Now that your known one has been diagnosed with celiac disease, it is quite natural that you would want to know more about this disease. You may think it is a rare disease as you have not heard about it until now, but let me tell you that it is widely prevalent in different parts of the world including India as well.
What is Celiac Disease?
Celiac disease is an autoimmune inflammatory disease of the small intestine. It occurs due to an allergic reaction to gluten, which is protein contained in cereals such as wheat, barley, and rye. As wheat is the major cereal with gluten, the disease is generally known as wheat allergy.
A defect in the enzyme system that splits gluten along with atrophy of the jejunal mucosa may be a specific cause for the celiac disease.
Symptoms of Celiac Disease
- Loss of appetite
- Abdominal pain
- Stools are large, pale and offensive due to the presence of fat
- Anemia (low hemoglobin level) due to Celiac disease may lead to paleness, fatigue, fast pulse.
- Flattening of the villi (villi’s task is to absorb the nutrients and vitamins which can then be used by the body. Destruction of the villi will interfere with the body’s ability to digest and absorb nutrients from the food that we eat. This leads to deficiencies of various macro (calories/proteins) and micro (iron, Vitamins D, Vitamin B12) nutrients.
- Neurologic disorders including epilepsy, cerebral calcifications, and neurological neuropathy.
- Celiac disease for a long period may lead to malnutrition and complications like osteoporosis, seizures, and convulsions.
What is the treatment for this disease?
Once the diagnosis of celiac disease is confirmed, there is one and only known treatment of the disease and that is lifelong avoidance of gluten from the diet/ to follow a gluten-free diet.
A Gluten-free diet contains no gluten. Avoidance of gluten involves the complete omission of wheat (atta, suji, maida), rye, barley and all products like bread, breakfast cereals, pooris, paranthas, macaroni, noodles, biscuits, cakes, pastries, halwa, chocolates, etc. made from the above ingredients. These ingredients are often used as binding or thickening agents in various ready to eat foods, like sauces, kulfi, etc and hence must be avoided. The hidden sources of gluten include additives, preservatives, and stabilizers found in processed food, medicines, and mouthwashes.
Benefits of Following a Gluten-Free Diet
- Improves symptoms of celiac disease
- Heals intestinal damage – In celiac disease, eating gluten triggers an autoimmune response which leads to the destruction of the villi, where nutrients are absorbed. Therefore, eliminating gluten prevents the autoimmune response, heals the intestine and prevents further damage.
- Improves nutrient absorption – Destruction of the villi leads to nutrient deficiencies due to poor absorption. Various studies conducted have shown that a gluten-free diet heals the intestine, which can then properly absorb the macro and micro-nutrients. Efficient absorption of nutrients reduces the risk of iron deficiency anemia and osteoporosis.
Dietary Information and Tips for Celiac Patients
The following should be kept in mind for individuals with Celiac Disease
- There is no known cure for the disease at present. The only treatment is dietary management.
- The disorder can be in control by avoiding the food items which contain gluten.
- The person with celiac disease cannot be given wheat, barley, rye or any other food product/item containing any of these ingredients – not even in minute quantities.
- Always read the food label before buying any commercial food.
- Be very careful when you eat out. It is always better to eat pack something from the home or ask the waiter/chef before ordering ant food. Even traces of gluten in the food can be harmful to the person with Celiac Disease.
- Make sure to continue with the supplements/medicines which have been advised by the dietician/doctor along with the gluten-free diet.
- Take good of small school-going children. It is always better to speak with the concerned authority and teachers, informing them about the disorder and hence the reason for not sharing the food.
Guidelines on flours
- Do not buy readymade flours as they may be contaminated.
- Never accept a flour from any shop or flour mill when unsure if wheat is been grounded in the other grinder.
- Use Mixer/Grinder or Masala grinder at home to make flours with various gluten-free grains.
