Maintaining a healthy diet with celiac disease

“There is nothing wrong with you. It’s all in your head.”

“All your basic test results are normal. It must be just stress related.”

These are some of the responses that members of the Celiac Disease Support Group at WakeMed Cary Hospital heard from friends, family and even physicians.

I help run the group, whose members suffer from a variety of symptoms and often struggle to get a correct diagnosis. One member told me: “I went through my life not knowing what was wrong, because I got different results from different medical facilities and doctors.”

Even when a diagnosis is made, patients may not receive enough information. One member said she was told to go on the Internet and find out things on her own.

Family and friends can fall short of being supportive and understanding; holidays can be particularly stressful. Members recall hearing such comments as, “Oh, she’s coming! What am I going to feed her?” and “Just have a small bite. It’s not going to hurt you!”

What is celiac disease?

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein found in wheat, rye and barley. When the body does not absorb nutrients properly, a person becomes malnourished, no matter how much food one eats.

One in 100 people worldwide have celiac disease and many more have gluten sensitivity. It is estimated that about 2.5 million people are undiagnosed. Symptoms may include abdominal pain, bloating, diarrhea, constipation, unexplained weight loss or weight gain, anemia and depression.

Celiac disease is an autoimmune disorder. If left untreated, it can lead to vitamin and mineral deficiencies, osteoporosis, infertility and miscarriage, epilepsy and migraines, growth issues and intestinal cancers. Celiac is also hereditary; if someone in your immediate family has it, you are more likely to have it.

Facts about gluten-free labeling

There is no treatment other than strictly following a gluten-free diet. It becomes imperative for those diagnosed with celiac to be able to identify gluten-free foods.

In 2013, the Food and Drug Administration announced its long-awaited gluten-free food labeling rule. To be labeled gluten-free, a product must contain less than 20 parts per million of gluten. All FDA regulated foods, drinks, and dietary supplements are subject to the rule. Foods not covered are meat, poultry, unshelled eggs, imported products, distilled spirits, wine and malted beverages. No symbol has been approved by the FDA to identify food that meet its gluten-free standard. Restaurants are encouraged to label foods but there is no requirement.

Since there are a wide variety of foods that are not covered, it becomes important to learn how to read ingredient labels and avoid cross contamination.

Eating a healthy diet

The fundamentals for healthy eating apply even for a gluten-free diet. A gluten-free cookie is still a cookie. Eating a balanced diet to get all nutrients is important for long-term health.

▪ Eat foods that are naturally gluten-free. Eat a variety of protein from lean meats, beans, lentils, nuts and nut butters. Focus on colorful vegetables and fruits.

▪ Try gluten-free whole grains, such as millet, quinoa and brown rice.

▪ Limit packaged and processed foods.

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▪ Limit eating out. If you dine at a restaurant, make sure the the food is prepared in a gluten-free area of the kitchen.

This story was originally published May 26, 2015 at 8:51 PM with the headline "Maintaining a healthy diet with celiac disease."