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Gluten
puts many foods off-limits for some
June 1, 2006
Suzanne Havala Hobbs
Imagine
that for the rest of your life, you couldn’t eat anything
that contained wheat, rye, oats or barley.
You couldn’t eat pizza crust, cookies, cake, pie, or
a dinner roll. No toast, no raisin bran, no biscuits. Even
the glue on the backs of postage stamps and envelopes might
contain tiny amounts of these forbidden grains.
About one out of every 100 people in this country –
including a few readers who have contacted me – have
celiac disease, an autoimmune disorder caused when the body
reacts to gluten, a protein found in several common grains.
A wide range of symptoms may include gas, chronic diarrhea,
fatigue, abdominal pain and bloating, anemia, smelly stools,
weight loss or gain, joint pain or muscle cramps, and many
others. There may also be no symptoms at all. The disease
can show up in children or adults.
Celiac disease is also called gluten-induced enteropathy or
nontropical sprue.
According to the National Institutes of Health, the prevalence
of celiac disease is ten times higher than estimates from
as recently as a few years ago. It’s likely that many
cases go undiagnosed or misdiagnosed due to lack of testing
and because symptoms may be attributed to other conditions.
Complications include damage to the intestines and malnutrition
that can lead to other diseases and conditions. There’s
no cure, and the only treatment available is diet.
The good news is that a gluten-free diet usually halts symptoms
and allows the intestines to heal over a period of months
or a couple of years. Painstaking care has to be taken at
all times, though, to keep any amount of wheat, rye, barley
– and usually oats – out of the diet. For example:
* Types of wheat, including spelt, triticale, and kamut, ancient
grains used more often these days in breakfast cereals and
natural foods products, must be avoided.
* Residual bits of off-limits grains can hitchhike onto corn
or rice products made in factories that also process other
grains. Common ingredients such as modified food starch and
other additives used in processed foods may also contain tiny
amounts of gluten. Looking for foods labeled “gluten-free”
is one way to avoid hidden sources of gluten.
* Gluten is used in some medications and supplements. A pharmacist
can guide you to gluten-free products.
* Special care is needed when eating out, since foods in cafeterias,
restaurants, and at other peoples’ homes usually don’t
come with ingredient labels.
It’s a challenge to eat a gluten-free diet, no doubt
about it. But it’s not impossible. In fact, you can
get all the nutrients you need on a diet that excludes all
sources of gluten.
What’s left if you don’t eat wheat, rye, oats
and barley?
For starters, people with celiac disease can eat rice, buckwheat,
amaranth (another ancient grain) and quinoa. Potatoes, soybeans
and other dried beans can also be used to make flours that
can be substituted for wheat in recipes. Health food stores
and other specialty food stores carry these products, and
some are even sold in conventional supermarkets now.
Fruits, vegetables and meat or fish with no added sauces or
breading are also gluten-free.
If you are diagnosed with celiac disease, you’ll need
a referral to a registered dietitian for individualized counseling.
You’ll also need reliable sources of information about
common and hidden sources of wheat, rye, oats and barley,
tips for recipe substitutions, and advice on eating out. Two
good online resources: http://www.nlm.nih.gov/medlineplus/celiacdisease.html
and http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/.
And take heart in knowing that if you do have celiac disease
– or any other food intolerance – you have more
resources and options today than ever before.
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