A Comprehensive Guide to a Gluten-Free Diet

September 26, 2024

4 mins

Gluten is a protein found in wheat, rye, barley, and triticale (a hybrid of wheat and rye), amongst others. Over the past decade, fad diet culture has promoted the idea that gluten is unhealthy and harmful to the body. But for most people, gluten is not inherently bad. 

What is Gluten?

Human bodies break down food using digestive enzymes. Protease – the enzyme that processes proteins – is unable to fully break down gluten. Most people are able to handle the undigested gluten protein, but some people are not. 

Undigested gluten passes through the small intestine, where it can potentially trigger responses in those with gluten-related conditions. 

What is Celiac Disease?

The most severe condition associated with the inability to process undigested gluten is celiac disease. Meaning “pertaining to the abdomen or bowels”, celiac disease is a chronic autoimmune disorder that damages the small intestine as a result of gluten entering the digestive system. 

When the immune system has an excessive reaction to gluten in food, it harms the small, hairlike structures called villi that line the small intestine. These villi are responsible for absorbing vitamins, minerals, and other nutrients. If they are damaged, your body can’t absorb enough nutrients, regardless of how much you eat.

Without healthy villi to absorb essential nutrients like vitamins and minerals, the body can suffer from deficiencies, leading to a range of health issues, even if you're eating a well-balanced diet. This is referred to as malabsorption, and it can result in fatigue, weight loss, and other symptoms related to poor nutrition.

An estimated 1% of people around the world have celiac disease. When somebody with celiac disease eats gluten, they may experience severe digestive symptoms, including:

• Bloating and pain in the abdomen

• Chronic diarrhea

• Constipation

• Nausea or vomiting

• Lactose intolerance triggered by damage to the small intestine

What’s the Difference Between Celiac Disease and Gluten Intolerance?

It’s possible to experience negative reactions to gluten even without having celiac disease. This condition, known as non-celiac gluten sensitivity (NCGS), is triggered by gastrointestinal inflammation due to the presence of gluten. This is also known as gluten intolerance.

People with NCGS often experience symptoms that closely resemble those seen in celiac disease – such as bloating, diarrhea, fatigue, and headaches – but without the immune system's attack on the small intestine.

Unlike celiac disease, NCGS does not cause damage to the villi or lead to long-term harm to the digestive system. While the symptoms can still cause significant discomfort and disrupt daily life, the lack of intestinal damage means that people with NCGS don’t typically face the risk of malnutrition or other complications linked to nutrient absorption issues. 

The exact cause of NCGS isn’t fully understood, and diagnosis can be challenging since there’s no specific test for it. Treatment usually involves reducing or eliminating gluten from the diet, which can alleviate symptoms for many people.

What’s a Wheat Allergy?

A wheat allergy is an overreaction of the immune system to wheat, as opposed to all gluten. This can be as severe as celiac disease, with symptoms that may include:

• Hives or rashes

• Nausea and vomiting

• Stomach cramps

• Wheezing

• Runny or stuffy nose

• Anaphylaxis

When somebody is allergic to wheat, they can usually handle gluten in other grains. That being said, many people with wheat allergies choose to stay away from gluten altogether to avoid cross-contamination with wheat.

The Benefits of a Gluten Free Diet

If you believe you may have celiac disease, a wheat allergy, or are gluten intolerant, it may be advised that you “go” gluten-free.

A gluten-free diet can be helpful in getting to the bottom of your gastrointestinal (GI) issues. If you are experiencing uncomfortable GI symptoms and are not sure why, cutting out gluten for a period of time may help you figure it out.

That being said, it’s important to consult with your licensed healthcare provider to receive a proper diagnosis and work on an eating plan that fits in with your daily life.

Some of the reported benefits of a gluten-free diet include reduced inflammation, increased energy levels, and better digestive health.

Gluten-Free Diet and Erectile Health

Sexual dysfunction can sometimes be a side effect of chronic gastrointestinal and liver conditions. A 2022 study that anonymously surveyed 114 men with celiac disease found that over 30% of them experienced mild to severe erectile dysfunction as a side effect of consuming gluten. 

The study also found that the higher body mass index a man has, the more likely he is to experience sexual dysfunction as a side effect of celiac disease. 

Having a gluten sensitivity can also impact your sexual health. The inflammation of the gut lining as a result of NCGS can impair blood flow, contributing to ED in some men. It can also impair the absorption of important vitamins and minerals, including those that are essential for maintaining healthy erectile function.

Therefore, incorporating a gluten-free diet into your life may help with erectile health if you believe you are sensitive to gluten or have celiac disease. That being said, there is no evidence to show that eating gluten-free will help relieve ED symptoms in someone who is unaffected by gluten. 

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Gluten-free diet and fertility

Studies have shown that there is a possible link between gluten-related conditions and men’s fertility issues. Because it results in nutrient deficiencies, celiac disease has been connected to hypogonadism, a male fertility condition that occurs when the testes produce extremely low levels of testosterone. This can result in ED and male infertility.

