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Celiac disease - nutritional considerations
Definition Celiac disease , usually first seen in childhood, involves an intolerance to gluten. Gluten is the protein component in wheat, oats, rye and barley. The cause is not understood; it may involve an immune factor or an inherited mucosal defect. Diagnosis is made by intestinal biopsy and blood work. The disease can cause the destruction of the intestinal villi (tiny hair-like projections on the interior surface of the small intestine) following the ingestion of gluten-containing products. The results can be a decrease in the absorption of sugars , fat and protein. This causes abnormal stools, due to the fermentation of undigested carbohydrates and excessive amounts of fat in the stool. If untreated, affected people may show signs of malnutrition : weight loss , growth failure , muscle wasting , peripheral neuritis and prolonged bleeding times.
Alternative Names Gluten-free diet; Gluten sensitive enteropathy - diet; Celiac sprue - diet
Food Sources Fruits and vegetables, meat and fish are good sources of calories for people with celiac disease. Avoid food that are processed and prepared without knowing what they contain and how they were prepared.
Side Effects 
Recommendations Therapy is to eliminate all gluten from the diet. This diet must be followed indefinitely. Strict adherence presents a challenge because gluten may be in the form of additives as a stabilizer or emulsifier. Corticosteroids and water-soluble multivitamins may be prescribed. Some of the foods that should be avoided if gluten enteropathy is diagnosed include bread, crackers, buns, biscuits, graham crackers, wafers, pancakes, cones, matzo, macaroons, cakes, cookies, dumplings, doughnuts, pretzels, pie crust, rolls, wheat germ, cereals, oatmeal, chili, some meat loaves, gravies, cream sauce, breaded foods, macaroni, lasagna, noodles, spaghetti, vermicelli, ravioli, and stuffing for turkey or chicken. Some foods which do NOT contain gluten include puffed rice, grits, Chinese rice noodles and some of the gluten-free bakery goods prepared or sold at health food stores. Tapioca flour, corn starch, corn flour, potato flour, cornmeal, and rice flour can be used for thickening gravy and for baking. Combining flours usually makes a better product. Be aware that although some products do not include gluten in their ingredients, they may share production lines with gluten-containing products. There are also numerous foods that may contain gluten that may not be readily apparent, so label reading is important. Some examples of non-cereal foods that may contain gluten are: commercial chocolate milk, cocoa mixes, commercial salad dressings, non dairy creamers, commercial seasoned rice mixes, commercial candies, white vinegar and many others. A Registered Dietitian can provide in-depth consultation and support regarding the diet therapy. A celiac disease - support group may also be helpful.