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Celiac Disease Resource Guide for a -Free A family resource from the Celiac Disease Program

celiacdisease.stanfordchildrens.org What Is a Gluten-Free How Do I Diet? Get Started? A gluten-free diet is a diet that completely Your first instinct may be to stop at the excludes the gluten. Gluten is on your way home from made up of and which is the doctor’s office and search for all the found in including , , gluten-free products you can find. While and . Gluten is found in any or this initial fear may feel a bit overwhelming product made from these grains. These but the good news is you most likely gluten-containing grains are also frequently already have some gluten-free in used as fillers and flavoring agents and your pantry. are added to many processed foods, so it is critical to read the ingredient list on all food labels. Manufacturers often Use this guide to select appropriate change the ingredients in processed and . Prepare your own gluten-free foods, so be sure to check the ingredient foods and stock your pantry. Many of your list every time you purchase a product. favorite brands may already be gluten-free.

The FDA announced on August 2, 2013, that if a product bears the label “gluten-free,” the food must contain less than 20 ppm gluten, as well as meet other criteria. *The rule also applies to products labeled “no gluten,” “free of gluten,” and “without gluten.” The labeling of food products as “gluten- free” 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 Diet celiacdisease.stanfordchildrens.org | 3 Which Foods Contain Gluten? Gluten is found in wheat, rye, barley, and grains. Gluten is also found in things made from these grains, like , , , einkorn, , faro, Foods and , graham , flour, kamut, , and . These grains are found in a variety of foods, including cakes, , , and . Additives That Gluten-Containing Foods and Ingredients to Avoid: Wheat Barley Atta Kamut Ale Bulgur Matzo, matzo Barley Malt extract/ (flakes, flour, pearl) malt syrup Contain Gluten Couscous Modified wheat Malt flavoring Dinkel (spelt) Seitan Brewer’s yeast1 Malt vinegar Complying with a gluten-free diet can be challenging. Durum Semolina If a product contains the symbol at left, then that Lager Malted Spelt product is gluten-free. Einkorn (, faro, dinkel) Tabouleh Grains containing gluten are often added to processed foods, Rye so it’s important to carefully read the food labels to check for Farina Triticale Rye Rye flour sources of gluten. Manufacturers often change the ingredients Farro or faro (spelt) Wheat Bran in processed foods, so you need to be sure to check each food every time you buy it. Graham flour Oats2 Hydrolyzed Wheat germ wheat protein flour As you learn to spot gluten on food labels, be sure to remember that wheat-free does not mean gluten-free. If you’re not sure Wheat starch Oat bran whether a food has any gluten, it’s best not to eat it. Notes: 1 Brewer’s contains barley; however, other are gluten-free. 2 Unless oats are labeled “certified gluten-free oats.”

4 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 5 After your child’s diagnosis of celiac disease and on your first trip to the grocery store, think about shopping the perimeter of the store. This is where At the you will find naturally gluten-free foods. Start with the fresh produce section Grocery Store and stock up on -rich, low-, low-sodium and . Next, visit the fresh meat, poultry, and seafood As the demand for gluten-free products increases, section. Again, these are naturally gluten-free. many grocery stores now stock more products Think about making a fresh breast or lean that are specifically gluten-free. Look in the Asian roast for dinner and then using the leftovers as a section for and crackers. Check filling for a for . Use caution when out the “organic” or “health food” section for choosing luncheon meat and other processed meats. gluten-free , , and baking products. Within the inner aisles The processed meats may contain gluten as fillers or enhancers, so read the label carefully. of the grocery store, Specialty health food stores typically have gluten-free

foods in a designated section and in the frozen foods After the meat section, you can visit the egg and look for: section of the store, offering shoppers many foods dairy section. These products are, for the most part, • Corn tortillas such as gluten-free , bread, and gluten-free. Calcium-rich and snacks like ice to defrost and bake at home. • Plain or brown rice, , cream, , and may be good choices for a gluten-free diet, but always thoroughly check the Some frozen food sections also have gluten-free • Dried and list of ingredients. frozen meals as a convenient option. • Fresh and If your child has lactose intolerance, try lactose- • or free milk, yogurt, and hard cheese as these are • Cooking oils (canola and oils usually well tolerated in those patients. Lactaid tablets can also be taken with dairy products. are low in saturated and contain healthy monosaturated fat)

6 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 7 CHIPS CHIPS

Produce Meat, Fish, Dairy Snacks CondimentsCEREAL CEREALCEREAL CerealsCEREAL CHIPS S S Poultry P P & Grains

