Resources

“I can’t begin to describe how critical it was for me to have a resource and a support network that knew exactly what I was going through and how to help.”

– Kimberly

Resources

The following resource section includes many helpful tools for managing your gluten-free diet. At the tabs below you will find recipes, lists of gluten-free foods, how to set up your kitchen, how to read labels, a restaurant finder and more.

The Gluten-Free Diet

What is Gluten?

Gluten is a protein found in wheat, barley, rye and all their derivatives. It is the most common protein in the human diet. Gluten is what makes baked goods doughy and stretchy, and what makes them fluffy and chewy. This is why gluten-free products often are crumbly. Most oats contain gluten because of crop rotation, and being processed and transported with gluten-containing grains.

Allowed foods
  • The following foods are considered safe. All grains, starches, and flours made from the foods below must be labeled gluten-free, except for plain rice:
    Amaranth Nut flours (almond, hazlenut)
    Arrowroot Oats**
    Bean flours Potato (flour, starch)
    Buckwheat Quinoa
    Cassava Rice (flour, bran, wild rice, rice blends)
    Chia (seed, flour) Seed flours (pumpkin, sunflower)
    Coconut flour Sorghum
    Corn (grits, meal, starch, flour, bran) Soy (flour, soybean)
    Flax (seed, flax seed meal/flour) Tapioca (flour, starch, pearls)
    Legume flours (chick pea, lentil)* Teff
    Mesquite flour Yam flour
    Millet Yucca flour

    Lentils and Legumes Lentils and other legumes are allowed by law to contain a certain percentage of foreign grain, including wheat, barley, and/or rye unless they are labeled gluten-free. However, whether the lentils and other legumes you buy are labeled gluten-free or not, rinse canned ones thoroughly under running water. Pour dry legumes onto a cookie sheet, pick through them, and then rinse thoroughly under running water.

    ** Oats Conventionally grown oats are not gluten-free due to high levels of cross-contact.  See “NCA Stance on Oats” to learn more.

    Bulk bins Avoid purchasing items from bulk bins since there is a great risk of cross-contact with gluten-containing ingredients stored next to or above the gluten-free ones. Scoops can also be easily contaminated when used for items from a different bin. It is recommended to purchase gluten-free items that are packaged by the manufacturer and labeled gluten-free.

    Nuts and Seeds Nuts and seeds may be cross-contaminated with gluten-containing grains in the facility. Choose labeled gluten-free nuts and seeds when possible, particularly seasoned or dry roasted.

    It’s important to note that “wheat free” does not necessarily mean “gluten free.” For instance, breads labeled “wheat free” might contain rye or other grains, which are not allowed on the gluten-free diet.

Not-allowed foods
  • The following foods are considered not safe:
    • Wheat All varieties, such as spelt; khorasan; einkorn; emmer; and most forms, such as wheat starch (unless labeled gluten-free), wheat flours (for example, semolina), wheat bran, wheat germ, cracked wheat, and hydrolyzed wheat protein
    • Rye All types, including triticale, secale, triticosecale
    • Barley Most forms, including Brewer’s yeast, malt, malt flavoring, malt extract, and malt vinegar
    • Crossbred All crossbread varieties of gluten-containing grains, such as triticale (a cross between wheat and rye)
    • Oats Conventionally grown oats are not gluten-free due to high levels of cross-contact.  See “NCA Stance on Oats” to learn more.
Confusing ingredients

Knowledge is power. Following is some useful information on food ingredients that usually set off alarm bells among people with celiac disease. For information on other gluten-free/gluten-containing ingredients and frequently overlooked sources of gluten, visit the NCA website.

