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Dietitians Dish: Celiac Disease

By By Lindsay Adams
May 29, 2012 at 12:29 a.m.

Lindsay Adams

May is internationally recognized as Celiac Disease Awareness month. For those of you who have not heard of this condition, celiac disease is an autoimmune disorder that has been proposed to affect about one in 133 individuals in the U.S.

It is characterized by a genetic sensitivity to gluten, which is found in wheat, barley and rye.

When someone with celiac disease consumes one of these grains, an immune response is triggered, which causes damage to the lining of the small intestine. This damage results in mal-absorption of nutrients and can cause a number of symptoms including abdominal pain, diarrhea, bloating, anemia, weight loss, osteopenia, fatigue, infertility, mouth ulcers, numbness in hands or feet, migraines or itchy, blistery skin.

Severity of sensitivity and symptoms varies, which often leads to individuals remaining undiagnosed because they think that their symptoms are a result of another issue.

Celiac disease is sometimes confused with a gluten intolerance or allergy, however allergies and intolerances cause symptoms to occur, but will not result in damage to the intestines. Blood work and a biopsy of the small intestine are typically performed to diagnose celiac disease.

To avoid damage to the intestine and the negative side effects of celiac disease, individuals with the condition must adopt a gluten-free diet. To do so, wheat, barley, and rye should be avoided, and it is even best to avoid cooking in pans that have once been used to prepare a gluten-containing dish.

When gluten is removed from the diet, the small intestine can heal. Even if a person does not have a severe reaction to a particular food that contains gluten, gluten should be avoided as the internal damage can still occur without the presence of symptoms.

Reading the food label is very important to avoid hidden gluten in products.

According to the Food and Drug Administration's regulation, a food that contains a protein derived from wheat must clearly state the word "wheat" on the food label, either in the ingredient list located under the nutrition facts chart or in a separate statement. Some processed foods and supplements may also contain gluten. Many products put a gluten-free claim on the food label, but if not, don't hesitate to call the company and ask if it is gluten free.

Beer, ale, porter, stout and any other fermented beverages also contain gluten and should be avoided. However, gluten-free beers are available.

Pure distilled alcoholic beverages, such as gin and vodka, may be included in a gluten-free diet.

Although the beverage may be derived from a gluten-containing grain, the process of distillation prevents any gluten from remaining in the final product.

Grains that are OK to eat include rice, corn, amaranth, quinoa, millet, sorghum, arrowroot, buckwheat, flax, potato, soy, legumes, tapioca, wild rice, cassava, yucca, nuts and seeds.

All meats, fruits and vegetables are gluten free unless a product with gluten has been added to it.

Fortunately, the availability of gluten-free products is increasing because of the rising numbers of individuals being diagnosed. Most grocery stores have a gluten-free section where breads, cakes, crackers and other treats can be found, which makes life a little easier for those suffering from celiac disease.

For more information on celiac disease, go to celiac.org, celiaccentral.org, or contact a registered dietitian.

Lindsay Adams is a registered dietitian. Send questions or comments to dietitians@vicad.com.

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