Then incidence of celiac disease has doubled in the United States every fifteen years since 1974. It is also a disease that hits adults more often than children, with elderly people twice as likely to develop the disease compared to the general population. To that end, there has been a proliferation of products, books, and cookbooks that have come to market addressing the topic.
Celiac disease is an inherited digestive system disorder caused by an intolerance to gluten that affects the digestive process of the small intestine. Once thought to be a rare condition, research shows that it affects about 3 million people. The only treatment for celiac disease is a gluten-free diet. But despite the fact that manufacturers are required to label food that contains gluten, adhering to a gluten-free diet can be tricky, and costly, business.
Given the upcharge that producers attach to gluten-free products, it is wise to arm yourself with as much knowledge as possible about the disease, and learn the tricks of keeping your costs down while managing the disease. An excellent source of both information and recipes is the Complete Gluten-Free Diet & Nutrition Guide by Alexandra Anca, a registered dietician and nutrition advisor to the Canadian Celiac Association, and Theresa Santandrea-Cull, who has celiac disease and teaches gluten-free baking classes.
The book is a wealth of knowledge, covering the basics, foods to avoid, how to shop, maintaining nutrition, and both recipes and meal plans. Following is an excerpt from that book. The Gluten-Free Diet.
How to manage celiac disease is no mystery — simply avoid gluten in your diet. If only it were so easy. What foods with gluten content should you avoid? What can you substitute for gluten-containing foods? What foods can you enjoy without risk? These are more complicated questions.
Getting to know how to eat a gluten-free diet is challenging. You need to be patient and persistent. Give yourself the time to experiment with new foods and allow yourself to fail — this is how you learn best. Remember that it took you a long time to be diagnosed and you are now on your way to recovery. Having a positive attitude and a reliable source of information is the key to mastering this new way of eating. It’s just like learning a new job — the job of eating properly to manage celiac disease. Along the way, you will discover the strength to make changes in your lifestyle. And the recipes in this book will amaze you at how simple and delicious the gluten-free diet really is!
How much gluten can I have? This is the most common question asked by patients who are newly diagnosed with celiac disease. Andrew, 75 years old, newly diagnosed, wanted to know his gluten limits. “I really like my soda bread. Can I have a slice once in a while?” The only treatment for celiac disease is a 100% gluten-free diet. While no health professional would ever deviate from this recommendation, life all around us is not gluten-free, and gluten contamination of other foods is very common.
While sources of hidden gluten are becoming rare as labeling laws require manufacturers to declare sources of allergens on food labels, gluten-free foods may sometimes be contaminated with trace amounts of gluten. Recent studies found that 15% of so-called gluten-free foods in Canada and 30% in Europe had more than 20 parts per million of gluten. In the Canadian study, about half of the contaminated samples were flours such as buckwheat flour and cornmeal, and the rest were cooked processed foods, but the contamination levels were similar.
One of the latest studies shows that as little as 50 mg of gluten a day for 3 months can cause damage to the intestinal lining. Consider that a slice of bread is estimated to contain as much as 3.5 grams of gluten, which amounts to about 70 times this 50 mg threshold for damage. In other words, it takes as little as a bread crumb (1⁄70th of a slice of bread) to inadvertently start the inflammatory process and intestinal damage. Because of the small number of patients in this study, no firm conclusions could be made about the effect of ingesting less than 10 mg of gluten daily. This remains a gray area for research. As a dietitian, I encourage you to give 100% effort to following the gluten-free diet. Because even your best effort may be thwarted by cross-contamination, you need to be vigilant about accidental ingestion of glutenous food.