Question: What to do for Celiac Disease ?
Answer: Eating, diet, and nutrition play a significant role in treating celiac disease. People with the disease should maintain a gluten-free diet by avoiding products that contain gluten. In other words, a person with celiac disease should not eat most grains, pasta, and cereal, and many processed foods.
People with celiac disease can eat a wellbalanced diet with a variety of foods. They can use potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour. They can buy gluten-free bread, pasta, and other products from stores, or order products from special food companies. Meanwhile, "plain"meaning no additives or seasoningsmeat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat these foods.
In the past, health care providers and dietitians advised people with celiac disease to avoid eating oats. Evidence suggests that most people with the disease can safely eat small amounts of oats, as long as the oats are not contaminated with wheat gluten during processing. People with celiac disease should talk with their health care team when deciding whether to include oats in their diet.
Eating out and shopping can be a challenge. Newly diagnosed people and their families may find support groups helpful as they adjust to a new approach to eating. People with celiac disease should
- read food labelsespecially canned, frozen, and processed foodsfor ingredients that contain gluten - avoid ingredients such as hydrolyzed vegetable protein, also called lecithin or soy lecithin - ask restaurant servers and chefs about ingredients and food preparation inquire whether a gluten-free menu is available - ask a dinner or party host about glutenfree options before attending a social gathering
Foods that are packaged as gluten-free tend to cost more than the same foods containing gluten. People following a gluten-free diet may find that naturally gluten-free foods are less expensive. With practice, looking for gluten can become second nature.
The Gluten-free Diet: Some Examples
The Academy of Nutrition and Dietetics has published recommendations for a glutenfree diet. The following chart illustrates these recommendations. This list is not complete, so people with celiac disease should discuss gluten-free food choices with a dietitian or health care professional who specializes in celiac disease. People with celiac disease should always read food ingredient lists carefully to make sure the food does not contain gluten.
Table 1. Gluten-free foods and foods that contain gluten
Foods and Ingredients That Contain Gluten barley rye triticale (a cross between wheat and rye) wheat, including - including einkorn, emmer, spelt, kamut - wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein brewer's yeast dextrin malt (unless a gluten-free source is named, such as corn malt) modified food starch oats (not labeled gluten-free) starch Other Wheat Products That Contain Gluten bromated flour durum flour enriched flour farina graham flour phosphated flour plain flour self-rising flour semolina white flour Processed Foods That May Contain Wheat, Barley, or Rye* bouillon cubes brown rice syrup candy chewing gum chips/potato chips cold cuts, hot dogs, salami, sausage communion wafers french fries gravies imitation fish matzo and matzo meal rice mixes sauces seasoned tortilla chips self-basting turkey soups soy sauce vegetables in sauce *Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer. Food Products and Ingredients Made from Barley* ale beer malt malt beverages malted milk malt extract malt syrup malt vinegar other fermented beverages porter stout *People should only consume these foods if they are labeled gluten-freesuch as sorghum-based beeror they list a grain source other than barley, wheat, or ryesuch as corn malt. Foods That Do Not Contain Gluten amaranth arrowroot buckwheat cassava corn flax legumes lentils millet nuts oats (labeled gluten-free) potatoes quinoa rice sago seeds sorghum soy tapioca tef (or teff) wild rice yucca
Food Labeling Requirements On August 2, 2013, the U.S. Food and Drug Administration (FDA) published a new regulation defining the term "glutenfree" for voluntary food labeling. This new federal definition standardizes the meaning of "gluten-free" foods regulated by the FDA. Foods regulated by the U.S. Department of Agriculture, including meat and egg products, are not subject to this regulation. The regulation requires that any food with the term "gluten-free" on the label must meet all of the requirements of the definition, including that the food should contain fewer than 20 parts per million of gluten. The FDA rule also requires foods with the claims "no gluten," "free of gluten," and "without gluten" to meet the definition for "gluten-free." If a food that is labeled "gluten-free" includes "wheat" on the ingredients list or "contains wheat" after the list, the following statement must be included on the label: "The wheat has been processed to allow this food to meet the Food and Drug Administration requirements for gluten-free food." If this statement is included, people with celiac disease may consume foods labeled "gluten-free."