Gluten-free (GF) foods are everywhere. Some of our fave recipes these days are based on ingredients like millet and almond meal — things we probably hadn’t heard of before GF products went mainstream. The growth of the GF food market is especially important for people living with celiac disease, who are unable to eat any foods containing gluten. According to recent estimates, around 2.5 million Americans are walking around with undiagnosed celiac disease. The invisible chronic illness can trigger a range of other health issues if left untreated, so it’s crucial to familiarize yourself with the signs and symptoms.
What is celiac disease?
Celiac disease is an autoimmune condition. This category of diseases, which has been gaining awareness thanks to celebs like Zoe Saldana and Selena Gomez, is characterized by the immune system mistaking healthy cells for bad ones, and attacking them as it would an infection.
For people with celiac disease, this “autoimmune response” is triggered by ingesting gluten. Any amount of gluten — even traces — can set off this response. With celiac disease, the autoimmune response targets the small intestine. That’s especially problematic because the damage can make it harder for people with celiac disease to absorb certain vitamins and minerals.
There’s no cure for celiac disease, and the only existing treatment option is following a strict gluten-free diet. Eliminating gluten will prevent the disease from causing any further damage, and will allow gut health to improve. An autoimmune response is only triggered by dietary sources of gluten, so there’s no need to seek out GF beauty products or skin care, for example.
Symptoms AND DIAGNOSIS
Pinning down a celiac disease diagnosis can be tricky. In some cases, there may be no noticeable symptoms for many years. Others may have symptoms that mimic another condition. Adult symptoms of celiac disease are different than childhood ones, and they include a broad range of digestive and other issues.
1. Digestive Symptoms: Nausea and vomiting, abdominal pain, bloating and gas, heartburn and acid reflux, and troublesome bowels (usually diarrhea, but constipation and other out-of-the-ordinary number twos can also occur).
2. Other Symptoms: Headaches, fatigue and brain fog, joint pain, skin rashes, nutrient deficiencies, weight loss, osteoporosis, mouth ulcers and dental enamel defects, issues with the liver and spleen, mental health issues like anxiety and depression, and more.
Celiac disease is genetic, so if a family member has a confirmed diagnosis, tell your doctor. Some have even figured out the cause of their symptoms after having a genetic variant flagged by an at-home DNA testing services like 23andMe. (These tests can’t confirm a diagnosis, but may provide a helpful roadmap for your doctor.)
If your doctor suspects that you may have celiac disease, they’ll probably order a blood test. The test only works if you have gluten in your system, so if you’ve been following a GF diet for another reason (for example, to reduce symptoms associated with endometriosis), this may not be your best option. Depending on your blood test results, your doctor may recommend a biopsy to confirm the diagnosis.
Anne R. Lee, EdD, RDN, LD is an instructor in nutritional medicine at Columbia University Celiac Disease Center. She previously worked at Schär USA, a company known for their gluten-free food products. Lee explains that, on a gluten-free diet, it’s especially important to make food choices that satisfy your daily nutritional requirements.
Before the recent growth of the GF market, many of the products available to consumers with celiac disease did not deliver the same nutritional value as their gluten-containing counterparts. “One study reported that a traditional gluten-free diet did not meet the daily recommended values for folate, thiamine, calcium, iron, and fiber,” Lee says. “Of concern is the low levels of folate and iron for young women on the gluten-free diet.”
Anyone who’s hunted for celiac-friendly options in a non-specialty grocery store has seen GF foods pretending to be healthy. In some cases, bread might have been dressed up to *look* more like a whole wheat loaf, but the fiber content listed told a different story. “Traditionally, many gluten-free products have relied on white rice, potato, and tapioca starch,” Lee says. “These products often had higher sugar, salt, and fat content than their wheat-based counterparts.”
Newer products, on the other hand, use whole and ancient grains, like oatmeal and quinoa. Lee explains that these ingredient swaps make it easier to hit your daily nutrient targets on a gluten-free diet. Additionally, she says, “Some manufacturers have also started to fortify their products to provide the missing nutrients.”
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