Diet plan for celiac disease — The first step in any diet plan for celiac disease is to eliminate gluten from your diet. After you have gotten rid of gluten and include foods that are essential to getting your body back on track, you can then plan a diet around fats, carbohydrates, and protein.
Celiac Disease
Celiac disease is a digestive problem that hurts your small intestine. It stops your body from taking in nutrients from food.
You may have celiac disease if you are sensitive to gluten. Gluten is a kind of protein found in wheat, rye, barley, and sometimes in small amounts in mixed oats.
When you have celiac disease and you eat foods with gluten, your body has a reaction that is not normal. The part of your body that fights disease (the immune system) starts to hurt your small intestine. It attacks the tiny bumps (villi) that line your small intestine.
The villi help your body take in nutrients from food into your bloodstream. Without the villi, your small intestine can’t get enough nutrients, no matter how much food you eat.
Celiac disease is genetic. This means it can be passed down from parent to child.
More than 2 million Americans have been diagnosed with celiac disease. Studies show that as many as 1 in every 133 Americans may have it. They may not know they have it.
Celiac disease is more common in people:
- Whose ancestors came from Europe
- Who are white
- Who have type 1 diabetes
- Who have Down syndrome
- Who have other autoimmune diseases
- Who are infertile
- Who have irritable bowel syndrome with diarrhea
What causes celiac disease?
Celiac disease is a genetic disease that runs in families. You may have celiac disease and not know it because you don’t have any symptoms.
Some things that may make symptoms start to appear are:
- Too much stress
- Pregnancy
- Surgery
- Physical injury
- Infection
- Childbirth
What are the symptoms of celiac disease?
Celiac disease affects people in different ways. Some have symptoms as children. Others have symptoms only as adults. Some people have diarrhea and belly (abdominal) pain. Others may feel moody or depressed.
Each person’s symptoms may vary. Common signs of celiac disease include:
- Constant (chronic) diarrhea or constipation
- Weight loss
- Gas
- Pale, bad-smelling stool
- Unexplained low blood count that makes you feel tired (anemia)
- Tingling, numb feeling in the legs
- Missed menstrual periods (linked to too much weight loss)
- Infertility
- Early osteoporosis or fractures
- Teeth changing color or losing their enamel
Celiac disease can be painful. Some common pain symptoms are:
- Stomach pain or swelling (bloating) that keeps coming back
- Muscle cramps or bone pain
- Pain in the joints
- Painful, itchy skin rash
Children who have celiac disease may not grow at a normal rate.
You may have celiac disease but not have any symptoms. That is because the part of your small intestine that is not hurt can still take in enough nutrients. But you may still be at risk for problems of the disease.
Celiac disease symptoms may look like other health problems. Always see your healthcare provider to be sure.
How is celiac disease diagnosed?
Celiac disease can be hard to diagnose. Its symptoms may look like symptoms of other digestive problems such as:
- Crohn’s disease
- Irritable bowel syndrome
- Ulcerative colitis
- Infected colon (diverticulitis)
- Intestinal infections
- Small intestinal bacterial overgrowth
To see if you have celiac disease, your healthcare provider will look at your past health and do a physical exam. You may also have tests such as:
- Blood work. This is done to check the level of infection-fighting cells (antibodies) you have to gluten in your blood. People with celiac disease have higher than normal levels of these cells. Your immune system makes these cells to help fight things (such as gluten) that the body feels are a danger.
- Biopsy. This is the most accurate way to tell if you have celiac disease. A tissue sample (biopsy) is taken from your small intestine to check for damage to the villi. To do this, a long, thin tube (endoscope) is placed in your mouth, down to your stomach and into your small intestine. A tissue sample is taken using tools passed through the tube. The sample is checked in a lab.
What is the treatment for celiac disease?
If you have celiac disease, you must stop eating gluten. Eating gluten will do more damage to your small intestine. Eliminating gluten is the only treatment for this disease. You must not eat gluten for the rest of your life.
In most cases, taking gluten out of your diet will stop your symptoms. And, any damage to your intestine will heal. It will also stop any more damage from happening.
Removing gluten from your diet can be difficult. This is because gluten can contaminate many foods. It can be found in condiments, salad dressings, and other unexpected places. For this reason, your healthcare provider may refer you to a dietitian who specializes in celiac disease.
After you stop eating foods with gluten, your symptoms will likely get better in a few days. Your small intestine should heal completely in 3 to 6 months. Your villi will be back and working again. If you are older, it may take up to 2 years for your body to heal.
Dietary Changes for Celiac Disease
Celiac disease is a disorder that damages your small intestine and keeps it from absorbing the nutrients in food. The damage to your intestinal tract is caused by your immune system’s reaction to gluten. Gluten is a protein found in wheat, barley, and rye. Some oats contain gluten.
