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Although there are some good websites, information on the Internet is not always accurate or up-to-date. If you are uncertain about the reliability of the information, contact your health care provider.
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The grains to avoid are wheat, barley, and rye. Since oats are usually contaminated with wheat and some patients are sensitive to the oats themselves, the safest course is to also eliminate oats until the issue is discussed with your health care provider.
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A gluten-free diet is not automatically a healthy diet. Many gluten-free breads and cereals are not fortified with vitamins and minerals at the same level as wheat-containing breads and cereals. Keeping a food record and discussing it with the dietitian can help identify whether the diet is meeting requirements for growth and development. You should take a gluten-free multivitamin with iron and zinc for a least one year following the diagnosis of celiac disease.
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Learn to read food labels carefully. Products labeled as wheat-free may still include barley, rye, or oats, making them unsafe for a gluten-free diet. In addition, contact information for the manufacturer is usually provided on the product label. Re-read labels every time you purchase a product, since food labels change over time. Bring some of the labels on your favorite foods to your nutrition appointment and practice reading labels with your dietitian.
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How much gluten is safe? Even as little as a crumb of gluten-containing food can potentially damage the intestinal villi and cause symptoms, so the goal is a 100% gluten-free diet.
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Children with symptoms from celiac disease usually feel better within days to weeks of starting the gluten-free diet.
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Try not to focus on foods you have to give up, the goal of learning the diet should be to find acceptable gluten-free alternatives to your favorite foods.
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There are many hidden sources of gluten, including glue on stamps and envelopes, and play dough.
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A number of extremely valuable books have been written on the subject of celiac disease and the gluten-free diet. Some of these are listed on our website.
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A follow-up visit with the dietician or nurse educator within 4-6 weeks is recommended, since there is much to learn about the gluten-free diet.
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Gastrointestinal symptoms such as diarrhea, bloating, or gas that continue even on a gluten-free diet may be due to lactose intolerance. This is usually temporary and disappears when the intestine heals completely. Talk to your health care provider about the possible need to temporarily restrict dairy products.
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Children with Type 1 diabetes mellitus and celiac disease need to continue to follow their diabetes meal plan or count carbohydrates while eliminating gluten from their diet. Insulin requirements may change as their intestine heals and absorption of nutrients improves. Many processed gluten-free foods are quite low in fiber and have a high glycemic index. Gluten-free breads are often higher in carbohydrates than wheat bread. Meeting with a dietitian well versed in both diabetes and celiac disease is very important.
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It is important to become familiar with lists of grains and flours that are safe and unsafe for individuals who must restrict gluten. Safe grains and flours include: amaranth, bean flours, buckwheat, corn, millet, montina, nut flours, potato, quinoa, rice, root flours, sorghum, tapioca, and teff. Unsafe grains and flours include: barley, bran, farina, graham, rye, semolina, spelt, triticale, wheat, and any flour where the source is not specified.
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