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Eating well with celiac disease: How to safely go gluten-free

30 January 2023 dot 5-minute read
Healthy Body Feature Celiac disease Diet and nutrition Eat Well
The Celiac Disease Foundation estimates that celiac disease affects one in 100 people worldwide, but only 30 per cent get a proper diagnosis. (Credit: Shutterstock)
Gluten is a protein found in wheat, barley and rye, and is found in many foods, from pasta to cereals to bread. Unfortunately, this protein spells bad news for people with celiac disease who can experience symptoms like abdominal pain and diarrhoea after eating food with just a tiny amount of gluten.
 
Celiac disease is a severe autoimmune condition that damages the villi, which are small finger-like projections that line the small intestine. Eating food with gluten triggers an immune response that weakens the villi's function to absorb nutrients.
 
There is no cure for celiac disease. Treatment means managing long-term symptoms by following a strict gluten-free diet. Making lifestyle changes will also allow the body to heal

What are the symptoms of celiac disease?

Celiac disease can be challenging to diagnose as it affects people differently. For example, some people show no symptoms but still test positive on the celiac disease blood test, while others only get diagnosed through a positive intestinal biopsy.
 
Your body may develop any of the following chronic symptoms if it has trouble absorbing nutrients from food and experiences intestinal inflammation.
 
  • Abdominal pain
  • Bloating and gas
  • Chronic diarrhoea or constipation
  • Nausea or vomiting
  • Cognitive impairment
  • Depression and anxiety
  • Itchy, blistery skin rash (dermatitis herpetiformis)
  • Joint pain
  • Weight loss or trouble maintaining weight
  • Underlying complications, like iron-deficiency anaemia
If you regularly experience these symptoms, schedule an appointment with your doctor, who can do tests to determine if it is celiac disease.

What is the celiac disease diet?

People with celiac disease must follow a gluten-free diet to prevent inflammation and intestinal damage. (Credit: Shutterstock)
A gluten-free diet generally means avoiding all foods and drinks containing wheat, barley and rye, which is tricky because many everyday food products count gluten as an ingredient. Take extra care with triticale, a cross between wheat, rye and oats.
 
You can still eat a well-balanced diet, such as meat, fish, rice, vegetables and fruits. Any prepared foods marked gluten-free are safe to consume as well. Specialty food stores usually offer a range of gluten-free products, including bread, pasta, flour, cereals, crackers and baked goods.
 
The risks of gluten exposure can seem daunting, but your doctor can guide you on what to consume to maintain a balanced diet. Fortunately, many foods are naturally gluten-free.
If you still feel symptoms while following the diet, check that you're not consuming gluten hidden in sauces, canned soups or food preservatives made with wheat.

Lifestyle changes to manage celiac disease

Following a gluten-free diet requires a different approach to food and your lifestyle, as the slightest amount may trigger symptoms. Besides the foods you can and cannot eat, you'll need to be cautious when reading the ingredient list on a food package. This lifestyle change will take time and practice to become "normal".

Read food labels

Many grocery food products, including soups and sauces, can contain gluten. (Credit: Shutterstock)
Most products now have gluten-free labels on their packaging. If there are no labels, it is better to read the ingredient list before heading to the checkout counter. You can find gluten in items you would never suspect, from food to medications and supplements, oral care, dental products and cosmetics.
 
Check for ingredients like einkorn, wheat starch and hydrolysed wheat protein, as these are gluten sources. Stay away from emulsifiers, dextrin, mono- and di-glycerides and seasonings.
 
Remember that "wheat-free" doesn't mean "gluten-free".

Prevent cross-contamination

Oats are gluten-free if they are not processed in the same facility as gluten-containing grains. One-eighth of a teaspoon contains enough gluten to cause intestinal damage in most people with celiac disease.
 
Make the transition to a gluten-free diet easier at home by separating kitchen tools for preparing gluten and gluten-free foods. These include cooking utensils and cutting boards. Put gluten-free and gluten-containing foods in different containers.

Dine out at a restaurant

Check out a restaurant's website to browse the menu before arriving to ensure you have options. You will also benefit from calling ahead and letting the chef know about your dietary restrictions and asking if they can accommodate you safely.
 
At the restaurant, let the wait staff know your condition and ask about a dish's ingredients or how the kitchen prepares the food. Always ask for the sauce on the side and look for croutons on a salad or dumpling wrappers because they contain gluten
 
By reading food and product labels, you will be able to find hidden sources of gluten before causing damage. Celiac disease can be hereditary. If you know you are at risk, it may be worthwhile to consider medical protection coverage against any symptoms or complications associated with celiac disease.
 
 
References:
 
National Health Service. Coeliac disease. [online]  [Accessed on 3 October 2022]
 
Journal of Gastroenterology and Hepatology. 2016. Prevalence of celiac disease in Asia: A systematic review and meta-analysis.  [online]  [Accessed on 3 October 2022]
 
Celiac Disease Foundation. What is Celiac Disease?  [online]  [Accessed on 3 October 2022]
 
Johns Hopkins Medicine. Dietary Changes for Celiac Disease.  [online]  [Accessed on 3 October 2022]
 
Colorado State University Extension. Gluten-Free Diet Guide. [online]  [Accessed on 3 October 2022]
 
National Institute of Diabetes and Digestive and Kidney Diseases. 2020. Eating, Diet, & Nutrition for Celiac Disease.  [online]  [Accessed on 3 October 2022]
 
Celiac Disease Foundation. Gluten-Free Foods  [online] [Accessed on 3 October 2022]
Disclaimer:
This is general information only and is not intended as financial, medical, health, nutritional or other advice. You should obtain professional advice from a financial adviser, or medical or health practitioner in relation to your own personal circumstances.