Article by: Noaa Bujanover, MS, RD/LD,N, CSCS
Celiac disease is a lifelong autoimmune disease that is triggered by gluten. Gluten is a protein present in wheat, barley, rye, and/or their derivatives. The exposure to gluten causes an autoimmune response, attacking the small intestine and preventing absorption of important nutrients.
Celiac disease can be diagnosed at any age and many people may not have obvious symptoms (asymptomatic). Statistics show that 1 in every 133 healthy people have celiac disease. It affects 1% of the healthy, average American. That means that there are at least 3 million people in the United States that are living with celiac disease. However, only 3% are diagnosed. Research shows a genetic link to celiac disease. The disease can often present itself during traumatic life events such as car accident, pregnancy, anxiety, excessive stress, surgery or other events.
Common symptoms of celiac disease include:
ï‚· Chronic diarrhea or constipation
ï‚· Unexplained weight loss
ï‚· Gas/abdominal cramping
ï‚· Fatigue or depression
ï‚· Bone or joint pain
Â If left untreated or undetected, celiac disease may cause gastrointestinal (GI) cancers, gall bladder malfunction, vitamin K deficiency, other vitamin and mineral deficiencies, osteoporosis and other serious conditions.
In order to detect celiac disease, one must first do antibody blood testing. This will only suggest the presence of the disease but not confirm it. In order to confirm it, one must go through an endoscopic biopsy of the small bowel. Genetic testing can also be done, however, it may just indicate that the person has a predisposition for the disease.
The disease can often
present itself during traumatic
life events such as
car accident, pregnancy,
anxiety, excessive stress,
surgery or other events.
Treatment of celiac disease is avoiding all gluten containing products. When gluten is removed from the diet, the small intestine can restore itself and overall health improves. In certain cases, due to the damage to the small intestine, lactose -containing foods (milk, cheese, ice-cream, etc.) may also need to be removed from the diet. After the small intestine restores itself, lactose-containing foods can be reintroduced. Restoring the small intestine may take from 6-18 months.
In order to follow a strict gluten free diet one must read all food labels when shopping and eating:
Grains to avoid: wheat, barley, rye, malt, spelt, kamut, triticale, semolina, faro, graham, enkorn, and spelt. (Wheat free is not necessarily gluten free)
Grains allowed: rice, soy, corn, potato, tapioca, beans, garfava, sorghum, quinoa, millet, buckwheat, arrowroot, amaranth, teff, MontinaÂ®, flax, and nut flours.
Don't forget, you must avoid cross contamination in preparation between gluten containing foods and gluten free foods. Example: do not cut wheat bread on the same board or with the same knife as gluten free bread. Do not fry in the same pan.
Athlete Check List:
- Athletes with celiac disease need to carry snacks with them at all times.
- Make sure the coach, athletic trainer or other person traveling knows your restrictions so they can help watch out for contaminated food.
- If you train at a facility that has a kitchen, make sure the chef and the cooks know so that they can pre-pare gluten free foods for you with-out cross contaminating. If need be, make your own food, and bring it with you in a personal cooler.
- Make sure you read ALL labels and when in doubt contact the manufacturers.
There are multiple common foods containing gluten which the celiac athlete cannot eat. However, there are many other sources of carbohydrates that do not contain gluten: rice, quinoa, wild rice, tapioca, potatoes, corn and buckwheat are some examples. Many grocery stores also carry gluten free crackers, pretzels, breads and cereals that can travel well.
Oats can also be consumed only if they were processed in a facility that uses proper techniques to prevent contamination. However, some people may not tolerate oats at all.
Athletes can eat all vegetables, fruits, most dairy, most meats and fish, as long as they are not breaded.
Other gluten free foods include nuts, seeds, oils and gluten free snacks (clearly labeled on packaging).
- Green, PH. The many faces of celiac disease: clinical presentation of celiac
disease in the adult population. Gastroenterology. 2005;128:S74-78