  • Oats – NCA is concerned that some manufacturers are not adequately testing their oats for gluten, or using methods to sort and then test their products that are inadequate. Sound information about the safety of gluten-free oats is greatly in flux at this time. See “NCA Stance on Oats” to learn more.
  • Artificial flavorings – These are blended from chemical compounds, so they are gluten-free.
  • Color additives – These generally are derived from chemicals and dyes and are free from food allergens.
  • Distilled vinegar – Vinegar made from wine, rice, balsamic, or apple cider is risk-free. White vinegar is also safe because it is made from corn and other gluten-free grains. Malt vinegar, however, is not gluten-free because it is made from barley.
  • Malt – This is a flavoring ingredient that is usually made from barley. It may be listed as malt, malt flavoring, malt extract, or malt syrup. Any product containing malt is not gluten-free,and must be avoided.
  • Maltodextrin – Maltodextrin is not related to malt. It is a sugar that is usually derived from corn, rice or potatoes. Even if it is made from wheat, the ingredient is considered gluten-free because the amount of gluten it would contain is highly unlikely to result in a food product to contain 20ppm or more gluten.
  • Modified food starch – Most often this ingredient is made from corn. If it is derived from wheat starch, however, modified food starch may not be gluten- free. If an FDA-regulated product sold in the U.S. contains modified food starch which contains wheat protein, the word wheat will appear in the ingredients list or the “Contains” statement on the package. In USDA-regulated products containing wheat-based modified food starch, wheat may not be stated on the label. Food containing wheat-based modified food starch may be labeled gluten- freeas long as the final product contains less than 20ppm.
  • Monoglycerides and diglycerides – These are fats used as chemical binding agents. They do not contain gluten, though occasionally wheat may be used as a “carrier.” If so, wheatwill be listed in the ingredients list or the “Contains” statement on an FDA-regulated package.
  • Natural flavorings – Unless wheat, barley, rye or malt is included in the manufacturer’s ingredients list, or the “Contains” statement (wheat) on the package, the natural flavoring is probably free of gluten protein.3
  • Smoke flavoring – When used as an ingredient in a food product, dry smoke flavoring may sometimes use barley malt flour to capture the smoke. It is not known at this time how often this occurs or how much gluten smoke flavoring may contain. Contact the manufacturer if you have concerns about this ingredient.
  • Yeast extract/autolyzed yeast extract – These ingredients may be made from spent Brewer’s yeast, a by-product of the beer brewing process. To be on the safe side, avoid yeast extract and autolyzed yeast extract unless the product is labeled gluten-free.
Reading the label

How Can I Determine if an FDA Product is Gluten-Free? 1,2

Step 1: Look for the words gluten-free on the front or the back of the package. You may also see the phrases “no gluten,” “free of gluten,” and “without gluten.” These phrases are equivalent to the phrase “gluten-free.” Please note that any product made with a grain, flour, or starch should be labeled gluten-free.

Step 2: If the food is NOT labeled gluten-free it does not mean that it contains gluten. But, it is now necessary for you to review the ingredients list and “Contains” statement to see if there are words that indicate if gluten is present.

If it is not labeled gluten-free, is wheat in the ingredients list or are the words “Contains Wheat” near the ingredients list?

If Yes, Stop! This product is not gluten-free. If No, Proceed to Step 3.

Step 3: Read the ingredients list. Do you see the words barley, malt (unless a gluten-free source is named, such as corn malt), rye, oats* and/or Brewer’s yeast (yeast extract/autolyzed yeast extract)?**

If Yes, Stop! This product is not gluten-free.

If No, the ingredients in this product are gluten-free and it is safe to eat.***

* People with celiac disease are advised to consult with their physician about including gluten-free oats in their diet.

** For more information on additional ingredients, click here.

*** Please review the most important points about labeling and cross contact below before consuming any product NOT labeled gluten-free.

How Can I Determine if a USDA Product is Gluten-Free?

Unlike the FDA, there is no official standard for gluten-free labeling of USDA products. These include: 1,2

  • Meat products (e.g. hot dogs)
  • Poultry products (e.g. seasoned turkey breasts)
  • Egg products (e.g. some liquid egg products)
  • Mixed food products that contain certain amounts of meat or poultry (e.g. some stews and some chili)

Look for the USDA seal if you are unsure whether a product is regulated by the USDA.

