Celiac Disease & How Nutrition Can Help

Last updated on March 25, 2021 at 02:25 pm

There is no way around specific nutrition for Celiac Disease. Celiac disease is a chronic immune disorder. In people with celiac disease, consuming gluten causes an abnormal immune response in the small intestine, which creates inflammation and damage to the intestinal wall.

Since most nutrients are absorbed in the small intestine, the damage done to these cells blocks to various degrees the absorption of the nutrients present in the food we consume.

The inflammation and the nutritional imbalances caused by the destruction of the lining of the small intestine are responsible for the symptoms and manifestations of celiac disease.

What is the Meaning of Gluten Intolerance and Celiac Disease?

Although the term “gluten intolerance” is often used, celiac disease is not really food intolerance since an immune reaction is involved.

The abnormal immune system reaction produces antibodies triggered by the consumption of gluten. These antibodies will turn against the body by attacking the lining of the small intestine. Celiac disease is therefore an autoimmune disease induced by the ingestion of gluten.

In recent years, the term non celiac gluten sensitivity has appeared in scientific studies (1). It manifests with symptoms similar to celiac disease and irritable bowel syndrome when eating foods containing gluten, but without the immune response associated with celiac disease or with wheat allergy.

The real prevalence of non celiac gluten sensitivity related disorders is hard to estimate, especially since most people call themselves gluten intolerant through self-diagnosis in absence of a medical opinion.

What are Common Symptoms of Celiac Disease?

Symptoms of celiac disease depend on many factors like age and severity of the condition.

Children can develop celiac disease anywhere from 6 months of age to when they are 2 years old, which is usually the period when gluten is introduced in their diet. These children can present with symptoms like: weight stagnation or weight loss, anemia, delay in cognitive and psychological development, diarrhea and increased abdominal circumference.

However, many children and adults remain undiagnosed, especially if their condition is less severe and they only experience mild and non specific symptoms such as bloating, flatulence or diarrhea.

Celiac disease can also present as iron deficiency, which is found in 20 to 50% of people when first diagnosed (2). Signs of iron deficiency are fatigue, paleness, shortness of breath, brittle nails and hair loss.

How is Celiac Disease Diagnosed?

A celiac disease diagnosis is based on 3 criteria:

Clinical criteria: signs and symptoms associated with celiac disease directly or indirectly as consequences of malnutrition or nutrient deficiencies.
Biological criteria: based on the presence of certain markers and antibodies in the bloodstream.
Histological criteria: based on the direct study of the inner intestinal wall after a small bowel biopsy and therefore the observation of the damage done to these cells.

A definitive diagnosis is accepted based on these criteria and/or in the case of clinical, biological and histological improvement after the exclusion of gluten from the patient’s diet.

A gluten free-diet is currently the only available cure for celiac disease.

What is Gluten?

Gluten is a complex protein made of Glutenin and Gliadin (3). Gluten is present in grains like wheat, rye, barley and spelt and it is the substance that develops when flour is mixed with water. Gluten is responsible for the stickiness of the dough and the chewy texture of bread and other grain based foods.

Opinions are mixed about gluten, while most studies affirm that gluten is safe for non gluten intolerant people, other sources claim that gluten consumption can have some negative effects which are especially linked to the protein Gliadin (3).

One study found that wheat gluten can increase inflammation levels in the body (4). But although people report feeling better after eliminating gluten from their diet, more studies are needed to truly understand this protein and to know if there is any scientific basis to non gluten intolerant people going gluten-free.

What should I eat if I suffer from Celiac Disease?

The only known way to cure celiac disease is to adopt a gluten-free diet for life. This means that any products deriving from wheat, barley, spelt and rye cannot be consumed under any circumstance.

The Celiac Disease Foundation also recommends excluding the following foods: faro, graham, semolina, brewer’s yeast, wheat starch and malt, including malted milk, malt extract and malt vinegar (5).

Most beers are made with grains and additives that contain gluten, which makes beers unsafe for consumption for celiac patients.

Gluten is tricky because it’s present in most processed foods, and incorporated by many restaurants into most of their dishes. Gluten can be present in some supplements or medications and even in personal care products such as toothpastes and lip balms (5).

Gluten-free foods and products are also very easy to contaminate with gluten. This can happen either by hand, in restaurants that serve both gluten-free and traditional meals, or in factories that handle both gluten- free and non gluten-free products.

While oats are naturally gluten-free, it’s important to note that these grains are frequently sourced in a factory that handles wheat, rye, spelt or barley. This can cause the oats to be contaminated with gluten in the factory, making them not suitable for consumption by celiac patients.

Subsequently, even when buying naturally gluten-free grains, it can be helpful to look for the ones that are certified to be gluten-free.

It is common to suffer from weight-gain when starting a gluten-free diet as many ready-to-buy products in the shops are high in sugars. Our 21-days weight-loss challenge focusses on healthy, (almost) plant-based eating and limiting processed foods. In fact, our very first client suffers from celiac disease and talk about her journey in our video describing the 21-days weight-loss challenge and why we started it.