When you have celiac disease, gluten causes your immune system to damage or destroy villi. Villi are the tiny, fingerlike tubules that line your small intestine. The villi’s job is to get food nutrients to the blood through the walls of your small intestine. If villi are destroyed, you may become malnourished, no matter how much you eat. This is because you aren’t able to absorb nutrients. Complications of the disorder include anemia, seizures, joint pain, thinning bones, and cancer.
Lifestyle changes to cope with celiac disease
A gluten-free diet is the only treatment if you’ve been diagnosed with celiac disease. You’ll have to avoid gluten for the rest of your life. Even the slightest amount will trigger an immune system reaction that can damage your small intestine. Eating a gluten-free diet requires a new approach to food. A gluten-free diet generally means not eating most grains, pasta, cereals, and processed foods. The reason is that they usually contain wheat, rye, and barley. You’ll need to become an expert at reading ingredient lists on packages. Choose foods that don’t contain gluten. You can still eat a well-balanced diet with many different foods, including meat, fish, rice, fruits, and vegetables, along with prepared foods that are marked gluten-free.
Gluten-free bread, pasta, and other products have long been available at organic food stores and other specialty food shops. Today, you can find gluten-free products in just about every grocery store. Gluten-free dishes are on menus at all kinds of restaurants.
Tips for following a gluten-free diet
Here are steps to take when getting gluten out of your diet.
Rethink your grains:
- Avoid all products with barley, rye, triticale (a cross between wheat and rye), farina, graham flour, semolina, and any other kind of flour, including self-rising and durum, not labeled gluten-free.
- Be careful of corn and rice products. These don’t contain gluten, but they can sometimes be contaminated with wheat gluten if they’re produced in factories that also manufacture wheat products. Look for such a warning on the package label.
- Go with oats. Recent studies suggest you can eat oats as long as they are not contaminated with wheat gluten during processing. You should check with your healthcare provider first.
- Substitute potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour for wheat flour. You can also use sorghum, chickpea or Bengal gram, arrowroot, and corn flour, as well as tapioca starch extract. These act as thickeners and leavening agents.
- Know terms for hidden gluten. Avoid einkorn, emmer, spelt, kamut, wheat starch, wheat bran, wheat germ, cracked wheat, and hydrolyzed wheat protein. Stay away from emulsifiers, dextrin, mono- and di-glycerides, seasonings, and caramel colors because they can contain gluten.
- Check the labels of all foods. Gluten can be found in food items you’d never suspect. Here are some likely to contain gluten:
- Beer, ale, and lagers
- Bouillon cubes
- Brown rice syrup
- Candy
- Chips, potato chips
- Cold cuts, hot dogs, salami, and sausage
- Communion wafers
- French fries
- Gravy
- Imitation fish
- Matzo
- Rice mixes
- Sauces
- Seasoned tortilla chips
- Self-basting turkey
- Soups
- Soy sauce
- Vegetables in sauce
More strategies for a gluten-free lifestyle
Here are ideas to better make the transition to a gluten-free diet:
- Separate all kitchen items used for preparing gluten and gluten-free foods. These include cooking utensils, cutting boards, forks, knives, and spoons.
- When eating out, if you’re not sure about the ingredients in a particular dish, ask the chef how the food was prepared. You can also ask whether a gluten-free menu is available. Most restaurants have a website where you can review the menu in advance.
- Ask your pharmacist if any of your medicines contain wheat or a wheat byproduct. Gluten is used as an additive in many products from medicines to lipstick. Manufacturers can provide a list of ingredients on request if they are not named on the product. Many herbals, vitamins, supplements, and probiotics contain gluten.
- Watch your portion sizes. Gluten-free foods may be safe and good for you, but they’re not calorie-free.
If you still feel symptoms on your gluten-free diet, double check that you’re not still consuming small amounts of gluten hidden in sauces, salad dressings, and canned soups or through additives, such as modified food starch, preservatives, and stabilizers made with wheat. Even some medicines can contain gluten. Tablets and capsules can be sources of gluten contamination. The risk of your medicines containing gluten is very small but, if you are concerned, you should discuss this with your healthcare provider.
As you and your family become experts in reading food and product labels, you’ll be able to find hidden sources of gluten before they can cause a problem. You might also get more ideas from joining a support group, in person or online, that can help you adjust to your new way of life. These are great forums for learning a wealth of delicious recipes for everything from gluten-free cookies and banana bread to biscuits, trail mix, and grits.
Foods to Eat
There are many naturally gluten-free foods to enjoy on the celiac disease diet, including:
- Animal proteins: Beef, chicken, dairy products, eggs, game meat, lamb, pork, seafood, and turkey.
- Fats and oils: Avocado, coconut oil, olives, oils, solid fats, and butter.
- Fruits and vegetables: In any form, including fresh, frozen, dried, or canned.
- Gluten-free cereals and pseudocereals: Amaranth, buckwheat, corn, millet, quinoa, rice, sorghum, teff, and wild rice.
- Herbs and spices: All fresh and dried herbs and spices are naturally gluten-free and can be enjoyed liberally.
- Legumes: Beans, lentils, peanuts, peas, and soy.
