Coeliac disease is a disorder involving the small intestine caused by an immune response to gluten. The ingestion of gluten by coeliac disease sufferers causes the body to mount an attack (anti-bodies) against the proteins found in gluten. This attack results in damage to the cells lining the intestine, flattening the surface and impairing absorption of nutrients. People with coeliac disease must strictly avoid all sources of gluten.
Common symptoms of coeliac disease may include:
- Gastrointestinal symptoms eg diarrhoea, constipation, bloating, alternating bowel habits, nausea, abdominal pain
- Fatigue and changes in mood
- Unexplained changes in weight
- Anaemia and nutrient deficiencies
- Skin rash
- Bone and joint pain
If you have been recently diagnosed with coeliac disease or simply looking for some gluten-free dietary help, below are my top tips on how to eat around the problem.
- Remove all sources of gluten from the diet and replace with gluten-free alternatives
Gluten containing grains to be excluded may include:
- wheat, rye, durum wheat, barley, some oats, spelt, kumut, semolina, couscous, bulgur and triticale.
Gluten-free options may include:
- buckwheat, quinoa (seed), amaranth, rice, rice noodles, corn meal/polenta, millet, besan flour, sorghum, sago, lentils/legumes, teff, lupin and uncontaminated oats.
Hidden sources of gluten – to be cautious of:
- soy sauce, malt extract, thickeners, breadcrumbs, sausages, curry powders, batters, yeast extracts, soy milk, malt vinegars, beer, licorice, baking power and icing sugar.
- Correct nutritional deficiencies due to malabsorption
Damage to the intestinal surface can result in malabsorption of nutrients and minerals. The most common deficiencies observed in coeliac disease are iron, calcium and magnesium. Getting tested for deficiencies is important to determine whether supplementation is warranted. Nonetheless, having a diet rich in iron, calcium and magnesium can assist to overcome further deficiencies. Aim to include a variety of the below in your diet:
- Iron: red meat, almonds, apricots, parsley, soybeans – tip: try eating iron rich foods alongside vitamin c for increased absorption.
- Calcium: dairy, almonds, broccoli, buckwheat, salmon bones, soybeans, green leafy vegetables.
- Magnesium: almonds, eggs, figs, mineral water, soybeans, cashews, cocoa and green leafy vegetables.
- Support the immune system with an anti-inflammatory diet
Exposure to gluten in people with coeliac disease results in constant stress on the immune system. As you would have learnt in last weeks article this can lead to inflammation within the body. Coeliac disease sufferers may benefit from enjoying an anti-inflammatory diet. In summary this means eating a diet rich in:
- Salmon, small white fish (whiting or snapper)
- Avocado, tahini, nuts and seeds, macadamia nut oil
- Legumes, chickpeas, tempeh
- Green leafy vegetables
- Bright coloured vegetables (capsicum, sweet potato, carrot)
- Fruits (kiwi, strawberry, berries, red grapes)
- Spices and herbs (coriander, ginger, garlic, turmeric)
For more information on anti-inflammatory diets read here (link to last weeks article).
- Repair and support the gastrointestinal tract
As coeliac disease causes damage to the small intestines and gastrointestinal tract generally supporting healthy repair is important. When it comes to gut repair, two important dietary inclusions to pop on the plate are glutamine and zinc:
- Glutamine is an amino acid and is the main energy source of intestinal cells and is found in beans, cottage cheese, dairy, legumes and most protein sources (eg chicken, fish, red meat).
- Zinc is a mineral important for maintenance of the gastrointestinal tract, foods rich in zinc include; red meat, oysters, seafood, pumpkin seeds, egg yolks and capsicum.
Confidence in the kitchen
We all know a confident chef is a happy chef! To help ensure the food you prepare is gluten-free, follow these tips:
- Use separate cutting boards, knives and cooking utensils
- Make sure appliances such as toasters are clean before preparing gluten-free foods
- Clearly label gluten free products are store in separate containers
- Avoid contaminating dips and spreads with knives/forks used to pick up gluten containing foods
- Read labels: If a food label says “gluten free” it must contain no detectable gluten and should be a safe pick. Look out for ‘may contain traces of gluten’ as this will not an ok option.
Finally, just because you must avoid doesn’t mean you have to miss out on all the yum! Try my individual gluten-free blueberry clafoutis or salmon and parmesan fritters, you will be pleasantly surprised by how easy and delicious cooking gluten-free can be!