Nutrition Advice for Celiac Disease:

Food group:	Nutritional guideline:	Additional information:
Wheat, barley, rye, spelt and various products derived from these grains.	Prohibited for life.
Processed foods like cookies, candy bars, pasta, pizza, breads, noodles, crackers, sauces, gravies, stocks, soups, salad dressings and other packaged foods.	Caution advised.	Very likely to contain gluten unless specified otherwise. Only consume if the food is certified gluten-free.
Fried foods and most restaurant dishes and recipes.	Caution advised.	Always ask if the recipe is gluten free before ordering. Only consume if the food is certified gluten-free.
Oats.	Caution advised.	Cross contamination is possible. Choose products certified gluten-free.
Quinoa, Rice, Amaranth, Buckwheat, corn, flax, millet and other gluten-free grains.	Allowed.	.
Vegetables and fruits	Allowed.
Fats and oils like avocado, butter, coconut and olive oils…	Allowed.
Legumes like beans, chickpeas, lentils and soy.	Allowed.
Vegetarian and vegan meat substitutes.	Caution advised.	Products like seitan , veggie bugers, veggie sausages and other mock meats may contain gluten in the form of starch or flour.
Eggs and non processed lean meats and fish.	Allowed.
Nuts and seeds.	Allowed.
Dairy products.	Allowed.	Pay attention to yogurts that contain added wheat or cereals, or cookies and brownies mixed into ice cream.
Herbs and spices.	Allowed.	Watch out for seasoning packets that might contain gluten in the form of starch or flour.
Alcohol.	Most wines and distilled alcohols (like gin, vodka and whiskey): Allowed. Beers are prohibited unless labeled gluten-free.

Nutrition For Celiac Disease – A Simple Recipe

Rocket Orange Fennel Salad

To nourish the body and ease the symptoms of celiac disease, we suggest this simple and healing salad made of rocket, fennel, oranges and sprouted lentils or pumpkin seeds.

This salad is made with fresh produce that has high water content. This is important since some celiac patients can experience diarrhea and are therefore prone to dehydration.

Lentils are high in iron and thus need to be consumed by celiac patients since many of them are iron deficient. However lentils like other legumes are high in sugars and can cause additional bloating and flatulence. A good way to solve this is to allow the lentils to sprout before consuming them, which makes them easier to digest and their nutrients are more readily available for absorption.

If you don’t have access to sprouted lentils, you can easily use pumpkin seeds instead. These seeds are rich in iron and are a great source of protein, dietary fiber and essential fatty acids.

Fennel is a delicious and aromatic bulb known for its anti-inflammatory and relaxant properties. Additionally, fennel is rich in fiber and potassium which are great for intestinal health. All these properties make fennel one of the best foods to consume to fight bloating and ease intestinal discomfort.

Oranges are high in vitamin C, which is powerful antioxidant that can help to decrease the local and general inflammation associated with celiac disease. Vitamin C will also increase the intestinal absorption of the iron in the lentils or the seeds.

Arugula or rocket is high in fiber, which will make the salad satisfying and more filing. Rocket is also naturally high in calcium, potassium and folate which celiac patients tend to be deficient in [2]. Rocket is also high in vitamin C, which will help to absorb the iron in the sprouted lentils or the seeds.

To prepare the salad, here is what you need:

You can either use sprouted lentils for this recipe or you can use pumpkin seeds if you prefer. If you choose to prepare sprouted lentils, here is how:

Step 1 (in advance):

Sprouting the lentils

If you don’t have sprouted lentils on hand, you will need to complete this step a day or two before you are able to enjoy this salad. The good news is that you can make a big batch of sprouted lentils for you to use in many recipes.

Instructions to sprout the lentils:

In a mason jar, soak the lentils in water for 12 hours.
Drain the water from the jar and let the lentils sit in a well aerated environment. A good way to do that is to cover the Mason jar with a mesh or cloth in order to keep debris and insects away but allowing air circulation.
Rinse and drain lentils every twelve hours. Sprouts should start to appear within 12 to 36 hours.
When sprouts are the desired length, spread the lentils on a paper towel and let them dry.
Store in the fridge or use for a recipe.

Step 2:

Salad recipe:

Ingredients: (recipe for one person)

1 fennel bulb.
1 ripe orange.
2 handfuls of rocket.
A handful of lentil sprouts or a handful of pumpkin seeds.
A tbsp of olive oil.
Optional dressing:
1 tablespoon (tbsp) of mustard.
1 tablespoon (tbsp) of agave or maple syrup.

Instructions:

Rinse and dry the rocket. Lay it on a serving plate.
On a bed of fresh rocket, cut the fennel bulb and the orange to the desired shape and size.
Add the olive oil and mix.
Add the lentil sprouts or the pumpkin seeds on top for an additional crunch and texture.
You can either consume the salad as it is, since it’s rich in the aromatic flavors of orange and fennel.
But if you’d like more flavor you can mix the sweetener with the mustard to make a healthy plant-based version of the honey mustard dressing.
Drizzle your dressing on top and enjoy.

If the recipe is for two people, the amounts can be doubled, or tripled for three.

The Bottom Line:

Celiac disease is a chronic condition in which an immune response against the inner lining of the intestine is triggered by the consumption of gluten.
Celiac disease symptoms are bloating, diarrhea, malnutrition, weight loss, fatigue, anemia and various nutritional imbalances.
The only cure available for celiac disease is a gluten-free diet for life (see nutrition for celiac disease above)
Gluten is a protein present in grains such as wheat, barley and rye and subsequently found in grain-based products like bread, pasta, cookies and beer.
Gluten is an additive widely used in processed foods, in restaurant dishes, in drugs and medications and even in personal care products.
Consuming a whole foods homemade diet and paying close attention to labels and ingredient lists are the best ways to manage celiac disease.
A balanced gluten-free nutrition is the key to healing celiac disease and avoiding the deficiencies and nutritional imbalances associated with this disorder.