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Celiac DiseaseResource Guide for aGluten-Free DietA family resource from the Celiac Disease Programceliacdisease.stanfordchildrens.org
What Is aGluten-FreeDiet?A gluten-free diet is a diet that completelyexcludes the protein gluten. Gluten ismade up of gliadin and glutelin which isfound in grains including wheat, barley,and rye. Gluten is found in any food orproduct made from these grains. Thesegluten-containing grains are also frequentlyused as fillers and flavoring agents andare added to many processed foods,so it is critical to read the ingredient liston all food labels. Manufacturers oftenchange the ingredients in processedfoods, so be sure to check the ingredientlist every time you purchase a product.How Do IGet Started?Your first instinct may be to stop at thegrocery store on your way home fromthe doctor’s office and search for all thegluten-free products you can find. Whilethis initial fear may feel a bit overwhelmingbut the good news is you most likelyalready have some gluten-free foods inyour pantry.Use this guide to select appropriate mealsand snacks. Prepare your own gluten-freefoods and stock your pantry. Many of yourfavorite brands may already be gluten-free.The FDA announced on August 2, 2013, that if a product bears the label “gluten-free,” the food mustcontain less than 20 ppm gluten, as well as meet other criteria. *The rule also applies to productslabeled “no gluten,” “free of gluten,” and “without gluten.” The labeling of food products as “glutenfree” is a voluntary action for manufacturers.Be sure to always look for the certified “gluten-free” label on products before purchasing.Notes: * Important – Read ingredient labels before purchasing gluten-free products.2 Celiac Disease Resource Guide for a Gluten-Free Dietceliacdisease.stanfordchildrens.org 3
Foods andAdditives ThatContain GlutenComplying with a gluten-free diet can be challenging.If a product contains the symbol at left, then thatproduct is gluten-free.Grains containing gluten are often added to processed foods,so it’s important to carefully read the food labels to check forsources of gluten. Manufacturers often change the ingredientsin processed foods, so you need to be sure to check each foodevery time you buy it.As you learn to spot gluten on food labels, be sure to rememberthat wheat-free does not mean gluten-free. If you’re not surewhether a food has any gluten, it’s best not to eat it.4 Celiac Disease Resource Guide for a Gluten-Free DietWhich Foods Contain Gluten?Gluten is found in wheat, rye, barley, and triticale grains. Gluten is also found inthings made from these grains, like bran, bulgur, couscous, einkorn, durum, faro,farina, graham flour, matzo flour, kamut, semolina, and spelt. These grains arefound in a variety of foods, including cakes, breads, pasta, and cereals.Gluten-Containing Foods and Ingredients to Avoid:WheatBarleyAttaKamutAleMaltBulgurMatzo, matzo mealCouscousModified wheat starchBarley(flakes, flour, pearl)Malt extract/malt syrupDinkel (spelt)SeitanBeerMalt flavoringDurumSemolinaBrewer’s yeast1Malt vinegarLagerMalted milkEinkornSpelt(farro, faro, dinkel)EmmerTaboulehFarinaTriticaleFarro or faro (spelt)Wheat BranGraham flourWheat flourHydrolyzedwheat proteinWheat germOatmealOat flourWheat starchOat branOatsRyeRye breadOatsRye flour2Notes: 1 Brewer’s Yeast contains barley; however, other baking yeasts are gluten-free.2Unless oats are labeled “certified gluten-free oats.”celiacdisease.stanfordchildrens.org 5