• All fresh fruits • Fresh • Unflavored milk • chips • Jam and jellies, • Cream of rice (caution: flavoredCEREAL chips) marmalade CEREAL CEREAL • All fresh vegetables • Fresh • Cream • Grits S P • Corn chips • Honey • • Fresh poultry • Aged cheese (caution: • Puffed rice • Popcorn • Peanut or nut butters • White or sweet potato (caution: self-basting) processed cheese) • Plain or brown rice, • Rice crackers,CEREAL rice cakes • Corn or potato starch Quinoa, millet • Corn • Fresh fish or seafood • Most • Plain nuts, • Corn and syrup • Corn tacos or tortillas • Edamame • Eggs • , • Cream cheese (fat-free • Jello • Molasses • Chex cereals products may not be GF) • Pudding • Brown, white and • confectioner’s • Spices and herbs • Sour cream • Salt, pepper Packaged • , pickles, Beverage Fats Frozen CHIPS & Canned & Oils Foods Foods • , mustard • Distilled vinegars • 100% • , canola • Plain fruits • Plain fruits • Most dressing and and vegetables CEREAL CEREAL and vegetables • , , cocoa (read label for gluten S • MostP • All canned meats (read presence) • Nut (almond, • Shortening and sherbet label for gluten presence) cashew, , pistachio) • Gluten-free breads, • Dried beans, lentils, • Soft bagels, English muffins CEREAL • Most baked beans • Swiss Miss hot cocoa • Gluten-free frozen

8 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 9 CHIPS

Gluten-Free CEREAL CEREAL S P

• RiceCEREAL Chex or Corn Chex or other • Grits with butter and salt Meal Ideas gluten-free cereal with milk, nut milks, • Cottage cheese and fruit fresh fruit • Gluten-free (gluten-free • Corn tortillas, warmed with brands include , Bob’s scrambled eggs, chopped , Red Mill, Gluten-free Essentials, and melted cheese Gluten-free Pantry, Kinniknnick, Sylvan, • Cream of rice cereal with and Vans) with butter and syrup chopped almonds and milk • Gluten-free yogurt layered with • Gluten-free waffles with • Hard-boiled eggs mixed with mayonnaise, butter and syrup served on toasted corn tortillas • Omelet with , peppers, and • Gluten-free oatmeal with fruit tomatoes, with two soft corn tortillas

10 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 11 CHIPS

CHIPS

CEREAL CEREAL CEREAL CEREAL S S P P

Lunch CEREAL Dinner CEREAL

• Sliced turkey with lettuce, tomato, and • Gluten-free ham on gluten-free toast • Grilled portabella mushroom marinated • Salmon baked with mustard, and honey, mayonnaise on warmed corn tortillas or warmed corn tortillas with mustard in garlic and oil, served with mixed served with brown rice and steamed with baby and coleslaw green salad green beans • Grilled sliced chicken over mixed • Cottage cheese with mixed fruit • Peanut or nut butters and jelly • Hard-boiled egg, sliced, with steamed greens, with red peppers, sliced • Grilled chicken cutlet marinated in garlic, on rice cakes green beans, baby , sliced tomatoes, broccoli florets, and oil, and , served over chopped • Grilled cheese made with gluten-free , sliced tomato, and chickpeas chickpeas, served with oil and vinegar romaine lettuce, with gluten-free Caesar bread served with roasted veggies with oil and vinegar or gluten-free or gluten-free salad dressing salad dressing dressing, parmesan cheese, and gluten- • Turkey roll-up with cream cheese and • Toasted gluten-free bread or warmed free rice crackers spear • Grilled chicken cutlet marinated in corn tortillas, with tuna fish made with • Grilled or broiled sirloin burger with garlic, oil, and powder, served with mayonnaise, chopped onion, sliced • Quesadilla using corn tortillas, chopped cooked brown rice, steamed broccoli, lettuce, tomato, sliced onion, ketchup, chicken, and tomatoes tomato, shredded lettuce, and and a gluten-free roll if available – if not and mixed greens served with oil and chopped cucumber available, serve over a mixed salad with • Baked potato with cheese and chives vinegar or gluten-free salad dressing • Grilled salmon or tuna served over oil and gluten-free vinegar • Quinoa with lemon juice, chickpeas, • Broiled skirt steak with garlic, onion mixed greens with shredded carrots, • Grilled chicken marinated in garlic, and olive oil powder, and a dash of salt, served with chopped tomatoes, and . oregano, oil, salt, and pepper, with a steamed cauliflower and a medium Serve with oil and vinegar, or favorite sweet potato, butter, and mixed veggies baked potato with butter or margarine gluten-free salad dressing, gluten-free • Baked flounder cooked with chopped rice crackers, and lemon wedges • Chicken salad made with cooked chicken, mayo, onions, , and onions, tomatoes, cilantro, garlic, and • Grilled chicken, salmon, or tuna, with , over a mixed green salad onion powder, served with steamed shredded lettuce, sliced tomatoes, baby spinach, rice, and a mixed green salad carrots, and gluten-free rice cakes sliced tomato and cucumber and oil and vinegar or gluten-free salad dressing

