No pizza, beer, no cakes, cookies or pie! This is what I was told when I was first diagnosed with celiac disease. While this advice makes nutritional sense for everyone, these indulgences were particularly threatening to my health. All these foods contain a protein called gluten, which acts as a poison to the intestines of a person with celiac disease.
These words were hard to swallow, since at the time I was a teenager and these foods were considered staples. I thought, “how am I going to manage?” However, once I got past the shock of the radical changes that would be made to my diet, I realized that my health was more important. I wanted to feel better.
Celiac disease, also called celiac sprue or gluten-sensitive enteropathy, is a permanent intolerance to gluten. Gluten is a sticky protein found in wheat, rye, barley, oats, durum, semolina, spelt and kamut. When a celiac patient eats gluten, an immune response causes inflammatory damage to the finger-like projections (villi) which are part of the mucosal lining of the small intestine. These villi absorb nutrients from foods and deposit them in the bloodstream. Gluten destroys the villi and this absorptive surface in celiac disease. If left untreated, this often results in severe malnutrition and increased risk of other diseases, including lymphoma (any malignant tumor of the lymph nodes, including Hodgkin’s disease) and osteoporosis.
Other conditions associated with celiac disease include multiple sclerosis, thyroid disease, schizophrenia, insulin dependent diabetes, infertility and attention deficit disorder.
The first description of celiac disease dates back to 1888. In 1950, Dr W.K. Dicke demonstrated that remission of the disorder could be obtained by eliminating certain types of flour, especially wheat and rye, from the diet. This remains true today, however other grains containing gluten must also be avoided.
Celiac disease can strike at any age. The incidence of celiac disease in North America has risen from estimates of 1:5,000 10 years ago to 1:2,000 recently. However, many researchers regard this as an underestimate, due to mis- or under-diagnosis. Public awareness of this disease is important, since many people suffer for long periods of time before diagnosis. The prevalence is as high as 1:150 in Ireland and 1:300 in Denmark, Finland, Scotland and Sweden. With better methods of diagnosis and screening, as well increasing public awareness, it is likely that higher numbers will be found here in North America.
A Diet for Life
Adherence to a strict gluten-free diet is the only treatment for celiac disease. There are many different phases to the disease and symptoms may vary in severity. This leads some individuals to believe that they might be in remission or have a mild case of the disease. However, once a celiac, always a celiac. While patients may vary in their sensitivity to gluten, all gluten-containing grains and products must be avoided completely to allow the intestinal tract to heal and to prevent complications. This seems like an easy treatment for such a painful disease, however being gluten-free can be challenging.
Gluten is pervasive in the average North American diet. As well, there are many hidden sources of gluten, such as thickeners in salad dressings and sauces, coatings on meat and even non-medicinal ingredients in pharmaceuticals, which can create problems. Despite one’s best efforts, inadvertent ingestion of gluten is quite likely. Thus, successful treatment of this disease requires great effort and long-term commitment from the patient and patient’s family. The reward for this commitment and dedication is better health and well-being. Once diagnosed, the response to the gluten-free diet is rapid and dramatic. Most patients feel better in a matter of days. The gastrointestinal symptoms (diarrhea and gas) are the first to subside. The other physical and emotional symptoms improve with time. The gluten-free diet is a healthy diet as it allows all fruits and vegetables, meats, and certain gluten-free grains.
While diet is the mainstay of treatment, there is a strong role for the use of nutritional supplements to correct potential deficiencies and restore health. Since many patients suffer for a long period of time before diagnosis, intestinal damage and subsequent malabsorption of nutrients pose a serious health threat. The use of nutritional supplements is especially important in the early management of the condition to hasten the recovery period. On a chronic basis, supplements can help prevent complications and optimize health.
A multivitamin/mineral complex is the foundation of a supplement program. Look for a product that contains antioxidants (vitamins A, C, E, zinc and selenium). Antioxidants neutralize oxygen free radicals that can damage tissues and cells. The supplement should also contain at least 50 milligrams of all the B-vitamins, as these are often deficient in the gluten-free diet. Time-release formulas are preferable.
Mineral deficiencies are common in celiacs, increasing the risk for osteoporosis. Ensuring adequate intake of certain minerals, such as calcium and magnesium, along with vitamin D, is important. Individual needs vary, so check with your health care practitioner or holistic pharmacist.
Essential fatty acids are the good fats (omega-3 and omega-6) that have healing qualities in the body. They are called essential because we need to get them from food, as our body can’t produce them. Flax seed oil, evening primrose oil and cold-water fish oils like those from herring, salmon and cod are all examples of these good fats.
Digestive enzymes aid in proper breakdown and absorption of foods.
Panax ginseng G115 has been shown to aid in recovery from illness. It also helps to increase energy levels and improve immune function.
Contact the manufacturer to ensure the product is gluten-free. Look for quality products that are free of dyes, chemical fillers and shellac coatings.
Where is the Fibre?
Gluten-containing grains and flours are a main source of fibre in the diet. However, there are many foods that provide great sources of gluten-free fibre.
- Raw fruits and vegetables
- Milled flax seed
- Rice and corn bran
- Nuts, seeds, dried fruits
- Whole bean flour
Tips for Thriving as a Celiac
- Read labels on food items very carefully: avoid products with questionable ingredients.
- Prepare a “Restaurant Card” with the specifics of your diet.
- Carry healthy, gluten-free snacks with you. (Gluten-free snack bars, nuts, seeds, rice crackers, soy nuts or dried fruit).
- Write to food manufacturers and request gluten-free product lists.
- Stay positive–there are worse diseases that we could have!
Gluten-Free Grains and Flours