Celiac disease arises when proteins in certain grains trigger an immune reaction that damages the small intestine in genetically susceptible people, making strict avoidance of those proteins essential for health. Alessio Fasano Center for Celiac Research and Treatment Massachusetts General Hospital has described this mechanism and the necessity of a lifelong gluten-free diet, a reality that affects nutrient absorption, growth in children and long-term risk of complications when gluten is not eliminated. The relevance is global because wheat and related grains are staple foods across many cultures, so dietary change has medical, social and practical consequences.
Common gluten-containing foods
Wheat in its many forms is the primary source to avoid, including flour, bread, pasta, couscous, bulgur, semolina, durum and varieties like spelt and kamut; rye and barley are also problematic because they contain similar gluten proteins, as noted by Joseph A. Murray Mayo Clinic. Beers, malted products and foods that use barley-derived ingredients carry gluten, and many processed items such as sauces, soups, deli meats, sausages and some candies can contain gluten or be thickened with wheat-based starches, a point emphasized by guidance from the National Institute of Diabetes and Digestive and Kidney Diseases.
Hidden sources, cross-contact and cultural foodways
Cross-contact in shared kitchens, toasters and fryers can contaminate otherwise safe products, and oats are tolerated by many but often become contaminated during growing or processing, so certified gluten-free oats are recommended by multiple celiac specialists. Cultural practices make avoidance uniquely challenging in each territory: flatbreads in the Middle East, pasta in Italy, chapati in South Asia and beer-centered social life in many temperate regions all carry culinary identity and require adaptation. The Celiac Disease Foundation Alice Bast highlights the social and emotional dimensions of removing staples from communal eating.
Managing the diet therefore goes beyond reading ingredient lists to include careful sourcing, clear communication in restaurants and awareness of traditional recipes that may use hidden thickeners or fermented grain products. Health professionals recommend working with dietitians experienced in gluten-free diets to ensure balanced nutrition and to replace fortified grains that are avoided, thereby minimizing long-term impacts and preserving cultural food practices while protecting intestinal health.