However, the USDA does state that if a product has a gluten-free label, it should meet the same standard as FDA products.

Step 1: Always look for the gluten-free label first. You may also see the equivalent phrases “no gluten,” “free of gluten,” and “without gluten.”

Step 2: When you are looking at food that does NOT have a gluten-free label, it does not mean that it contains gluten. But, it is now necessary for you to review the ingredients list and “Contains” statement to see if there are words that indicate if gluten is present.

Do you see the words wheat, barley, malt (unless a gluten-free source is named, such as corn malt), rye, oats*, and/or Brewer’s yeast?**

If Yes, Stop! This item is not gluten-free.

If No, does the product contain modified food starch, starch, and/or dextrin?

If Yes, Stop! This product could contain gluten.

Modified food starch, starch, and dextrin are possible, but not common, sources of gluten in these products.

If you don’t see a gluten-free label, contact the manufacturer to ask the source of the modified food starch, starch, or dextrin, or avoid the product until you can find out more information. The name and address of the company is a required feature on all USDA labeled products.

If No, the ingredients in this product are gluten-free and it is safe to eat.

  • People with celiac disease are advised to consult with their physician about including gluten-free oats in their diet.
  • For more information on additional ingredients.
  • Please review the most important points about labeling and cross contact below before consuming any product NOT labeled gluten-free.

Important points about cross-contact and labeling

Cross-contact may occur anywhere gluten-free food comes in contact with gluten, including the field or factory. Some gluten-free foods are processed in facilities that only make gluten-free food, but the manufacturer may use ingredients that have been contaminated with gluten.

Other gluten-free foods are made in shared facilities and/or on shared equipment with gluten. This does NOT necessarily mean that the food is unsafe or is contaminated. It does make it very important that all manufacturers test their gluten-free products to be sure that they contain less than 20ppm gluten.1

Many naturally gluten-free foods and beverages (for example, bottled water, a can of olives, plain diced tomatoes, olive oil) have little or no risk of cross-contact with gluten-containing grains. In these low-risk cases, it is generally safe to buy the food or beverage even without a gluten-free label. Other foods, such as grains and flours, energy bars, candy, etc., have a much higher risk of cross-contact. In these higher-risk cases, it is recommended to choose foods labeled gluten-free.1

Gluten-free foods that list wheat ingredients: “Some products are labeled gluten-free but include the word “wheat” in the ingredients list or “Contains” statement. This labeling may seem odd. However, it is allowed because certain ingredients derived from wheat may be included in foods labeled gluten-free as long as the final food product contains less than 20ppm of gluten. Examples are wheat starch, modified food starch (wheat), and ingredients that may be made from wheat starch, including dextrin (wheat), maltodextrin (wheat), glucose syrup (wheat), and caramel (wheat). Under the FDA’s gluten-free labeling rule, if a food is labeled gluten-free and also includes the word “wheat” in the ingredients list or “Contains” statement, the following must be added to the label. [The wheat has been processed to allow this food to the meet the Food and Drug Administration requirements for gluten-free foods.]” 1,2

If you have questions about manufacturing practices that could result in cross-contact or concerns about any of the ingredients, a call or message to the food manufacturer may be helpful.

Allergen Advisory Statements

One unintended consequence of the allergen labeling law is that many companies have added cautionary or “may contain” statements to their labels. A label with one of these statements might read, for example, “Processed in a facility that also processes wheat,” “May contain wheat,” or “Processed on shared equipment with wheat.”

Products with these types of statements are not necessarily contaminated and products without them are not necessarily free of contamination. These statements are voluntary; manufacturers may choose not to include them on food labels even if their products are processed using shared equipment or facilities. All food is required to be processed using current Good Manufacturing Processes (GMP) to prevent unintentional ingredients, such as allergens, from ending up in a product.

