Celiac Disease Q & A
Commonly asked questions on nutrition and Celiac Disease, answered by Melinda Dennis, MS, RD, LDN of the
Celiac Disease Center at Beth Israel Deaconess Medical Center. Ms. Dennis has herself had Celiac Disease for more than 18 years.
Q. What is it like for a person you see who is newly diagnosed with Celiac Disease?
A. The gluten-free diet requires more preparation, taking food with you when you travel, making sure that you are safe in dining-out situations or when you are visiting with family or friends. So for some, it is very simple and straightforward and they are already experimenting with healthy gluten-free grains such as quinoa, sorghum, and teff. But some people are completely unfamiliar with these grains and it is a bit more of a challenge for them in the beginning. Many people just eat on the run these days and this also makes it challenging.
Some are in denial. Perhaps they were having no symptoms but this was discovered through a blood test and they wonder, do I really need to change my life? Those are the people who, understandably, ask "how much can I get away with?" So there are all different types of people. But more and more people are coming into the clinic well educated about this disease because of increasingly accurate information on the web. That's a big change from about seven or so years ago when there were very few resources.
Q. There are many gluten-free foods on the market now. Does this make it easier for those diagnosed with Celiac Disease?
A. Yes. But it's important to stress that the gluten-free diet isn't just about what we need to remove from our diet; it's about making sure the foods you DO choose are nutrient-rich. Rice, corn and potatoes have a high glycemic index, and are low in fiber. They can create food cravings and lead to weight gain. So when we think of Celiac Disease, we think - how can we make up for the fact that we aren't eating a high protein wheat product any longer? What can we substitute and what would be superior? That's when we work on educating patients about other grains that are healthier and have plenty of vitamins and minerals, such as amaranth, buckwheat, millet, brown rice, etc. Several of the gluten-free products are now fortified with B vitamins, iron and trace minerals, and you can check the labels to make sure.
Q. It's great there are more gluten-free options, but even reading the labels doesn't always help. What items have hidden gluten?
A. Many foods and other products that you wouldn't expect contain gluten. Toothpaste can have gluten. You have to be careful to wash your hands carefully after feeding your pets because chow usually contains gluten. Soy sauce, gravies and marinades are suspect. Even communion wafers and matzoh contain gluten. Patients need to be educated on all of this, because consistent exposure to gluten will lead to increased damage to the small intestine.
Q. Do most patients eventually adopt a healthy, gluten-free diet?
A. Most patients, even those who have a hard time with the diagnosis, do learn how to eat well. From my own experience, I feel it was actually a blessing to be diagnosed. It changed my life for the better. It empowered me to make the right decisions, to eat well-actually better than I had ever eaten before. I travel more now and experiment with tasty foods, more ethnic food, as well. So it's a good thing to have a diagnosis-and learn the best ways to take care of your body and be healthy.
Above content provided by Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.
Posted March 2009