Complete Guide to Gluten Challenge & Celiac Diet Foods

Understanding the Gluten Challenge

The gluten challenge is a critical part of getting tested for celiac disease. To get an accurate diagnosis from the blood tests and biopsy, you need to be eating a gluten-containing diet for at least 2 weeks leading up to the procedures.

This allows any immune reaction and intestinal damage from gluten to be detected. However, after following a strict gluten-free diet, adding gluten back in can be unpleasant and even dangerous for those sensitive to it.

Why the Gluten Challenge is Necessary

When someone with celiac disease removes gluten from their diet, the immune system reactions and intestinal damage improve. This causes antibody levels to drop and intestinal healing to occur. But the person still has celiac disease.

If they get tested for celiac while on a gluten-free diet, the test results may come back negative even if they do have celiac. This inaccurate test result is why a gluten challenge is needed beforehand.

Length of the Gluten Challenge

Research shows that eating gluten daily for 2 weeks leading up to testing is enough to cause immune activation and intestinal changes detectable by the celiac blood tests and biopsy.

Some doctors recommend longer gluten challenges up to 8 weeks. But studies have found that 2 weeks produces accurate test results in most people. Less than 2 weeks of gluten intake often does not provide enough reaction to properly diagnose celiac.

Foods to Eat During a Gluten Challenge

A gluten challenge involves eating foods with the protein gluten daily. This includes grains like wheat, barley, and rye that trigger immune reactions in those with celiac disease.

Here are some important foods to include in your diet during a gluten challenge:

• Bread, pasta, crackers, baked goods with wheat flour
• Cereals containing wheat, barley, rye
• Beer and grain-based alcohol
• Oats unless certified gluten-free
• Wheat-based soy sauce or sauces
• Soup stocks and bouillons with gluten-grains

Key Tips for the Gluten Challenge

Getting through a gluten challenge can be difficult for those sensitive to gluten. Here are some tips to help:

• Reintroduce gluten slowly then build up
• Drink plenty of water to stay hydrated
• Take over-the-counter medicines as needed for symptoms
• Avoid overly fatty, spicy, or fiber-rich foods which are harder to digest
• Consider taking probiotic supplements to support gut health

Foods to Eat on a Gluten-Free Diet for Celiac Disease

Following a strict lifelong gluten-free diet is the only treatment for celiac disease currently. For most people with celiac, eating gluten triggers immune system destruction of the small intestine lining and resulting malabsorption issues.

Thankfully many nutritious and delicious foods are naturally gluten-free. Focus your gluten-free diet around these beneficial whole foods:

Proteins

• Beans, lentils, peas
• Nuts and seeds
• Eggs
• Fish and seafood
• Meat and poultry
• Milk
• Yogurt
• Cheese

Fruits and Vegetables

• All fresh vegetables
• Fresh and frozen fruits
• Canned fruits packed in juice or water
• Canned vegetables with no added gluten ingredients

Grains and Starches

• Rice
• Quinoa
• Gluten-free oats
• Buckwheat
• Cornmeal and corn flour
• Gluten-free bread
• Gluten-free pasta

Fats and Oils

• Olive oil
• Coconut oil
• Avocado oil
• Ghee or clarified butter
• Non-hydrogenated nut butters
• Olives
• Nuts and seeds
• Nut and seed oils
• Butter

Herbs, Spices and Condiments

• All fresh and dried herbs like basil, oregano, cilantro
• Spices like black pepper, cinnamon, turmeric
• Salts like Himalayan and sea salt
• Mustard
• Ketchup and BBQ sauce with no gluten ingredients
• Honey, maple syrup, balsamic vinegar
• Soy sauce specifically labeled gluten-free
• Distilled white vinegar
• Hot sauce and salsas with no gluten ingredients

Beverages

• Water, sparkling water, coconut water
• Coffee and tea
• Wine and distilled gluten-free alcohol like vodka or gin
• Nut milk like almond or coconut milk
• 100% fruit and vegetable juices

Snacks

• Fresh fruits
• Nuts
• Seeds like pumpkin or sunflower
• Nut butters
• Popcorn
• Corn chips
• Rice cakes
• 100% dark chocolate
• Gluten-free granola bars

Foods to Avoid on a Gluten-Free Diet for Celiac Disease

Alongside eating nutritious gluten-free foods, you also need to know which foods contain gluten and should be avoided. This includes obvious sources of gluten like wheat flour as well as some hidden sources found in packaged foods and sauces.

Grains with Gluten

The key grains to eliminate from your diet with celiac disease include:

• Wheat including varieties like durum, farro, graham flour
• Barley
• Rye
• Triticale
• Malt
• Brewer's yeast
• Some oats may be cross-contaminated

Check labels to avoid foods that contain flours, starches or alcohol made from these gluten grains.

Gluten May Be Hidden in These Foods

• Check sauces and condiments for gluten ingredients
• Seasonings and spice mixes
• Soup stocks and bouillon cubes
• Certain candies and flavored nuts
• Imitation bacon bits or seafood
• Bottled fruit juices and frozen pops

If a product's label includes mentions like wheat, barley or malt, then it contains gluten. Also beware of labels with statements like "contains gluten ingredients."

Avoid Cross-Contamination

Gluten can also sneak into your food if prepared on contaminated surfaces. Avoid cross-contamination by:

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.