That being said, many of the studies occurred years ago, and there is a lack of updated information and studies regarding male infertility as a result of celiac disease and other gluten-related conditions.

Nonetheless, avoiding gluten when you are diagnosed with celiac disease or suspect you have a sensitivity to gluten is very important, whether or not it lessens your chances of male infertility.

Foods to Avoid

If you believe a gluten-free diet might be right for you, it’s time to get familiar with some of the foods you’re going to need to avoid. Gluten is found in all foods made with wheat, barley, and rye, and can also be hidden in many more sources. 

Some of the most common gluten-containing foods that will now be a big “no-no” are:

Grains: Rye, barley, farina, spelt, wheat, kamut, farro, couscous, semolina, bulgur

Grain-based foods: Bread, pastas, cereals, cookies, crackers, etc.

Condiments: Soy sauce, Worcestershire sauce, barley malt, barbecue sauces, spice blends, ketchup, gravy mixes

Alcoholic beverages: Beer, hard ciders, wine coolers, and malt beverages

It can sometimes be hard to spot gluten-containing items on an ingredients list. Look out for these words as hidden gluten:

• Wheat starch, bran, or germ

• Cracked wheat

• Durum

• Einkorn

• Emmer

• Fu (common in Asian cuisines)

• Gliadin

• Graham flour

• Matzo 

When selecting foods to incorporate into your gluten-free diet, be mindful about reading food labels carefully. You’ll want to be on the lookout for various gluten derivatives and potential cross-contamination. 

Gluten-Free Alternatives and Substitutes

The list of foods to avoid may be daunting, but remember: There are tons of gluten-free alternatives and substitutes hitting the shelves that you can add to your diet to supplement the foods you’re taking away.

Many naturally gluten-free grains, legumes, and seeds offer a wide variety of nutrients. They can easily be used to substitute gluten-containing ingredients. These alternatives include:

• Corn, cassava, and potato

• Nut flours

• Chia and flax seeds

• Soybean and other legumes

• Millet, quinoa, and rice

• Amaranth, buckwheat, and sorghum

• Arrowroot and tapioca

Keep in mind that while none of these ingredients contain gluten, there is a potential for cross-contamination unless you specifically purchase ‘gluten-free’ marked items.

Avoiding gluten doesn’t mean you’ll never be able to indulge in a delicious chocolate chip cookie straight out of the oven.

Because of the popularity of gluten-free diets – with over 30% of Americans now avoiding gluten – most grocery stores and restaurants are stocked with delicious substitutes that are made to taste as similar to their gluten alternatives as possible.

Some of these substitutions include:

• Gluten-free breads, crackers, and baked goods

• Rice- or chickpea-based pastas

• Gluten- or grain-free baking mixes

• Grain-free corn tortillas and tortilla chips

• Cauliflower pizza crust

Planning Balanced Gluten-Free Meals

Following a gluten-free diet is possible and attainable, with tons of substitutes and alternatives available to replace typical gluten-based foods. Incorporating a wide variety of naturally gluten-free foods such as fruits, vegetables, lean proteins, and healthy fats is key to living a healthy, gluten-free life.

As with any diet or lifestyle plan, nutritious and well-balanced meals are key. 

Everybody has different preferences and goals when it comes to food. That being said, a typical day of eating gluten-free could look like this:

Breakfast: Two to three scrambled eggs with a side of gluten-free toast with avocado and fruit.

Lunch: An almond flour tortilla with turkey, lettuce, tomato, and mustard — with a side of carrots and hummus.

Dinner: Chicken stir-fry with peppers, onions, and broccoli, prepared with gluten-free soy sauce and served with brown rice.

Dessert: Flourless chocolate cake with vanilla ice cream and berries.

Gluten-Free Dining Out and Traveling

Dining out and traveling can be intimidating with any dietary restriction. Fortunately, there are many ways to feel more comfortable. Some of the best tips to help you eat gluten-free while at a restaurant or on the road include:

• Check the menu ahead of time for gluten-free options

• Call the restaurant before going, for additional clarification

• Inform the wait staff of the severity of your restriction

• Come prepared with your own snacks while traveling

• Use one of the many apps that help you identify gluten-free friendly restaurants, including Find Me Gluten Free and Gluten Dude

Overcoming Challenges and Staying Motivated

Starting a new eating plan, specifically one that cuts out such a prominent element of your diet, can be overwhelming. But there are many ways to overcome these challenges and keep yourself motivated.

Remember: You are not alone! Online communities are there to help you, with thousands of other people experiencing the same challenges as you sharing tips and tricks for living gluten-free.

Seeking support from family and friends will help you navigate through social situations surrounding eating, such as parties and holidays. In addition, meeting with a registered dietitian or nutritionist will help you work through the challenges of eliminating gluten from your diet and sufficiently replacing it.  

Try to remember that the hard part will not last forever. You are adapting to a new way of eating, and it will just take some time to adjust. Be patient and persistent, and eventually you will be leading a healthy life, gluten-free.

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