At theGrocery StoreWithin the inner aislesof the grocery store,look for: Corn tortillas Plain or brown rice, quinoa, millet Dried beans and legumes Fresh spices and herbs Peanut or nut butters Cooking oils (canola and olive oilsare low in saturated fats and containhealthy monosaturated fat)6 Celiac Disease Resource Guide for a Gluten-Free DietAfter your child’s diagnosis of celiac disease and on your first trip to thegrocery store, think about shopping the perimeter of the store. This is whereyou will find naturally gluten-free foods. Start with the fresh produce sectionand stock up on nutrient-rich, low-fat, low-sodium fruits and vegetables.Next, visit the fresh meat, poultry, and seafoodsection. Again, these are naturally gluten-free.Think about making a fresh turkey breast or leanroast for dinner and then using the leftovers as afilling for a corn tortilla for lunch. Use caution whenchoosing luncheon meat and other processed meats.The processed meats may contain gluten as fillers orflavor enhancers, so read the label carefully.After the meat section, you can visit the egg anddairy section. These products are, for the most part,gluten-free. Calcium-rich desserts and snacks like icecream, yogurt, and pudding may be good choices fora gluten-free diet, but always thoroughly check thelist of ingredients.As the demand for gluten-free products increases,many grocery stores now stock more productsthat are specifically gluten-free. Look in the Asiansection for rice noodles and crackers. Checkout the “organic” or “health food” section forgluten-free pastas, flours, and baking products.Specialty health food stores typically have gluten-freefoods in a designated section and in the frozen foodssection of the store, offering shoppers many foodssuch as gluten-free bagels, bread, and pizza doughto defrost and bake at home.Some frozen food sections also have gluten-freefrozen meals as a convenient option.If your child has lactose intolerance, try lactosefree milk, yogurt, and hard cheese as these areusually well tolerated in those patients. Lactaidtablets can also be taken with dairy products.celiacdisease.stanfordchildrens.org 7
CHIPSProduceMeat, Fish,PoultryDairy Fresh beef Unflavored milk All fresh vegetables Fresh pork Cream Tofu Fresh poultry Aged cheese (caution:CEREALSPprocessed cheese)CondimentsCEREALS Potato chips All fresh fruits(caution: s& Grains Jam and jellies,marmalade Cream of rice Corn chips Honey Popcorn Peanut or nut butters Puffed riceCEREAL(caution: flavoredchips)CEREAL GritsCEREALCEREAL Corn Fresh fish or seafood Most yogurts Rice crackers, rice cakes Corn or potato starch Plain or brown rice,Quinoa, millet Edamame Eggs Butter, margarine Plain nuts, seeds Corn and maple syrup Corn tacos or tortillas Cream cheese (fat-free Jello Molasses Chex cereals Pudding Brown, white andconfectioner’s sugar White or sweet potatoCEREALproducts may not be GF) Cottage cheese Spices and herbs Sour creamBeverage 100% fruit juice Coffee, tea, cocoa Nut milks (almond,FrozenFoodsFats& OilsPackaged& CannedFoodsCHIPS Vegetable, canolaand olive oil Plain fruitsCEREALand vegetables Plain fruitsCEREALand vegetables ShorteningP Mostice creamand sherbet All canned meats (readcashew, coconut, pistachio) Soft drinks Swiss Miss hot cocoa8 Celiac Disease Resource Guide for a Gluten-Free DietS Gluten-free breads,bagels, English muffins Gluten-freefrozen waffles Salt, pepper Relish, pickles, olives Ketchup, mustard Distilled vinegars Most salad dressing(read label for glutenpresence)label for gluten presence) Dried beans, lentils, peasCEREAL Most baked beansceliacdisease.stanfordchildrens.org 9
