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Although avoiding gluten in the diet takes a little extra effort, it is important not to lose sight of the importance of a healthy, balanced, and wholesome diet. A balanced diet is one that includes adequate amounts of the various nutrients that are required for:

  • Keeping us alive
  • Giving us energy
  • Preventing chronic diseases

Table 1 offers guidelines for healthy, balanced eating. The gluten-free diet can be naturally wholesome because so many healthy foods are naturally gluten-free.

Following these basic nutrition guidelines below can help you feel great as well as lower your risk for chronic diseases such as diabetes, cardiovascular diseases, and certain cancers. 1

TABLE 1. HEALTHY EATING GUIDELINES:
  • Balance calories with physical activity to manage weight. 
    Click here for Physical Activity Guidelines for Americans of all age groups:http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf
  • Consume more foods that are high in nutrients, such as fruits, vegetables, gluten-free whole grains, fat-free and low-fat dairy products, and seafood.
  • Consume fewer foods with sodium (salt), saturated fats, trans fats, cholesterol, added sugars, and refined grains. 2
HEALTHY EATING RECOMMENDATIONS SPECIFIC TO CELIAC DISEASE: THE BASICS:
  • Grains: Consume the recommended number of servings (6-11) from the gluten-free grain food group each day. The number of grain servings depends on how many calories you need to eat per day. 

    Consume at least half of your gluten-free grains each day from whole grain sources. 

    Try to choose gluten-free whole grain products whenever possible. These should be labeled gluten-free. Click here for information on gluten-free whole grains: 
    http://www.glutenfreedietitian.com/newsletter/healthy-gluten-free-grains/ 
    http://www.glutenfreedietitian.com/newsletter/dietcom-blog-my-favorite-gluten-free-grain/ 

    Choose enriched and/or fortified, gluten-free products over refined, unenriched products whenever possible. 

    HEALTH TIP: To find out if a product is enriched or fortified, look for the words "enriched" or "fortified" on the box or look for added vitamins and minerals (such as thiamin, riboflavin, niacin, folic acid, and iron) in the ingredient list.


  • Fiber: Speak to your dietitian to discuss your individual fiber needs since they vary by gender, age and medical conditions.
  • B-Vitamins: Get adequate B-vitamins (thiamin, riboflavin, niacin, folate, etc) from gluten-free whole grains, enriched and/or fortified bread, pasta, baking mixes, and fortified cereals.
  • Iron: Make sure to have sufficient iron in your diet. Iron deficiency is common especially in those who suffer from significant malabsorption, those on a vegetarian diet, and menstruating women. Iron needs vary by gender, age and medical conditions and too much iron can be dangerous. Speak with your doctor or dietitian before starting an iron supplement.
  • Calcium and Vitamin D: In general, consume three servings of low-fat or non-fat gluten-free dairy foods or non-dairy alternatives each day. 
    Click here for a chart of calcium and vitamin D rich food sources. 
  • Protein: Make sure that your diet has adequate protein by choosing dried beans, peas, nuts and seeds, fish, lean cuts of poultry, beef, and pork, and fat-free or low-fat dairy.
  • Fruits & Vegetables: Pick a variety of fruits and vegetables to get enough vitamins, minerals, fiber, and antioxidants. 

    What's a serving size of fruits and vegetables?
    • 1/2 cup fruit
    • Medium-sized piece of fruit (the size of a tennis ball)
    • 1/4 cup dried fruit
    • 3/4 cup (6 ounces) of 100% fruit or vegetable juice
    • 2 cups leafy vegetables (spinach, lettuce leaves, etc.)
    • 1 cup cooked or raw vegetables
    healthy eating
  • Fats: Make a healthy choice by reducing your saturated fat intake such as by choosing fish, lean poultry and lean meat. Use vegetable oils (olive oil, grapeseed oil, sunflower oil, safflower oil, canola oil) instead of butter.
  • Sweets: Limit your intake of sweets and sugar-sweetened beverages.
  • Salt: Monitor your salt/sodium intake. Depending on your medical conditions, your doctor or dietitian may recommend a low sodium diet. 

    Click on this link to review low sodium diet guidelines. PLEASE NOTE: this is a generic handout that includes gluten-containing foods. If you use this handout, choose the gluten-free alternatives and pay attention to any difference in sodium levels between the gluten-containing suggestion and the gluten-free equivalent.
  • Water: Staying healthy also requires staying well hydrated. Make sure that you drink enough water each day.man smiling
  • Supplements: Talk to your doctor or dietitian about gluten-free multivitamin/multi-mineral supplements. 

    • Click here for a 15-page guide to the gluten-free diet by Food Category.

TAKE HOME MESSAGES:

  • Avoiding gluten is the most important first step toward health for someone with celiac disease. It is also very important to eat a well-rounded, heart-healthy gluten-free diet.
  • Eating healthy makes you feel great and lowers your risk of chronic disease.
  • Consult with a dietitian skilled in celiac disease if you have questions about the nutritional value of your diet.

References:

  1. Descher N. Balanced and Delicious: A Healthy Gluten-Free Diet. In Real Life with Celiac Disease: Troubleshooting and Thriving Gluten-Free . Eds. Dennis M, Leffler D. AGA Press, Bethesda, MD, 2010.
  2. USDA Dietary Guidelines for Americans 2010. http://www.health.gov/dietaryguidelines/2010.asp. Accessed 4/23/12. 

    Revision Date: 11-6-12 
    Author: Melinda Dennis, MS, RD, LDN 
    Editors: Mary Kay Sharrett, MS, RD, LD, CNSD and Daniel Leffler, MD, MS

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