How to Read a Label if you Have Celiac Disease

For the Canadian version of reading a label with celiac disease, click here.

WHEN you have celiac disease, the only way to avoid symptoms is to avoid eating any gluten. But how do you know which box of crackers is safe and which isn’t? Gluten can be hidden in almost anything you might find at the grocery store, so careful label reading is necessary to stay healthy.

In the United States, there are regulations that make label-reading easier, but it can still be daunting walking down those aisles at the grocery store. Here are some tips for how to know what can go in the shopping cart, and what should stay on the shelf.

Tips to Read Labels with Celiac

– Look for a “gluten-free” claim. These claims are regulated by the Food and Drug Administration (FDA). Food can be identified as “gluten-free” if any gluten in the product is below 20 ppm.

– Gluten-free certification programs provide assurance that a product is made with good gluten-free manufacturing practices, and contains less than 20 ppm of gluten. Main examples include the Gluten-Free Certification Organization or GFCO (created by the Gluten Intolerance Group of North America); the Gluten-Free Certification Program or GFCP (endorsed by the nonprofit Beyond Celiac), and MenuTrinfo’s Certified Free From (gluten-free) program. If a product bears one of these logos as certified gluten-free, then it is safe for a person with celiac disease to eat.

– Valid gluten-free claims include: “gluten-free”, “free of gluten”, “no gluten” and “without gluten”. Claims such as “made with no gluten-containing ingredients” and “not made with gluten-containing ingredients” do not have to comply with the 20 ppm rule.

– If there is no “gluten-free” claim, or if the product has not been certified as gluten-free, you will have to carefully go through the ingredient list to identify any obvious sources of gluten, and any hidden sources of gluten.

– Remember that gluten is a protein found in wheat, barley, rye and oats (unless they are pure, uncontaminated oats).

– In the United States, wheat is considered a “major allergen”, and therefore must be identified on a packaged-goods label, either in the ingredient list, or in a “contains” statement after the ingredient list. If you see wheat identified, the product is not safe for you.

See: How to Read a Label if You Have a Food Allergy for more information on the FDA’s food allergy labeling rules.

Labels with Celiac, Trickier Points

– If you do not see wheat on the package, then you must carefully examine the ingredient statement for the other sources of gluten: barley, rye and oats (unless they are pure, uncontaminated oats).

If you see any of these on the label, the food is not safe for you. However, these are not always easy to identify. Look for words like:

– Malt

– Brewer’s yeast

– Hordeum vulgare (barley)

– Secale cereal (rye)

– In the United States, companies are not required to list the components of ingredients such as “natural flavor”, “color” or “spice” (unless it is a major allergen, e.g. wheat.) If you see any of these words on the package, exercise caution. Consider calling the manufacturer to find out what makes up these ingredients.

– Also look for advisory labels. These are warnings, such as “this product may contain wheat,” that companies voluntarily put on products where there may be a risk of cross-contamination with an allergen. These would likely only identify wheat, not other sources of gluten.

– Gluten can be in any product you might find on a store’s shelves. Here is a list of products where gluten can hide.

Always carefully read the label, call the manufacturer if something is unclear, and avoid the food if you are unsure.

– If you believe a product labeled “gluten-free” contains gluten, you can report this to an FDA Consumer Complaint Coordinator in the state where the food was purchased.