12 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 13 CHIPS

CEREAL CEREAL

S P

SnacksCEREAL

• Pork loin cut into two-inch cubes • Grilled shrimp over a mixed green • Fresh fruit • Nuts with * (nuts are naturally of and tomatoes salad with baby potatoes and favorite • String cheese* gluten-free unless flavored or processed marinated in gluten-free Italian dressing, gluten-free dressing on gluten-containing equipment) • Rice crackers with grilled, and served with steamed • Hand-pressed hamburger or turkey • with Cool Whip broccoli and corn with butter or or cheese* burger (100% pure ground beef or • Plain or almonds* margarine and a dash of salt turkey), with onion and sliced tomato, • Popcorn* • Roasted chicken with carrots, potatoes, baked sweet potato fries, and • Sliced veggies with gluten-free • Rice cakes with cream cheese and jam* and onions, seasoned with garlic, onion green beans dip* • ice cream, sorbets, powder, salt, pepper, and Italian herbs • Frozen gluten-free pizza baked • Canned fruit in its own sherbets, ice milk* • Grilled or baked chicken, shrimp, or veal and served with mixed green salad • Plain yogurt • Edamame placed in a casserole dish and topped and gluten-free salad dressing • Applesauce with cinnamon • Celery with peanut butter with tomato sauce, mozzarella, and or cream cheese* parmesan cheese, served with • Baby carrots and snow peas gluten-free pasta with * • Hard-boiled egg • Rice, corn, or quinoa pasta with tomato • String cheese and dried fruit* * Double-check labels particularly sauce and a mixed green salad with • Pudding* favorite gluten-free dressing in these items. • Rice cakes*

14 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 15 and Preparation Once you get your groceries home, you need to think about how your food is prepared. Here are several suggestions to help you avoid contaminating your Gluten-Free food with gluten:

• Do not purchase foods from open bins or bulk bins. Can I Eat Packaged Foods • Store gluten-free foods separately. with These Ingredients? Cooking • Label gluten-free foods to prevent confusion. • Maltodextrin* • Have designated gluten-free appliances and tools, like • Starch or modified food starch* toasters, non-stick and cast iron pans, colanders, etc. • Dextrin* • Use clean tools for cooking, cutting, mixing, serving, storing, etc. • MSG () • Avoid tools that can harbor gluten crumbs or have • Vanilla and almond extracts Gluten-Free Grains scratches (e.g., wooden cutting boards, non-stick • Caramel coloring • (seeds or flour) • Guar gum • Soy flour pans, etc.) • Vinegar (except malt vinegar) • Have separate containers of foods that food or • Canola oil • flour • Mesquite • knives are dipped into, like peanut butter, hummus, • Bean flours • Millet • Flour or starch etc., or have a strict “no double-dipping” rule. Yes! Just avoid foods with labels that list: wheat, rye, barley, malt, malt extract, • • Nut flours • Teft malt flavoring, malt vinegar, brewer’s • Corn • Potato • Quinoa What about Oats? yeast, and oats (not marked gluten-free). All commercial, regular oats are contaminated with gluten. • Corn flour • Potato flour • *Rare potential exception: meat, poultry or Most people with celiac disease can eat small amounts egg products. • Corn meal • Potato starch (around ½ cup uncooked) certified gluten-free oats. A small percentage of people with celiac react the same way to • Cornstarch • Rice the protein in oats as they do to gluten. Talk to your doctor • Expandex (a modified food • to get more specifics for your individual needs. starch made from tapioca)