Gluten-FreeMeal IdeasCHIPSCEREALSCEREALBreakfastP RiceCEREALChex or Corn Chex or othergluten-free cereal with milk, nut milks,fresh fruit Corn tortillas, warmed withscrambled eggs, chopped tomato,and melted cheese Cream of rice cereal withchopped almonds and milk10 Celiac Disease Resource Guide for a Gluten-Free Diet Grits with butter and salt Cottage cheese and fruit Gluten-free pancakes (gluten-freebrands include Arrowhead Mills, Bob’sRed Mill, Gluten-free Essentials,Gluten-free Pantry, Kinniknnick, Sylvan,and Vans) with butter and syrup Gluten-free yogurt layered with berries Gluten-free waffles withbutter and syrup Hard-boiled eggs mixed with mayonnaise,served on toasted corn tortillas Omelet with onions, peppers, andtomatoes, with two soft corn tortillas Gluten-free oatmeal with fruitceliacdisease.stanfordchildrens.org 11
SSPLunchPDinnerCEREALCEREAL Sliced turkey with lettuce, tomato, andmayonnaise on warmed corn tortillaswith baby carrots Gluten-free ham on gluten-free toastor warmed corn tortillas with mustardand coleslaw Grilled portabella mushroom marinatedin garlic and oil, served with mixedgreen salad Salmon baked with mustard, and honey,served with brown rice and steamedgreen beans Grilled sliced chicken over mixedgreens, with red peppers, slicedtomatoes, broccoli florets, andchickpeas, served with oil and vinegaror gluten-free salad dressing Cottage cheese with mixed fruit Peanut or nut butters and jellyon rice cakes Hard-boiled egg, sliced, with steamedgreen beans, baby spinach, slicedcucumber, sliced tomato, and chickpeaswith oil and vinegar or gluten-freesalad dressing Toasted gluten-free bread or warmedcorn tortillas, with tuna fish made withmayonnaise, chopped onion, slicedtomato, shredded lettuce, andchopped cucumber Grilled salmon or tuna served overmixed greens with shredded carrots,chopped tomatoes, and cucumbers.Serve with oil and vinegar, or favoritegluten-free salad dressing, gluten-freerice crackers, and lemon wedges Grilled chicken, salmon, or tuna, withshredded lettuce, sliced tomatoes, babycarrots, and gluten-free rice cakes12 Celiac Disease Resource Guide for a Gluten-Free Diet Grilled chicken cutlet marinated in garlic,oil, and lemon, served over choppedromaine lettuce, with gluten-free Caesardressing, parmesan cheese, and gluten-free rice crackers Grilled or broiled sirloin burger withlettuce, tomato, sliced onion, ketchup,and a gluten-free roll if available – if notavailable, serve over a mixed salad withoil and gluten-free vinegar Grilled chicken marinated in garlic,oregano, oil, salt, and pepper, with asweet potato, butter, and mixed veggies Chicken salad made with cookedchicken, mayo, onions, walnuts, andgrapes, over a mixed green salad Grilled cheese made with gluten-freebread served with roasted veggies Turkey roll-up with cream cheese andasparagus spear Quesadilla using corn tortillas, choppedchicken, and tomatoes Baked potato with cheese and chives Quinoa with lemon juice, chickpeas,and olive oil Grilled chicken cutlet marinated ingarlic, oil, and onion powder, served withcooked brown rice, steamed broccoli,and mixed greens served with oil andvinegar or gluten-free salad dressing Broiled skirt steak with garlic, onionpowder, and a dash of salt, served withsteamed cauliflower and a mediumbaked potato with butter or margarine Baked flounder cooked with choppedonions, tomatoes, cilantro, garlic, andonion powder, served with steamedspinach, rice, and a mixed green saladsliced tomato and cucumber and oil andvinegar or gluten-free salad dressingceliacdisease.stanfordchildrens.org 13
