Gluten-Free Living Guidelines, Part 1

©All articles are copyright of Dr. Susan Mitchell and Practicalories, Inc. and cannot be reprinted or used without permission. To obtain permission, please contact Dr. Mitchell.

Did you know that the glue on envelopes, imitation seafood and gum may contain gluten? The vast majority of you who are following a gluten-free diet are doing so because you've been diagnosed with celiac disease also referred to as CD or non tropical sprue. Some of you may have chosen a gluten-free lifestyle because you feel you have a gluten intolerance or someone in your family has autism and you want to see if a gluten-free diet will help. Currently researchers at the University of Texas Medical School in Houston are conducting a clinical study, part of a number of clinical studies, to determine if the elimination of some foods, like gluten containing foods, truly have an effect on autism. I'm focusing on celiac disease today since for you a gluten-free diet is not a choice. It's a diet for life. A gluten-free diet is the only treatment for celiac disease.

I want to say right up front that if you have celiac disease life as you know it is NOT over. It's OK to feel upset, frustrated, down, sad, mad or a myriad of other emotions tied to a diagnosis of celiac disease. But your diet, the gluten-free diet, can not only make you feel better but it's so much easier to follow than just a few years ago. Plus, when you live a gluten-free lifestyle, most of the complications associated with celiac disease can be prevented. Yes, you will have to give up some food items that you may love but you can find new ones to replace them. Yes, there's a learning curve for the gluten-free diet. Yes, it takes extra work and detailed shopping. Yes, you have to change what you eat for the rest of your life. But there is so much accurate information available on the Internet to help guide you and I'll give you some websites to check out. Also, there are more gluten-free foods available in stores and online than ever before and they taste good..not like a cardboard box. You know what I'm talking about.that flat, pasty, no flavor taste that is awful. You can live a gluten-free lifestyle and live it well.

Celiac disease is an autoimmune disorder that attacks your small intestine. Autoimmune basically means that your body turns on itself. Specifically your intestine is damaged by the protein you eat found in wheat, rye and barley. Collectively this protein is referred to as gluten. Any food item which contains gluten is like poison to your small intestine. This intestinal damage makes it difficult to absorb the nutrients from food such as vitamins and minerals. Celiac disease does run in the family and can show up in people with Type 1 diabetes, Down syndrome and thyroid disease. CD can be tough to diagnose because the symptoms are so variable, can occur at any age (even in the elderly) and often involve other organ systems besides the gastrointestinal tract.

Symptoms can range from bloating, gas, diarrhea and weight loss to anemia, lactose intolerance, mouth ulcers, bruising, joint pain and more. Because the symptoms vary person to person, CD is often misdiagnosed and it's not uncommon for someone to have celiac disease for 8-10 years before it's diagnosed correctly. A skin condition called dermatitis herpetiformis or DH, often seen with CD, is celiac disease showing up on the outside of your body, on your skin. DH is an itchy, burning rash where small blisters form and then become erosions. This rash might appear on the scalp and back of the neck, knees, elbows and upper back. Today we have better blood tests for diagnosing CD but they're not foolproof. The only definitive diagnosis for celiac disease is a small intestinal biopsy. The skin rash DH is also diagnosed by biopsy where a skin biopsy is taken in an area close to the blisters. A gluten-free diet can interfere with obtaining an accurate diagnosis so never start on the diet until you've had the blood test and biopsy.

With Celiac disease, the tiniest amount of gluten can set you off and harm your intestines. One easy way to remember the categories of food to avoid is the word BROW like your eyebrow. BROW reminds you of the dangerous proteins including barley, rye, oats and wheat...BROW. Remember wheat free is NOT gluten free. Wheat free can contain barley, bulgur or other grains with gluten.

In the past, oats have been restricted because of cross-contamination. Oats were usually contaminated with wheat, barley or rye during harvesting and processing. Studies from the past 10 years have found that for most people eating oats in moderate amounts, meaning about ½ cup of dried oats is safe. A growing number of celiac organizations and health professionals allow oat consumption in the gluten-free diet. More good news: various food companies are offering pure, uncontaminated oat products.

Where can you find the information that you need to get started now? There are many terrific websites to start with that will lead you to others.

Celiac Disease Foundation: celiac.org

Dietitian Shelley Case's website: glutenfreediet.ca

Her Book: Gluten-Free Diet: A Comprehensive Resource Guide

Gluten Intolerance Group: gluten.net

Recipes and cookbooks: savorypalate.com

Gluten-free products:

Gluten-free pantry: glutenfree.com

The Gluten-Free Mall: glutenfreemall.com

If you have questions that need answers and want a personalized gluten-free diet, consider making an appointment with the nutrition expert, a registered dietitian. You can search for an RD in your area at the American Dietetic Association homepage at eatright.org.