Quick-Start Guide to Celiac Disease and Gluten Sensitivity

This quick-start guide to celiac disease will help until you and your doctor can assess your condition.

quick-start guide to celiac disease

More and more food products are using this type of graphic as a shout-out to those requiring a gluten-free diet.

© Elena Torre | Dreamstime.com

Understanding requirements of a gluten-free diet will enable anyone newly diagnosed with celiac disease or gluten allergy symptoms to read labels of food products and determine whether a product is gluten-free. Therefore, it’s important to have a quick-start guide to celiac disease.

Celiac disease is a life-long genetic disorder affecting children and adults. When people with celiac disease eat foods that contain gluten, it creates an immune-mediated toxic reaction that causes damage to the small intestine. This does not allow food to be properly absorbed. Even small amounts of gluten in foods may affect those with celiac disease and cause health problems. Intestinal damage can occur even in the absence of symptoms.

Gluten is the generic name for certain types of proteins contained in wheat, barley, rye, and their derivatives. Research indicates that pure, uncontaminated oats consumed in moderation (up to 1/2 cup dry oats daily) are tolerated by most celiacs. Gluten-free oats are currently available in the United States. Consult your physician or dietitian before including oats in your diet and for regular monitoring.

Quick-Start Guide to Celiac Disease Begins With Knowing Your Grains

Grains allowed: rice, corn (maize), soy, potato, tapioca, beans, garfava, sorghum, quinoa, millet, buckwheat, arrowroot, amaranth, teff, montina, flax and nut flours.

Grains not allowed in any form: wheat (einkorn, durum, faro, graham, kamut, semolina, spelt), rye, barley and triticale.

Food products that may contain gluten:
beers, ales, lager
breading and coating mixes
brown rice syrup
communion wafers
drugs and over-the-counter medications
energy bars
flour and cereal products
herbal supplements
imitation bacon
imitation seafood
nutritional supplements
processed luncheon meats
sauces, gravies
self-basting poultry
soup bases
soy sauce and soy sauce solids
stuffings, dressings
thickeners (roux)
vitamins and mineral supplements

What about alcohol? Distilled alcoholic beverages and vinegars (except malt vinegar) are gluten-free. Distilled products do not contain any harmful gluten peptides. Research indicates that the gluten-peptide is too large to carry over in the distillation process. This process leaves the resultant liquid gluten-free. Wine and hard liquor beverages are gluten-free. Beers, ales, lagers and malt vinegars often aren’t gluten-free, although specialty gluten-free beers are on market.

Always read the label: The key to understanding the gluten-free diet is to become a good label reader. Don’t eat foods with labels that list questionable ingredients unless you can verify they do not contain or are not derived from prohibited grains. Labels must be read every time foods are purchased. Manufacturers can change ingredients at any time. Wheat used in products is identified on the label. As of August 2014, products bearing “gluten free” on the package must contain less than 20 parts per million (ppm) gluten.

Be a food detective: Call first. You can verify ingredients by calling or e-mailing a food manufacturer and specifying the ingredient and the lot number of the food in question. State your needs clearly—be patient, persistent and polite.

When in doubt, go without: Don’t eat a food if you are unable to verify the ingredients or if the ingredient list is unavailable. Regardless of the amount eaten, if you have celiac disease, damage to the small intestine occurs every time gluten is consumed, whether symptoms are present or not.

Wheat-free is not gluten-free: Products labeled wheat free are not necessarily gluten free. They may still contain spelt, rye or barley-based ingredients that are not gluten free. Spelt is a form of wheat.

Keep in mind: Starting the gluten-free diet before being tested for celiac disease makes an accurate diagnosis difficult.

Substitution Solutions

Whether you’re newly diagnosed with a food allergy or sensitivity or someone you love is, the prospect of cooking can be overwhelming. But once you understand which alternatives work for dairy products, nuts, and flour, the process will become routine.

Understand also that substituting ingredients for those staples doesn’t mean you have to miss out on favorite foods, flavors, and dishes. No matter what type of ingredient you’re allergic to, there are plenty of tasty gluten- and casein-free recipes that hit the spot. (Visit GlutenFreeAndMore.com for hundreds of examples.)

Depending on the recipe, replace 1 cup cow’s milk with 1 of the following:

  • 1 cup rice milk
  • 1 cup fruit juice
  • 1 cup coconut milk
  • 1 cup goat’s milk, if tolerated
  • 1 cup hemp milk

Depending on the recipe, replace 1 cup buttermilk with 1 of the following:
1 cup soy milk plus 1 tablespoon lemon juice or one tablespoon cider vinegar
(Let stand until slightly thickened.)

  • 1 cup coconut milk
  • 7/8 cup rice milk
  • 7/8 cup fruit juice
  • 7/8 cup water

Depending on the recipe, replace 1 cup yogurt with 1 of the following:

  • 1 cup soy, rice or coconut yogurt
  • 1 cup unsweetened applesauce
  • 1 cup fruit puree

(1 stick = 8 tablespoons = ½ cup = 4 ounces)
Depending on the recipe, replace 8 tablespoons butter with 1 of the following:

  • 8 tablespoons Earth Balance (Non-Dairy) Buttery Spread or Sticks
  • 8 tablespoons Spectrum Organic Shortening
  • 8 tablespoons coconut oil
  • 8 tablespoons vegetable or olive oil

Note: For reduced fat: 6 tablespoons unsweetened apple-sauce + 2 tablespoons fat of choice.