16 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 17 Bay Area R.O.C.K. Davis – Celia Gluten Intolerance (Raising Our Celiac Kids) Support Group Group of Marin (South Bay and Peninsula) Diane Craig Sheila Wagner Kelly Velez Email (415) 924-1700 Northern (650) 303-8409 Barb Sobel Email Davis - Gluten-Free Group Email at the Davis Food Co-op Yahoo group: bayareaceliacROCK Group’s Email Email Website Berkeley – GlutenX: Facebook page California Marin - Celiac Community Cal’s Gluten Free Alliance East Bay/Tri-Valley R.O.C.K. Foundation of Northern Campus advocacy and support California Support Group group for registered students, (Raising Our Celiac Kids) Jennifer Iscol faculty and staff Julia Babka-Kurzrock Email Support Email Email Carla Mira Website Mendocino County Email Facebook page Jeni Guth Yahoo Group: eastbayceliacROCK Email Groups Contra Costa County Facebook page Gluten-free discussion group - Gluten Intolerance Group meets in the rossmoor community – East Bay and Mid-Peninsula Contact in Creek South Bay locations Joan Terry Walter Moeller Kim Rice (650) 726-5310 (925) 930-8875 Email Email Email Website Morgan Hill Contact Dolores Kent Email

18 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 19 Napa County Salinas Contact Santa Cruz Support Group Celiac Community Adriana Morga – Celiac Disease Foundation Foundation of Northern (831) 210-3218 Pam Newbury California Support Group Email (831) 423-6904 Email Jennifer Iscol San Francisco Celiac Kids Resources Email Website (adults welcome) David Drutz NorCal Gluten-Free Teens Sonoma County (415) 203-3798 Facebook page Email Celiac Community Foundation of Northern S.F. community contact Oakland Support Group – California Support Group Lisa Palmer Celiac Disease Foundation Email Jennifer Iscol Melissa Batavia 707-579-9683 (voice mail Email San Francisco Celiacs checked weekly at most; email at Gluten-Free Grocery checked daily) Sacramento Celiacs Calvin Chin Email on Facebook (415) 626-FREE Joann Mitchell Email South Bay Support Group Email Website Vic Dolcourt Facebook page Email Santa Clara Kaiser Brenda Falk Sacramento – Celiac Support Group (open to all) Email Support Group Barbara Dodson Gluten-Free Bay Area Diane Craig Email Email Meet-Up Group Website

20 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 21 S P CEREAL Meal Plan Meal “Traffic Light” The Celiac CHIPS

foods from this list. day. You should choose and are safe to eat every foodsThese are GO! • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Teff Tapioca Soy Sorghum Rice noodles Rice Rice flours Rice Rice Quinoa Potato starch Potato Potato flour Potato Potato bread Potato Plain tortilla chipsPlain tortilla Plain rice cakes Plain popcorn Plain Plain chips corn , ) flours Nut (almond, Montina Millet Hominy (grits) Hominy Gluten-free cereals Gluten-free Cream of rice Corn tortillas tortillas Corn Buckwheat Arrowroot Amaranth CEREAL CEREAL

Gluten-free Bay Area Grocery Stores National Organizations Websites Apps Magazines GO! Mariposa Baking Company Whole Foods Markets Celiac Disease Foundation www.celiac.org Find Me Gluten Free Simply Gluten-Free gluten-free

Comprehensive list(s) of safe/ Breads, Cereals, Flours, and Other Grains 5427 Telegraph Avenue Draeger’s Market (818) 716-1513 www.findmeglutenfree.com Gluten-Free Living forbidden foods, gluten-free Oakland, CA 94609 Trader Joe’s www.celiac.org products, recipes, and Is That Gluten Free? GFF Magazine Mollie Stone’s Markets relevant news University of One Ferry Building, Suite 32 WalMart Dine Gluten Free Living Without’s Gluten-Free Celiac Disease Center San Francisco, CA 94111 Target (Grocery) + More www.glutenfreedrugs.com to gluten-free! be they can’t guaranteed be to eat, careful but be because These foods may safe be SLOW!

(773) 702-7593 (510) 595-0955 Safeway (limited items) Provides accurate lists of the Books • • • • • www.cureceliacdisease.org • (may contain barley) Rice cereals corn and Oatmeal Oatmeal Oats Flavored snacks snacks Flavored (chips, etc.) popcorn, Flavored rice mixes Amazon.com majority of medications both Gluten-Free Diet with wheat flour) (sometimes is mixed flour Buckwheat generic and non-generic

Zest A comprehensive resource SLOW! Gluten Intolerance Group which are gluten-free 1224 Arroyo Gluten Free Grocery (253) 833-6655 guide by Shelly Case, RD San Carlos, CA 94070 600 Illinois Street www.gluten.org www.triumphdining.com The Gluten-Free Gourmet (650) 241-9378 San Francisco, CA 94107 Publisher of the most Fast and healthy recipes www.zestbakery.com (415) 626-3733 National Foundation for comprehensive gluten-free by Bette Hagman Celiac Awareness restaurant guide in North America, dining cards that help you order Miglet’s Cupcake Shop Country Sun (215) 325-1306 www.celiaccentral.org gluten-free at restaurants where Kids with Celiac Disease 480 San Ramon Valley Blvd., Ste. 2 440 S. California Avenue language barriers, and popular A family guide to raising happy, gluten contamination. severe reactions due to you to experience mild to Eating them may cause free and should avoided! be These foods are not gluten- STOP!

