nutrition and Celiac Disease, answered by Melinda Dennis, MS, RD, of the Celiac Disease Center at Beth Israel Deaconess Medical Center. Ms. Dennis has herself had Celiac Disease for more than 17 years.
Q. What is it like for a person you see who is newly diagnosed with Celiac Disease?
A. The gluten-free diet requires more preparation, taking food with you when you travel, making sure that you are safe in dining-out situations or when you are visiting with family or friends. So for some, it is very simple and straight forward and they are already experimenting with new grains like amaranth, buckwheat, millet, sorghum, and teff. But some people are completely unfamiliar with these grains and it is a bit more of a stretch for them. Many people just eat on the run these days and this really makes it challenging.
Others are in complete denial. Perhaps they were having no symptoms but this was discovered through a blood test and they think – do I really need to change my life? Those are the people who, understandably, ask “how much can I get away with?” So there are all different types of people. But more and more people are coming into the clinic well educated about this because of the good information on the web. That’s a big change from about seven or so years ago when there were very few resources.
Q. There are many gluten-free foods on the market now. Does this make it easier for those diagnosed with Celiac Disease?
A. Yes. But it’s important to stress that the gluten-free diet isn’t just about what we need to take out of our meals, it’s about making sure the foods you do choose have lots of nutrients. Rice, corn and potatoes have a really high glycemic index, and they don’t have a lot of fiber. They can create food cravings. They can lead to weight gain and they are not nutritionally dense. So when we think of Celiac Disease, we think – how can we make up for the fact that we don’t have a very high protein wheat product any longer? What can we substitute and what would be superior? That’s when we work on educating about other grains that are healthier and have plenty of vitamins and minerals. Several of the gluten-free foods are now fortified with B vitamins, iron and trace minerals, and you can check the labels to make sure.
Q. It’s great there are more gluten-free options, but even reading the labels don’t always help. What items have hidden gluten?
A. Lots of things you wouldn’t expect contain gluten. Toothpaste can have gluten; you have to be careful to wash your hands carefully after feeding your dog because chow usually contains gluten. Dental pumice that is used to polish your teeth may contain gluten. Soy sauce, gravies and marinades are suspect. Even communion wafers. Patients need to be educated on all of this, because consistent exposure to gluten will lead to increased damage to the small intestine.
Q. Do most patients eventually adopt a healthy, gluten-free diet?
A. Most patients, even those who have a hard time with the diagnosis, do learn how to eat well. From my own experience, I feel it was actually a blessing to be diagnosed. It changed my life for the better. It empowered me to make the right decisions, to eat well—actually better than I had ever eaten before. I travel more now and experiment with tasty foods, more ethnic food, as well. So it’s a good thing to have a diagnosis—and learn the best ways to take care of your body and be healthy.
Above content provided by Beth Israel Deaconess Medical Center.
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