Celiac disease - nutritional considerations

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Celiac sprue - foods to avoid

Gluten-free diet; Gluten sensitive enteropathy - diet; Celiac sprue - diet

Staples of the gluten-free diet include:

• fruits and vegetables
• meat
• milk-based items
• potatoes, rice, corn, beans
• cereals made without wheat or barley malt
• a wide variety of specialty foods (such as pasta, bread, pancakes, and pastries) made with alternative grains (rice, tapioca, potato, or corn flours and starches)

Such products can be purchased through local and national food companies, or can be made from scratch using numerous alternative flours and grains.

The gluten-free diet involves eliminating all foods, beverages, and medications made from the offending grains. This means all items made with flour (all-purpose, white, wheat) are prohibited -- including pasta, bread, buns, pancakes, bagels, waffles, pizza, cakes, cookies, pie, most cereals, breaded foods, stuffing, gravies, crackers, most soups, and most convenience foods.

These are the obvious sources. Far less obvious foods that must be eliminated include communion host, many sauces such as teriyaki and soy, some salad dressings, beer, marinades, croutons, and some candy. Further complicating the diet is risk of cross-contamination. Items that are naturally gluten-free may share transportation, a production line, a fryer, or a grill with a grain such as wheat, thereby contaminating a product that would have been safe otherwise.

Restaurant eating and social gatherings pose an additional but manageable challenge. Calling ahead and special planning become important measures. Label reading becomes a frequent, essential task due to the widespread use of wheat and barley in foods.

Despite its challenges, maintaining a healthy, balanced diet is achievable with education and planning.

Review Date: 12/22/2005
Reviewed By: William McGee, M.D., M.H.A., Assistant Professor of Medicine and Surgery, Tufts University School of Medicine, Boston, MA, and Director ICU Quality Improvement, Critical Care Division, Baystate Medical Center, Springfield, MA. Review provided by VeriMed Healthcare Network.