Why Not Eat Gluten?

By: Amanda Markie, MS, RDN, LD

Celiac disease is an autoimmune disease that affects one in one hundred people worldwide. The disease occurs when the consumption of gluten causes damage to the small intestines. With those individuals affected by celiac disease, continued consumption of gluten can cause long-term issues including; decreased absorption through damaging the villi (finger-like projections in the small intestines), osteoporosis, some thyroid disorders, and onset of other autoimmune diseases.

Some common symptoms of celiac disease include the following:

• Abdominal cramping
• Chronic diarrhea
• Constipation
• Fatigue and irritability
• Vomiting
• Delayed growth and short stature in children
• Attention Deficit Hyperactivity Disorder (ADHD)
• Infertility issues in adults
• Seizure disorder
• Depression and anxiety
• Osteoporosis or osteopenia

Both men and women can suffer from celiac disease, and there are several risk factors that increase an individual's chances of having celiac disease. You may be at increased risk if you have a biological relative with celiac disease, a other autoimmune disease, or if you are a carrier of one of two specific genes (HLA-DQ2 or HLA-DQ8). It is important to remember that having these risk factors increases your chance of having celiac disease, but does not indicate that you do suffer from the disease. Interestingly a person can be a carrier of the gene indicating risk for celiac disease, but may never develop celiac disease. For a genetic carrier to develop celiac disease there must also be an environmental trigger like a stressful event, illness or even pregnancy.

A person can be diagnosed with Celiac disease through several different tests which can include either a blood test or a biopsy of the small intestines. When a person is diagnosed with celiac disease there is no cure for this illness. Instead treatment includes lifestyle and dietary adjustment to avoid gluten in one’s diet. 

Gluten is a protein found in wheat, barley and rye. Gluten is useful in the food industry acting as a glue that binds food and helps hold structure. Common places a person may find wheat include breads, pastas, baked goods, cereals, salad dressings and roux. Barley is most commonly seen in the form of malt, beer, soups, and food coloring. The final form of gluten, rye, is found within rye and pumpernickel breads, rye beer and some cereals.

Individuals affected by celiac disease it can be important to check products for hidden forms of gluten. Keep in mind gluten can be used in medications, candy, soy sauce, potato chips and processed lunch meats. Cross contamination can also be an issue through transfer of gluten on cooking surfaces or appliances like cutting boards, toasters, frying baskets, and colanders. 

If you are struggling with celiac disease, seeing a Registered Dietitian can help to improve your ability to make lifestyle and dietary choices through proper education. Most importantly is starting to understand what hidden gluten sources may be in your diet. Not only can nutrition counseling identify those hidden gluten sources, but you can also learn how to make healthful substitutions and ensure you are meeting your nutritional needs.

Amanda Markie, MS, RDN, LD is a dietitian at the University of Maryland Baltimore Washington Medical Center’s Digestive Health Center and can be reached at 410-553-8187.