Nutritional Info

Gluten Free

Definition

A gluten-free diet is an eating plan that excludes foods containing gluten. Gluten is a protein found in wheat, barley, rye, and triticale (a cross between wheat and rye).

Purpose

A gluten-free diet is essential for managing signs and symptoms of celiac disease and other medical conditions associated with gluten.

A gluten-free diet is also popular among people who haven’t been diagnosed with a gluten-related medical condition. The claimed benefits of the diet are improved health, weight loss and increased energy, but more research is needed.

Diet details

Following a gluten-free diet requires paying careful attention to food selections, the ingredients found in foods, and their nutritional content.

Allowed fresh foods

Many naturally gluten-free foods can be a part of a healthy diet:

  • Fruits and vegetables
  • Beans, seeds, legumes and nuts in their natural, unprocessed forms
  • Eggs
  • Lean, nonprocessed meats, fish and poultry
  • Most low-fat dairy products

Grains, starches or flours that can be part of a gluten-free diet include:

  • Amaranth
  • Arrowroot
  • Buckwheat
  • Corn — cornmeal, grits and polenta labeled gluten-free
  • Flax
  • Gluten-free flours — rice, soy, corn, potato and bean flours
  • Hominy (corn)
  • Millet
  • Quinoa
  • Rice, including wild rice
  • Sorghum
  • Soy
  • Tapioca (cassava root)
  • Teff

Processed foods that often contain gluten

In addition to foods in which wheat, barley and rye are likely ingredients, these grains are standard ingredients in a number of other products. Also, wheat or wheat gluten is added as a thickening or binding agent, flavoring, or coloring. 

  • Beer, ale, porter, stout (usually contain barley)
  • Breads
  • Bulgur wheat
  • Cakes and pies
  • Candies
  • Cereals
  • Communion wafers
  • Cookies and crackers
  • Croutons
  • French fries
  • Gravies
  • Imitation meat or seafood
  • Malt, malt flavoring and other malt products (barley)
  • Matzo
  • Pastas
  • Hot dogs and processed lunchmeats
  • Salad dressings
  • Sauces, including soy sauce (wheat)
  • Seasoned rice mixes
  • Seasoned snack foods, such as potato and tortilla chips
  • Self-basting poultry
  • Soups, bouillon or soup mixes
  • Vegetables in sauce
Results

Keeping a strict gluten-free diet is a lifelong necessity for people with celiac disease. Following the diet and avoiding cross-contamination results in fewer symptoms and complications of the disease.

For some people with non-celiac gluten sensitivity, the condition may not be lifelong. Some research suggests that you may follow the diet for a certain period, such as one or two years, and then retest your sensitivity to gluten. For other people with non-celiac gluten sensitivity, the diet may be a lifelong treatment.

Some clinical studies have looked at the benefits of the diet among people who do not have celiac disease or who have non-celiac gluten sensitivity. More research is needed to determine the accuracy of the following claims about the diet’s results:

  • Weight loss
  • Overall improved health
  • Improved gastrointestinal health
  • Improved athletic performance
Risks

The foods not included in a gluten-free diet provide important vitamins and other nutrients. For example, whole-grain breads and other products are natural or enriched sources of the following:

  • Iron
  • Calcium
  • Fiber
  • Thiamin
  • Riboflavin
  • Niacin
  • Folate

Therefore, following a gluten-free diet will likely change your nutrient intake. Some gluten-free breads and cereals have significantly varied nutrient levels compared with the products they are replacing.

Some gluten-free foods also have higher fat and sugar contents than the gluten-containing food being replaced. It’s important to read labels, not only for gluten content but also for overall nutrient levels, salt, calories from fats and calories from sugars.

You can talk to your doctor or dietitian about foods that would provide healthy, nutrient-rich alternatives.

Costs

The costs of prepared gluten-free foods are generally higher than the cost of the foods being replaced. The expense of following a gluten-free diet can be substantial, especially if your diet includes foods that aren’t naturally gluten-free.

Keto

Definition

The ketosis diet focuses on a high-fat foods and severely restricts carbohydrates in which your body will use the fat you consume for fuel rather than carbs.

How It Works

Wellness Dietitian: Jason Ewoldt, RDN, LD

About 60% to 80% of calories should come from fat. A true keto diet includes only moderate amounts of protein, and less than 50 grams of carbohydrates a day. A typical American diet consists of 50% or more carbohydrates, which convert to glucose in the body. Your cells burn that glucose as fuel. But when you switch to a very high-fat, low-carb diet, your body, by necessity, shifts away from glucose and instead uses fatty acids and ketone bodies for energy. This process is called ketosis — hence the diet’s name.

