Definition - an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages. . A reaction to gliadin (a protein in wheat) causes inflammation in the small intestine and damages the micovilli which decreases the absorption of food. Other glutinous grains include rye and barley.
Cause – genetic predisposition that has been activated.
Symptoms - include pain and discomfort in the digestive tract, chronic constipation and diarrhea, failure to thrive (in children), anemia and fatigue, but these may be absent, and symptoms in other organ systems have been described.
Diagnosis - Blood test and or biopsy through your physician. You can also be genetically tested for celiac disease. The most important thing is to continue to eat gluten until you have the testing done.
Definition - Non-celiac gluten sensitivity has been coined to describe those individuals who cannot tolerate gluten and experience symptoms similar to those with celiac disease but yet who lack the same antibodies and intestinal damage as seen in celiac disease.
Cause – a general immune response to gluten as oppose to an antibody specific response
Symptoms - non-celiac gluten sensitivity shares many symptoms with celiac disease. Individuals with non-celiac gluten sensitivity have a prevalence of extra intestinal or non-GI symptoms, such as headache, “foggy mind,” joint pain, and numbness in the legs, arms or fingers. Symptoms typically appear hours or days after gluten has been ingested, a response typical for innate immune conditions like non-celiac gluten sensitivity.
Diagnosis - non-celiac gluten sensitivity is diagnosed by process of exclusion. Experts recommend that you first get tested for a wheat allergy and for celiac disease. If both of those are negative, then your doctor may recommend a gluten elimination diet. If symptoms improve on a gluten-free diet, then you likely have non-celiac gluten sensitivity.
Gluten Allergy – proper term “wheat allergy”
Definition - people who are allergic to wheat — actually, truly allergic to it — sometimes also experience gastrointestinal symptoms and rashes, but they also experience more "typical" allergy symptoms, like a runny nose. People occasionally refer to a wheat allergy as a "gluten allergy," but true wheat allergy doesn't necessarily involve gluten — it's possible to be allergic to many different components of the wheat plant
Cause – over active immune system to a component of wheat
Symptoms - nasal congestion, itchy, red, watery eyes, hives and/or itchy rashes, swelling of lips, tongue and/or face nausea, vomiting and/or abdominal pain, diarrhea, difficulty breathing
Diagnosis – with skin prick testing if the celiac disease has been ruled out.
The Gluten Free Diet
What you can eat – contrary to popular belief you still have so many things you can eat.
What is off limits – wheat, rye and barley, triticale, kamut and spelt. Also oats if you cannot get gluten free oats.
Based on the available scientific evidence, Health Canada considers that gluten-free foods, prepared under good manufacturing practices, which contain levels of gluten not exceeding 20 ppm as a result of cross-contamination, meet the health and safety intent of when a gluten-free claim is made.
The health benefits of the diet – without gluten you naturally eat less sugar especially if you are choosing whole grain gluten free. A lot of packaged items can be very high sugar and very low fiber. Essentially you are eating way less desserts. It forces you to eat healthier in the sense that you tend to eat more vegetables and salads since you can’t have sandwiches. Focus on whole foods since a lot of processed foods contain wheat/gluten as a filler.
Cooking for a gluten free diet – It is important to watch out for cross contamination; for instance using different pans if you are making a gluten and non-gluten version of a meal or make sure to wash very thoroughly in between. Have a separate toaster for gluten and non gluten toast. Making sure to have a separate butter so crumbs do not cross contaminate. Keep food items separate in the fridge if you can or label them well so know which is which and the same if you put anything in the freezer.
Grocery shopping – Most grocery stores have a strategy for making it easier to shop for gluten free. Some stores have a separate section for gluten free and some will incorporate. At CNF we incorporate but also have a gluten free labeling system for easier identification.
Menu Planning – I am not certain if everyone does a menu plan but it is probably more important if you have celiac disease or gluten intolerance etc especially if you are new diagnosed and are still working through the details. I have a 6 week rotational menu. Essentially you can modify recipes to now be gluten free.
Feeding your family – In general you can have the same meals you did before with some basic substitutes. Pasta, bread, wraps, cereal etc all come in alternate varieties appropriate for gluten free.
Restaurants – it has never been easier to eat out at restaurants in Calgary. Lots of menus will even have the items marked especially. More and more people want gluten free options so restaurants are offering. With that being said I would go to restaurants that you trust. If the server doesn’t know what gluten free is you shouldn’t eat there. The staff should be well versed. Plan ahead and check menus before you go. Make sure to tell the server at the beginning of the meal about eating gluten free.
With friends (at their homes) – I have a list of items I can’t eat and some suggestions of easy items I can have. I also offer to bring something which I of course make gluten free.
While traveling – Depending on where you are travelling to makes a difference. Certain cities and countries are really in tune with gluten free. Small town are not so much. If it is a country where you don’t speak the language it can be challenging. You can download for free or some sites charge for cards you can take with you when you travel. You can always look ahead and plan where you will be eating to find ideas of where you can eat.
Other health considerations
Common adjunct issues - The changes in the bowel make it less able to absorb nutrients, minerals and the fat-soluble vitamins A, D, E, and K.
The inability to absorb carbohydrates and fats may cause weight loss (or failure to thrive/stunted growth in children) and fatigue or lack of energy.
Anaemia may develop in several ways: iron malabsorption may cause iron deficiency
Calcium and vitamin D malabsorption may cause osteopenia (decreased mineral content of the bone) or osteoporosis (bone weakening and risk of fragility fractures).
Supplements – It is important to work with a health professional if you have celiac disease and or a wheat allergy for sure. Celiac disease leads to malabsorption issues so supplementations may be necessary. Your health care provider can test you for certain key issues such as anemia, Vitamin D deficiency, osteopenia or osteoporosis etc.
Lifestyle – No substantial affects on lifestyle except for being less focused on food. You should be able to do everything you did before but in a slightly more modified way.