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Johns Hopkins Health Alert

Separating the Wheat From the Teff

Although people with celiac disease need to avoid many common grains such as wheat, a wide variety of grains are safe for people who require a gluten-free diet. In this Health Alert, Johns Hopkins reviews safe grains and food ingredients for people with celiac.

A diagnosis of celiac disease -- intolerance to the protein gluten -- means that patients must avoid all foods that contain gluten, including all products made with wheat, barley, rye, and related grains. A diet without these common ingredients may seem restrictive at first, yet there are many alternative grains, such as teff (a cereal grain native to northeastern Africa), that do not have any naturally occurring gluten and can be used safely as gluten substitutes.

Below is a list of acceptable and unacceptable grains and food ingredients for people who eat a gluten-free diet. However, there are some caveats. The first deals with oats: Recent research suggests that pure oats do not contain gluten and appear to be safe for people with celiac disease, but obtaining oats that have not been contaminated with gluten during the food-manufacturing process is difficult. Therefore, experts currently recommend that people with celiac disease avoid oats and all derivatives of oats, including oat bran, oat fiber, and oat gum.

The second caveat deals with alcohol: Although many spirits such as gin, vodka, and whiskey are made with grains that contain gluten, research has demonstrated that gluten doesn't survive the distilling process and is undetectable in the final product. Because of this finding, the Canadian Celiac Association and the Celiac Disease Foundation in the United States say that such spirits are acceptable for people with celiac disease.

Ask your doctor or dietitian if it's safe for you to drink gin, vodka, and whiskey. Also, check that a product's label says "gluten free" or verify with the manufacturer that a product is gluten free before consuming it. Many otherwise gluten-free products come into contact with gluten during processing, causing contamination. Last, check with the product's manufacturer regarding the following ingredients to ensure that their sources do not contain gluten: caramel, hydrolyzed plant protein (HPP), hydrolyzed vegetable protein (HVP), malt and its derivatives, modified food starch, monosodium glutamate (MSG), and textured vegetable protein (TVP).

Safe Ingredients: • amaranth • arrowroot/arrowroot corn • bean/whole-bean flour • besan • buckwheat/buckwheat groats • calrose • cassava • channa • chickpea • corn/corn flour/corn gluten/corn malt/cornmeal/cornstarch • cottonseed • fava bean • flax/flaxseed • gram flour (do not confuse with "graham flour") • hominy/hominy grits • kasha • millet • modified corn starch • modified tapioca starch • nuts/nut flour • pea flour • potato/potato flour/ potato starch/ potato starch flour • quinoa • rice • saffron • sago • sorghum • soy/soybean • starch • tapioca • teff

Ingredients To Avoid: • barley • bulgur • couscous • dinkel/dinkle • durum/durum flour • emmer • farina • gluten flour • graham flour (do not confuse with "gram" flour) • kamut • rye • seitan • semolina • spelt (German wheat) • triticale • wheat/wheat bran/wheat germ/wheat starch

Posted in Digestive Health on November 24, 2008
Reviewed July 2009

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.


How do I know if I have Celiac disease? What are the symtptoms?

Posted by: davblack | November 29, 2008

Good question! It is actually known as 'the great mimic' because the symptoms are similar to several other digestive disorders. The Celiac Sprue Association http://www.csaceliacs.org/celiac_symptoms.php has a list of what to look out for.

Posted by: Jo | December 4, 2008

I react to all cereals except rice, including having a strong reaction to corn/maize and derivatives like xanthan gum.

I keep reading articles like yours saying it's safe to have corn/maize and it isn't always! My reaction to them is not as severe as to wheat, but it's still marked and leaves me with a fuzzy brain, jerky heart and intense sleepiness.

I've met quite a few people who are like me, so it's not that rare. Perhaps you should mention this wider reaction to cereals as well as the basic celiac reaction?

As a result of articles like yours saying corn/maize is OK, manufacturers seem to think all who are wheat-intolerant eat maize and just about everything on finds in the shops has some form of maize in it. As a busy novelist (Anna Jacobs) I would prefer to buy more prepared foods, but simply dare not.

Thank you for your health notices. They're very interesting.

Anna Jacobs

Posted by: Shannah | March 30, 2009



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