Just Diagnosed Coeliac and Overwhelmed: Where to Start With Food
You can eat far more than it feels like today. In the first few days after a coeliac diagnosis it can seem as though everything is off the list. A huge amount of everyday food is naturally gluten-free with no special free-from version needed. Plain meat and fish, eggs, most fruit and vegetables, rice, potatoes and dairy. The part that takes learning is where gluten hides in processed food, and how to avoid picking it up by accident. None of that has to be mastered in week one.
It's a real change, and missing your old habits is fair enough. It gets a lot easier once you have a handful of meals and snacks you trust.
Start with food that's already safe
These are single-ingredient foods that are gluten-free as they come, so they make a reliable base while everything is still new.
- White rice and potatoes are go-to staples the world over, and fine on most other elimination diets too
- Chicken, turkey, salmon, white fish such as cod and other plain, unprocessed meat and fish
- Eggs
- Carrots are a go-to for a lot of people on elimination diets, as they're also fine on low-histamine and low-FODMAP. But almost all plain vegetables are wonderfully gluten-free
- Bananas, apples, berries, mangoes, you name it. Fresh fruit is perfectly gluten-free, and so is most tinned fruit
- Quinoa, buckwheat, rice noodles and rice pasta are great too
- Nuts, nut butters, oils, herbs and spices. Check the label on spice blends and flavoured nuts, as some use wheat flour
The fewer things on a label, the fewer places gluten can hide. Building your first meals from foods with no label at all takes most of the guesswork out. A tray of roasted salmon, potatoes and carrots with olive oil, lemon and a few herbs is a proper dinner and there's nothing in it to check.
There are plenty of gluten-free versions of your old favourites out there, such as bread, cakes and biscuits. They tend to be hugely disappointing, full of additives and sweeteners that don't do a sensitive gut any good, and overpriced. The best advice I can give is to stick to food that's naturally gluten-free. A lot of Mexican, South American and Asian cooking, including Indian, Thai and Vietnamese, is built on rice, corn or potatoes rather than wheat, so many dishes are gluten-free without trying and don't feel like they're missing anything. The exceptions to watch for are soy sauce, wheat breads like naan and chapati, and flour tortillas.
A few trickier ones
If dairy bothers you too
Dairy is naturally gluten-free, but it doesn't always agree with you around the time of diagnosis. Coeliac UK links lactose intolerance with undiagnosed coeliac disease. The damaged gut lining can't make enough of the enzyme that digests lactose, the sugar in milk. It's usually temporary, and once the gut heals on a gluten-free diet most people can have it again.
So if milk in your tea or coffee still upsets you, it doesn't mean the gluten-free diet isn't working. Lactose-free milk is an easy swap in your mug while you find out. Hard cheese such as mature cheddar has very little lactose and is usually fine. Talk to your GP or dietitian before cutting dairy out completely, as it's a big source of calcium.
Where gluten hides
Once you're past the naturally safe foods, the processed aisles are where it gets fiddly. The usual ones are bread, pasta, most breakfast cereals, batter and breadcrumbs. Then the places you wouldn't think to look: gravies and sauces, and processed foods with additives such as malt flavouring. Avoid soy sauce unless it's labelled gluten-free, and check the label on stock cubes and sausages. Reading ingredients becomes second nature quicker than you'd expect. In the UK, cereals containing gluten have to be emphasised in the ingredients list, for example in bold, which makes them easier to spot. Recipes change, so it's worth a read of the label each time rather than trusting what it said last month.
Oats
Oats contain avenin, a protein similar to gluten, and most people with coeliac disease can eat gluten-free oats with no problems. Ordinary oats are the risk. Many are produced in the same place as wheat, barley and rye, so they can be cross-contaminated. If you want porridge, buy oats labelled gluten-free. A very small number of people with coeliac disease react even to gluten-free oats, so if you get symptoms after eating them, talk to your GP or dietitian.
Cross-contamination, kept simple
This is what sets coeliac disease apart from simply avoiding gluten. Even a small amount of gluten, such as a spoonful of pasta, can cause very unpleasant symptoms, and it can be picked up from shared utensils. In your own kitchen the things that matter most are a separate toaster or toaster bags, your own butter and jam kept free of crumbs from shared knives, and a clean chopping board and pan rather than ones with flour on. You don't need to strip the kitchen bare on day one. Start with the toaster and the shared spreads, since those catch people out most. There's a full rundown in what kitchen equipment to replace after a coeliac diagnosis.
What can wait
You don't have to solve eating out, travel and every awkward social situation this week. Get your home meals sorted first, learn to read a label, and let the rest come as it comes. If someone close to you is trying to help and isn't sure how, this one is worth sending them.
If you're a few months in, strict about gluten and your gut still isn't right, talk to your GP or dietitian. There's more on adding low-FODMAP on top of coeliac in coeliac and low-FODMAP: what can you actually eat?. If you're juggling another diet on top of coeliac, the ClearToEat food finder rates each food on gluten-free, lactose-free, low-FODMAP, low-histamine and SCD side by side, so you don't have to cross-check several lists yourself.
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This article is general information, not medical or dietary advice. A coeliac diagnosis should be managed with your GP or a registered dietitian, who can help you build a safe, balanced gluten-free diet that's right for you.