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What is Celiac Disease?
Celiac Disease is a genetic autoimmune condition affecting about 1 in 100 people. Following a strict gluten free diet is the only treatment. With over 200 symptoms spanning mental and physical health, often resembling other conditions, Celiac Disease goes frequently undiagnosed or misdiagnosed for an average of 6 to 10 years. Undiagnosed or poorly managed Celiac Disease can lead to additional autoimmune disorders and adverse health outcomes.
Understanding Celiac disease
For individuals with Celiac Disease, ingestion of gluten - a protein found in wheat, barley, and rye - triggers an immune response. This response leads the body to attack the lining of the small intestine. Extended exposure to gluten results in the flattening the villi that lines the small intestines, which leads to chronic inflammation, impaired absorption of essential vitamins and minerals, and various systemic symptoms.
SYMPTOMS
- Diarrhea
- Constipation
- Vomiting
- Joint pain
- Skin disorders
- Depression/anxiety
- Failure to thrive
- Malnutrition
- Anemia
- Bloating
- Gas
- Fatigue
- Dental defects
- Migraines
- Brain fog
Untreated celiac disease complications
Persistent damage to the villi and small intestines can increase the risk of developing:
- Malnutrition/stunned growth
- Chronic fatigue
- Dermatitis herpetiformis
- Dental complications
- Vision complications
- Infertility
- Pregnancy complications
- Certain cancers
- Central/peripheral nervous system disorders
- Neurological disorders
- Type 1 diabetes
- Multiple sclerosis
- Thyroid disease
- Arthritis
- Bone/joint pain
What is Gluten?
Technically, “gluten” is the general name for the series of proteins found in grains. Different grains have different gluten proteins that react differently in the body, when consumed, and behave differently, when used, in food and non-food products. Even though “gluten” is a general term, it is universally used in reference to the specific proteins found in wheat, barley, and rye.
Certified Gluten Free
According to the FDA, foods that are labeled “gluten free” are either naturally gluten free or do not contain more than 20 parts per million (ppm) of gluten. The general “gluten free” label is voluntary while “certified gluten free” labels are issued from 3rd party organizations that require rigorous and ongoing record keeping, testing and audits. These organizations can be trusted. All the companies that are certified follow strict protocols and are audited annually.
3rd party organizations
- Gluten Free Certification Organization (GFCO) from Gluten Intolerance Group (GiG)
- NSF from NSF International
- Gluten Free Certification Program (GFCP) from Beyond Celiac
- Gluten Free Food Program (GFFP)
- Association of European Coeliac Societies (AOECS)
oats
Someone with Celiac Disease must only consume oats that have been tested, by an independent 3rd party testing organization, to be gluten free and labeled as such. Due to the way oats are milled and processed, often in the same fields and facilities as wheat, barley, and rye, cross-contact with gluten is very common, challenging their gluten free status.
Where is Gluten?
You can find gluten free versions of everything listed, it just takes some research
Common sources of gluten
Dishes: Pizza, Gnocchi, Dumplings, Fish and Chips, Onion Rings, Meatloaf, Meatballs, Matzo, Tempura
Pastas: Ramen, Udon, Egg Noodles, Ravioli, Lasagna
Breads: Cornbread, Pita, Sandwich Bread, Hamburger/Hot dog Buns, Croutons, Stuffing, Bread Crumbs, Flour Tortillas, Bagels, Breadsticks
Baked Goods: Pies, Cakes, Muffins, Croissants, Cookies, Brownies, Quiche, Biscuits, Doughnuts, Pastries
Breakfast: Pancakes, Waffles, French Toast, Crepes, Cereal, Granola, Oatmeal
Drink: Beer
Snacks: Pretzels, Crackers
Possible hidden sources of gluten
- Soups, gravies & sauces: oyster sauce, teriyaki sauce, soy sauce
- Salad dressings & marinades
- French Fries - shared friers
- Potato chips, tortilla chips
- Energy bars, including versions with non-certified oats, granola
- Play-dough
- Processed lunch meats, meat alternatives, imitation seafood, pre seasoned meats
- Malt in all forms, but not maltodextrin
- Beer Alternatives, dessert wines, teas with added flavors, energy drinks
- Ice Cream, “Natural Flavoring,” some caramel color
- Protein Powder
Gluten Free Kitchen
After receiving a Celiac Disease diagnosis, it is important to create a safe space for cooking and enjoying meals
Tips for handling food in a shared kitchen
- When possible use Squeeze bottles for condiments, mayonnaise, mustard, relish, honey, jelly, making sure to not touch the gluten containing food with the tip
- Have separate containers of other spreadable or spoon dipped foods: peanut butter, hummus, jarred jams, jarred honey, butter, cheeses, dips, salsa, guacamole, yogurt
- Buy single serving packets of food: hummus, guacamole, yogurt, crackers, popcorn
- Wash hands before and after handling food, especially gluten containing food/ingredients
Kitchen items that may be shared
- Glasses
- Metal Silverware
- Metal & Glass Bowls
- Non-Porous Plates and Mugs
- Stainless Steal Pans
Kitchen Items to keep Separate
Gluten is very “sticky” and cannot be completely removed from certain surfaces. It is advised to invest in new versions of these items and use them only for preparing and serving gluten free food:
- Cutting Boards
- Strainers
- Toasters
- Baking Pans
- Wooden Utensils/Spatulas
- Plastic Utensils/Spatulas
- Sifters
- Rolling Pins
- Grooved Pans
- Non-Stick Pans
- Cast Iron Pans
- Waffle Irons
- Counter-top Grill Press
- Pizza Stone
- Sponges/Rags
- Plastic Storage Containers
Going to a Restaurant?
Going out to eat and needing to follow a strict gluten free diet, can be hard, but it can be done. You need to be your own advocate and use your best judgment when choosing what and where to eat outside the home. Clearly communicate your needs and decide for yourself if you feel comfortable eating the food. Other people’s opinions and experiences can be helpful but do not guarantee a safe experience and restaurants/people can make mistakes.
Go online
- Utilize review apps like “Find Me Gluten Free,” “Allergy Eats”, “Gluten Dude” and “Yelp” for reviewed restaurants that are near you
- Most restaurants have a copy of their menu on their website. Look and see if there are items that are marked gluten free (GF), if there is posted allergen information and/or verbiage outlining their ability to make substitutions and/or ability to prepare and serve food for people with dietary restrictions
Call Ahead
Ideas to consider during your call:
- Is there a dedicated fryer for french fries and other gluten free fried food?
- Are there dedicated gluten free food prep areas, storage, cooking areas and equipment to prevent cross-contact with gluten?
- Are fresh gloves used when handling gluten free food?
Speak with your server
- When you have arrived at the restaurant, even if there is a note on your reservation, politely let your server know about your dietary needs
- If food can’t be verified to be gluten free, it should be avoided all together, not just put on the side
- When your food arrives, double check that it is what you ordered and that all of your gluten free requests have been taken care of
- If there is any doubt speak with your server
Recipes
Ideas for Home Cooking:
Affiliates
Baking & Accessories:
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