Purpose

A low-carb diet is generally used for weight loss. Some low-carb diets may have health benefits beyond weight loss, such as reducing your risk of type 2 diabetes and metabolic syndrome.

Diet Details

A low-carb diet restricts the amount of carbohydrates you eat. Carbohydrates are grouped as simple natural (lactose in milk and fructose in fruit), simple refined (table sugar), complex natural (whole grains or beans) and complex refined (white flour).

Common sources of natural carbohydrates include:

  • Grains
  • Fruits
  • Vegetables
  • Milk
  • Nuts
  • Seeds
  • Legumes (beans, lentils, peas)

In general, complex carbohydrates are digested more slowly and they have less effect on blood sugar than refined carbohydrates do. They also provide fiber.

Refined carbohydrates such as sugar or white flour are often added to processed foods. Examples of foods with refined carbohydrates are white breads and pasta, cookies, cake, candy, and sugar-sweetened sodas and drinks.

Your body uses carbohydrates as its main energy source. During digestion complex carbs are broken down into simple sugars (glucose) and release into your blood (blood glucose).

Insulin is released to help glucose enter the body’s cells, where it can be used for energy. Extra glucose is stored in the liver and muscles, and some is converted to body fat.

A low-carb diet is intended to cause the body to burn stored fat for energy, which leads to weight loss.

In contrast, the Dietary Guidelines for Americans recommends that carbohydrates make up 45% to 65% of your total daily calorie intake. So if you consume 2,000 calories a day, carbs would account for between 900 and 1,300 calories a day.

Results

Weight loss

Most people can lose weight if they restrict calories and increase physical activity. To lose 1 to 1.5 pounds (0.5 to 0.7 kilogram) a week, you need to eat 500 to 750 fewer calories each day.

Low-carb diets, especially very low-carb diets, may lead to greater short-term weight loss than do low-fat diets. But most studies have found that at 12 or 24 months, the benefits of a low-carb diet are not very large.

Cutting calories and carbs may not be the only reason for the weight loss with low-carb diets. Some studies show that you may shed some weight because the extra protein and fat helps you feel full longer, which helps you eat less.

Other benefits

Low-carb diets that emphasize healthy sources of carbs, fat and protein may help lower the risk of type 2 diabetes and heart disease. In fact, almost any diet that helps you shed excess weight may improve blood sugar and cholesterol levels, at least temporarily.

Risks

A sudden and drastic reduction in carbs can cause temporary side effects, such as:

  • Constipation
  • Headache
  • Muscle cramps

Severe carb restriction can cause your body to break fat down into ketones for energy. This is called ketosis. Ketosis can cause side effects such as bad breath, headache, fatigue and weakness.

It’s not clear what kind of possible long-term health risks a low-carb diet may pose. Restricting carbs in the long term they may result in vitamin or mineral deficiencies and gastrointestinal disturbances.

Some health experts believe that if you eat large amounts of fat and protein from animal sources, your risk of heart disease or certain cancers may actually increase.

If you opt to follow a low-carb diet, pay attention to the fats and proteins you choose. Limit foods with saturated and trans fats, such as meat and high-fat dairy products, which may increase your risk for heart disease.

Vegan

Types of vegetarian diets

When people think about a vegetarian diet, they typically think about a diet that doesn’t include meat, poultry or fish. But vegetarian diets vary in what foods they include and exclude:

  • Lacto-vegetarian diets exclude meat, fish, poultry and eggs, as well as foods that contain them. Dairy products, such as milk, cheese, yogurt and butter, are included.
  • Ovo-vegetarian diets exclude meat, poultry, seafood and dairy products, but allow eggs.
  • Lacto-ovo vegetarian diets exclude meat, fish and poultry, but allow dairy products and eggs.
  • Pescatarian diets exclude meat and poultry, dairy, and eggs, but allow fish.
  • Vegan diets exclude meat, poultry, fish, eggs and dairy products — and foods that contain these products.

Some people follow a semivegetarian diet — also called a flexitarian diet — which is primarily a plant-based diet but includes meat, dairy, eggs, poultry and fish on occasion or in small quantities.

Planning a healthy vegetarian diet

To get the most out of a vegetarian diet, choose a variety of healthy plant-based foods, such as whole fruits and vegetables, legumes and nuts, and whole grains. At the same time, cut back on less healthy choices, such as sugar-sweetened beverages, fruit juices and refined grains.

Keep in mind that the more restrictive your diet is, the more challenging it can be to get all the nutrients you need. A vegan diet, for example, eliminates natural food sources of vitamin B-12, as well as milk products, which are good sources of calcium.