Wheat Flour Substitutes (home-made) Permitted in Celiac Disease
- Corn flour (Makki ka atta)
- Pearl Millet( Bajra ka atta)
- Buckwheat (Kuttu ka atta)
- Water Chestnut Flour (Singhare ka atta)
- Gram Flour
- Ragi Flour
- Amaranth Flour
- Soybean Flour
- Finger Millet Flour
- Arrowroot Flour
- Potato Powder
- Almond Flour
Foods that can be included are-
- Animal proteins: chicken, dairy products, eggs, seafood, mutton.
- Fats and oils: soyabean oil coconut oil, olives, oil, mustard oil, solid fats, and butter.
- Fruits and vegetables: In any form, including fresh, frozen, dried, or canned.
- Gluten-free cereals and pseudocereals: Amaranth, buckwheat, corn, millets, quinoa, rice, sorghum.
- Herbs and spices: All fresh and dried herbs and spices are naturally gluten-free and can be enjoyed liberally.
- Legumes: Beans, lentils, peanuts, peas, and soy.
- Nuts and seeds: Any type, including almonds, cashews, chia, flax, pecans, pine nuts, and walnuts.
Foods To Avoid
- Grains – Wheat, barley, oatmeal and other food items made from wheat flour (semolina, vermicelli, etc.)
- Prepared Food – Noodles, pasta, cakes, bread, bread-roll, pizza, bread crumbs, soup-sticks, oatmeal, commercial juices, cakes, refined flour products, etc.
- Snacks – Patty, burger, biscuits, cutlet, etc.
- Some beverages: Beer and other malted beverages.
Foods often containing cross-contaminated gluten include:
- Commercially fried foods: Many cafes/restaurants/hotels fry foods in the same fryer, which can contaminate gluten-free items like French fries.
- Improper handling of the gluten-free items at cafes: Gluten-free items should be prepared with designated gluten-free equipment and a clean pair of gloves.
- Oats: Oats are often processed in the same machine as gluten-containing grains and therefore, may get contaminated. It is hence, necessary to consume oats that are specifically labeled gluten-free.
Few Gluten-Free Snacks that can be included in the Diet are:
1. Gram Pancake
Pancakes are a perfect dish to be served as breakfast or an evening snack. Bengal gram flour is rich in protein and the addition of grated carrots, spinach, onion, and tomato will provide adequate amounts of vitamins and minerals, making it a wholesome dish for a celiac patient. One can also replace Bengal gram with either buckwheat or pulses. Serve it with green chutney.
2. Soya Tikkis
Soya Tikki is easy to make and a perfect meal to carry in the lunch box. Soya granules will provide the required amounts of protein. Along with this, you can add any green leafy vegetables such as amaranth leaves/spinach, this will provide iron, calcium, and manganese. Addition of carrots and peas will provide additional nutrients making it a perfect gluten-free snack served with mint and coriander chutney. You can also replace soybean granules with sago.
3. Millet / Cornflour ki Roti
Pearl Millet is rich in iron and is free of gluten; therefore it can be easily used to make chappatis rather than using wheat flour. To make it more palatable, you can fill it up with potato/grated carrot/paneer and some spices and condiments. This Indian bread can serve for the lunch along with a sabzi, chutney, curd or pickle. For variety, you can use ragi and cornflour instead of pearl millet for gluten-free Indian bread.
4. Mix Veg Fritters
Mix Veg Fritters makes a delicious snack for either mid-morning or evening snacks. Gluten-free pakoras can be made with Bengal gram flour, onion, spinach, ginger, radish leaves, and salt. All the above ingredients will provide the required amounts of macro and micronutrients.
Having a gluten-free diet can be burdensome for those who have gluten-related illnesses, such as Celiac Disease. There are many foods that have to be avoided and cautioned about, and it can be challenging to know how to put the food items together to make a nutritious and healthy meal. But one must not get disheartened as with proper guidance and knowledge following a gluten-free diet would not be difficult.