SPSnacksCEREAL Pork loin cut into two-inch cubesof pineapple and cherry tomatoesmarinated in gluten-free Italian dressing,grilled, and served with steamedbroccoli and corn with butter ormargarine and a dash of salt Roasted chicken with carrots, potatoes,and onions, seasoned with garlic, onionpowder, salt, pepper, and Italian herbs Grilled or baked chicken, shrimp, or vealplaced in a casserole dish and toppedwith tomato sauce, mozzarella, andparmesan cheese, served withgluten-free pasta Rice, corn, or quinoa pasta with tomatosauce and a mixed green salad withfavorite gluten-free dressing14 Celiac Disease Resource Guide for a Gluten-Free Diet Grilled shrimp over a mixed greensalad with baby potatoes and favoritegluten-free dressing Hand-pressed hamburger or turkeyburger (100% pure ground beef orturkey), with onion and sliced tomato,baked sweet potato fries, andgreen beans Frozen gluten-free pizza bakedand served with mixed green saladand gluten-free salad dressing Fresh fruit String cheese* Rice crackers with peanut butteror cheese* Popcorn* Sliced veggies with gluten-freebean dip* Canned fruit in its own juices Plain yogurt Applesauce with cinnamon Baby carrots and snow peaswith hummus* String cheese and dried fruit* Pudding* Rice cakes* Nuts with dried fruit* (nuts are naturallygluten-free unless flavored or processedon gluten-containing equipment) Strawberries with Cool Whip Plain peanuts or almonds* Rice cakes with cream cheese and jam* Vanilla ice cream, sorbets,sherbets, ice milk* Edamame Celery with peanut butteror cream cheese* Hard-boiled egg* Double-check labels particularlyin these items.celiacdisease.stanfordchildrens.org 15
Food Storage and PreparationGluten-FreeCookingOnce you get your groceries home, you need to think about how your food isprepared. Here are several suggestions to help you avoid contaminating yourfood with gluten: Do not purchase foods from open bins or bulk bins. Store gluten-free foods separately. Label gluten-free foods to prevent confusion. Have designated gluten-free appliances and tools, liketoasters, non-stick and cast iron pans, colanders, etc. Use clean tools for cooking, cutting,mixing, serving, storing, etc.Gluten-Free Grains Amaranth (seeds or flour) Guar gum Soy flour Arrowroot flour Mesquite Tapioca Bean flours Millet Flour or starch Buckwheat Nut flours Teft Corn Potato Quinoa Corn flour Potato flour Xanthan gum Corn meal Potato starch Cornstarch Rice Expandex (a modified foodstarch made from tapioca) Sorghum16 Celiac Disease Resource Guide for a Gluten-Free DietCan I Eat Packaged Foodswith These Ingredients? Maltodextrin* Starch or modified food starch* Dextrin* MSG (monosodium glutamate) Avoid tools that can harbor gluten crumbs or havescratches (e.g., wooden cutting boards, non-stickpans, etc.) Vanilla and almond extracts Have separate containers of foods that food orknives are dipped into, like peanut butter, hummus,etc., or have a strict “no double-dipping” rule. Canola oilWhat about Oats?All commercial, regular oats are contaminated with gluten.Most people with celiac disease can eat small amounts(around ½ cup uncooked) certified gluten-free oats. A smallpercentage of people with celiac react the same way tothe protein in oats as they do to gluten. Talk to your doctorto get more specifics for your individual needs. Caramel coloring Vinegar (except malt vinegar)Yes! Just avoid foods with labels that list:wheat, rye, barley, malt, malt extract,malt flavoring, malt vinegar, brewer’syeast, and oats (not marked gluten-free).*Rare potential exception: meat, poultry oregg products.celiacdisease.stanfordchildrens.org 17
NorthernCaliforniaSupportGroupsBay Area R.O.C.K.(Raising Our Celiac Kids)(South Bay and Peninsula)Kelly Velez(650) 303-8409EmailYahoo group: bayareaceliacROCKDavis – CeliaSupport GroupGluten IntoleranceGroup of MarinDiane CraigEmailSheila Wagner(415) 924-1700Davis - Gluten-Free Groupat the Davis Food Co-opEmailBerkeley – GlutenX:Cal’s Gluten Free AllianceCampus advocacy and supportgroup for registered students,faculty and staffEmailWebsiteFacebook pageFacebook pageEast Bay/Tri-Valley R.O.C.K.(Raising Our Celiac Kids)Julia Babka-KurzrockEmailCarla MiraEmailYahoo Group: eastbayceliacROCKContra Costa CountyGluten-free discussion group meets in the rossmoor communityin Walnut CreekGluten Intolerance Group– East Bay andSouth Bay locationsWalter Moeller(925) 930-8875Kim RiceEmailEmailBarb SobelEmailGroup’s EmailWebsiteMarin - Celiac CommunityFoundation of NorthernCalifornia Support GroupJennifer IscolEmailMendocino CountyJeni GuthEmailFacebook pageMid-Peninsula ContactJoan Terry(650) 726-5310EmailWebsiteMorgan Hill ContactDolores KentEmail18 Celiac Disease Resource Guide for a Gluten-Free Dietceliacdisease.stanfordchildrens.org 19
