For anyone with celiac disease or gluten sensitivity, it is important to learn what foods have gluten and to avoid all foods that contain it. Even small amounts of gluten for people with these conditions can cause damage to the body and lead to health problems, sometimes without causing any initial or noticeable symptoms.

What is gluten?

Gluten is the generic name for a number of different proteins contained in the common cereal grains wheat, barley, rye and their common derivatives (see full list below). Sources of gluten include bread, noodles, pasta, pastries, baked goods, and cereals, even those labeled “whole-grain” and “wheat-free.” (Be aware that “wheat-free” does NOT guarantee gluten-free). 

Identifying gluten-containing foods is not always black and white

At first glance, you might think it would be easy to learn which foods have gluten and which don’t. But the truth is that gluten is often hidden. Many processed food contain gluten. It can difficult to tell if gluten is present, even in foods that have all the ingredients listed on the label.

Anyone newly diagnosed with celiac or gluten sensitivity must carefully read all labels and be willing to ask questions and investigate to determine if a food is appropriate. This is true even if it is a food you have eaten before because ingredients can change without warning. If you are ever in doubt, call the company to confirm ingredients. If you are unsure, it is better to not eat the food than risk exposure to gluten.

The U.S. FDA defines “gluten-free” foods as food that is either inherently gluten-free (such as rice), or a food that does not contain a gluten-containing grain (such as wheat, barley, or rye); and states that “any unavoidable presence of gluten” — such as foods made in a shared facility — must be less than 20 parts per million (ppm) of gluten. The World Health Organization and the United Nations also use the 20 ppm standard for gluten-free label claims. There are a variety of gluten-free symbols used to designate whether or not a product is truly “gluten-free”. Most of these symbols look similar to this:

Foods that are inherently gluten-free include: rice (rice bran, rice flour (brown, white, or sweet), rice polish, rice starch flour), corn (corn starch, corn bran, corn flour, corn germ, corn meal), soy flour, potato flour, tapioca starch, bean (garbanzo and broad beans/garfava), sorghum, quinoa, millet, buckwheat (kasha), arrowroot, amaranth, teff, Montina (Indian rice grass), chia, flax, and nut flours. Specially prepared gluten-free breads, baked goods, and other foods should use these gluten-free grains and ingredients.

The following grains, starches, and baking ingredients contain gluten:

• Barley
• Bulgur
• Einkorn
• Emmer
• Faro
• Malt (malt extract, malt flavoring, malt syrup, malt vinegar)
• Oats (assume contaminated unless specifically labeled gluten-free)
• Rye
• Triticale (a combination of wheat and rye)
• Wheat (wheat germ, durum, graham, kamut, farina, semolina, spelt, matzo, couscous, all-purpose flour, cake flour, pastry flour, self-rising flour, bread flour, whole wheat flour, stone ground flour, wheat starch, modified wheat starch, hydrolyzed wheat protein)

All breads, cereals, baked goods, and other foods containing these gluten-containing grains, flours, thickening agents, and baking products should be avoided.

Those avoiding gluten must be extra cautious about the following foods:

• Gravy, sauces, soups are often thickened with gluten-based ingredients. Soy sauce contains wheat and therefore gluten unless specifically labeled gluten-free. Many dressings and marinades contain soy sauce or other gluten ingredients. Teriyaki sauces almost always contain gluten. Worcestershire sauce may or may not contain gluten.
• Dairy. While most dairy products, including milk, cream, and yogurt are gluten-free, watch out for sour cream, commercial chocolate drinks, and non-dairy creamers, which may contain gluten. Avoid malted milk. Processed cheeses (spray cheese) may contain gluten.
• Meats and eggs. While all fresh meats, seafood, and poultry are gluten-free, be cautious about any processed meats (some hot dogs, sausages, lunch meats, cured meats), canned meat and fish, imitation crab, imitation bacon, and imitation seafood. Canned chili with meat may contain gluten. Meat dishes such as Swiss steak, meat loaf, meatballs, and croquettes usually contain gluten. Tuna canned with hydrolyzed wheat protein and turkey injected with hydrolyzed wheat protein as part of the basting solution contain gluten. “Imitation crab” or other meat analogs often contain wheat starch or other gluten ingredients. Quick individually frozen seafood may also be coated in gluten-containing flours. While eggs are certainly gluten-free, some restaurants may add a wheat-based filler to scrambled eggs and omelets.
• Vegetables and fruits. Some canned, frozen, or commercially-prepared vegetables, salads, and bean dishes, such as creamed vegetables and some baked beans and chili, and some commercially-prepared vegetables and salads (deli salads) may contain gluten. All batter dipped vegetables must be avoided, as should French fries made in a fryer shared with breaded products. Some dried, thickened or prepared fruits and pie fillings have gluten.
• Alcoholic beverages. Beer, ale and lager all contain gluten and must be avoided unless specifically labeled gluten-free. Distilled alcoholic beverages are gluten free because distillation effectively removes gluten from wheat.

Other controversial ingredients that may contain gluten:

• Modified food starch. This ingredient may be made from a variety of starches (generally corn or tapioca). Under today’s labeling laws, modified food starch is gluten free unless it is made from wheat, in which case “wheat” will appear on the label. If you don’t see the word wheat on the label, the modified food starch is not wheat derived.
• Hydrolyzed vegetable protein. Hydrolyzed vegetable protein is a phrase that under current federal regulation should not be used on food labels; the “vegetable” must be identified, so “hydrolyzed wheat protein,” is not gluten-free but “hydrolyzed soy protein” is gluten-free.
• Seasonings, seasoning mixes, flavorings, dextrin, and caramel color could contain gluten from wheat or barley. If made from wheat, wheat will be noted on the label as required by law. If made from barley, malt or barley will almost always be listed. Caramel color is almost always made from corn, but it can be made from malt syrup. Most experts now say you can consider caramel color to be gluten free.
• Oats. Most oats are highly contaminated with gluten, but several companies produce pure, gluten-free oats that are labeled gluten free.
• Soy Sauce is usually fermented from wheat. However, some brands don’t include wheat and are gluten free. Read the label to be sure. Tamari is like soy sauce but almost always gluten-free.
• Certain candies like licorice contain gluten.
• Some medications, dietary supplements and herbal products may contain gluten ingredients. Some hair care products, makeup, lotions also contain gluten.

Knowing what foods have gluten is just the tip of the iceberg when it comes to understanding why gluten can negatively affect health and knowing how to live a gluten-free lifestyle. For more gluten-related information, see the following articles:

• Grain Brain – Dr. Perlmutter’s Controversial Book on Dietary Grain Perils
• Depression Symptoms Linked to Gluten Sensitivity
• Gluten Allergy Symptoms Are Commonly Mistaken for Irritable Bowel Syndrome