Monday, November 12, 2012

Live Gluten Free! - All you need to know about celiac disease



1. What is celiac disease?

Celiac disease is a disease of the digestive system that damages the small intestine and interferes with the absorption of nutrients from food. It is an allergic reaction to gluten, a protein found in wheat (قمح), oats (الشوفان), rye (حبوب الجاودار) and barley (الشعير).

It is not clear what causes celiac disease. However, it has been proven that it runs in the family. People who suffer from this condition are genetically predisposed and they may start experiencing the symptoms at any age. In other terms, they have it in their genes but it may not appear during childhood. The symptoms might start at later stages in life.


Symptoms may be different from one person to another. And they may also be common with other diseases. That’s why the diagnosis is not made right away. They may include decrease of appetite, diarrhea or constipation, abdominal pain, bloating, unexplained weight loss, skin rashes, etc.

If left untreated, celiac disease may lead to malnutrition, loss of bone density, lactose intolerance, bruising easily, fatigue, hair loss, depression or anxiety, nosebleeds, cancer, etc.

Many tests are available to detect celiac disease; however, the only conclusive one would be a biopsy of the intestinal lining.

2. What is the appropriate diet?

There is no cure for celiac disease. The only way to make symptoms disappear and allow the villi to heal is to adopt a GLUTEN-FREE diet.

So basically, if you are suffering from celiac disease, you should omit all sources of gluten from your diet. This means that you should not consume wheat, oat, barley and rye.

Once gluten is removed from the diet, you may start feeling better in just a few days. However, complete rehealing and regrowth of the villi may take several months. You should note that the healing process is faster in children than adults.

Now, if you accidently eat a product that contains gluten, you might experience abdominal pain or diarrhea. Sometimes, you might not see any signs. But any traces of gluten in your diet can be damaging, whether you experience symptoms or not. So please be careful and save the following list!


Food group
Allowed
Prohibited

Breads and cereals

-      Rice and rice flour
-      Corn and corn flour
-      Potatoes and potato flour
-      Tapioca and tapioca flour
-      Soy and soy flour
-      Rice noodles
-      Quinoa


-      Pita bread of all kinds
-      French bread
-      Kaak
-      Toast
-      Cracottes
-      Wheat starch and wheat flour
-      Barley: starch and flour
-      Bulgur (برغل)
-      Couscous
-      Semolina (سميد)
-      Pasta
-      Vermicelli (شعيريه)
-      “Moghrabieh”
-      “Keshek”
-      Falafel
-      All breakfast cereals
-      Bread crumbs


Meat, fish and poultry

-      All types of fresh and frozen products (unprocessed): beef, lamb, veal, chicken, fish and sea food
-      Canned fish like tuna and sardines
-      Eggs


-      Processed meats: jambon, mortadelle, etc.
-      “Kebbeh”
-      Sausages
-      Pastrami
-      Hot dogs
-      Cordon bleu
-      Chicken nuggets
-      Escalope


Legumes

-      All legumes such as hummus, beans, soy, etc.



Milk and milk products

-      All types of fresh milk, pasteurized, powder and sterilized, concentrated and cream.
-      Labneh
-      Laban
-      Cheese: cheddar, edam, cottage, parmesan, gruyere, akkawi, halloum and double crème.


-      Soy milk
-      Cheese: blue cheese and roquefort

Fruits and vegetables

-      All fresh, frozen and unprocessed fruits and vegetables


-      Check labels of canned ones as some may contain gluten

Desserts

-      White sugar
-      Honey
-      Jam
-      Molasses
-      Cocoa
-      “Halawa”
-      Sahlab, meghli, mhallabieh
-      Jell’O
-      Any other dessert that is sure not to contain the 4 grains


-      Arabic sweets: baklava, osmallieh, knefeh, maamoul.
-      Cakes, pancakes, doughnuts, ice cream (cornet), croissants and all types of biscuits.

Fats and oils

-      Butter
-      Margarine
-      Vegetable oils
-      Tehine


-      Wheat oil

Drinks

-      Wine and distilled liquors, ciders and spirits
-      Tea
-      Juices


-      Beers
-      Sodas may contain minimal traces of gluten and an allergic reaction to them depends on your sensitivity.


Miscellaneous

-      Spices
-      Pickles, olives
-      Ketchup, mustard, tomato paste, gluten free soy sauce


-      Regular soy sauce
-      Ready to serve salad dressings

Fortunately, there are wide ranges of Gluten-Free products on the market. I’ve taken a few pictures of products you can find in your local supermarket. I’m sure there are more so always look for the “Gluten-free” label.

There are many other brands you can 
find in supermarkets. These are just 
examples



It is very important to watch out for hidden sources of gluten. A product might not seem like it contains gluten but it might be contaminated. And that’s why it is crucial to read food labels (ingredients and potential allergens) in every product that you buy. In the next picture, the product is rice cakes. Check the label: it clearly states that the product might be "contaminated with gluten".





Celiac disease can be effectively managed through changing your diet. You might find it tricky at first but after all, eating is a habit and you will get used to it. And of course, all of us dietitians are ready to help you whenever you need us. So don’t hesitate to call us if you run out of food ideas J  

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