When a product is labeled gluten-free under the FDA gluten-free labeling rule, the food must contain less than 20ppm. This rule applies even when an allergen advisory statement for wheat is also printed on the label. The rule applies to gluten that is in a product intentionally (an ingredient) and unintentionally (through cross-contact).”3

Regardless of the label, it is always a good idea to ask the manufacturer about steps taken to avoid cross-contact.

References

1. Thompson T. Celiac Disease Nutrition Guide 

2. Food and Drug Administration.  Food Labeling; Gluten-Free Labeling of Foods

Sharing a gluten-free kitchen

Make your kitchen GF friendly to make it easy to prepare delicious and healthy meals at home. Take stock of your kitchen as it was, and then:

  • Begin to read all food labels and keep a list of gluten-free products handy for future reference. Sort through the foods you have on hand in your freezer, refrigerator, and pantry shelves.
  • Identify which foods contain gluten (all traditional bread products, pizza, pasta, cake, cookies, etc.). Check your packaged goods and sauces, looking for ingredients such as wheat as a thickener or malt as a flavoring.
  • Notice how many foods are naturally gluten-free (fruits, vegetables, unadorned meats, fish and poultry, cheese, and a large variety of GF grains, beans, and legumes, such as rice, corn, and lentils). Make sure to store any gluten-containing foods in a way that eliminates the risk of cross-contact or leakage. Place items with gluten in separate cabinets or on the bottom shelf. Individual types of GF flours should be kept in separate, sealed containers.
  • Inspect kitchen utensils, pots, and anything else that has had contact with gluten. All need to be washed carefully or replaced. Avoid using wooden utensils, cutting boards, and rolling pins that have previously been used with gluten. Use a separate, new colander for gluten-free foods. A new toaster and bread machine should be purchased for dedicated use with gluten-free bread.
  • Be careful of cross-contact from knives and other utensils that have been used to spread peanut butter, mayonnaise, mustard, jellies, etc.
  • Watch out for cross-contact from the containers of condiments themselves. If, for example, you use a knife to spread jam on a gluten-containing piece of toast, then dip that knife back into the jam jar, the jam has probably become contaminated with gluten-containing crumbs. You might choose to keep two jars of such spreadables, making sure to label the GF one. Squeeze bottles are also a good option.

If you decide to make your kitchen gluten-free, please remember that the gluten-free diet is not recommended for someone for whom it is not medically necessary. If an individual with CD/NCGS/DH shares a kitchen with those who eat gluten, consider setting up a system that strikes a balance between all members of the family/household.

Family meals – should everyone eat gluten free?

  • Everyone in the family does not have to eat gluten-free but aim to make family meals gluten-free.
  • It is safer for your child if the whole meal is gluten-free, cross-contact can pose a risk when preparing GF foods at the same time as gluten containing foods.
  • It is more inclusive for your child if they eat the same foods as everyone else in the family, it can feel alienating to always receive separate food from everyone else.
  • Cooking GF does not have to be difficult or expensive. Focus on preparing naturally GF foods such as rice, beans, fruits, vegetables, meats, poultry, eggs. You do not need “special” or expensive GF foods to make a healthy delicious GF meal.

 

Check out this video where Lily goes over some of the places where gluten can hide in the kitchen.

 

Support Networks

Living a healthy gluten-free lifestyle means building a supportive team.  Most people want to help if they are given the correct information.  Check out the boxes below for some tips for success.

For the newly diagnosed - coming soon!

Getting Started: Gluten-Free in 1, 2, 3 for Parents and Caregivers

Getting Started is a free comprehensive workshop designed for parents and caregivers of a newly diagnosed child.  This 26-page module outlines the most important things to know about celiac disease and the gluten-free diet in three easy steps.  Getting Started is scheduled to be published in June 2019.

