Celiac Disease is a unique auto-immune disorder affecting approximately .5-1% of the population in the United States, a rate which is estimated to be occurring similarly throughout the wheat-eating populations of the world, although largely undiagnosed.
Previously called celiac sprue, similar to tropic sprue, symptoms of Celiac disease include diarrhea, emaciation, aphthous stomatitis, fatigue, iron-deficiency anemia, osteoperosis, and malabsorption, primarily in reaction to gluten intolerance. (It should be noted this is separate from wheat allergy.)
Doctors note that there are a number of contributing factors to the development of celiac disease – environmental factors such as the introduction of gluten in a child before 4 months of age is associated with an increased risk of development, as well as genetic factors, such as a family history of the disease, or the presence of Down syndrome, Turner’s Syndrome and Type 1 Diabetes. Generally, two or three times as many women as men are affected.
What is gluten? As gluten is the major storage protein of wheat and other grains, (present in wheat, barley and rye, and responsible for the chewiness of bread) it is essentially ubiquitous, and the adoption of a gluten-free diet can be a difficult and costly endeavor for many. In many European nations, costs are off-set by state subsidization of gluten-free products. Unfortunately, we’re not so lucky in North America, and countless sufferers of celiac disease are unable to main the diet, owing to factors such as expense, lack of access and the poor palatability of gluten-free products.
Beyond that, many are generally unaware, owing to absence of symptoms, that they suffer from the disease, and may also possess inadequate or incorrect information about the diet itself.
The Specific Carbohydrate Diet was developed in the 1920s, a precursor to the gluten-free diet, to treat children with celiac disease. Focuses on consumption of whole foods
Many of those affected by Celiac disease are also lactose intolerant. The Specific Carbohydrate Diet eliminates high lactose dairy, but allows low-lactose or no lactose dairy.
A gluten-free diet emphasizes using ground, blanched almonds as an alternative to flour in recipes, and even instead of mixing alternative flours. Many health-stores sell ground almonds in bulk, and it’s possible to reduce the cost even further by
buying almond flour on line.
Nuts in general are a great source of fibre and healthy, unsatured fats, which aid the body in absorbing vitamins, the regulation of body temperature, and hormone production.
Anyone on a gluten-free diet would do well to avoid processed and pre-packaged foods, sticking mainly to whole foods, such as fruits, vegetables, fish and meat.
Many over-the-counter medicines, prescriptions, vitamins and even cosmetics contain gluten, and must be avoided.
Avoid oats – though they don’t contain gluten, it’s been recently discovered that avenin, a naturally-occurring protein that closely resembles gluten is present in them, and also causes mucosal information in those afflicted with celiac disease.
Many foods in the United States do not list gluten as an ingredient, as it has been labeled GRAS (Generally Recognized As Safe) by the FDA, and some foods labeled gluten-free were in fact not. Tougher standards and legislation are in the works, however.
Generally, all distilled forms of alcohol are considered gluten-free (such as wine, sherry, port, rum, tequila, bourbon, and vermouth), provided they have no added colourings or additives. Avoid beer, liqueurs and pre-mixed drinks.
Sandy Dench is a nutritionist and lives in Manhattan.
