Living with Celiac
Judy Seybold, MS, RDN, LD, CLC
Chief Nutrition Officer
Celiac disease, sometimes called celiac sprue, is an immune reaction to eating gluten that leads to damage in the small intestine. Gluten is a protein found in wheat, rye, and barley. Eating gluten, in genetically predisposed people, can trigger an immune response that creates inflammation. This inflammation can damage the intestinal lining and prevent the absorption of some nutrients.
Screening for celiac disease is done through a simple blood test that looks for a higher than normal level of antibodies. These antibodies are produced as a result of the body’s perception of gluten as a threat. An intestinal biopsy may also be done to confirm the diagnosis.
Ingestion of gluten in people with celiac disease causes symptoms such as bloating, gas, fatigue, and anemia. Currently, the only treatment for celiac disease is lifelong adherence to a strict gluten-free diet. People living gluten-free must avoid foods with wheat, rye, barley, and sometimes oats.
Shop Sifter for gluten-free products
Foods to include:
- Beans, legumes, and nuts
- Dairy
- Fish and seafood
- Fruits
- Meat and poultry
- Vegetables
Some grains, starches and flours can be included in a gluten-free diet:
- Amaranth
- Arrowroot
- Buckwheat
- Corn and cornmeal
- Flax
- Gluten-free flours (rice, soy, corn, potato, bean)
- Hominy (corn)
- Millet
- Quinoa
- Rice
- Sorghum
- Soy
- Tapioca (cassava root)
- Teff
Foods to avoid:
- Barley
- Malt
- Oats (unless specified gluten-free)
- Rye
- Wheat (all types)
Reading Labels
Read labels while shopping. Gluten-free products will often state the product is free from gluten on the package. Look for gluten-free certification on the label. Watch out for the following gluten-containing ingredients that are commonly found in products such as flour, bread products, pasta, breakfast cereals, cakes, and cookies:
- Breadcrumbs
- Bulgur
- Cereal extract
- Couscous
- Durum, durum flour, durum wheat
- Emmer
- Einkorn
- Farina
- Flour (all wheat types)
- Kamut
- Semolina
- Spelt
- Sprouted wheat
- Triticale
- Vital wheat gluten
- Wheat (bran, germ, gluten, grass, malt, starch)
- Whole wheat-berries
Healthy Eating Tips
People with celiac disease may be prone to nutrient deficiencies due to exclusion of foods and malabsorption. It’s important to get enough B-vitamins, iron, and fiber. Make sure to choose enriched, whole-grain, gluten-free products when possible. Consider taking a gluten-free multivitamin and mineral supplement.
When eating out, look for gluten-free menu items or ask detailed questions about food preparation to avoid cross-contamination of gluten. Plan ahead and view restaurant menus online to determine your best options or call before visiting. Talk to your doctor or dietitian for more information on a gluten-free diet.
Adhering to a strict gluten-free diet is a lifelong necessity for people with celiac disease. Proper diet and avoiding cross-contamination results in fewer symptoms and complications of celiac disease.
Additional Resources
Academy of Nutrition and Dietetics
Celiac Disease Foundation
National Celiac Organization