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Celiac Disease Gluten Free Diet

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How To Start A Gluten

Celiac disease and the gluten-free diet

In addition to helping you avoid rookie mistakes while your body adjusts to going gluten-free, this approach will also help you isolate the cause of any symptoms later on if you add more foods to your diet. Furthermore, it may help you consume more needed nutrients since packaged goods have fewer vitamins and minerals than fresh, whole foods.

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What is Celiac Disease?

May is National Celiac Disease Awareness Month, so to bring awareness to the disease we are looking at what it is, how it is diagnosed, and what are the treatment options available. Celiac disease only affects about 1% of all Americans based on proper diagnostic tests. In fact, many people self-diagnose themselves as having celiac disease, so you may hear of more people than this 1% saying they have the disease. Those people who have diabetes, autoimmune disorders, or have family members with celiac disease are at higher risk of developing it.

Celiac disease affects the small intestine and causes the lining of intestine to become damaged and less effective in digesting nutrients. Because this is an autoimmune disease, the body is triggering an immune response to gluten, therefore causing damage to the lining of the intestine. Over time, the damage to the lining of the intestine prevents the absorption of nutrients causing diarrhea, fatigue, weight loss, bloating, and anemia. If left untreated, it can lead to serious complications.

How is celiac disease properly diagnosed?

It is important to talk with your doctor if you are experiencing any of the symptoms above for a long period of time. They will be able to determine if you need to undergo further testing for the disease, or if you are likely to have another issue.

Celiac disease treatment: the gluten free diet


What Is The Gluten

Many believe that the gluten-free diet is simply a quick way to lose weight. This, however, is not true. The gluten-free diet is currently the only treatment for people with celiac disease. People living with non-celiac gluten sensitivity also benefit from eating gluten-free. Since there are no pills or therapies available, the only way to manage celiac disease is through a strict, 100% gluten-free diet.

So what is gluten anyway? Gluten is a protein found in wheat, barley, rye and the derivatives of these grains, including malt and brewers yeast.

A gluten-free diet excludes all products containing these ingredients. Those who are gluten-free can still enjoy a healthy diet filled with fruits, vegetables, meats, poultry, fish, beans, legumes and most dairy products. Such ingredients are naturally gluten-free, and safe for individuals who do not have allergies to these respective food groups.

  • Unexplained infertility and other reproductive health problems
  • Weight gain or weight loss

Three million Americans have celiac disease, and an estimated 18 million Americans have non-celiac gluten sensitivity . Unfortunately, most live unaware and remain undiagnosed or misdiagnosed.

Think you may have celiac disease? Complete our Celiac Disease Symptoms Checklist and share the results with your doctor.

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Step : Explore Gluten

There are many gluten-free grains you may not have tried before, like sorghum, teff, and buckwheat . Often when some doors are closed, others are opened. Look at your gluten-free diet as an opportunity to discover new gluten-free foods and cuisines. Get inspired by Mexican and Indian spices and ingredients. Corn tortillas, salsas, guacamole, and beans are naturally gluten-free. Cook with traditional Indian ingredients like cumin, turmeric, and lentils.

Other naturally gluten-free foods are fruits and vegetables fresh meats, poultry and fish legumes, nuts and seeds, and plain dairy products. These foods in their pure forms are gluten-free. Processed or flavored versions may have gluten-containing ingredients.

Gluten-free substitutes for foods commonly made with wheat are widely available at mainstream, international, and specialty food stores, direct from gluten-free food manufacturers, and from websites.

Distilled alcoholic beverages, distilled vinegars, and wine may be safely included in the gluten-free diet. Read our article, Does Fermentation or Distillation Make a Product Gluten-Free?

Check out our meal plans:

What Is Celiac Disease

5 foods to include in your gluten

When someone has celiac disease, eating gluten causes an immune response in their small intestines. This immune reaction causes damage to the lining of the small intestines over time, causing diarrhea, bloating, weight loss, fatigue, and anemia. Untreated celiac disease can also prevent the small intestine from absorbing nutrients, which can interfere with growth and development in children. In adults, malabsorption can lead to loss of bone density, infertility problems, miscarriage, and more serious conditions like coronary artery disease, certain cancers, and other autoimmune disorders such as multiple sclerosis and type 1 diabetes. There is currently no cure for celiac disease, but following a gluten-free diet can help alleviate symptoms and promote healing of the small intestines.

