Strategies for Success on a Gluten-Free Diet

// Sharyn Reinhold, M.S.


Strategies for Success on a Gluten-Free Diet

Navigating a gluten-free diet can be tricky, especially for those who are just getting started. However, a well-executed gluten-free diet is crucial for those who need to do so in order to improve their health. Some key factors in helping your patients maintain a long-term and successful gluten-free diet include: meal-planning resources, education on appropriate foods, and an “emergency” plan for accidental exposure. Accidental exposure from hidden sources or through cross-contamination can stand in the way of desired health outcomes and can also sabotage accurate assessment of progress.

Encountering gluten accidentally can be both physically and mentally detrimental to the sensitive individual.” Sharyn Reinhold, MS

Hidden Sources of Gluten and Cross-Contamination

Most people are aware that wheat products contain gluten, but it is also found in other grains – specifically rye, barley, and triticale which is a hybrid grain of wheat and rye. Other gluten-containing grains go by the names einkorn, faro, spelt, kamut, farina, and emmer. While these sources of gluten are generally easy to recognize, many other food ingredients and food additives are also unwittingly sources of gluten. Processed and packaged foods are common places to look for these hidden sources of gluten. Food (or beverage) products/ingredients that may contain gluten include1:

  • beer
  • malt (often made from barley)
  • instant tea/coffee
  • sauces/gravies/marinades
  • breaded items
  • thickeners
  • canned soups, baked beans, etc.
  • processed meats (i.e. lunch meats, hot dogs)
  • condiements
  • seasonings
  • colorings/flavorings (i.e. caramel color is often made from barley)
  • chips (may contain wheat starch or wheat protein)
  • dextrin (often from corn but may be from wheat)
  • modified corn starch
  • hydrolyzed plant starch (HPP)
  • hydrolyzed vegetable protein (HVP)
  • textured vegetable protein (TVP)
Unfortunately, hidden sources of gluten can include non-food items as well. A few examples are lipsticks, medications, toothpaste, and playdough. Personal care products, paints, envelopes, and pet food may also contain gluten. While these items are not directly ingested, they could be transferred from the hands to mouth inadvertently.

Cross-contamination occurs when food that does not naturally contain gluten comes into contact with it in other ways. Perhaps the most common example is oats, which have an extremely high risk of contamination with gluten during the harvesting and milling process. Because of this, oats are often excluded on a gluten-free diet unless they are certified gluten-free. In addition to food processing plants, there is also risk of cross-contamination at home and even more so when eating out at restaurants.1

Tips for Coaching Patients on a Gluten-Free Diet

If you are a practitioner wondering how to best support your patients on a gluten-free diet, keep in mind that they need both practical and emotional support. For emotional eaters, removing foods previously used as comfort foods is particularly challenging and may require additional interventions. Here are some specific steps you can take to help your patients:

  • Spend time educating your patients on the “why’s” of eliminating gluten – if they understand the connection between gluten ingestion and their health concerns, they will be more likely to stay motivated and push through the difficulties
  • Give them resources such as recipe ideas and print-outs on gluten-containing foods, safe foods, hidden sources, avoiding cross-contamination, etc.
  • Have them keep a food journal and review it a few weeks into their gluten-free diet to ensure they are on the right track
  • Coach them on whole, nutrient dense foods in order to minimize the risk of vitamin and mineral deficiencies and recommend dietary supplements as appropriate
  • Practice empathy – if you personally have been following a gluten-free diet for some time, it can be easy to forget how overwhelming it can be at the beginning.
  • If you do follow a gluten-free diet yourself, tell them what a typical eating day looks like for you. Being transparent will help you lead by example and show them that they are not alone (and that a gluten-free diet is, in fact, very sustainable!)
  • Discuss with them the importance of keeping a gluten enzyme supplement always on hand to help minimize the effects of unintentional gluten exposure or cross-contamination (such as while dining out)*3
  • Compile a list of local restaurants that offer gluten-free options

Early success is important, because the positive improvements in health will speak for themselves and subsequently cement an individual’s motivation and long-term compliance. Although it can be a hard transition, there are many great resources currently available on gluten-free diets for both patients and practitioners. Encountering gluten accidentally can be both physically and mentally detrimental to the sensitive individual. Gluten enzyme supplements are a novel solution to this dreadful roadblock. * Following these tips will not only help with a smooth transition to a gluten-free diet, but will also help set individuals up for long-term success on their gluten-free lifestyle.

Sharyn Reinhold, M.S

Sharyn Reinhold holds a Bachelor's degree in Psychology and a Master's degree in Applied Clinical Nutrition, with a special interest in the gut/brain connection and other behavioral nutrition concepts. Sharyn became passionate about nutrition after her own battle with chronic Lyme disease and seeks to help others combat pain and inflammation through diet and lifestyle changes, from a functional perspective.

  1. Hlywiak K. Hidden Sources of Gluten. Practical Gastroenterology. 2008 Sept. Celiac Disease: A Comprehensive Review and Update, Series #2: 27-39.
  2. Vici, G, et al. Gluten-free diet and nutrient deficiencies: A review. Clin Nutr. 2016; 35:1236-41.
  3. Salden BN, et al. Randomised clinical study: Aspergillus niger-derived enzyme digests gluten in the stomach of healthy volunteers. Aliment Pharmacol Ther. 2015 Aug; 42(3): 273-85.

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