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 may be contaminated by 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, infertility, long-term (chronic) diarrhea, low vitamin levels, and cancer.

Lifestyle changes to cope with celiac disease

A gluten-free diet is the only treatment for celiac disease. You’ll have to stay away from gluten for the rest of your life. Even the smallest amount will trigger a reaction that can damage your small intestine. Eating a gluten-free diet means a new approach to food. A gluten-free diet often means not eating most grains, pasta, cereals, and processed foods. This is because they often contain wheat, rye, and barley. You’ll need to become an expert at reading ingredient lists on packages. Choose foods that don’t have gluten. You can still eat a well-balanced diet with many different foods. You can have meat, fish, rice, fruits, and vegetables. You can also have prepared foods that are marked gluten-free. Be especially careful about condiments, dressings, and gravy, because these may contain gluten. Prescription and over-the-counter medicines may also contain gluten.

You can find gluten-free bread, pasta, and other products in just about every grocery store. Gluten-free dishes are on menus at all kinds of restaurants. But remember that gluten can be hidden in many foods. This includes foods served that a restaurant says are gluten-free. This is why preparing your own food is often the best way to go.

Tips for following a gluten-free diet

Here are steps to take when getting gluten out of your diet.

• Know terms for hidden gluten. Stay away from einkorn, emmer, spelt, kamut, wheat starch, wheat bran, wheat germ, cracked wheat, and hydrolyzed wheat protein. Steer clear of emulsifiers, dextrin, mono- and di-glycerides, seasonings, and caramel colors. These all can contain gluten.

• Check the labels of all foods. Gluten can be found in food items you’d never suspect. Here are some that are likely to have gluten:

  • Beer, ale, and lagers

  • Bouillon cubes

  • Brown rice syrup

  • Candy

  • Chips, potato chips

  • Cold cuts, hot dogs, salami, and sausage

  • Communion wafers

  • French fries

  • Gravy

  • Imitation fish

  • Matzo

  • Rice mixes

  • Sauces

  • Seasoned tortilla chips

  • Self-basting turkey

  • Soups

  • Soy sauce

  • Vegetables in sauce

Rethink your grains

• Stay away from all products with barley, rye, triticale (a cross between wheat and rye), farina, graham flour, semolina, and any other kind of flour. This includes self-rising and durum not labeled gluten-free.

• Be careful with corn and rice products. These don’t have gluten, but they can sometimes be contaminated with wheat gluten. This can happen if they're processed in factories that also make wheat products. Look for such a warning on the package label.

• Go with oats. Recent studies suggest you can eat oats if they are not contaminated with wheat gluten during processing. Check with your healthcare provider first.

• Use potato, rice, soy, amaranth, quinoa, buckwheat, nut, or bean flour instead of wheat flour. You can also use sorghum, chickpea or Bengal gram, arrowroot, and corn flour. Tapioca starch extract is another choice. These act as thickeners and can be used for leavening.

More ideas for a gluten-free lifestyle

Here are ideas to help 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, dishes, forks, knives, and spoons.

• When eating out, if you’re not sure about the ingredients in a 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 look at the menu before you go. 

• Ask your pharmacist if any of your medicines contain wheat or a wheat byproduct. Gluten is used in many products from medicines to lipsticks and lip balms. Manufacturers can give you a list of ingredients 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 getting small amounts of gluten hidden in sauces, salad dressings, and canned soups. Also double check food additives. These include modified food starch, preservatives, and stabilizers made with wheat. Medicines that are in tablets or capsules may be contaminated with gluten. The risk of your medicines containing gluten is very small. But if you are concerned, 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 that can help you adjust to your new way of life. These are great places to find delicious recipes. You can make gluten-free cookies and banana bread to biscuits, trail mix, and grits.