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The Celiac Disease Diet: Gluten

A gluten-free celiac disease diet is the only effective diet option.

Although we call it gluten-free, its near impossible to remove 100% of gluten. The exact safe amount is unknown, but less than 10 mg per day has been suggested .

In the US, Europe and Canada, a food must have less than 20 ppm of gluten to be labelled gluten-free .

Australia is stricter, requiring foods to have no detectable gluten.

What Is The Celiac Disease Diet

Also known as a gluten-free diet, the celiac disease diet requires you to remove gluten from your diet completely. If you have celiac disease, ingesting even small amounts of gluten can damage your intestines, even if you dont display symptoms. Following the celiac disease diet helps reduce the symptoms of celiac disease, allows the small intestines to heal, improves the absorption of nutrients, and can offer other, long-term benefits like improving your fertility and lowering your risk for more serious conditions like coronary artery disease, certain cancers, and other autoimmune disorders.

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An Overview Of The Gluten

Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases.

After a diagnosis of celiac disease, you will need to go on a gluten-free diet. Gluten,the main protein in kernels of wheat, rye, and barley grainsis what triggers the immune system to attack the lining of the small intestine in this condition, so it must be avoided to manage symptoms.

Gluten is in many foods and it’s extremely difficult to avoid. In fact, the learning curve on a gluten-free diet is equal to or greater than the learning curves on almost any other type of diet. You will get the hang of it eventually, but you’ll learn more about food labeling and ingredient names than you ever thought you would need to know in the process.

You’ll also make mistakes as you learn how to eat gluten-free and may even experience them decades into following the diet.

Do your best to educate yourself about gluten-containing foods to set your gluten-free diet up for success.

Verywell / Brianna Gilmartin

People With Gluten Sensitivity

Celiac Disease: What Is a Gluten-Free Diet?

Another condition that may prompt someone to cut gluten from their diets is a non-celiac gluten sensitivity, sometimes called gluten intolerance. We dont have a clear definition for gluten intolerance or a clear way to explain it, says Rajagopal. We know that some people eat something that contains gluten and then they dont feel well.

Its important not to assume that gastrointestinal irritation is the result of gluten. If you think you may have a gluten intolerance, Rajagopal recommends working with a physician and a registered dietitian to get to the bottom of your symptoms.

There isnt a test for gluten intolerance, so we might try a process of elimination such as the low FODMAP diet, says Rajagopal. This is a temporary eating plan that eliminates lots of foods that can irritate the gut, including wheat-based products. If gluten is the source of the irritation, you may notice an improvement in symptoms such as:

  • Bloating
  • Stomach pain

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How To Eat Gluten

Eating a gluten-free diet can be challenging. But if you take your time to read labels and ask questions, you can stay on a gluten-free eating plan.

  • Don’t eat any foods that contain gluten.

    These include foods made with wheat, barley, rye, or triticale . Common foods that contain these grains include:

  • Bagels.
  • Bread.
  • Breakfast cereals made with wheat, barley, or rye, or that have the term “malt” or “malted” in their names. Malt is made from barley.
  • Crackers.
  • Pizza.
  • Avoid all beer products unless they’re gluten-free.

    Beers with and without alcoholincluding lagers, ales, and stoutscontain gluten unless they specifically say they are gluten-free.

  • Avoid oats, at least at first.

    Oats may cause symptoms in some people who have celiac disease. This may be a result of contamination with wheat, barley, or rye during processing. But many people who have celiac disease can eat moderate amounts of oats without having symptoms. Health professionals vary in their long-term recommendations about eating foods with oats. But most agree that it’s safe to eat oats labelled as gluten-free.

  • Read food labels carefully.

    Look for hidden gluten. Foods such as ice cream, salad dressing, candy, canned and frozen soups and vegetables, and other processed foods may have hidden gluten.

  • Know what foods you can eat.

    When you’re on a gluten-free eating plan, there are many foods you can still have. Foods you can eat include:

  • Certain alcohol drinks, including wine, liquor , liqueurs, and ciders.
  • More Strategies For A Gluten

    Here are ideas to better make the transition to a gluten-free diet:

    • These include cooking utensils, cutting boards, forks, knives, and spoons.

