Celiac Diease and Gluten Free Diet

What is Celiac disease?

Celiac disease is an autoimmune disorder that affects the digestive system, causing damage to the small intestine and hindering the body's ability to absorb nutrition. This condition is widely prevalent as a hereditary autoimmune disorder. First-degree relatives, such as parents, siblings, and children, have a risk ranging from 5% to 15%. Aunts, grandparents, and uncles, who are considered second-degree relations, have a chance of 2-3%. A gluten-free diet is the only solution for Celiac disease.

What is a Gluten-free diet?

A gluten-free diet is one that strictly forbids the consumption of any food item that contains gluten. The four grains wheat, barley, rye, and triticale contain the protein gluten.

How Celiac disease is diagnosed?

Initially, it is necessary to do a blood test to examine the presence of an antibody known as tissue transglutaminase IgA, or tTG-IgA. A high tTG-IgA level in the data indicates a potential presence of celiac disease in your child.

The diagnosis will be confirmed by a gastroenterologist by the use of an endoscopy, which involves the insertion of a short, flexible tube through the mouth, down the esophagus, and into the stomach and small intestine. A biopsy of the gut will be conducted to determine the presence of any indications of celiac disease.

Symptoms of Celiac Disease

Celiac disease presents itself in many different ways ranging from severe malabsorption to nutritional deficiencies. Patients with celiac disease may experience

• Abdominal pain
• Gas
• Bloating
• Constipation
• Decreased appetite
• Diarrhea
• Lactose intolerance
• Nausea or vomiting
• Abnormal stools
• Unexplained weight loss

Additional symptoms may include growth delay in children, fussy behavior, foul-smelling stools, hair loss, itchy skin, and mouth ulcers. Always remember the symptoms may vary from child to child.

What are the risks of not following a strict gluten-free diet?

Consequences include:

• Iron deficiency anemia and/or other nutrient deficiencies
• Delayed puberty
• Osteoporosis
• Infertility
• Gastrointestinal cancers
• Altered mental state
• Increased risk of other autoimmune conditions

Role of RDNs in Celiac Disease

Registered Dietitian Nutritionists (RDNs) play a crucial role in the management of celiac disease in children within the field of pediatric medicine. They coordinate closely with physicians and pediatric gastroenterologists to promptly diagnose and effectively manage the illness. They assist with creating gluten-free meal plans, understanding food labels, and identifying safe food options that are appropriate for children. Their focus is on addressing difficulties related to nutrient deficiencies, as well as promoting optimal growth and development in children. Dieticians aim to ensure that children obtain a sufficient amount of key vitamins and minerals that are vital for their general health.

Micronutrient Deficiency in Celiac Patients

Individuals diagnosed with celiac disease commonly experience micronutrient deficiencies as a result of damage caused to the small intestine. Malabsorption, a characteristic feature of celiac disease, frequently results in insufficient absorption of essential nutrients. The American Journal of Gastroenterology states that approximately 20-40% of persons with celiac disease experience calcium deficiencies, highlighting the importance of monitoring bone health in this group. A study published in the European Journal of Clinical Nutrition has reported a significant occurrence of folate and vitamin B12 deficiencies in people with celiac disease, with prevalence rates ranging from 10% to 30%.

Essential Micronutrients and their food sources:

1. Vitamin A

It is important to boost the immune system, keep skin healthy, and improve vision. Food rich in Vitamin A includes:

• Spinach
• Apricot
• Sweet Potatoes
• Papaya

2. Vitamin D

Vitamin D is the building block of the bones, it helps in absorbing Calcium and prevent various bone diseases. Vitamin D food sources include:

• Fatty fish
• Shrimp
• Egg
• Fortified Milk

3. Vitamin E

It is rich in antidioxant and plays an important role in boosting the immune system. It ensures sufficient blood circulation in the body. Vitamin E food sources include:

• Almonds
• Avocado
• Kiwi
• Green Leafy Vegetables

4. Vitamin K

It helps in blood clotting and bone growth. Food sources rich in Vitamin K are:

• Cauliflower
• Broccoli
• Green leafy Vegetable

5. Vitamin B12

It helps in developing the immune system, neural system, and cognitive function. Food sources rich in Vitamin B12 are:

• Meat
• Egg
• Cheese
• Milk

6. Calcium

Calcium is essential in building strong bones and teeth. Calcium food sources include:

• Almond
• Cheese
• Milk
• Oranges

7. Iron

For children, iron plays a vital role in growth and development. Iron-rich food sources are:

• Meat
• Beans
• Dried fruits
• Fish

Supplements for my kid

Supplementation plays a crucial role in the management of celiac disease in children, particularly in addressing certain nutrient shortages. Nevertheless, it is imperative to get guidance from your child's healthcare provider or a certified dietitian before commencing any supplementation, to ascertain their suitability and safety for your child's particular requirements.