•

Danville, CA 94526 Palo Alto, CA 94309 gluten-free grocery guides healthy gluten-free children Celiac Support Association • • • • • • • • • • • • • • • • • • • • • • • • • • • • • (925) 831-9016 •

by Danna White flour White White bread White Wheat germ Wheat Wheat and wheat bread and Wheat Triticale Spelt Semolina Rye Pizza Pastas Modified starch wheat Modified Matzo Kamut wheat protein Hydrolyzed vegetable proteinvegetable Hydrolyzed Graham Flour tortillas tortillas Flour Farro Farina Emmer Einkorn Durum C Crackers Couscous Cereals Bulgar Bran (650) 324-9190 Barley (402) 558-0600 www.migletsgf.com www.celiaccentral.org/kids/ routons www.csaceliacs.org

Sprouts Free resources for gluten-free Incredible Edible Gluten-Free STOP! kids and parents Food for Kids 111 E. El Camino Real

by Sheri L. Sanderson Sunnyvale, CA 94087 (408) 702-1172 The Gluten-Free Kid: A Celiac Disease Survival Guide by Melisa London

22 | Celiac Disease Resource Guide for a Gluten-Free Diet celiacdisease.stanfordchildrens.org | 23 Be careful with dairy foods. Sometimes people who have celiac disease are also lactose intolerant. Fruits and Vegetables If you experience symptoms after eating dairy foods you may want to avoid them.

GO! SLOW! STOP!

• All plain fresh, canned, • FlavoredCHIPS potato dishes • Baked beans or frozen fruits • French fries (often • Fruit pies • All plain, fresh, cooked in same oil as canned, or frozen breaded foods)

vegetables CEREAL • VegetablesCEREAL in sauces • Jams and jellies S P • Legumes (beans, chickpeas, garbanzo) • Dates (sometimes are CEREAL tossed with flour)

Dairy CHIPS

• Buttermilk CEREAL • CEREALBlended milk drinks • Cheese sauces

S • CheeseP • Flavored cheeses • Cheese spreads • Cottage cheese • Flavored yogurts • Malted milk • Cream cheese • Frozen yogurt CEREAL • Plain milk • Some ice creams may • Plain yogurt have gluten-containing ingredients • Sour cream

Meats and Other

GO! SLOW! STOP!

CHIPS • Eggs • Seasoned tofu products • Peanut butter • Deli meats • Breaded (fried) chicken or meats • Plain chicken • Dry roasted nuts CEREAL CEREAL • Imitation bacon bits • Plain fish • Hot dogs S • Imitation seafood P • Plain meats • Marinated meats • • Plain nuts (check ingredients)

• Plain tofu CEREAL • All canned meats (check ingredients for

gluten presence) CHIPS

OtherCEREAL Foods CEREAL S P

CEREAL • Gluten-free specialty • Baking powder • Broths products (some brands have • Cakes/frostings wheat starch) • Honey • Candies • Mustards • Italian ice • • Pudding • Ketchup • Gravies • Pepper • Marinades • Popsicles • Medications • Pure herbs and spices • Play dough • Salsa • Pies and • Salt • Sauces • Sorbet • • Sugar or sugar • Seasoned nuts substitutes • Soups •

Fats and Oils CHIPS

GO! SLOW! STOP! CEREAL CEREAL • Butter • Cooking spray • Malt vinegar S •P Margarine • Salad dressings CHIPS • Mayonnaise • Sandwich spreads • Pure canola oil • Pure olive oil CEREAL

CEREAL CEREAL

S P Drinks

CEREAL • Coffee • mixes • Ale • Diet sodas • Flavored • Beer • Tea and • Lager • Soy or rice drinks • Malt and malted milk (may contain barley malt or rice syrup) Celiac Disease Care Team, Stanford Children’s Health Director of the Celiac Disease Program and Nasha “Nasim” Sabery Khavari ,MD, MPH Contact Fax (650) 498-5608 Tel Palo Alto,CA94304 730 Welch Road Mary L. Johnson Specialty Services Pediatric Gastroenterology service, islocated at: The Celiac Disease Program, offered by our (650) 723-5070 Printed post-consumerrecycled material.Please recycle.

001221 | 12/2015