Step Away from the Flour — Celiac Disease

During this past winter, Alex and I had an ongoing joke that whatever content Breezy Mama covers, one of her kids catches (RSV, Strep Throat… the list goes on). Well, celiac disease is one topic I’ve been meaning to cover and low and behold, it was recommended that I have one of my kids tested (results came back negative). While waiting for the results, I wondered, “What does this mean? How does this change the way we will live our lives forever?” To find out these answers and many more, including how to know if you should have your child tested and what can happen if it goes untreated, Breezy Mama turned to Nicole Kuhl, CCN, Director of Nutrition at LifeSpan Medicine. And although we are celiac disease free, her answers have me re-thinking what I feed my kids!

What exactly is celiac disease?

Celiac disease is a condition that damages the lining of the small intestines and prevents absorption of nutrients. It is due to a reaction to gluten.

What are some red flags that indicate a child should be checked?

GI symptoms such as gas, bloating, pain, decreased appetite, diarrhea, and constipation. There are also non-GI symptoms such as weight loss, easy bruising, fatigue, skin conditions, hair loss, anxiety, and depression.

What is the treatment?

The only treatment is a gluten free diet for life.

What can happen if it goes untreated?

Severe damage to the GI tract, autoimmune disorders, intestinal cancer, low blood count, low blood sugar, and liver disease. Inability to absorb nutrients leads to conditions associated with malnourishment.

How is it diagnosed?

Blood tests can detect antibodies. If tests are positive, usually an endoscopy is done to biopsy the small intestine to determine whether there is flattening of the villi.

Is there any harm in having a child tested even if they don’t have any of the symptoms?

I do not believe there is any harm in testing for antibodies. It is better to error on the side of caution.

Since it involves a change in diet, are there special stores to shop in?

In the last 5 years gluten free products have become readily available. Almost every supermarket carries gluten free products. Some supermarkets such as Whole Foods have entire sections of gluten free products. Gluten free products can be purchased online too.

What ingredients must be avoided?

The 3 grains that contain gluten are wheat, barley, and rye. Oats are often cross contaminated with gluten. Anything made from these grains must be avoided. Foods that may contain gluten include; bread, bagels, muffins, pizza crust, bread sticks, breaded meat, pasta, crackers, cookies, cake, brownies, doughnuts, waffles, meat substitutes, and countless other foods. There are also many unsuspecting sources of gluten such as soy sauce and medications.

What are some optimal foods to serve?

Fruits, vegetables, nuts, seeds, nut butter, meat, poultry, fish, eggs, and non-gluten containing grains such as quinoa, buckwheat, amaranth, rice, corn, and millet. There are many gluten free products to substitute for your favorite gluten containing foods.

Any good cookbooks you can recommend that are a fit for those with celiac?

Donna Washburn’s books are very good. “The Best Gluten Free Family Cookbook” and “The 125 Best Gluten Free Recipes.”

Is celiac disease on the rise? If so, why do you think?

Celiac disease and gluten sensitivity are indeed on the rise. The reason for increased incidence is multi-factorial. One reason is because the gluten content in grains is much higher than it was 70 years ago. Another factor has to do with the way grains are processed for food products through a process called deamidation. Deamidating gluten makes it more likely to be reactive.

Anything else you’d like to share?

Celiac disease and gluten sensitivity should not be taken lightly. The damage caused to the GI tract from gluten is a slippery slope to health complications, accelerated aging, and degenerative disease. Living a gluten free life is an adjustment in the beginning, but the resources available for people who need to follow a gluten free diet are endless. There are websites, cookbooks, support groups, and plenty of gluten free products that make living a gluten free lifestyle a reality. If you’ve just been diagnosed with celiac disease or believe you have gluten sensitivity it’s important to work with a nutritionist in the beginning to get the facts and build a foundation of education. A good nutritionist will ensure you have the resources you need and provide solutions to diet obstacles.