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Digestive Disorders > Intolerances > Gluten Intolerance

Gluten basics: All you need to know

Dr. med. André Sommer

Dr. med. André Sommer

Everybody talks about gluten these days. It’s often associated with feeling poorly and gastrointestinal issues. Grain protein is also often blamed for headaches and fatigue. As more and more gluten-free products fill supermarket shelves, gluten remains a mystery to many.

What is gluten?

Gluten refers to a mixture of proteins, carbohydrates, and lipids (fats). Gluten occurs in the seeds of various types of cereals. The proteins contained in gluten are storage proteins. Alongside glutelins, gluten consists of a second group of proteins: the gliadins. Glutelin and gliadin are water-insoluble proteins. If they are mixed with water, they form an elastic mass, a property particularly important for the baking quality of flour. Thanks to gluten, dough can be kneaded and sticks well together.

What contains gluten?

Many types of cereals contain gluten as a grain protein. This includes:

  • Wheat
  • Spelt
  • Rye
  • Barley
  • Unripe spelt
  • Oats (commercially available)
  • Einkorn wheat
  • Emmer
  • Kamut
  • Triticale

Are oats gluten free?

Oats are naturally gluten free. However, cultivation, harvesting and production processes sometimes result in contamination with grains containing gluten. Therefore, commercially available oats are not gluten-free. Oats contain 5,600 milligrams of gluten per 100 grams.

This means that all products made from one or more of the above-mentioned cereals contain gluten. In addition to flour, wheat starch and breadcrumbs, this includes products made from durum wheat semolina such as couscous. Cereals from cereal flakes, pasta, and all baked goods (bread, rolls, cakes, cookies, pretzel sticks) are therefore unfortunately also gluten-containing products. And you can't forget beer too.

Unfortunately, gluten is also hidden in foods that are not associated with it at first glance. This includes, for example, soy sauce, which is often made on the basis of wheat. And wheat flour is often added to gluten-free soy in smoked tofu. Chocolate is gluten-free in itself, but can be problematic depending on the manufacturer. Namely, when malt extract has been added. Generally you really have to look at the ingredients with all industrially manufactured food products. Because flour is often used as a binding agent. Gluten can also be hiding in packaged spices because flour is used for dusting.

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What does gluten-free mean?

Gluten-free is the name given to foods that contain less than twenty milligrams of gluten per kilogram (20ppm). Frequently, gluten-free products are also marked with the symbol of a crossed-out ear of wheat. Since grain-containing baked goods and flours in particular are made from gluten-containing grains, the corresponding substitute products are highlighted by the label, making it easier for consumers to distinguish between gluten-containing and gluten-free products.

There are now gluten-free noodles, breads, cakes, and baking mixes. But in addition to these special products, there are a large number of foods that naturally do not contain gluten. All types of vegetables and fruits, legumes (lentils), beans, dairy products, and certain types of grains are gluten-free. Since flour made from gluten-free grains do not have such good baking properties, they are often less well known. The naturally gluten free grains and cereals include:

  • Corn
  • Rice
  • Amaranth
  • Buckwheat
  • Millet
  • Quinoa
  • Teff (dwarf millet)

Potato starch, tapioca starch (from the cassava root), and guar and carob flour are also suitable as binders. Many of the products mentioned can only be found in health food stores or organic stores. But the food industry remains inventive. Lentil noodles and chestnut pasta are now also available for the gluten-free culinary palate.

To eat gluten-free, you don't necessarily have to resort to expensive replacement products. Potatoes and rice are naturally gluten free.

Tip: Glass noodles and rice noodles from Asian shops provide a delicious alternative to gluten-free noodles!

How do I eat a gluten-free diet?

Eating a gluten-free diet requires a good portion of discipline and good knowledge of what foods contain gluten. While you will be skipping the morning pretzel, a piece of cake in the afternoon, or a pasta dish in the evening, there are a lot of creative alternatives. You can find some inspiration in our recipe collection.

At the start, the dietary changes are sure to be difficult. Looking through the ingredients on the back will probably take a little longer at first, but you’ll be a professional in no time. If it’s tempting to use specially gluten-free baked goods—they often contain a lot of fat and salt and are therefore not necessarily healthy. And the high price may put a strain on your wallet. Rice and potatoes are inexpensive alternatives as a side dish.

Do you suffer from indigestion and suspected gluten intolerance? Or have you been diagnosed with celiac disease? Then feel free to try our app to help find out which foods are good for you and which are bad for you.

What is gluten-free bread?

Even if a bread or baked product is made from natural gluten-free flour, it might not be gluten-free. Since even the smallest amounts of gluten are very harmful to people with celiac disease, there are strict rules. Products labeled as gluten-free must always be produced and stored far away from those containing gluten (this is the only way to ensure there is no transfer of gluten). This separation is often not possible with conventional bakeries.

In many health food stores, it is now possible to buy a variety of fresh gluten-free bread. In addition to corn and rice flour, there is also gluten-free oat bread. You can also find a baking mix that suits you and bake your bread at home, or try frozen rolls to fall back on. They are not just available in health food stores now. Drugstores and well-stocked grocery stores have gluten-free breads in their range. Even discounters now produce their own gluten-free products for small budgets.

Another option is crispy corn or rice cakes, especially as a light snack for in between meals.

What is the gluten content in spelt flour?

Spelt is a type of wheat that also contains gluten. You have to avoid spelt if you have celiac disease. It contains even more gluten than wheat flour: up to 10,300 milligrams of gluten per hundred grams of flour is possible.

Many people with gluten intolerance report that they tolerate spelt. On the one hand, this could be due to the composition and content of gluten. But there are also new assumptions that such intolerances are not caused by gluten per se. Other components of wheat are now suspected as triggers (e.g. amylase trypsin inhibitors, FODMAPs).

How much gluten is in beer?

Wheat beer contains the most gluten: a whopping 274 milligrams per 100 grams. Non-alcoholic beer and malt beer contain significantly less (3.2 mg and 3.4 mg). There is good news: Pils contains the least gluten and—at 1.2 mg per 100 grams—is probably also digestible for gluten-sensitive people. However, as a precaution, it is advised that they drink gluten-free beer.

Leiß, O. (2014). Fiber, Food Intolerances, FODMAPs, Gluten und funktionelle Darmerkrankungen–Update 2014. Zeitschrift für Gastroenterologie, 52(11), 1277-1298. Downloaded online on October 11, 2018 from:

Andersen, G., Köhler, H. in Zusammenarbeit mit Rubach, M., Schaecke, W. (2015). Jahresbericht der Deutschen Forschungsanstalt 2014. Freising, p. 136 - p. 139 Downloaded online on October 11, 2018 from:

Dr. med. André Sommer

Dr. med. André Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara Care.

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