Find a ROCK group!

Find a ROCK group here

Having productive conversations with caregivers

Article by Carla Carter:

It’s the tug and pull of your heart strings, your anxieties, fears and hopes that when your young loved one with celiac disease leaves the house to go, well, anywhere, that they do not get sick.

In this column, I frequently discuss the difficulty of “doing for them” vs. “learning for themselves.” Initially, we have to take responsibility for reading labels, calling ahead, and talking for our children at restaurants, thereby modeling for them what is needed to become pillars of strength, of self-advocacy and confident decision makers. However, this also includes educating other caregivers who will also be helping them to make safe decisions and, more likely, making the decisions for them. It’s tough not to have that over-bearing and protective response so I am hoping to give you a couple of tips to have a successful initial conversation to further discourse with caregivers, whether it be teachers, coaches, babysitters, bus drivers, friends, or family members. Read full article here.

Gluten Free Away from Home

There are ways to navigate a safe, gluten-free trip no matter how you are traveling and where you are going. Finding gluten-free shopping and dining options away from home is as easy as searching the internet and contacting local NCA celiac support groups. If you plan to travel internationally, finding restaurant cards in just about every language is easy on the web.

Search for summer camps

If you are looking for a summer camp for your child with celiac disease or gluten intolerance, please check out our list of camps. Some have dedicated gluten-free weeks while others are able to accommodate gluten-free campers.

 

     

    Restaurant guidelines

    Staying safe while dining out requires a little homework ahead of time. The bedrock of this is your knowledge of the gluten-free diet and how food is prepared. For a list of gluten-free and gluten-friendly restaurants, click here. Many smartphone apps are available to help you find suitable restaurants.

    Tips for dining out gluten-free:

    Ordering

    • Review menus in advance to get an idea of which items are likely to be safe and which are to be avoided.
    • Call the restaurant at a quiet time to inquire about gluten-free options.
    • Always bring a gluten-free dining card that explains the diet.
    • Let the staff know that you have CD, NCGS, or DH; this diet is medically necessary, not a choice.
    • Tell the staff that you must avoid food, sauces, soy sauce, marinades, and salad dressings that contain or come into contact with wheat, rye, and barley, even in tiny amounts.
    • Emphasize the need to avoid cross-contact.
    • If you are ordering fried food, make sure it is prepared in a dedicated fryer (one not used to fry anything with gluten).
    • Always confirm that your food is gluten-free when you receive it.  If something doesn’t look right, do not hesitate to question it.
    • Never take a chance with the food. If your salad arrives with croutons or your hamburger with a bun (not gluten-free), insist that this dish needs to be re-made from scratch because of the cross-contact.
    • If you have any doubts about the restaurant’s ability to feed you, order as plainly as possible (plain broiled fish, chicken or steak, plain steamed vegetables and a baked potato).
    • If the restaurant staff makes a genuine effort to respect your diet, make sure to show your appreciation by thanking them sincerely and by tipping generously.

    Other Tips

    • Soups are rarely gluten-free.
    • Au jus almost always contains gluten.
    • Believe it or not, some restaurants add flour to mashed potatoes or eggs; double check this.
    • Rice dishes are often enhanced by spices, broth, or other hidden gluten, such as orzo (wheat). Make sure yours is gluten-free.
    Parties and celebrations

    Holidays and celebrations can be a challenge for kids with celiac disease. You definitely need to plan ahead. It is hard to just do things at the spur of the moment. Here are some tips to make it easier at celebrations:

    • Find out in advance what will be served and prepare your child ahead of time
    • Pick out special treats to bring
    • Talk about what foods will be served
    • Offer to help the host with cooking or providing the food
    • Potlucks are great!
    • Bring an appetizer, entrée and dessert so you are sure there will be a complete meal for your child!
    • Be the host! Invite people to your home and let them try gluten-free foods
    • Gluten-free can be delicious and you do not need “special” foods to eat gluten-free
    • Make the whole party gluten free!
    • Parties are more fun if everyone can participate and eat everything, it is not always possible for all types of situations, but it is definitely appreciated when it happens

