Tag - celiac disease

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Celiac Awareness Month
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WIC & Gluten-Free Living

Celiac Awareness Month

By: Drs. Helen and Marty Linseisen

May is Celiac Disease Awareness Month. There is widespread misunderstanding and misinformation regarding Celiac Disease. Celiac Disease is not an allergy, sensitivity, or a lifestyle choice. Celiac disease is a serious genetic autoimmune disease that affects the digestive process of the small intestine. When a person with Celiac Disease consumes gluten, a protein found in wheat, barley, and rye, the individual’s immune system responds by attacking the small intestine, inhibiting the absorption of important nutrients into the body. Specifically, the tiny fingerlike projections called villi, on the lining of the small intestine, are destroyed.

Celiac Disease affects people differently. There are more than 200 signs and symptoms of Celiac Disease, yet some people with Celiac Disease have no symptoms at all. People without symptoms are still at risk for certain complications of Celiac Disease, such as cancer. Symptoms may or may not occur in the digestive system. For example, one person may experience diarrhea and abdominal pain, while another person displays infertility or anemia. Some individuals develop Celiac Disease as children, others as adults. Celiac Disease can affect men and women of all ages and races, and it is possible to be diagnosed with the disease at any age. Other symptoms of Celiac Disease include painful joints, fatigue, tingling/numbness in the legs, unexplained infertility or recurrent miscarriages, osteopenia, and psychiatric disorders.

Celiac Disease is more common than most people realize. An estimated 1 in 133 Americans, or 3 million people, have Celiac Disease. By comparison, Alzheimer’s disease affects approximately 2 million people. Unfortunately, it is estimated that up to 83% of Americans who have Celiac Disease are undiagnosed or misdiagnosed with other conditions. The average time a person waits to be correctly diagnosed is six to ten years. Most primary care providers have been taught that Celiac Disease is a rare condition and patients only have gastrointestinal symptoms. Lectures on Celiac Disease in medical schools, even today, are limited.

Patients with gastrointestinal symptoms should be tested for Celiac Disease. However, testing should be expanded to include patients with nongastrointestinal complaints, as less than 50% of patients present with classic gastrointestinal symptoms. Additionally, children older than 3 years of age, regardless of symptoms, should be tested if a close relative is diagnosed with Celiac Disease. Anyone with an automimmune disorder such as Type 1 diabetes, thyroid problems, Addison’s disease and genetic syndromes like Down’s syndrome should be tested periodically. Women who experience persistent miscarriages or infertility without a determined medical cause should be tested as well. Diagnosis of Celiac Disease initially requires blood tests to measure levels of certain antibodies. If antibody tests and/or symptoms suggest Celiac Disease, the diagnosis needs to be confirmed by an endoscopic biopsy procedure. 

The only treatment for Celiac Disease is a 100% gluten free diet for a lifetime, avoiding all foods that contain or come in contact with gluten. Ingesting any gluten, no matter how small an amount, can damage the small intestine even without having noticeable symptoms. The gluten free diet requires a completely new approach to eating that affects a person’s entire life. Individuals with Celiac Disease must be extremely cautious with each food or product purchased, where they eat and how the food is prepared. Gluten is often found in cosmetics, medications, household products, food fillers or thickeners, and many processed foods. Even if a product does not contain gluten, it may have gluten due to cross-contact which can occur at many stages of product production. Despite the increase in gluten free food options, many times foods labeled “gluten free” are not safe for those with Celiac Disease to consume. Frequently, food items are processed in facilities that produce wheat products, putting people at risk for cross contact. Thus, living with Celiac Disease has a significant lifestyle burden. Those with Celiac Disease report a higher negative impact on their quality of life than do people with Type 2 diabetes, congestive heart failure, hypertension, and inflammatory bowel disease.

Despite restrictions, people with Celiac Disease can eat a well-balanced healthy diet. The gluten free diet can seem overwhelming at first. Support and education are essential to avoid isolation, to foster safe inclusion in social gatherings, and to promote overall health. With time, patience, and guidance, living with Celiac Disease can become easier, with the ability to lead an active and healthy lifestyle. 

WIC & Gluten-Free Living

By: Nancy Segreto, BS, Nutritionist, Vermont Department of Health, Morrisville

WIC in Morrisville office recently offered a class on Gluten-Free Living in partnership with the Morrisville Co-op. WIC  provides nutrition education as well as healthcare referrals and supplemental foods for income-eligible pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five. WIC offers wellness classes and activities that are often open to the public, free of charge.

The class focused on simplifying the process of planning, shopping and cooking gluten-free, as well as sharing basic facts that could clear up common misconceptions. Participants played a ‘Fact or Fiction’ sorting game, sampled delicious healthy gluten-free foods and went home with mini binders filled with tips, recipes, planners and a free gluten-free cookbook for busy people on a budget.

What’s all the craze about eating gluten-free?

Why are so many people choosing to be gluten-free? Are gluten-free foods healthy? Is there a roadmap for navigating the myriad of gluten-free foods on the market? What is the difference between food allergies, celiac disease, and gluten sensitivity? How do we sort gluten-free fact from fiction?

Gluten is a protein found naturally in wheat, barley, and rye. It is also used as a filler to improve texture and is found in many processed foods. People who have been diagnosed with celiac disease or with non-celiac gluten sensitivity must follow a gluten-free diet. Currently, the only treatment for celiac disease or non-celiac gluten sensitivity (NCGS) is a gluten-free diet. Fortunately, a gluten-free diet will improve symptoms, according to a 2008 Journal of the American Dietetic Association (now Journal of the Academy of Nutrition and Dietetics) article.

How do you plan a gluten-free meal?

MyPlate is the latest USDA nutrition guide, a pie chart (plate) depicting a place setting divided into five food groups:  

  • 50% vegetables and fruits (mostly vegetables)
  • 20% protein
  • 30% whole grains, with additional healthy fats and dairy. 

To become gluten-free only the whole grains section needs to be adjusted, choosing grains such as quinoa, rice, millet, teff, and gluten-free oats instead of wheat, barley, and rye. WIC offers brown rice, corn tortillas, and gluten-free breakfast cereals as alternatives to whole wheat bread, whole wheat pasta and breakfast cereals made with gluten.

 

Traditional Diet Whole Grains Gluten Free Whole Grains
Wheat, barley, rye
Rice, quinoa, millet, teff, oats, corn Rice, quinoa, millet, teff, GF oats, corn
Baked goods- all (use sparingly) Baked goods with GF flour only (use sparingly)

 

Myths and Misconceptions

Avoid the gluten-free processed food traps! That chocolate cupcake is not good for you. Gluten-free processed baked goods usually have more sugars, carbohydrates, and additives than their wheat counterparts. These items should be used sparingly as a treat or when everyone else is eating the pizza or party cake, and the gluten intolerant person wants to join in.

If you suspect you have celiac or NCGS, experts recommend being screened by a healthcare provider. If you try a gluten-free diet, stick with whole foods and grains and use baked goods sparingly. The Celiac Foundation website has a wealth of resources. You can also check out the Morrisville Department of Health Facebook page for upcoming scheduled classes and events.