Gluten-free diet

Introduction

A gluten-free diet means a diet that does not contain gluten.

What is gluten?

Gluten is a protein found in wheat, barley and rye and is present in any food or drink that has been made using or containing any of these.

Why can’t some people eat gluten?

Some people develop health conditions like coeliac disease and dermatitis herpetiformis in reaction to eating gluten. These people need to follow a lifelong gluten-free diet to treat their condition.

Gluten-free food and drink

Many gluten-free foods are available in supermarkets, health food shops or on prescription as alternatives to gluten-containing foods.

Gluten-free alternatives are available for the following gluten-containing foods:

  • Pasta
  • Pizza bases
  • Flours
  • Breakfast cereals
  • Bread
  • Biscuits

There are also many foods available that are naturally gluten-free, such as:

  • meat
  • fruit and vegetables
  • rice
  • dairy foods
  • eggs
  • pulses

A dietitian can help to identify which foods are safe to eat if you are unsure.

Gluten-free drinks

Many soft and alcoholic drinks don’t contain gluten, including:

  • fruit juice and cordials
  • flavoured water
  • fizzy drinks
  • cider
  • wine
  • sherry
  • port
  • spirits and liqueurs.

The following drinks are not gluten-free but you can find gluten-free versions in your local supermarket and some health food stores:

  • Squashes and fizzy drinks that contain barley 
  • Lager
  • Stout
  • Ales

Oats

Many people with coeliac disease avoid eating oats because they can become contaminated with other cereals that contain gluten during the milling process.

Oats do not contain gluten, but they do contain a similar protein that some people have a reaction to.

If, after discussing this with your health professional, you want to include oats in your diet you should make sure they are gluten-free.

When to avoid eating oats

It is recommended that you avoid eating all oats for the first year after diagnosis, until the gluten-free diet has taken full effect and symptoms have cleared up.

When symptom free, you can gradually reintroduce gluten-free oats into your diet but must stop eating oats if symptoms return.

A dietitian can provide advice and assistance through this process.

Gluten-free labelling

By law, foods labelled as ‘gluten free’ can contain no more than 20 parts per million (ppm) of gluten and are safe for you to eat.

You should always check for gluten on food and drink labels before buying. A dietitian can help to explain the labeling of gluten-free foods if you are unsure.

Processed Foods

Before eating processed foods such as ready meals and soups, you need to check that they are gluten-free first.  You can do this by checking the label or the Coeliac UK Food and Drink Directory, which lists thousands of gluten-free food items for sale.

Cross-contamination

If you eat a gluten-free diet to treat a health condition, it is important that you do not contaminate your gluten-free food with other food that contains gluten.

To stop cross-contamination:

  • Wipe down surfaces
  • Clean pots and pans with soap and water
  • Use separate breadboards to keep gluten-free and gluten-containing breads separate.
  • Use a separate toaster or toaster bags
  • Use different butter knives and jam spoons to prevent breadcrumbs from getting into condiments
  • Use separate containers to store gluten-free food from gluten-containing foods

Gluten-free food on prescription

If you have a confirmed diagnosis of coeliac disease or dermatitis herpetiformis, you can access gluten-free foods on prescription either through your GP or through the Scottish Gluten-free Food Service.

What is the Scottish Gluten-free Food Service?

The Scottish Gluten-free Food Service is a new service that means people who have coeliac disease or dermatitis herpetiformis and require gluten-free food on prescriptions:

  • can place a gluten-free food order through their pharmacist
  • will no longer have to visit their GP to order a prescription
  • will be in charge of the amount and type of foods they order each month up to an agreed amount.

This service will allow people who need a gluten-free diet greater control and flexibility to try different foods each month.

Find out who can use the Scottish Gluten-free Food Service

Dining out

When dining out, choose dishes from the menu that are more likely to be gluten-free such as  rice or potato based dishes and try to avoid pasta or flour based dishes. 

If there is nothing suitable on the menu, chefs are usually happy to cook something specific once they know why.

You might find it useful to call ahead to explain:

  • why you need a gluten-free diet what foods you can eat
  • how the food should be prepared and served to avoid cross-contamination.

Talk to waiting staff

At the restaurant, you should ask the waiter which menu items might be suitable as many restaurants and takeaways now offer gluten-free meals as part of their menu.

Gluten-free medicine

All medications and drugs that a GP prescribes are gluten-free.

If you are buying medicine that has not been prescribed, you can tell that a medicine is gluten-free if there is a Product Licence (PL) number on the packet. Your pharmacist will be able to help you with this.

Sometimes side effects caused by medications are similar to symptoms that occur after accidentally eating gluten. If you have any unexpected side effects, speak to your GP.

Hospital visits

If you follow a gluten-free diet and have to go into hospital for whatever reason, you must make sure that staff know that about your dietary needs.

Knowledge of the gluten-free diet may be variable and specialist gluten-free food may not be kept in stock. If your visit is planned, speak to the hospital staff beforehand to ensure they can be prepared.

More information about a gluten-free diet

Coeliac UK provides very useful information about adopting a gluten-free diet and lifestyle

Last updated: 03 April 2014