Ask a Dietitian

May is Celiac Disease Awareness Month. It is estimated that 1 in 133 Canadians are affected by celiac disease.

What is Celiac Disease?

Celiac disease is a medical condition in which the absorptive lining of the small intestine is damaged by gluten. This results in the inability to absorb nutrients. Symptoms are usually the result of malabsorption and include diarrhea, fatigue, bloating, cramping, weight loss and low iron levels. Long term, untreated celiac disease can result in osteoporosis, iron deficiency anemia, low folate and vitamin B12, and some forms of cancer. Dermatitis Herpetiformis is a burning, itching skin rash that results from gluten intolerance and may not have GI symptoms.

Non-celiac Gluten sensitivity is a condition in which people experience symptoms of Irritable Bowel Syndrome, fatigue and headaches but do not have damage to the small intestine. These people feel better when they avoid gluten but it is still not known if they will outgrow this sensitivity or not.

Screening for celiac disease

The best way to test for celiac disease is first to assess your symptoms (as listed above). The second step is to get a blood screening test done through your family doctor. There are 2 tests and either one or both will be performed (IgA-human tissue transglutaminase (TTG) or IgA-endomysial antibody (EMA)). You must be eating gluten to get an accurate test reading. Because this test is only 90% accurate, if you get a positive reading you will need to do step 3 which is a biopsy of the small intestine. Again, it is crucial that you are still eating gluten daily until you have this test done.

What is Gluten?

Gluten is the protein found in wheat, rye and barley and related grains spelt, kamut and triticale. In wheat the toxic fraction is gliadin. In cooking and baking gluten acts as a binding agent helping to prevent crumbling.

How do I treat Celiac Disease?

There is no known cure for celiac disease. The only treatment is the complete avoidance of all sources of gluten for life. A gluten free diet will allow your small intestine to heal, will eliminate the symptoms of diarrhea, constipation, cramping, weight loss, low iron and fatigue and will reduce your risk for osteoporosis and intestinal cancer.

Eating Gluten Free

When cooking at home, be aware of potential source of cross-contamination. A person with gluten intolerance should use their own toaster, butter dish, jar of peanut butter etc. Always ensure cutting boards, cooking surfaces and pans are clean and free of gluten.

At the grocery store, avoid the bulk bins. Look for the gluten free labels in the isles. Unprocessed fruits, vegetables, milk, cheese and meats are gluten free. Ask your local store of a list of their gluten free products.

Deli counters making sandwiches with regular bread would be potential sources of cross-contamination.

Restaurants using the same deep fryers for breaded items as gluten free items would also pose a risk.

Some Hidden Sources of Gluten

HVP (Hydrolyzed Vegetable Protein)

HPP (Hydrolyzed Plant Protein)

Malt

Spelt

Kamut

Some medications

Soups/broths

Deli meat

Sausages/hotdogs

Beer/ale/lager

Smarties, some chocolate, licorice

Imitation bacon bits

Sauces, marinades

Gravies

Seasonings

Soy sauce

Gluten Free Grains

Items made with amaranth, arrowroot, buckwheat, corn bran, corn flour, cornmeal, cornstarch, flax, legume flours (bean, garbanzo or chickpea, lentil, pea), millet, nut flours (almond, chestnut, hazelnut), potato flour, potato starch, pure uncontaminated oat products, quinoa, rice (black, brown, red, white, wild), rice bran, rice flours, sago, sorghum flour, soy flour, sweet potato flour, tapioca (cassava, manioc),taro, teff

Brands with Gluten Free Products (Note: always read the label)

Glutino (pancake mixes, crakers, cookies, cereal, muffin mixes),

Udi’s Healthy foods (breads, muffins, cookies, tortillas, pizza crusts, hamburger and hotdog buns, baguettes)

San Jay tamari and teriyaki sauces

Bob’s Red Mill (cereals and flours)

Eden Organics (canned beans, vegetables, tomatoes)

Olympic yogurts

Pacific organics (soups and broths)

Imagine (soups and broths)

Lundberg rice

Mary’s organic crackers

Kinnikinnick (frozen waffles, pizza crusts, English muffins)

So Nice Soymilk

For more information on Celiac Disease and eating Gluten-Free go to www.celiac.ca