Dietary Management of Celiac disease

Celiac disease is an autoimmune condition that causes severe damage to the lining of the small
intestine. Gluten — a protein found in wheat, barley, and rye — triggers its symptoms. There’s currently
no cure for celiac disease. A strict gluten-free diet — also known as the celiac disease diet — must be
followed to allow your body to heal.
If you have celiac disease and consume even small amounts of gluten, damage to your intestines will
continue, regardless of the absence of symptoms.
For those with celiac disease, avoiding gluten is essential but can be harder than it seems.
Celiac Disease Diet Management
Anyone diagnosed with celiac disease must follow the celiac disease diet.
When someone with celiac disease eats gluten, it causes an autoimmune response in their body that
damages the lining of the small intestine.
As a result, the small intestine cannot properly absorb nutrients from food, creating symptoms like
diarrhea, unexplained weight loss, and malnutrition.
The only way to prevent this damage is to strictly follow the gluten-free celiac disease diet.
Benefits of gluten free diet
 Reduces the Symptoms of Celiac Disease
Many people with celiac disease experience uncomfortable symptoms, such as diarrhea, indigestion,
abdominal pain, fatigue, and headaches. Following a gluten-free diet for at least one year has been
shown to improve these symptoms in more than 90% of people with celiac disease, significantly
improving quality of life.
Intestinal symptoms like diarrhea tend to be the quickest to resolve — with some people experiencing
relief after just two days on a gluten-free diet.
Overall, it takes an average of one month to see significant improvements in bowel
movements, bloating, and abdominal pain. For people with celiac disease, eating gluten triggers an
autoimmune response that damages the small intestine, where nutrients are absorbed.
Avoiding gluten prevents this autoimmune process, and the small intestine can heal and return to
normal function.
This process takes time — so the earlier a gluten-free diet is started, the better. In one study, up to 95%
of children with celiac disease who followed a gluten-free diet for two years no longer showed signs of
intestinal damage.
Recovery tends to be slower in adults — with 34–65% achieving gut healing in two years.

However, this number jumps to at least 66% — and up to 90% — after five or more years on a gluten-
free diet. Being vigilant about avoiding gluten is crucial. Exposure to even tiny amounts can hinder the
healing of your intestine.
Improves Nutrient Absorption
Nutrient deficiencies are prevalent in people with celiac disease due to poor absorption in the damaged
small intestine. Deficiencies in iron, calcium, magnesium, zinc, vitamin B12, niacin, riboflavin, and folate,
as well as vitamins A, D, E, and K, are the most common.
In fact, unexplained iron deficiency anemia is one of the most recognized signs of celiac disease in
adults. Yet, supplementing will not always correct deficiencies in people with celiac disease if their
intestines are still damaged and unable to absorb nutrients.
Following a gluten-free diet has been shown to repair the intestines enough to correct iron deficiency
anemia within six to twelve months, even without taking a supplement.

Lowers the Risk of Osteoporosis
Up to 75% of people with untreated celiac disease have lower bone density and a higher risk of
osteoporosis. This may be due to poor calcium and vitamin D absorption, as well as increased
inflammation that interferes with the bone-building process.
Research shows that diagnosing celiac disease early and starting a gluten-free diet can help stop bone
loss and reduce the risk of developing osteoporosis.
Foods to Eat
There are many naturally gluten-free foods to enjoy on the celiac disease diet, including-
Animal proteins: Beef, chicken, dairy products, eggs, meat, lamb, pork, seafood, and turkey.
Fats and oils: Avocado, coconut oil, olives, oils, solid fats, and butter.
Fruits and vegetables: In any form, including fresh, frozen, dried, or canned.
Gluten-free cereals : Amaranth, buckwheat, corn, millet, quinoa, rice, sorghum etc.
Herbs and spices: All fresh and dried herbs and spices are naturally gluten-free and can be enjoyed
Legumes: Beans, lentils, peanuts, peas, and soy.
Nuts and seeds: Any type, including almonds, cashews, chia, flax, pecans, pepitas, pine nuts, and

There’s also a wide variety of specialty products, including gluten-free bread, cereals, flours, crackers,
pastas, and baked goods.

Foods to Avoid

The only foods that should be avoided on the celiac disease diet are those that contain gluten.
Foods that naturally contain gluten include the following grains
 Wheat
 Semolina
 Wheat germ
 Wheat bran
 Barley
 Rye

Products made with these ingredients include:
Breakfast and baked goods: biscuits, bread, donuts, flatbread, flour tortillas, French toast, muffins,
naan bread, pancakes, pita bread, potato bread, rolls, and waffles.
Desserts: Brownies, cake, cookies, pastries, pie crust, and some candy.
Pasta: Chowmein, noodles and wheat pasta.
Some beverages: Beer and other malted beverages.
Other: Breadcrumbs, wheat flour, barley flour, rye flour, gravy, malt flavoring/extract, sauces thickened
with flour, soy sauce, stuffing, and anything with a flour coating.

Prevalence in India
The prevalence rate of celiac disease (including in India) is understood to be 1% globally with some
variations across countries.

In India, celiac disease is suspected to be more prevalent in the North Indian population where wheat is
primarily grown and forms the staple cereal. These states would include Punjab, Haryana, Delhi, Uttar
Pradesh, Maharashtra, Rajasthan, Bihar, Uttaranchal, Madhya Pradesh and Gujarat.
So far, it was considered non-existent in South India but there is now evidence that it is being diagnosed
in the native population of South India too though it is rarer than in the North.

Studies show that the prevalence of celiac disease has been doubling every 20 years. It is not clear why
there has been an increase in the number of cases, but the reasons could be many consumption of
wheat, usage of the new strain of wheat which is considered more antigenic, increased use of antibiotics

The diagnosis rate of celiac disease though is extremely low presently, only about 5%. That would mean
out of 100 people affected with celiac disease, 95 are not aware of this condition. This has therefore
been popularly depicted in the form of an iceberg where the visible part i.e. the number of diagnosed
cases is miniscule (3-5%) whereas most of the cases are submerged, i.e., not yet diagnosed.
Is a gluten-free diet safe for the health-conscious people (don’t have celiac

In recent years, more people without celiac disease have adopted a gluten-free diet, believing that
avoiding gluten is healthier or could help them lose weight. No current data suggests that the general
public should maintain a gluten-free diet for weight loss or better health. 
A gluten-free diet isn’t always a healthy diet. For instance, a gluten-free diet may not provide enough of
the nutrients, vitamins, and minerals the body needs, such as fiber, iron, and calcium. Some gluten-free
products can be high in calories and sugar.

If you think you might have celiac disease, don’t start avoiding gluten without first speaking with your
doctor. If your doctor diagnoses you with celiac disease, he or she will put you on a gluten-free diet.