Depending on the recipe, replace 1 large egg with 1 of the following:

  • Flax or Chia Gel: 1 tablespoon flax meal, chia seed or salba seed + 3 tablespoons hot water. (Let stand, stirring occasionally, about 10 minutes or until thickened. Use without straining.)
  • Egg Replacer: Ener-G Foods egg replacer, according to package directions
  • Tofu: 4 tablespoons pureed silken tofu + 1 teaspoon baking powder
  • Applesauce: 4 tablespoons unsweetened applesauce (or other fruit puree) + 1 teaspoon baking powder

Important: Replacing more than two eggs can change the integrity of a recipe. For recipes that call for a lot of eggs (like a quiche) use pureed silken tofu, if soy is tolerated. Because egg substitutions add moisture, you may have to increase baking times slightly.

Depending on the recipe, replace tree nuts or peanuts with an equal amount of 1 of the following:

  • Toasted coconut flakes
  • Sunflower seeds
  • Toasted sesame seeds (use only 2 to 3 tablespoons)
  • Crushed cornflakes
  • Crushed crispy rice cereal
  • Crushed potato chips
  • Pumpkin seeds

Gluten-Free Flour Recipes

To make a flour blend, thoroughly combine all ingredients. Store in a covered container in the refrigerator until used. You can double or triple these recipes to make as much flour blend as you need.

All-Purpose Flour Blend
Use this blend for all your gluten-free baking.

½ cup rice flour
¼ tapioca starch/flour
¼ cup cornstarch or potato starch

Nutrition Information*:
Each cup contains 436 calories, 1g total fat, 0g saturated fat, 0g trans fat, 0mg cholesterol, 99g carbohydrate, 3mg sodium, 2g fiber, 5g protein.
Note: ½ cup brown rice or sorghum flour may be added to boost nutritional content without changing texture or taste.

High-Protein Flour Blend
This nutritious blend works best in baked goods that require elasticity, such as wraps and pie crusts.

1 1/4 cups bean flour (your choice), chickpea flour, or soy flour
1 cup arrowroot starch, cornstarch, or potato starch
1 cup tapioca starch/flour
1 cup white or brown rice flour

Nutrition Information*:
Each cup contains 588 calories, 3g total fat, 0g saturated fat, 0g trans fat, 0mg cholesterol, 128g carbohydrate, 24mg sodium, 6g fiber, 11g protein.

High-Fiber Flour Blend
This high-fiber blend works for breads, pancakes, snack bars, and cookies that contain chocolate, warm spices, raisins or other fruits. It is not suited to delicately flavored recipes, such as sugar cookies, crepes, cream puffs, birthday cakes, or cupcakes.

1 cup brown rice flour or sorghum flour
½ cup teff flour (preferably light)
½ cup millet flour
2/3 cup tapioca starch/flour
1/3 cup cornstarch or potato starch

Nutrition Information:*
Each cup contains 428 calories, 2g total fat, 0g saturated fat, 0g trans fat, 0mg cholesterol, 92g carbohydrate, 19mg sodium, 5g fiber, 8g protein.

Self-Rising Flour Blend
Use this blend for muffins, scones, cakes, cupcakes or any recipe that uses baking powder for leavening.

1¼ cups white sorghum flour
1¼ cups white rice flour
½ cup tapioca starch/flour
2 teaspoons xanthan or guar gum
4 teaspoons baking powder
½ teaspoon salt

Nutrition Information*:
Each cup contains 514 calories, 3g total fat, 0g saturated fat, 0g trans fat, 0mg cholesterol, 113g carbohydrate, 1163mg sodium, 8g fiber, 10g protein.

*Nutritional analyses of recipes are based on data supplied by the U.S. Department of Agriculture and certain food companies. Nutrient amounts are approximate due to variances in product brands, manufacturing and actual preparation.

General Guidelines for Using Xanthan or Guar Gum

Gum (xanthan or guar) is the key to successful gluten-free baking. It provides the binding needed to give the baked product proper elasticity, keeping it from crumbling.

  • Add ½ teaspoon xanthan or guar gum per cup of flour blend to make cakes, cookies, bars, muffins and other quick breads.
  • Add 1 teaspoon per cup of flour blend to make yeast bread or other baked items that call for yeast.
  • Add 1½ teaspoons per cup of flour blend to make pizza dough or pie crust.

We hope this quick-start guide to celiac disease has been helpful to you. What other tips would you suggest? Let us know in the comments section.


For more information, contact these organizations.
Celiac Disease Foundation
20350 Ventura Blvd., Ste 240
Woodland Hills, CA 91364

Celiac Support Association
PO Box 31700
Omaha, NE 68131-0700

Gluten Intolerance Group
31214 124th Ave. SE
Auburn, WA 98092

National Foundation for Celiac Awareness
PO Box 544
Ambler, PA 19002-0544

As a service to our readers, University Health News offers a vast archive of free digital content. Please note the date published or last update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Timothy Cole

Timothy Cole has served more than 30 years as chief content officer of Belvoir Media Group, publisher of University Health News. In addition to oversight duties on University Health News, … Read More

View all posts by Timothy Cole

Enter Your Login Credentials
This setting should only be used on your home or work computer.