditions or dietary requirements.

A dietitian can:

• prepare an individual dietary plan
• teach you how to read food labels
• make sure your diet is nutritionally balanced
• determine if you need vitamin supplements

You can find an Accredited Practising Dietitian through Dietitians Australia.

What foods can I eat on a gluten-free diet?

On a gluten-free diet you can eat:

• foods that are naturally gluten-free — such as fresh fruit and vegetables, fresh meats, eggs, nuts and legumes, milk, oils and gluten-free grains such as rice and corn
• products labelled ‘gluten-free'
• products that use the ‘crossed grain logo' — this logo is recognised both in Australia and overseas and means the food item is suitable for a gluten-free diet
• products that are gluten-free according to their ingredients list

In Australia, food labels must specify any ingredients derived from wheat, rye, barley or oats. Avoid products with statements such as ‘may contain gluten' because they can be cross-contaminated with gluten.

Different countries have different labelling laws, especially regarding oat. Some countries may include oat as gluten free food so if you travel, you will need to research which foods are safe to eat.

Managing a gluten-free diet at home

If a child or household member is diagnosed with coeliac disease and requires a gluten-free diet, it's not essential for the entire household to go gluten-free. A gluten-free diet isn't necessarily healthier and it can be more expensive.

Even small amounts of gluten can be harmful to someone with coeliac disease. It's important to take steps to minimise the risk of cross-contamination, especially in a kitchen shared by people on unrestricted and gluten-free diets.

Cross-contamination is when gluten from a gluten-containing food is accidentally transferred onto a food that doesn't contain gluten.

Here are some tips to reduce the chance of cross-contamination and other mistakes:

• Ensure that food preparation areas, appliances, utensils and your hands are clean before you prepare food.
• Enforce a ‘clean spoon' (or ‘no double dipping') rule in spreads and condiments such as butter, jam and honey, to avoid transferring crumbs into the container.
• Clean your toaster and sandwich press regularly or keep a separate one for gluten-free products only. You can also consider using toast bags or wrapping your sandwich in baking paper before using a sandwich press.
• Use fresh water and clean oil when cooking gluten-free food.
• Remember not to dust fish, meats or cake tins with gluten-containing flour.
• Store gluten-free items in a dedicated shelf, bin or cupboard to reduce the chance of mistakes.

How do I choose gluten-free foods?

Choosing gluten-free foods requires an understanding of product labels. You also need to become aware of which ingredients may contain gluten.

Coeliac Australia can help you learn these skills and provide resources to help you follow a gluten-free diet.

For more information, contact Coeliac Australia online or call the Coeliac Australia helpline on 1300 458 836.

An Accredited Practising Dietitian can also teach you how to choose gluten-free foods and products.

How can I eat out on a gluten-free diet?

Most restaurants now have gluten-free options, but these tips might make eating out on a gluten-free diet easier:

• Consult the Coeliac Australia restaurant finder.
• Have realistic expectations. Not everything on the menu will be gluten-free.
• Research ahead of time if you know where you are going to be eating. For example, check if their menu is online. If they don't have gluten-free options listed, give them a call to discuss your needs.
• If you haven't called ahead of time, tell the waiter that you require gluten-free food as soon as you arrive and ask if they can cater for you. If they can't, you may need to find another restaurant.
• Be prepared to pay more, because providing gluten-free foods often costs restaurants more.
• If it doesn't seem right, don't assume it's gluten-free. For example, if bread is served as an accompaniment to soup, check that the bread is also gluten-free.
• Exercise common sense and patience.

Unexpected sources of gluten to remember when you're eating out include:

• stocks and sauces
• soy milk
• icing sugar or dusting chocolate
• salad dressings
• chicken salt
• dusting or coating flour
• oil used for other purposes such as frying foods with a batter that contains wheat flour
• alcoholic beverages

Can anyone follow a gluten-free diet?

Many people think a gluten-free diet is a healthy alternative — but it's not the best option for everyone. Gluten-free products often have higher fat or sugar contents to make the food tastier and improve its texture.

A gluten-free diet is essential for people medically diagnosed with coeliac disease. Others should consider the benefits against the disadvantages of a gluten-free diet. A gluten-free diet can lack essential nutrients if it's not well-balanced.

Gluten itself doesn't offer special nutritional benefits, but the many whole grains that contain gluten do. Gluten-containing grains can be an excellent source of some vitamins and minerals such as B vitamins, folate and iron, as well as fibre. You may miss out on these nutritional benefits if you follow a gluten-free diet and have not sought professional help from a dietitian to ensure your diet is balanced.

Resources and support

Contact Coeliac Australia for more information and advice about following a gluten-free diet or call the Coeliac Australia helpline on 1300 458 836.

You can find an Accredited Practicing Dietitian through the Dietitians Australia website or at 1800 812 942.

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.