Napa CountyCeliac CommunityFoundation of NorthernCalifornia Support GroupSalinas ContactJennifer IscolEmailSan Francisco Celiac KidsNorCal Gluten-Free TeensFacebook pageDavid Drutz(415) 203-3798EmailOakland Support Group –Celiac Disease FoundationS.F. community contactLisa PalmerEmailMelissa BataviaEmailSacramento Celiacson FacebookJoann MitchellEmailFacebook pageSacramento – CeliacSupport GroupDiane CraigEmailAdriana Morga(831) 210-3218Email(adults welcome)Santa Cruz Support Group– Celiac Disease FoundationPam Newbury(831) 423-6904EmailWebsiteSonoma CountyCeliac CommunityFoundation of NorthernCalifornia Support GroupJennifer IscolSan Francisco Celiacsat Gluten-Free Grocery707-579-9683 (voice mailchecked weekly at most; emailchecked daily)Calvin ChinEmail(415) 626-FREEEmailSouth Bay Support GroupWebsiteVic DolcourtEmailSanta Clara KaiserSupport Group (open to all)Brenda FalkEmailBarbara DodsonEmailResourcesGluten-Free Bay AreaMeet-Up GroupWebsite20 Celiac Disease Resource Guide for a Gluten-Free Dietceliacdisease.stanfordchildrens.org 21
SLOW! STOP!These foods may be safeto eat, but be careful becausethey can’t be guaranteedto be gluten-free!The Celiac“Traffic Light”Meal PlanGO!These foods are gluten-freeCHIPSand are safe to eat everyday. You should choosefoods from this list.STOP!These foods are not glutenfree and should be avoided!Eating them may causeyou to experience mild tosevere reactions due togluten contamination. Barley23 Bran Bulgarceliacdisease.stanfordchildrens.orgBreads, Cereals, Flours, and Other GrainsSLOW! Cereals Buckwheat flour(sometimes is mixedwith wheat flour) Flavored rice mixesThe Gluten-Free Kid: A CeliacDisease Survival Guide Couscousby Sheri L. SandersonCEREALCEREALGO! Amaranth Arrowroot Buckwheat Cornmeal Corn tortillasIncredible Edible Gluten-FreeFood for Kidsby Melisa London22 Celiac Disease Resource Guide for a Gluten-Free Diet CrackersFree resources for gluten-freekids and parents Flavored snacks(chips, popcorn, etc.)(408) 702-1172www.celiaccentral.org/kids/ EinkornSunnyvale, CA 94087www.csaceliacs.org Emmer111 E. El Camino Real(402) 558-0600 Farina FarroSproutsCeliac Support Association Flour tortillas(650) 324-9190 Hydrolyzedvegetable protein(925) 831-9016www.migletsgf.comA family guide to raising happy,healthy gluten-free childrenby Danna Korn Hydrolyzedwheat proteinPalo Alto, CA 94309Kids with Celiac Disease KamutDanville, CA 94526www.celiaccentral.org Matzo440 S. California Avenue Modified wheat starch480 San Ramon Valley Blvd., Ste. 2 Pastas(215) 325-1306 PizzaCountry SunFast and healthy recipesby Bette Hagman RyeMiglet’s Cupcake ShopThe Gluten-Free Gourmet SemolinaNational Foundation forCeliac AwarenessPublisher of the mostcomprehensive gluten-freerestaurant guide in North America,dining cards that help you ordergluten-free at restaurants wherelanguage barriers, and populargluten-free grocery guides Spelt(415) 626-3733www.triumphdining.com StuffingSan Francisco, CA 94107 Triticale(650) 241-9378www.zestbakery.comwww.gluten.org Wheat and wheat bread600 Illinois Street Wheat germSan Carlos, CA 94070(253) 833-6655A comprehensive resourceguide by Shelly Case, RD White breadGluten Free GroceryGluten-Free Diet White flour1224 ArroyoBooks Cream of riceGluten Intolerance