Food list for Celiac Patients

		Gluten-free		Contains Gluten
Vegetables		Any kind of fresh or plain commercially frozen or canned vegetables		Canned or frozen vegetables with cream or cheese.
Fruits		All fresh fruits		Commercial fillings thickened with anything other than corn starch.
Dairy		Whole/low-fat milk, All cheese (cheddar, Swiss, cottage)		Malted Milk Oat Milk
Meat/Fish/Poultry		Any plain, roasted, grilled meat. Fried if the coating is gluten-free.		Crumbed meat Patties Samosa Thickened Gravy
Bread/Chapatti		Made with soy, potato, corn, rice, flour		All bread, biscuits, chapatti, and naan made from wheat, barley, millet, and oats
Cereal		Plain rice and Corn cereal Rice noodles Rice porridge Gluten-free pasta and lasagna		Egg noodles Noodles/Spaghettis Oats Vermicelli
Desserts		Ice Lolly Kheer Cakes and biscuits prepared with Gluten-free flour. Custard		Commercial dessert mixes Suji Halwa Shahi tukray Commercial Sherbets
Beverages		Coffee Tea Chocolate drinks with pure cocoa powder Soft drinks		Malt Ovaltine Barley flavored drinks Commercial flavored milk

Possible Weight changes

People who have celiac disease often loss or gain weight, both before and after they are diagnosed. Many people lose weight for no clear reason because their intestines are damaged and can't absorb nutrients properly. On the other hand, some people may gain weight because they eat too much to make up for missing nutrients. If you are diagnosed with celiac disease and follow a strict gluten-free diet, your weight may change as your bowels heal and your body absorbs nutrients better. Some people may be able to get their weight back to normal while others may still have trouble controlling their weight while on a gluten-free diet. Overall, changes in weight in people with celiac disease show how important it is to get nutritional help and keep an eye on their health to ensure the best results.

Importance of Fiber for Celiac Patients

Due to its many health benefits, fiber is vital for the well-being of children with celiac disease. Incorporating fiber-rich foods into their restricted diet helps maintain their digestive health by encouraging regular bowel movements and relieving constipation. Fiber helps keep the lining of the digestive tract in good condition, which in turn improves the absorption of nutrients. Food rich in fiber includes:

• Apples
• Broccoli
• Almonds
• Gluten-free Oats

Gluten-free food label Guidelines

• Look out for the food labels such as‘Gluten-free.”
• Look out for the food ingredients label containing wheat, barley, rye or their derivatives as they contain Gluten.
• Look out for the cross-contamination statement, ensuring that food is prepared in safe environment.

Non-Food Gluten Sources

Other products may also contain Gluten, make sure to keep them out of reach from your kid. Other products include:

• Play dough
• Art supplies
• Cosmetics and Shampoo
• Pet food
• Medicines

Guidelines for Parents to accommodate their kid’s dietary changes

Has your child been diagnosed with Celiac disease? As a parent, you may be experiencing a sense of being overwhelmed and abundant of thoughts may be flooding your mind at this moment. It is perfectly normal to feel this way for the sake of your child. As a parent, you must implement multiple changes to your child's way of life. Adopt a gradual approach, Attempt to educate your child, particularly if they are attending school. Engage in conversations with teachers, family members, and caretakers to ensure their understanding and awareness. If your child is in an age bracket where they possess a mental capacity to comprehend dietary restrictions, it is important to provide them with proper education regarding what foods are permissible and what foods are not. Commence the introduction of new snacks and food products specifically designed to align with the dietary program.

Guidelines for preparing food

• Wash hands with soap and water to prevent inadvertent intake of gluten-containing foods or items.
• Utilize a specifically assigned gluten-free zone within the kitchen or carefully cleanse surfaces with hot, soapy water to eradicate all traces of gluten.
• Before preparing gluten-free food, ensure that all utensils and cooking equipment are well cleaned using soap and hot water to avoid any cross-contamination.
• Utilize separate, clearly marked containers for gluten-free products such as bread, biscuits, and flour to prevent cross-contamination with things that contain gluten.
• To ensure the safety of gluten-free toast, it is important to employ certain precautions. These include utilizing a clean grill or toaster.
• Utilize different spreads such as margarine specifically for gluten-free products and refrain from 'double-dipping' to prevent contamination.
• Utilize fresh water and a distinct container for cooking pasta that is free of gluten. Likewise, make sure to clean the strainer or reserve it solely for gluten-free foods.
• When engaging in deep frying, it is advisable to utilize uncontaminated oil for frying gluten-free items. Alternatively, you may select to fry gluten-free options before gluten-containing ones to prevent cross-contamination.

Food Balance to the Rescue

The Food Balance is committed to supporting children in their pursuit of a gluten-free lifestyle, particularly following a diagnosis of celiac disease. Our proficient nutritionist create customized nutritional regimens designed to enhance health after diagnosis. We provide expert information and steadfast support to empower children and their families in confidently navigating every aspect of gluten-free life.

Conclusion

By following expert guidance and dedicating themselves to specific dietary goals, individuals can effectively and confidently navigate their path to well-being. Through our specialized knowledge and unwavering commitment, our goal is to enable individuals and families to attain and maintain their highest level of physical and mental health, guaranteeing a healthier and more contented future for everyone.