    Beware of cross-contact when eating away from home

    • Buffets may seem like a good idea, but there can be cross-contact between foods
    • Make sure there are separate serving spatulas for each dish
    • Make sure foods containing gluten are not next to gluten-free foods
    • Beware of double dippers! Ask to be the first to serve your child from a buffet to decrease the risk of cross-contact
    • Teach your child to ask to be served first at events to prevent cross-contact

    BIRTHDAY PARTIES

    Click here to view a step-by-step list to birthday parties.

    • The key with birthday parties is to communicate early with the host and discuss your child’s needs. Ask what foods and drinks will be served and if any activities will involve food. Give suggestions on foods that are gluten free that everyone can eat.
    • Get foods that are similar to the ones that are served at the party. Get your child involved with picking them out. Gluten-free cupcakes are usually good to bring, and can be frozen and stored in advance for special occasions. Make sure the food is packed in a sealed leak-proof container and labeled with your child’s name.
    • Educate and prepare your child ahead of the party. Practice explaining about the gluten-free diet and how to watch out for cross-contact. Reassure your child that it is ok to be different. Your child might feel apprehensive about going to a party or have negative thoughts about it. Validate their feelings and try to talk through these feelings and help them find solutions.
    • Walk in with your child to the party and talk to the host and explain again about your child’s needs, and make sure the foods you bring are put somewhere where they will not be in cross-contact with foods that contain gluten. Also check about seating and serving arrangements so that your child’s foods stays free of cross-contact. Stay with your child if possible at the party.

    Click here to read an article on how to navigate parties and celebrations as a parent or caregiver of a child with celiac disease or non-celiac gluten sensitivity.

    Travel

    There are ways to navigate a safe, gluten-free trip no matter how you are traveling and where you are going. Finding gluten-free shopping and dining options away from home is as easy as searching the internet and contacting local NCA celiac support groups. If you plan to travel internationally, finding restaurant cards in just about every language is easy on the web.

    Most cities have stores that carry gluten-free foods. For convenience and comfort, you might want to carry GF cereals, snacks, breads, pastas, energy bars, and crackers.

    Good Snacks to Carry when Traveling

    • Fruit and GF nut bars
    • Cheese sticks
    • Whole fruits
    • GF sandwiches
    • GF crackers/rice cakes
    • GF beef jerky
    • Rolled up ham and cheese sticks

    *Note that some foods may not be allowed to be brought to certain destinations. Make sure to check before traveling.

    A few additional tips:

    • For car travel, fill a cooler with gluten-free goodies. GF snacks, breads, bagels, frozen waffles, energy bars, sandwiches, and cookies will ensure that you won’t go hungry.
    • Some international airlines offer gluten-free meals. Ask and arrange for one when you reserve your flight (and identify yourself as soon as you get on the plane so someone else doesn’t get your meal!). Bring some GF staples in your carry-on in case you are delayed.
    • At hotels/motels, ask for a room with a refrigerator and microwave. Some places may let you store your gluten-free items in their kitchen refrigerators.
    • Contact your tour company or travel agent before booking a trip to find out how gluten-free needs will be accommodated.
    • Look for travel companies that cater to gluten-free clients.
    • Contact local NCA celiac support groups for restaurant and shopping recommendations or look over the restaurant list on NCA’s website.
    • If renting a house, consider bringing your own toaster bags (they can be found on-line) and a few utensils, pots, and pans that you know will be safe.

    Games

    Check out the boxes below for games and puzzles for printout.

    Word search

    Print word search #1.

    Print word search #2.

    Crossword puzzle

    Print Crossword puzzle #1.

    Coloring pages

    Print coloring pages #1.