- Nuts and seeds: Any type, including almonds, cashews, chia, flax, pecans, pepitas, pine nuts, and walnuts.
There’s also a wide variety of specialty products, including gluten-free bread, cereals, flours, crackers, pastas, and baked goods.
SUMMARY
All animal proteins, fruits, vegetables, nuts, seeds, legumes, herbs, and spices are naturally gluten-free. There are many naturally gluten-free grains and specialty products, too.
Foods to Avoid
The only foods that should be avoided on the celiac disease diet are those that contain gluten.
Foods that naturally contain gluten include the following grains:
- Wheat
- Dinkel
- Durum
- Einkorn
- Emmer
- Farina
- Farro
- Graham
- Khorasan (KAMUT®)
- Semolina
- Spelt
- Wheat berries
- Wheat germ
- Wheat bran
- Barley
- Rye
- Triticale (a cross between wheat and rye)
Products made with these ingredients include:
- Breakfast and baked goods: Bagels, biscuits, bread, cornbread, crepes, croissants, donuts, flatbread, flour tortillas, French toast, muffins, naan bread, pancakes, pita bread, potato bread, rolls, and waffles.
- Desserts: Brownies, cake, cookies, pastries, pie crust, and some candy.
- Pasta: Chow mein, couscous, dumplings, egg noodles, gnocchi, ramen noodles, ravioli, soba noodles, udon noodles, and wheat pasta.
- Snacks: Crackers, graham crackers, and pretzels.
- Some beverages: Beer and other malted beverages.
- Other: Breadcrumbs, croutons, wheat flour, barley flour, rye flour, gravy, malt flavoring/extract, panko, sauces thickened with flour, soy sauce, stuffing, and anything with a flour coating, such as chicken tenders or tempura.
Foods that are often cross-contaminated by gluten include:
- Commercially fried foods: Many restaurants fry all of their foods in the same fryer, which can contaminate gluten-free items like French fries.
- Improperly handled gluten-free items at restaurants: Gluten-free items should be prepared with designated gluten-free equipment and a clean pair of gloves.
- Oats: Oats are often processed on the same equipment as gluten-containing grains and may be contaminated unless specifically labeled gluten-free.
Foods that frequently contain hidden gluten include:
- Brown rice syrup: Brown rice is naturally gluten-free, but the syrup is often made with barley malt, which contains gluten. Look for gluten-free varieties.
- Chips: Can be dusted with flour or contain malt vinegar, so check ingredients.
- Ice creams and frozen yogurts: Watch for cookie, cake, or brownie mix-ins.
- Lunch meats: Some brands add starches that contain gluten.
- Marinades and salad dressings: May contain malt vinegar, soy sauce, or flour.
- Meat substitutes: Seitan, veggie burgers, veggie sausages, imitation bacon, and imitation seafood can contain gluten.
- Meats: Some commercially prepared meat mixtures contain gluten or are marinated with gluten-containing ingredients.
- Seasoning packets: May contain gluten-containing starch or flour.
- Soup: Watch for flour thickeners (often used in creamy soups) or barley.
- Stock, broth, and bouillon: Some varieties contain flour.
Sample Gluten-Free Menu
Monday
- Breakfast: Hard-boiled eggs with fresh fruit and almonds.
- Lunch: Lettuce wrap with gluten-free deli meat, potato chips, and guacamole.
- Dinner: Shrimp and vegetable stir-fry with tamari (gluten-free soy sauce) over rice.
Tuesday
- Breakfast: Plain Greek yogurt with sliced fruit, nuts, and honey.
- Lunch: Leftover stir-fry.
- Dinner: Chicken tacos with sautéed peppers and onions served in corn tortillas with refried beans and salsa.
Wednesday
- Breakfast: Gluten-free toast with avocado and a fried egg.
- Lunch: Tuna stuffed avocados with a side of sugar snap peas and trail mix.
- Dinner: Baked chicken with lentil pasta, marinara sauce, and roasted vegetables.
Thursday
- Breakfast: Fruit smoothie made with plain Greek yogurt.
- Lunch: Leftover chicken and lentil pasta.
- Dinner: Dinner bowl made with quinoa, sauteed kale, avocado, and sweet potatoes with herbed tofu dressing.
Friday
- Breakfast: Overnight oats made with gluten-free oats, milk of choice, nuts, coconut, and blueberries.
- Lunch: Spinach salad with quinoa, chickpeas, vegetables, and olive oil dressing.
- Dinner: Pizza made with gluten-free crust.
Saturday
- Breakfast: Bacon and eggs with breakfast potatoes and berries.
- Lunch: Leftover pizza and a side salad.
- Dinner: Baked salmon with steamed vegetables and brown rice.
Sunday
- Breakfast: Omelet with mushrooms, peppers, and onions, along with a piece of fruit.
- Lunch: Vegetarian chili topped with cheddar cheese, green onion, and avocado.
- Dinner: Roast beef with potatoes, carrots, and onions.