GroupProvides accurate lists of themajority of medications bothgeneric and non-genericwhich are gluten-free C routonsZest .com OatsAmazon.com(773) 702-7593 FlaxSafeway (limited items) Durum(510) 595-0955 OatmealTarget (Grocery) Rice and corn cereals(may contain barley)San Francisco, CA 94111University of ChicagoCeliac Disease Center Gluten-free cerealsLiving Without’s Gluten-Free MoreWalMart Hominy (grits)Dine Gluten FreeOne Ferry Building, Suite 32 MilletGFF Magazine MontinaIs That Gluten Free?Mollie Stone’s Markets Nut flours (almond,hazelnut, pecan)Gluten-Free Livingwww.celiac.org GrahamTrader Joe’s Plain corn chipswww.findmeglutenfree.comOakland, CA 94609Comprehensive list(s) of safe/forbidden foods, gluten-freeproducts, recipes, andrelevant news Granola(818) 716-1513 Plain popcornDraeger’s Market Plain rice cakes5427 Telegraph Avenue Plain tortilla chipsSimply Gluten-Free Potato breadFind Me Gluten Free Potato flourwww.celiac.org Potato starchCeliac Disease Foundation QuinoaWhole Foods Markets RiceMariposa Baking Company Rice floursMagazines Rice noodlesApps SorghumWebsites SoyNational Organizations TapiocaBay Area Grocery Stores Taro TeffGluten-free Bakeries
PCEREALPCHIPSSFats and OilsCHIPSCEREAL Tea Diet sodas CoffeeCEREALCEREAL Pure olive oil Pure canola oil Soy or rice drinks(may contain barleymalt or rice syrup) Flavored coffeesand teas Drink mixesCEREAL Sandwich spreads Mayonnaise Cooking spray Salad dressingsDrinksCEREALSLOW! PMargarine ButterGO! Malt and malted milk Lager Beer Ale Malt vinegarSTOP! Soy sauce Soups Seasoned nuts Seasonings Sorbet Sugar or sugarsubstitutes Sauces Salt Pies and pastries Play dough Pure herbs and spices Salsa Medications Popsicles Gravies Marinades Ketchup Cookies Candies Cakes/frostings Broths Sausages Imitation seafood Imitation bacon bits Seasoned tofu products Breaded (fried)chicken or meatsSTOP! Malted milk Cheese spreads Cheese sauces Fruit pies Baked beansSTOP! Pepper Pudding Italian ice Baking powder(some brands havewheat starch)CEREALCEREAL Mustards Honey Gluten-free specialtyproductsSCEREALCHIPS Marinated meats(check ingredients)Other Foods(check ingredients forgluten presence) All canned meats Plain tofu Plain nuts Plain meats Plain fish Hot dogs Dry roasted nutsCEREAL Plain chickenCEREAL Deli meatsCHIPS Peanut butter EggsSLOW!Meats and Other ProteinsGO! Sour cream Plain yogurt Some ice creams mayhave gluten-containingingredientsCEREAL Frozen yogurt Cream cheese Plain milk Flavored yogurts Cottage cheese CEREALBlended milk drinks Flavored cheesesCEREALCHIPSCEREAL Vegetablesin saucesCEREAL French fries (oftencooked in same oil asbreaded foods)CHIPS Flavoredpotato dishesSLOW!S CheeseP ButtermilkDairy Dates (sometimes aretossed with flour) Legumes (beans,chickpeas, garbanzo)S Jams and jellies All plain, fresh,canned, or frozenvegetablesCEREAL All plain fresh, canned,or frozen fruitsGO!Fruits and VegetablesBe careful with dairy foods. Sometimes peoplewho have celiac disease are also lactose intolerant.If you experience symptoms after eating dairyfoods you may want to avoid them.ContactNasha “Nasim” Sabery Khavari , MD, MPHDirector of the Celiac Disease Program andCeliac Disease Care Team, Stanford Children’s HealthMary L. Johnson Specialty Services730 Welch RoadPalo Alto, CA 94304Tel (650) 723-5070Fax (650) 498-5608Printed post-consumer recycled material. Please recycle.001221 12/2015The Celiac Disease Program, offered by ourPediatric Gastroenterology service, is located at:
a gluten-free diet, but always thoroughly check the list of ingredients. If your child has lactose intolerance, try lactose-free milk, yogurt, and hard cheese as these are usually well tolerated in those patients. Lactaid tablets can also be taken with dairy pr
