Celiac Disease Recommendations and Considerations

Celiac Disease Recommendations

❑ Avoid any and all foods that contain gluten. Do not eat any products that contain barley, oats, rye, or wheat. Rice and corn can be eaten. Substitute rice, potato, cornmeal, and soy flour for wheat flour. Read all labels carefully. Watch for “hidden” sources of gluten, such as hydrolyzed vegetable protein, textured vegetable protein, hydrolyzed plant protein, and all derivatives of wheat, rye, oats, and barley, including malt, modified food starch, some soy sauces, grain vinegars, binders, fillers, inert substances, and “natural flavorings.” Do not consume hot dogs, gravies, luncheon meat, beer, mustard, catsup, nondairy creamer, white vinegar, curry powder, or seasonings. Gluten-free products are available at health food stores. Natural foods stores such as Whole Foods Market have a wide selection of gluten-free foods.

❑ Eat fresh vegetables, legumes (such as lentils, beans, and peas), rice bran, nuts, sunflower seeds, raisins, figs, and “seedy” fruits, such as strawberries, raspberries, and blackberries.

❑ Include in the diet blackstrap molasses, which is high in iron and the B vitamins. People with celiac disease need fiber and foods rich in iron and the B vitamins.

❑ Be sure to chew your foods thoroughly before swallowing. This improves the intake of nutrients.

❑ Do not eat sugary products, processed foods, dairy products, bouillon cubes, chocolate, and bottled salad dressings.

Celiac disease causes malabsorption of the B vitamins and the fat-soluble vitamins (vitamins A, D, E, and K), so take these nutrients. Note that gluten is found in many nutritional supplements. Read labels carefully, and use supplements that are hypoallergenic, wheat-free, and yeast-free.

❑ If a child develops any of the symptoms of celiac disease, omit all gluten-containing foods from the child’s diet and see if the problem clears up. Also eliminate milk, as lactose intolerance can occur with celiac disease. If you do this, be sure to offer another source of calcium, vitamin D, and magnesium. The disease can begin in the first few months of life, depending on the child’s diet.

Celiac Disease Considerations

❑ Any child who is not thriving could have celiac disease. The disease manifests itself differently with each person. Symptoms can include irritability, fatigue, and/or behavior changes; they do not always involve obvious digestive problems.

❑ A child who gets blisters and sores all over his or her body should be checked for celiac disease.

❑ If celiac disease is suspected, a blood test and then an intestinal biopsy should be performed to make a definitive diagnosis. Make a list of symptoms and foods that set off these symptoms for your child’s health care provider. Growing children need a wide range of nutrients to grow and for their brains to develop. Don’t restrict a child’s diet before seeking medical help.

❑ Starting a gluten-free diet is challenging because gluten is present in so many foods, including most grains, pasta, cereals, and processed foods. However, people with celiac disease can still eat a varied, well-balanced diet that includes breads and pastas made from potato, rice, soy, or bean flour. Gluten-free products are available from many health food stores and specialty food companies. There are also many cookbooks available for those on a gluten-free diet.

Grainaissance is an industry leader in providing wheat-, gluten-, and dairy-free products.

Mochi bake-and-serve rice squares are wheat-, gluten-, and dairy-free, as are Amazake Rice Shakes. Enjoy Life Foods sells a number of foods that are ideal for a gluten-free diet, including break-fast cereals. Mrs. Leepers carries a line of organic rice pastas and corn pastas that are gluten-, wheat-, and casein-free. Rizopia rice pasta is gluten-free. Nature’s Path carries a number of gluten-free products. U.S. Mills offers wheat-and gluten-free cereals under the Erewhon and New Morning brands.

❑ Several studies suggest that people with celiac disease can safely eat oats. However, since oats are frequently processed with other grains, it is difficult to determine whether oats are completely gluten-free. Follow your physician’s or dietician’s advice about including oats in a gluten-free diet. A clinical study in Finland showed that patients with celiac disease were able to tolerate both highly processed oats and those left in a more natural state, indicating that oats may be part of a gluten-free diet.

❑ It may be necessary to remove milk and milk products from the diet because of a secondary lactase deficiency. Many lactose-free dairy substitute products are available (milk, ice cream, cheese), so if you enjoy dairy, there are ample healthy options.

Vitamin K deficiency caused by celiac disease may lead to hypoprothrombinemia (a lack of clotting factors in the blood). “Friendly” bacteria in the intestines manufacture one form of vitamin K; another is present in certain foods, especially leafy greens, alfalfa, tomatoes, strawberries, whole grains, and yogurt. Bacteria such as those found in yogurt and acidophilus can also help to restore the intestinal flora necessary for vitamin K production.

❑ Martin F. Kagnoff, M.D., of the University of California—San Diego says that heredity is a vital factor in the development of this disease. He also says that celiac disease often develops in childhood but may trail off in adolescence; in some cases, reappearing in adults in their thirties and forties. Factors that may trigger the onset of celiac disease are emotional stress, physical trauma, a viral infection, pregnancy, or surgery.

❑ A report published in the British medical journal the Lancet pointed to a possible connection between celiac disease and epilepsy. Theories as to how the two might be linked include the possibility that endorphin-like substances may be created from wheat gluten and may affect brain metabolism; another possibility is that celiac disease increases intestinal permeability, which in turn allows the absorption of substances that may affect brain chemistry.

❑ Schizophrenia has been observed to occur more often in those with celiac disease.