celiac disease

Gluten-Free Mediterranean Diet

About the Gluten-Free Mediterranean Diet

A gluten-free diet (GFD) is the current treatment for celiac disease. When following a gluten-free diet, many questions may arise such as:

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Which foods contain gluten?
Can I continue to enjoy a healthy and balanced diet while avoiding gluten?
Is it safe to keep grains in my diet?

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We are here to guide you through everything you need to know to follow a gluten-free Mediterranean diet, ensuring it is both nutritious and enjoyable.

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It is well known that following a Mediterranean diet supports health benefits across various conditions, including cardiovascular disease, cancer, and diabetes. Many of these benefits are attributed to reduced inflammation and a higher consumption of vegetables, fruits, nuts, and healthy fats such as those found in avocados, fish, and olive oil.¹^,²

Learn more about the Mediterranean Diet

Healthy, Naturally Gluten-Free Foods

It is possible to follow a healthy Mediterranean-like diet that prioritizes naturally gluten-free foods:

Vegetables

Fruits

Meat and poultry

Fish and seafood

Dairy

Beans and legumes

Nuts

Figure 1. The Mediterranean gluten-free pyramid.³

Challenges to Following a Mediterranean Diet in Celiac Disease

Although the Mediterranean diet is one of the healthiest eating patterns and helps prevent many chronic diseases, those with celiac disease often follow it less closely than those without the condition. This is often because the primary focus is placed on avoiding gluten, rather than on overall diet quality.

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Some common challenges those with celiac disease experience include:

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Cultural food preferences or the sensory appeal of food
Financial constraints
Limited access to fresh, quality foods
Food preparation knowledge and skills
Convenience and time
Feeling too tired

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With proper dietary guidance during follow-up, it is possible to improve not only adherence to a gluten-free diet, but also enjoy the full benefits of a balanced Mediterranean-style diet.⁵ Keep reading to discover practical tips to help you overcome these challenges.

Choose Healthy Options Instead of Ultra-Processed Foods

If you are following a gluten-free diet, it is essential to focus on keeping it balanced and nutritious. While there are plenty of gluten-free products available, many are highly processed, so choosing whole, natural foods can make a big difference for your health.

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It is important to follow dietary guidelines for fresh food consumption to meet the recommendations of the Mediterranean diet.

Vegetables

2 servings per meal

Fruits

1-2 servings per meal

Extra virgin olive oil

3 tablespoons per day

Gluten-free grains

1-2 servings per day

Legumes

2 or more servings per week

Seafood

more than 2 servings per week

Eggs

2-4 servings per week

Poultry

2 servings per week

Limited dairy

1-2 servings per day

Low intake of red meat

less than two servings per week

Limited sweets

less than two servings per week

Gluten-Free Grains and Their Benefits

Eating whole grains instead of refined grains has been shown to lower the risk of many chronic diseases.⁶ In addition, 100% whole grain flours retain all the beneficial phytonutrients found in the bran and germ. They are a good source of protein, dietary fiber, and minerals, offering the full nutritional benefits of the whole grains themselves. The greatest nutritional benefits are seen in people who consume at least 3 servings (48 g) per day, but some studies suggest that even one serving daily can make a difference.⁶

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The only major change in a gluten-free diet involves the type of cereals that can be included. With some of the most common grains off the table, boosting whole grain intake might seem tricky. However, there are many naturally gluten-free cereals and pseudocereals available today that can successfully replace wheat and other gluten-containing grains and that do not lead to a reduction in nutrition quality.³

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The following carbohydrate-rich cereals, pseudocereals, tubers and legumes are naturally gluten-free and are safe options for substituting gluten-containing grains such as wheat, rye, and barley.

‍Cereals: teff, maize, rice, millet, sorghum
Pseudocereals: quinoa, buckwheat, amaranth, quinoa, and chia‍
Tubers: yuca (cassava), tapioca (a starch extracted from cassava root), sweet potato
Legumes: beans, lentils, chickpeas, soybeans

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Following a gluten-free diet doesn’t just come with challenges, it is also a great opportunity to explore new flavors and add more nutrients to your meals. Today, many supermarkets offer whole-grain pasta and flours made from ancient gluten-free grains, offering an appealing alternative to traditional gluten-containing whole grains.

Figure 2. Ancient gluten-free whole grains. Teff (top left), Buckwheat (top right), Quinoa (bottom left), and Amaranth (bottom right).⁶

Buying grains or legumes from bulk bins is not recommended due to the risk of gluten cross-contact.

Gluten-Free Grain / Pseudograins

Benefits

Pseudo-cereals: Buckwheat, Amaranth, Quinoa and Chia

Rich in protein (12–19%) with important amino acids like cysteine and methionine
Good source of fiber
Quinoa is especially rich in healthy fats including omega-3 and omega-6
Contains antioxidants
Some natural compounds may reduce nutrient absorption slightly

Teff

High in fiber (3 g per 100 g)
Protein content 10.5–13%
Rich in minerals: calcium, zinc, magnesium, iron, phosphorus, copper
Contains vitamins C, A, niacin, riboflavin, thiamine

Sorghum

High in fiber

Contains beneficial plant compounds (bioactive compounds)

Rice

Contains polyphenols, plant compounds that are widely recognized for supporting overall health. ⁴

Mize (Corn)

Provides many B vitamins, essential minerals, and fiber
Low in vitamin B12, vitamin C, calcium, folate, and iron

Oat

Mostly starch
High in soluble fiber, especially beta-glucans
Contains antioxidants like vitamin E

Oats naturally do not contain gluten, but they are often contaminated with gluten from wheat, barley, rye, or triticale during cultivation in North America, Europe, and other regions.

