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Eating well

May 20, 2016

Celiac disease: Going gluten-free

Celiac disease is on the rise — but so is information about this condition and the availability of foods that make its symptoms easier to manage.

For some people, avoiding gluten is a lifestyle option based on perceived health benefits. But for celiacs — people who have been medically diagnosed with gluten intolerance, known as celiac disease — it’s the only way to keep a serious disorder in check.

As Jax Wilkinson knows, being a celiac also means being a detective. “I've become so accustomed to checking ingredients and making sure my food is gluten-free and safe,” says the founder and president of Gluten-free Ontario. But Wilkinson says that in the seven years since she was diagnosed, enormous progress has been made in the availability of gluten-free foods, the labelling of food items in Canada — allowing consumers to avoid gluten — and research about the condition.

The end result: a new outlook on what was once a very restrictive way of life. “I think people need to focus on what they can eat rather than dwelling on what they can't,” says Wilkinson. “There are tons of naturally gluten-free foods in the grocery store, from fruits and vegetables to cheese and meats, plus gluten-free products to substitute for all of your old favourites.”

What is celiac disease?

According to Health Canada, celiac disease is a genetically based autoimmune condition in which the surface of the small intestine is damaged by gluten, the mixture of proteins found in wheat, rye, and barley. Once damaged, the small intestine fails to absorb other nutrients and fats, leading to malabsorption.

It’s estimated that celiac disease affects one in 133 people globally, according to Sue Newell, communication and education officer at the Canadian Celiac Association. And numbers are increasing. This is a function of higher awareness and, possibly, environmental factors.

What are the symptoms of celiac disease?

The condition can be insidious, with few symptoms. Or it can cause:

  • Deficiencies in iron, folate or vitamins A, B12, D, E and K
  • Abdominal pain, bloating, cramps, diarrhea and/or constipation
  • Osteoporosis at an early age
  • Fatigue
  • Male or female infertility
  • Elevated liver enzymes
  • Depression

Untreated, celiac disease can lead to myriad health issues. But if you remove gluten from your diet, your intestine can heal and you can live a normal life.

“Many people live an unrestricted life, with the exception of the food they eat,” says Newell.

How do you know if you have celiac disease?

If you suspect you have celiac disease, the first step is to get a proper diagnosis. This involves a blood test, a small-bowel biopsy or an observation of your symptoms when gluten is removed from your diet.

Starting a gluten-free diet

Next, go gluten-free. This takes research. “Many people think they know how to avoid gluten,” says Rich Ralph, a Vancouver-based nutritionist. “But it's hidden in so many products under many different names that it makes it difficult to be 100% gluten-free.” If you’re in doubt, check out gluten-free websites such as the Canadian Celiac Association for tried-and-true recommendations, or talk to a nutritionist.

Luckily, the number of gluten-free products is growing. You can often find them in the organics aisles of supermarkets or health-food stores.

But in addition to foods, people with celiac disease also have to be wary of cosmetics, says Rich: “Surprisingly, cosmetics and hygiene products contain gluten very often. Sometimes it's an actual ingredient in shampoo. Other times it's simply involved in the manufacturing process, which leads to cross-contamination.”

Reading labels is critical to ensure products and foods are gluten-free.

If your workplace health and benefits plan includes a wellness program, check out any workshops and other nutrition resources. If one isn’t offered, ask for a lunch-and-learn on gluten-free nutrition.

Other tips from the experts:

  • Travel cautiously. Ralph says that unless you’re travelling to countries like Thailand, which has a naturally gluten-free cuisine, select foods you’re sure won’t contain gluten, such as fruits, vegetables, cheese, steamed fish, rice, corn, etc. Quizzing local servers — particularly if language barriers exist — may prove perilous. Don't forget about travel insurance.
  • Read carefully. Information from as recently as three years ago may be out-of-date, says Wilkinson. And only source this information from reputable sites.
  • Connect with your local Canadian Celiac Association chapter. Every chapter has trained peer counsellors who can help you find gluten-free food, recipes for gluten-free baking and safe restaurants in your local area, says Newell.

Tips for going gluten-free:

  1. Look for gluten-free menu options at your favourite restaurant chain.
  2. Gluten-free doesn’t necessarily mean healthy – read labels carefully.
  3. Educate your friends and family about your condition.

“Managing celiac disease can seem like a major hurdle at first,” says Rich. “But after a while, it really becomes second nature.”

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