    • When eating out, if youre 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.

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    People With Celiac Disease

    A gluten-free diet is necessary for people with celiac disease, an autoimmune response to gluten that causes the body to attack the small intestine, causing belly pain, nausea, bloating or diarrhea. People with celiac disease cant tolerate gluten in any form, and need to follow a gluten-free diet for the rest of their lives. If you have celiac and accidentally eat gluten, youll probably experience the same symptoms you did before you went gluten-free.

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    If you have recognized nutrient deficiencies, your doctor may advise that you take one or more the following supplements. Keep in mind that once you restore these nutrient levels and your intestines heal, youll likely no longer need to take that specific vitamin or mineral. Many nutrients have store houses in the body once you replete the stores, you can go off the supplement, says Beringer.

    Your doctor should also monitor you periodically to ensure that your body is properly nourished, adds Mukherjee. Dont supplement unless recommended by your doctor or registered dietitian. Your doctor may advise:

    • Iron

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    Will I Go Through Gluten Withdrawal If I Start Eating Gluten

    Theres no scientific evidence to suggest that people actually go through withdrawal when they stop eating gluten. Some people report feeling dizziness, nausea, extreme hunger and even anxiety and depression when they suddenly go from eating a lot of gluten to being gluten-free. These symptoms usually go away after a few weeks on a gluten-free diet, but talk to your health care provider if they persist.

    Introduction To A Gluten

    Individuals with gluten-related disorders must avoid gluten for health reasons. This includes anyone diagnosed with celiac disease, non-celiac gluten sensitivity , or dermatitis herpetiformis , the skin condition related to celiac disease. Gluten is the generic name for certain types of proteins found in wheat, barley, and rye and their derivatives.

    When individuals with celiac disease ingest gluten, an immune response occurs which damages the lining of the small intestine and can lead to symptoms and health problems in virtually all body systems. Even very small amounts of gluten can cause problems, whether or not obvious symptoms are present. In the case of non-celiac gluten sensitivity , damage to the small intestine may not occur, but gluten must still be avoided.

    The gluten-free diet should not be started before being properly diagnosed with a gluten-related disorder. Starting the diet without complete testing makes later diagnosis difficult. Tests to confirm celiac disease could be falsely negative if a person were on a gluten-free diet for a period of time. For a valid diagnosis to be made, gluten would need to be reintroduced for at least several weeks before testing.

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    Should You Get Tested

    Celiac disease is difficult to diagnose, which is why its commonly under-diagnosed .

    Symptoms can vary a lot between individuals, and some may have no obvious symptoms at all.

    Conditions including Type 1 diabetes and hypothyroidism can also put you in the high risk category .

    Additionally, family history plays a part:

    • If your parent or sibling has celiac disease, you have a higher risk and its wise to get tested, particularly if you have symptoms.
    • Likewise, if you have celiac disease, your child has a higher risk. Children that have parents with celiac disease are often tested from 2-3 years old.

    How To Avoid Nutritional Deficiencies If Youre Managing Celiac Disease

    Celiac disease gives rise to gluten-free foods

    One complication that often arises from celiac disease is nutrient deficiencies. The severity of the inflammatory reaction in the intestine, and how much of the intestine is affected, influences how someone absorbs nutrients, says Bertiger.

    Bertiger points out that while people with celiac can be deficient in a range of vitamins, most commonly he sees B12, calcium, iron, and vitamin D. Along with those, Mukherjee often sees deficiencies of zinc, folic acid, and carnitine, a nutrient that helps the body produce energy.

    Problems with macronutrients can pop up as well. In worse cases of celiac disease, patients cannot absorb and digest fats very well, so they may have diarrhea filled with fat, he says. In that case, someone wont absorb calories very well, so weight loss and malnourishment becomes a legitimate concern.

    Iron deficiency is especially telling. Many people become iron deficient as the first sign of celiac disease, says Bertiger. When patients are mildly anemic, one of the first tests we give them is for celiac, he adds.

    The first course of action is to treat celiac with a gluten-free diet. Its best to meet with a registered dietitian who specializes in celiac who can assess your diet, provide guidance on what to eat, and help you meet your nutrient recommendations to correct deficiencies. He or she can also identify all the nooks and crannies in the world that gluten hides, says Bertiger.

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