Gluten-Free Grains and Their Benefits

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The following carbohydrate-rich cereals, pseudocereals, tubers and legumes are naturally gluten-free and are safe options for substituting gluten-containing grains such as wheat, rye, and barley.

‍Cereals: teff, maize, rice, millet, sorghum
Pseudocereals: quinoa, buckwheat, amaranth, quinoa, and chia‍
Tubers: yuca (cassava), tapioca (a starch extracted from cassava root), sweet potato
Legumes: beans, lentils, chickpeas, soybeans

Figure 2: Ancient gluten-free whole grains. Teff (top left), Buckwheat (top right), Quinoa (bottom left), and Amaranth (bottom right).⁶

Buying grains or legumes from bulk bins is not recommended due to the risk of gluten cross-contact.

Cooking Gluten-Free Whole Grains

Because most whole grains take longer to cook than refined grains, time-saving methods can be very helpful for busy lifestyles. For example, pressure cookers, pots with tightly sealing lids, can cook grains much faster while keeping them tender and nutritious.⁷ 

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Batch cooking is also a great way to save time. By doubling a recipe, you can have enough for leftovers for the next day's lunch or freeze portions to reheat later in the week.

Grain (1 cup dry)

Water (or other fluid)

Cooking Time

Amaranth

2 cups

20–30 minutes

Buckwheat

2–2^1/2 cups

40–60 minutes

Millet

2 cups (dinner grain)

20–30 minutes

3–4 cups (porridge)

30–40 minutes

Oats

2–2^1/2 cups (rolled oats)

10–20 minutes

2^1/2–3 cups (steel cut oats)

20–30 minutes

Rice (brown)

1^1/2 –2 cups (long grain)

45–60 minutes

2–2^1/2 cups (short grain)

45–60 minutes

Quinoa

1^1/2–2 cups

15–20 minutes

Sorghum

2^1/2–3 cups

30–45 minutes

Teff

2^1/2–3 cups

10–20 minutes

Wild Rice

3 cups

40–60 minutes

Note: if using a pressure-cooker, use 1/2 cup less liquid and reduce cooking time by half.

Enjoying Shared Meals While Staying Gluten-Free

Sharing meals with others is a central part of the Mediterranean diet, but it can be challenging for people with celiac disease.

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Whether it is a work lunch, a gathering with friends, or a family dinner, gluten can easily appear in shared dishes: breadcrumbs on the table, passed appetizers, traditional sauces or desserts meant for everyone. While these situations can feel frustrating, following a gluten-free diet doesn't mean you have to miss out or simply get through the meal.

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Consider these steps to help you enjoy shared meals safely and confidently.

Grab your appetizers first

Set aside a gluten-free plate before everyone starts snacking.

Serve yourself first at the main course

Being polite is great, but serve yourself first to avoid cross-contact.

Mind the bread crumbs

Ask family to pass bread carefully. Consider bringing your own gluten-free option.

Educate your loved ones

Make sure everyone knows you’re celiac and can enjoy gluten-free ingredients safely.

Skip bulk products

Nuts and other bulk items may have traces of gluten; choose packaged ones instead.

Take charge of the desserts

Gluten-free desserts can be hard to find, so consider bringing your own. If others bring desserts, take steps to avoid cross-contamination.

Choose the right restaurant

When dining out with family or friends, select the restaurant yourself or verify that it offers gluten-free options, rather than assuming it will be safe.

References

Tosti V, Bertozzi B, Fontana L. Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms. J Gerontol A Biol Sci Med Sci. 2018 Mar 2;73(3):318-326. doi: 10.1093/gerona/glx227. ‍
Guasch-Ferré M, Salas-Salvadó J, Ros E, Estruch R, Corella D, Fitó M, Martínez-González MA; PREDIMED Investigators. The PREDIMED trial, Mediterranean diet and health outcomes: How strong is the evidence? Nutr Metab Cardiovasc Dis. 2017 Jul;27(7):624-632. doi: 10.1016/j.numecd.2017.05.004.‍
Bascuñán K, Elli L, Vecchi M, et al. Mediterranean gluten-free diet: is it a fair bet for the treatment of gluten-related disorders? Front Nutr. 2020; 7:583981. doi: 10.3389/fnut.2020.583981.
Goufo P, Trindade H. Rice antioxidants: phenolic acids, flavonoids, anthocyanins, proanthocyanidins, tocopherols, tocotrienols, γ-oryzanol, and phytic acid. Food Sci Nutr. 2014 Mar;2(2):75-104. doi: 10.1002/fsn3.86.
Peresztegi MZ, Szakács Z, Vereczkei Z, Dakó E, Dakó S, Lada S, Lemes K, Holczer M, Farkas N, Bajor J. Mediterranean Diet Adherence in Celiac Patients: A Nested Cross-Sectional Study. Nutrients. 2025;17(5):788. https://doi.org/10.3390/nu17050788
Kahlon TS, Chiu, MCM. Teff, Buckwheat, Quinoa and Amaranth: Ancient Whole Grain Gluten-Free Egg-Free Pasta. FASEB J. 2015;29(1_suppl):591. doi:10.1096/fasebj.29.1_supplement.591.1
Pagano AE. Whole grains and the gluten-free diet. Practical Gastroenterology. 2006 Oct;30(10):66‑79.

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