Coeliac Disease & the Gluten Free Diet

What is Coeliac Disease?

There was period of my life where whenever I would tell anyone I had Coeliac Disease, I was initially stared at with slight confusion. At the time though, this was probably because it wasn’t classed as a common condition and therefore people didn’t know a. what the term meant and b. how it affected people.

To put it simply, all it means is that your body can’t digest gluten. Coeliac disease is not an allergy or intolerance but is in fact an autoimmune condition (1). This means that every time someone with the condition eats gluten, their body’s immune system attacks itself (2). Consequently there is usually damage to the small intestine, meaning that the body can’t properly absorb nutrients from food (3). In addition to nutritional deficiencies, individuals may also experience other symptoms such as bloating, tiredness and stomach pains (4). Research suggests that Coeliac Disease affects approximately 1 in 100 people within the UK (5).

How is Coeliac Disease treated?

The only known treatment for the condition is a strict lifelong adherence to a gluten free diet (6). But what exactly does that mean?. Well we’ve already talked about how a person with Coeliac Disease reacts badly to gluten, so it’s important to identify the foods in which gluten is present.

Foods that need to be avoided

Gluten is a protein that is found in the cereals; wheat, barley and rye (7). Now whilst it can sometimes be easy to spot gluten containing foods, there are instances where manufacturers will use gluten in pre –prepared products. It is therefore vital that if you have Coeliac Disease, you remain vigilant when it comes to checking packaging.

The more obvious sources of gluten include things like;

- Bread

- Pasta

- Biscuits or Crackers

- Cake and Pastries (8)

But let’s not forget… gluten can also be hidden. Sources include things like;

- Processed meats (sausages and burgers)

- Gravies

- Sauces (soy sauce and bread sauce) (9)

Foods that can be consumed

One of the most common questions I’ve had in my time of being gluten free is, “so if you’re a coeliac and have to avoid gluten, what do you eat “?”.” I’m sure there are others beside myself that can attest to being asked that. The answer for me though usually is “actually quite a lot!”. I believe that you just have to have sufficient knowledge of foods and products that are suitable, in order to maintain the diet.

Let’s start with foods that are naturally gluten free and are therefore suitable for someone with Coeliac Disease. Examples of these include;

- Fruits and Vegetables

- Rice

- Potatoes

- Lentils

- Meat

- Fish (10)

As well as items which are naturally gluten free, you can also find products that have been specially manufactured. Such products will usually state “gluten free” on the label and are available from most of the big supermarkets like; Asda, Tesco and Sainsbury’s.

The term “gluten free” however is not something that manufacturers have to state on their packaging. They are only obligated by law to tell you which of the 14 allergens are in a product (11). Now as someone who has always had to follow a special diet, I definitely feel that no one should be restricted when it comes to food. I do however feel that specially manufactured products should only form part of your gluten free diet. If you’re relying solely on these manufactured items, it can get expensive. Besides they do say that variety is the spice of life!

In summary….

There’s no denying that having Coeliac Disease and being on a gluten free diet can have its challenges. Food is an integral part of our day to day lives and having certain dietary requirements does make things a little more difficult. That being said, I believe that with the right support and sufficient knowledge you can have just as good a diet as anyone else!

A big thanks to this week's guest blog writer Heather McCaw. Heather graduated from University College Birmingham with a degree in Applied Food and Nutrition, back in September 2019. She then spent a year working as the Food Policy Officer for Coeliac UK and within that year, also gained registration as an Associate Nutritionist (ANutr) with the AFN. Heather shares “I’m so pleased that I decided to study nutrition. I won’t deny it was a challenging 3 years but it fuelled my desire to utilize my nutritional knowledge to help others. My ambition is to be part of ensuring that everyone has access to foods which will help them achieve and maintain optimal health”

Find Heather on Instagram: @glutenfree_nutritionist

References

1. Coeliac UK (2020) About coeliac disease. Available at: https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/

2. Parazanese, L.,Qehajaj,D.,Patrinicola,F.,Aralica,M., Chiriva – Internati,M.,Stifter,S.,Elli,L. and Grizzi,F. (2017) ‘Celiac disease: From pathophysiology to treatment’, World Journal of Gastrointestinal Pathophysiology, 8(2),pp. 27–38.

3. Kumar,P. (2014) ‘ROLE OF GLUTEN PROTEIN IN THE FOOD PRODUCTS OF LIVING BEINGS AND ITS EFFECT ON THEIR BODY BOTH PHYSICOCHEMICAL AND METABOLICALLY REACTIONS’ , International Research Journal of Commerce , Arts and Science, 5 (3), pp. 69 – 87.

4. Coeliac UK (2020) Coeliac Disease Symptoms. Available at: https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/what-are-coeliac-disease-symptoms/

5. NICE (2016) Coeliac Disease. Available at: https://www.nice.org.uk/guidance/qs134/chapter/introduction

6. Czaja-Bulsa, G. and Bulsa, M. (2018) ‘Adherence to Gluten-Free Diet in Children with Celiac Disease’, Nutrients, 10 (10), p.1424.

7. Jnawali,P.,Kumar,V. and Tanwar,B. (2016) ‘Celiac disease: Overview and considerations for development of gluten-free foods’, Food Science and Human Wellness, 5 (4), pp.169-176.

8. NHS (2020) Treatment Coeliac Disease. Available at: https://www.nhs.uk/conditions/coeliac-disease/treatment/

9. Biesiekierski,J,R. (2017) ‘What is gluten?’, Journal of Gastroenterology and Hepatology , 32 (1), pp. 78-81

10. Coeliac UK (2020) The gluten free diet. Available at: https://www.coeliac.org.uk/information-and-support/living-gluten-free/the-gluten-free-diet/

11. Food Standards Agency (2020). Available at: https://www.food.gov.uk/business-guidance/allergen-guidance-for-food-businesses