If you've been recently diagnosed with coeliac disease, our experts are here to help you manage your condition
According to the NHS definition, coeliac disease is a common digestive condition where the small intestine becomes inflamed and unable to absorb nutrients. It can cause a range of symptoms including diarrhoea, abdominal pain and bloating and it arises from an adverse reaction to gluten.
“Gluten is a protein that is found in wheat, barley and rye,” explains Emma Brown, a nutritionist at calorie-counting website Nutracheck. “Gluten is present in such obvious foods as bread, pasta, crisps and cereals but it can also be found in some less obvious ones. These include sauces, stock, some salad dressings and vinegar.” And if you’re partial to the odd lager and lime, do remember most beers are made from barley.
As you’ve probably discovered, eating foods containing gluten can trigger a range of gut-related symptoms, such as diarrhoea, which may smell particularly unpleasant, abdominal pain, bloating and flatulence, indigestion and constipation. Coeliac disease can also cause a number of more general symptoms, including fatigue, as a result of not getting enough nutrients from your diet, unexpected weight loss, an itchy rash (known as dermatitis herpetiformis), problems conceiving, nerve damage (peripheral neuropathy) and disorders that affect co-ordination, balance and speech.
“Coeliac disease is a medically diagnosed intolerance to gluten,” says Emma. “It is an autoimmune disease caused by the body’s intolerance to the protein. If someone with coeliac disease consumes gluten the body’s immune system will attack itself, so it is imperative that he or she removes gluten from their diet. “Some people may suffer from non-coeliac gluten sensitivity in which they experience discomfort, but the same immune response is not taking place as happens with coeliac disease.”
Sort your staples
If you’re vegetarian, or rely on meatfree meals then alarm bells may be ringing as gluten is present in many store cupboard essentials. “The vast majority of natural ingredients don’t include gluten, it’s only really in wheat and ingredients made from it, such as flour, bread, pasta and couscous,” says Rose Elliot, Britain’s leading vegetarian cookery writer and author. “Although these are staples for many vegetarians and meat-eaters alike, there are plenty of delicious foods you can use in their place. Cornflour or potato flour can be used for thickening soups, gravies and sauces; chickpea flour can work for batters and pancakes; instead of your usual wheat pasta you can use pasta made from grains such as rice or buckwheat. Cooked grains which will work as fillers for recipes such as nut roasts, include millet, quinoa, buckwheat or rice, or even cooked lentils or beans
It’s important to ensure that your gluten-free diet is healthy and balanced. An increase in the range of available gluten-free foods in recent years has made this much easier to achieve. While you can eat many foods including meat, fish, fruit, vegetables, rice and potatoes on a gluten-free diet, you should discuss what will work best for you regarding your age and lifestyle with your GP or a dietitian. It may be advisable to build up your general health and support your immune system with power ingredients, such as garlic (which is a rich source of Vitamin C, Vitamin B6 and manganese to help to eliminate toxins).
If you love baking, then there are plenty of alternatives to your usual flour. Have a look at brown teff, brown rice and buckwheat; you can also use sorghum millet, polenta and glutenfree oat flour. For lightness, it’s best to use combinations of these flours with arrowroot starch, which helps to bind the ingredients, for example, 150g of teff and brown rice flour with 10g of arrowroot. Nut flours like ground almonds, and coconut flour are other great alternatives, but they can be very fibrous and heavier than regular wheat flour so you need a lot less in your recipes, especially coconut flour. When it comes to cooking, grains like quinoa and amaranth are delicious when made into porridge and added to salads. And ground nuts or polenta are useful for adding a crispy finish.
Know your labels
Pay close attention to food labels as as it is a statutory requirement that any possible contamination is highlighted on the packaging. For example, oats can often be crosscontaminated with gluten if they are processed in the same place as wheat, barley, and rye. According to the Food Standards Agency (food.gov.uk) gluten-free and very low gluten options are based on legal limits. Anything which is labelled ‘glutenfree’: means it has 20 parts per million of gluten or less and ‘very low gluten’: has 100 parts per million of gluten or less - however, only foods with cereal ingredients that have been specially processed to remove the gluten may make a ‘very low gluten’ claim. If in doubt, don’t take a risk and compromise your health.
There’s no cure for coeliac disease, but switching to a gluten-free diet should help to control symptoms and prevent any long-terms complications such as osteoporosis or iron deficiency anaemia. Even if you have mild symptoms, changing your diet is still recommended because continuing to eat gluten can lead to serious complications. According to the team at the charity, Coeliac UK, it can take between six months and up to five years (in some cases longer) for the gut damage caused by gluten to fully heal. Several factors are thought to be involved in the recovery process, including age and severity of gut damage at diagnosis. Coeliac UK’s website (coeliac.org.uk) has a wealth of useful resources, including information about going gluten-free as well as details of local groups and ongoing campaigns.