To be sure that your diet includes everything your body needs, pay special attention to the following nutrients:

Calcium and vitamin D

Calcium helps build and maintain strong teeth and bones. Milk and dairy foods are highest in calcium. However, dark green vegetables, such as turnip and collard greens, kale, and broccoli, are good plant sources when eaten in sufficient quantities. Calcium-enriched and fortified products, including juices, cereals, soy milk, soy yogurt and tofu, are other options.

Vitamin D also plays an important role in bone health. Vitamin D is added to cow’s milk, some brands of soy and rice milk, and some cereals and margarines. Be sure to check food labels. If you don’t eat enough fortified foods and have limited sun exposure, you may need a vitamin D supplement (one derived from plants).

Vitamin B-12

Vitamin B-12 is necessary to produce red blood cells and prevent anemia. This vitamin is found almost exclusively in animal products, so it can be difficult to get enough B-12 on a vegan diet. Vitamin B-12 deficiency may go undetected in people who eat a vegan diet. This is because the vegan diet is rich in a vitamin called folate, which may mask deficiency in vitamin B-12 until severe problems occur. For this reason, it’s important for vegans to consider vitamin supplements, vitamin-enriched cereals and fortified soy products.

Protein

Protein helps maintain healthy skin, bones, muscles and organs. Eggs and dairy products are good sources, and you don’t need to eat large amounts to meet your protein needs. You can also get sufficient protein from plant-based foods if you eat a variety of them throughout the day. Plant sources include soy products and meat substitutes, legumes, lentils, nuts, seeds, and whole grains.

Omega-3 fatty acids

Omega-3 fatty acids are important for heart health. Diets that do not include fish and eggs are generally low in active forms of omega-3 fatty acids. Canola oil, soy oil, walnuts, ground flaxseed and soybeans are good sources of essential fatty acids. However, because conversion of plant-based omega-3 to the types used by humans is inefficient, you may want to consider fortified products or supplements or both.

Iron and zinc

Iron is a crucial component of red blood cells. Dried beans and peas, lentils, enriched cereals, whole-grain products, dark leafy green vegetables, and dried fruit are good sources of iron. Because iron isn’t as easily absorbed from plant sources, the recommended intake of iron for vegetarians is almost double that recommended for nonvegetarians. To help your body absorb iron, eat foods rich in vitamin C, such as strawberries, citrus fruits, tomatoes, cabbage and broccoli, at the same time as you’re eating iron-containing foods.

Like iron, zinc is not as easily absorbed from plant sources as it is from animal products. Cheese is a good option if you eat dairy products. Plant sources of zinc include whole grains, soy products, legumes, nuts and wheat germ. Zinc is an essential component of many enzymes and plays a role in cell division and in formation of proteins.

Iodine

Iodine is a component in thyroid hormones, which help regulate metabolism, growth and function of key organs. Vegans may not get enough iodine and may be at risk of deficiency and possibly even a goiter. In addition, foods such as soybeans, cruciferous vegetables and sweet potatoes may promote a goiter. However, just 1/4 teaspoon of iodized salt a day provides a significant amount of iodine.

Getting started

One way to transition to a vegetarian diet is to gradually reduce the meat in your diet while increasing fruits and vegetables. Here are a couple of tips to help you get started:

  • Ramp up. Each week increase the number of meatless meals you already enjoy, such as spaghetti with tomato sauce or vegetable stir-fry. Find ways to include greens, such as spinach, kale, Swiss chard and collards, in your daily meals.
  • Substitute. Take favorite recipes and try them without meat. For example, make vegetarian chili by leaving out the ground beef and adding an extra can of black beans. Or make fajitas using extra-firm tofu rather than chicken. You may be surprised to find that many dishes require only simple substitutions.
  • Branch out. Check the internet for vegetarian menus. Buy or borrow vegetarian cookbooks. Check out ethnic restaurants to sample new vegetarian cuisines. The more variety you bring to your vegetarian diet, the more likely you’ll be to meet all your nutritional needs.

References

Mayo Clinic. Gluten-free diet. 2021, www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gluten-free-diet/art-20048530.

Mayo Clinic. Low-carb diet: Can it help you lose weight? 2020, www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/low-carb-diet/art-20045831.

Mayo Clinic. Is keto diet right for you? A Mayo expert weighs in. 2020, www.mayoclinic.org/is-the-keto-diet-for-you-a-mayo-expert-weighs-in/art-20457595.

Mayo Clinic. Vegetarian diet: How to get the best nutrition. 2020, www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/vegetarian-diet/art-20046446.