Gluten-free Labeling: What You Should Know

Last updated: Oct 01, 2013

Are you one of millions of Americans who has digestive problems from eating gluten? If you answered yes to this question, then you are not alone. Approximately 18 million people in the United States have nonceliac gluten sensitivity and 3 million people in the United States have celiac disease — a condition that gluten aggravates.1,2

What is celiac disease and how does it differ from gluten sensitivity?

Celiac disease is an digestive disease that damages small, finger-like protrusions (or villi) in the wall of the small intestine. Villi contribute to the absorption of nutrients. But foods containing gluten (a protein found in wheat, rye, and barley), can damage villi and prevent the absorption of nutrients in people with celiac disease. Over time, people with celiac disease can become malnourished and develop osteoporosis. Although there is no treatment or cure for celiac disease, it can be managed by avoiding foods that contain gluten.1

People who have nonceliac gluten sensitivity (or gluten intolerance) have symptoms similar to those of celiac disease. But gluten insensitivity does not typically damage villi and cause malnourishment or osteoporosis.2

If you think you might be sensitive to gluten or might have celiac disease, your doctor can test you for wheat allergy and celiac disease. If the test is negative, your doctor might recommend dietary changes to see if your symptoms improve.

Symptoms of gluten sensitivity and celiac disease can include some or a combination of the following:

  • Stomachaches with or without
    • Gas
    • Bloating
    • Constipation
    • Cramps
    • Diarrhea
    • Nausea
  • Emotional issues such as
    • Feeling down or blue
    • Irritability
    • Sudden mood shifts
  • Fatigue, either ongoing or especially after meals
  • Headaches, including migraines
  • Musculoskeletal pain
  • Neurologic problems with or without
    • Balance problems
    • Dizziness
    • Pain and weakness in the extremities
    • Tingling and numbness in the extremities

What foods contain gluten?

Gluten is found in common ingredients such as malt flavoring, malt vinegar, soy sauce, hydrolyzed vegetable protein, and modified food starch.3 For this reason and because labeling on packaged foods has previously been somewhat unreliable, some consumers have found it difficult to identify all foods that contain gluten. In addition, food labels often are unclear or misleading, making it necessary for some consumers to contact food manufacturers to confirm the contents of packaged foods. Cross-contamination of gluten-free and gluten-containing products can be a problem during processing, transportation, and storage, which also makes it difficult for consumers to be sure the foods they eat are gluten free.4

New Gluten Labeling Regulations

The good new is that the US US Food and Drug Administration (FDA) has recently provided directives for voluntary gluten-free food labeling to help consumers identify gluten-free foods. The FDA suggests that by August 5, 2013, all labels for gluten-free foods confirm that the product:

  • Does not contain an ingredient that is a whole, gluten-containing grain such as wheat, barley, rye, or a cross-bred hybrid of the grains
  • Does not contain an ingredient derived from a gluten-containing grain
  • Has not been processed to remove gluten (such as wheat flour)
  • Might contain an ingredient derived from a gluten-containing grain, has been processed to remove gluten (such as wheat starch), and contains <20 parts per million (PPM) of gluten
  • Might contain unavoidable gluten at ≤20 PPM from cross contact or gluten migration from packaging materials5

A gluten limit <20 PPM is the lowest level that can be consistently detected in foods. The National Foundation for Celiac Awareness (NFCA) suggests that the amount of gluten you would ingest in a 1-ounce slice of bread containing 20 PPM of gluten is equivalent to the amount of gluten you would consume in an entire 1-ounce slice of gluten-free bread.6

New Gluten Regulations Help Consumers Stay Healthy

If you are sensitive to gluten or have celiac disease, new labeling regulations help ensure that foods marked gluten-free, without gluten, free of gluten, and no gluten are safe to enjoy. 

Naturally gluten-free foods include:3

  • Fresh fruits
  • Fresh beef, pork, chicken, turkey, fish, and seafood
  • Fresh eggs
  • Fresh, plain milk, butter, margarine, and cream
  • Dried beans and other legumes with no additives
  • Fresh corn or canned corn with no additives
  • White rice, brown rice, and wild rice with no additives
  • Fresh nuts and seeds with no additives
  • Oils
  • Sugar, honey, and molasses
  • Spices and herbs with no additives

Our registered dietitians
can develop a gluten-free diet for you!

For more information
or to schedule an appointment,
call us today
at 908-277-8731.



1. National Foundation for Celiac Awareness. Welcome to Celiac Central. Celiac disease. Accessed October 1, 2013.
2. National Foundation for Celiac Awareness. Welcome to Celiac Central. Non-celiac gluten sensitivity. Accessed October 1, 2013.
3. Li J, Anderson J, Roach J. Gluten-free diet guide for people with newly diagnosed celiac disease. Accessed October 1, 2013.
4. Eat Right.® Academy of Nutrition and Dietetics. It's About Eating Right. Celiac Disease. Avoiding gluten cross-contamination. Accessed October 1, 2013.
5. US Department of Health and Human Services. US Food and Drug Administration. For Consumers. What is gluten-free? FDA has an answer. Accessed October 1, 2013.
6. National Foundation For Celiac Disease Awareness. Welcome to Celiac Central. Archived Webinars. Understanding the FDA's gluten-free labeling rule: what you need to know. Accessed October 1, 2013.