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News 3 On Your Side, John B. Amos Cancer Center.
http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/News 3 On Your Side, John B. Amos Cancer Center.
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Stumble It!Celiac Disease Awareness Campaign
http://celiac.nih.gov/
Celiac disease is an immune reaction to gluten, a protein found in wheat, rye, and barley. An estimated 1 percent of all Americans suffer from celiac disease, though many have never been diagnosed and are not receiving treatment.
The Awareness Campaign provides current, comprehensive, science-based information about the symptoms, diagnosis, and treatment of celiac disease, also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.
Through the Awareness Campaign, you can access
news about celiac disease education and research
educational materials and resources
feature stories relevant to people with celiac disease practice guidelines on the diagnosis and management of celiac disease
examples of a gluten-free diet
professional and voluntary organizations devoted to celiac disease awareness
The Gluten-free Diet
A gluten-free diet means not eating foods that contain wheat (including spelt, triticale, and kamut), rye, and barley. The foods and products made from these grains are also not allowed. In other words, a person with celiac disease should not eat most grain, pasta, cereal, and many processed foods. Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods, including gluten-free bread and pasta. For example, people with celiac disease can use potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour. They can buy gluten-free bread, pasta, and other products from stores that carry organic foods, or order products from special food companies. Gluten-free products are increasingly available from regular stores.
Checking labels for “gluten free” is important since many corn and rice products are produced in factories that also manufacture wheat products. Hidden sources of gluten include additives such as modified food starch, preservatives, and stabilizers. Wheat and wheat products are often used as thickeners, stabilizers, and texture enhancers in foods.
“Plain” meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat as much of these foods as they like. Recommending that people with celiac disease avoid oats is controversial because some people have been able to eat oats without having symptoms. Scientists are currently studying whether people with celiac disease can tolerate oats. Until the studies are complete, people with celiac disease should follow their physician’s or dietitian’s advice about eating oats. Examples of foods that are safe to eat and those that are not are provided in the table below.
The gluten-free diet is challenging. It requires a completely new approach to eating that affects a person’s entire life. Newly diagnosed people and their families may find support groups to be particularly helpful as they learn to adjust to a new way of life. People with celiac disease have to be extremely careful about what they buy for lunch at school or work, what they purchase at the grocery store, what they eat at restaurants or parties, or what they grab for a snack. Eating out can be a challenge. If a person with celiac disease is in doubt about a menu item, ask the waiter or chef about ingredients and preparation, or if a gluten-free menu is available.
Gluten is also used in some medications. One should check with the pharmacist to learn whether medications used contain gluten. Since gluten is also sometimes used as an additive in unexpected products, it is important to read all labels. If the ingredients are not listed on the product label, the manufacturer of the product should provide the list upon request. With practice, screening for gluten becomes second nature.
The Gluten-free Diet: Some Examples
In 2006, the American Dietetic Association updated its recommendations for a gluten-free diet. The following chart is based on the 2006 recommendations. This list is not complete, so people with celiac disease should discuss gluten-free food choices with a dietitian or physician who specializes in celiac disease. People with celiac disease should always read food ingredient lists carefully to make sure that the food does not contain gluten.
Allowed Foods
Amaranth
Arrowroot
Buckwheat
Cassava
Corn
Flax
Indian rice grass
Job’s tears
Legumes
Millet
Nuts
Potatoes
Quinoa
Rice
Sago
Seeds
Soy
Sorghum
Tapioca
Wild Rice
Yucca
Foods To Avoid
Wheat Including einkorn, emmer, spelt, kamut,
Wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein,
Barley
Rye,
Triticale (a cross between wheat and rye)
Other Wheat Products
Bromated flour
Durum flour
Enriched flour
Farina
Graham flour
Phosphated flour
Plain flour
Self-rising flour
Semolina
White flour
Processed Foods That May Contain Wheat, Barley, or Rye*
Bouillon cubes
Brown rice syrup
Chips/potato chips
Candy
Cold cuts, hot dogs, salami, sausage
Communion wafer
French fries
Gravy
Imitation fish
Matzo
Rice mixes
Sauces
Seasoned tortilla chips
Self-basting turkey
Soups
Soy sauce
Vegetables in sauce
* Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer.
Points to Remember
People with celiac disease cannot tolerate gluten, a protein in wheat, rye, barley, and possibly oats.
Untreated celiac disease damages the small intestine and interferes with nutrient absorption.
Without treatment, people with celiac disease can develop complications like cancer, osteoporosis, anemia, and seizures.
A person with celiac disease may or may not have symptoms.
Diagnosis involves blood tests and a biopsy of the small intestine.
Since celiac disease is hereditary, family members of a person with celiac disease may wish to be tested.
Celiac disease is treated by eliminating all gluten from the diet. The gluten-free diet is a lifetime requirement.
A dietitian can teach a person with celiac disease food selection, label reading, and other strategies to help manage the disease.
