GFG: Let’s start with the basics. What is celiac disease?
Sherry Torkos: Celiac disease is an autoimmune disease triggered by consumption of gluten. In people with celiac disease, consumption of gluten stimulates the immune system to produce antibodies that attack the small intestine and many other body tissues, causing widespread inflammation and damage. This results in digestive problems, impaired nutrient absorption, a variety of physical and emotional symptoms and serious health risks. In most cases, the damage is reversible once gluten is excluded from the diet.
Who is at risk and why?
Celiac disease affects nearly 1% of Canadians. Genetics plays a role in who will develop celiac disease. Studies have shown that the familial occurrence of the disease ranges from 10% to 22%. There are 3 things required for a person to develop celiac disease:
1. Genetic disposition – carrying the genes associated with the disease
2. Trigger – exposure to an environmental, emotional or physical event, such as adolescence, pregnancy, childbirth, infection, surgery, an accident or stressful situation
3. Diet – eating foods that contain gluten, such as wheat, rye and barley or their derivatives
What kinds of food contain gluten?
Gluten is present in many foods, including breads, pasta, cereals, cookies, cakes and pie. These are the obvious sources, but it is also “hidden” and not so obviously found in many sauces, marinades, spices, coatings and thickeners. It is also present as an additive in some drugs and vitamin supplements.
Speaking of vitamins, is it important for people with celiac disease to take vitamins or nutritional supplements?
As a pharmacist I am often asked this question. The answer depends on many factors: state of health, age, lifestyle, diet, use of medications and other factors that can impact nutritional status (such as stress, smoking, drug use).
For many people, nutritional supplements can play an important role in optimizing health. The majority of people with celiac disease suffer for a long time prior to diagnosis. The intestinal damage caused by years of ingesting gluten can be quite significant. Since nutrient absorption occurs through the intestine, undiagnosed celiac disease can result in malnutrition and signs of nutrient deficiency, such as anemia, skin rash, fatigue, poor cognitive function and stunted growth of hair and nails. It may take several months for the intestines to heal on a strict gluten-free diet. Despite even the best efforts to follow the diet strictly, inadvertent ingestion of gluten can occur and this can compromise the health of the intestines and the ability to absorb nutrients. Lastly, the gluten-free diet, while healthy, can be lacking in certain nutrients. Gluten-free flours are typically lower in fibre and not enriched with iron and B vitamins. Nutritional supplements can help facilitate healing of the body, aid digestion and compensate for possible dietary deficiencies.
Click “more” to see what supplements people with celiac disease should consider taking…