Dietary Changes for Celiac Disease
Celiac disease is a disorder that damages your small intestine and keeps it from absorbing the nutrients in food. The damage to your intestinal tract is caused by your immune system's reaction to gluten. Gluten is a protein found in wheat, barley, and rye. Some oats contain gluten.
When you have celiac disease, gluten causes your immune system to damage or destroy villi. Villi are the tiny, fingerlike tubules that line your small intestine. The villi’s job is to get food nutrients to the blood through the walls of your small intestine. If villi are destroyed, you may become malnourished, no matter how much you eat. This is because you aren’t able to absorb nutrients. Complications of the disorder include anemia, seizures, joint pain, thinning bones, and cancer.
Lifestyle changes to cope with celiac disease
A gluten-free diet is the only treatment if you’ve been diagnosed with celiac disease. You’ll have to avoid gluten for the rest of your life. Even the slightest amount will trigger an immune system reaction that can damage your small intestine. Eating a gluten-free diet requires a new approach to food. A gluten-free diet generally means not eating most grains, pasta, cereals, and processed foods. The reason is that they usually contain wheat, rye, and barley. You’ll need to become an expert at reading ingredient lists on packages. Choose foods that don’t contain gluten. You can still eat a well-balanced diet with many different foods, including meat, fish, rice, fruits, and vegetables, along with prepared foods that are marked gluten-free.
Gluten-free bread, pasta, and other products have long been available at organic food stores and other specialty food shops. Today, you can find gluten-free products in just about every grocery store. Gluten-free dishes are on menus at all kinds of restaurants.
Tips for following a gluten-free diet
Here are steps to take when getting gluten out of your diet.
Rethink your grains:
Avoid all products with barley, rye, triticale (a cross between wheat and rye), farina, graham flour, semolina, and any other kind of flour, including self-rising and durum, not labeled gluten-free.
Be careful of corn and rice products. These don’t contain gluten, but they can sometimes be contaminated with wheat gluten if they're produced in factories that also manufacture wheat products. Look for such a warning on the package label.
Go with oats. Recent studies suggest you can eat oats as long as they are not contaminated with wheat gluten during processing. You should check with your healthcare provider first.
Substitute potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour for wheat flour. You can also use sorghum, chickpea or Bengal gram, arrowroot, and corn flour, as well as tapioca starch extract. These act as thickeners and leavening agents.
Become a label expert:
Know terms for hidden gluten. Avoid einkorn, emmer, spelt, kamut, wheat starch, wheat bran, wheat germ, cracked wheat, and hydrolyzed wheat protein. Stay away from emulsifiers, dextrin, mono- and di-glycerides, seasonings, and caramel colors because they can contain gluten.
Check the labels of all foods. Gluten can be found in food items you’d never suspect. Here are some likely to contain gluten:
Beer, ale, and lagers
Brown rice syrup
Chips, potato chips
Cold cuts, hot dogs, salami, and sausage
Seasoned tortilla chips
Vegetables in sauce
More strategies for a gluten-free lifestyle
Here are ideas to better make the transition to a gluten-free diet:
Separate all kitchen items used for preparing gluten and gluten-free foods. These include cooking utensils, cutting boards, forks, knives, and spoons.
When eating out, if you’re not sure about the ingredients in a particular dish, ask the chef how the food was prepared. You can also ask whether a gluten-free menu is available. Most restaurants have a website where you can review the menu in advance.
Ask your pharmacist if any of your medicines contain wheat or a wheat byproduct. Gluten is used as an additive in many products from medicines to lipstick. Manufacturers can provide a list of ingredients on request if they are not named on the product. Many herbals, vitamins, supplements, and probiotics contain gluten.
Watch your portion sizes. Gluten-free foods may be safe and good for you, but they're not calorie-free.
If you still feel symptoms on your gluten-free diet, double check that you're not still consuming small amounts of gluten hidden in sauces, salad dressings, and canned soups or through additives, such as modified food starch, preservatives, and stabilizers made with wheat. Even some medicines can contain gluten. Tablets and capsules can be sources of gluten contamination. The risk of your medicines containing gluten is very small but, if you are concerned, you should discuss this with your healthcare provider.
As you and your family become experts in reading food and product labels, you’ll be able to find hidden sources of gluten before they can cause a problem. You might also get more ideas from joining a support group, in person or online, that can help you adjust to your new way of life. These are great forums for learning a wealth of delicious recipes for everything from gluten-free cookies and banana bread to biscuits, trail mix, and grits.
March 22, 2017
Gluten Content of the Top 200 Medications: Follow-Up to the Influence of Gluten on a Patients Medication Choices. King A. Hospital Pharmacy. 2013;48(9):736-43., Patient information: Gluten-free diet (The Basics). UpToDate
Freeborn, Donna, PhD, CNM, FNP,Lehrer, Jenifer, MD