5 Things You Can Do to Make a Gluten-Free Friend Feel Loved

I’ve been gluten-free for nearly seven years. For me and millions of others, a gluten-free diet is a medical necessity, not a fad.

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Do you know someone who’s gluten-free? Here are five simple ways to love on them.  

1. Choose a safe restaurant. Inviting me out to eat? Awesome! Look for restaurants with gluten-free menus or offerings and ask your friend if it is safe for them. Some places that advertise gluten-free food don’t actually know how to avoid gluten cross-contamination in their kitchens.

I actually had a chef at a pizza restaurant tell me that I could eat their gluten-free pizza even though it was prepared on the exact same surface as the regular wheat-filled pizzas because “our oven is really, really hot so it burns off the gluten.” *facepalm*  

2. Let them cook with you. Having your celiac buddy over for dinner? Awesome! For the first time or two, he may want to help you cook. It’s not that he doesn’t trust you, it’s just that it takes time to learn what contains gluten since it can end up in surprising places (salad dressings, wooden spoons and dishwashing sponges, to name just a few).

Many gluten-free folks have learned to cook pretty well out of necessity, and having them in your kitchen can simplify your ingredient-checking and cross-contamination worries. Plus, cooking together is fun!  

3. Don’t get offended. When I ask you a bazillion questions about how the meal was prepared, it isn’t about you — it’s about me. I’ve learned over the years how easy it is to slip up when you aren’t living gluten-free every day. My own parents (both “normal” eaters) make me sick from time to time, and they are ridiculously careful about preparing food for me.

Maybe you worked really hard on those gluten-free cookies, but when you put them on the platter with others containing wheat, they became glutened.

If I have to turn down food you worked hard on or a restaurant you love, please understand that it breaks my heart. You responding with grace and not anger? That helps a whole lot.  

4. Provide a prepackaged snack. I met a friend for a playdate this week, and she brought a muffin for my preschooler (he’s a “normal” eater) and a prepackaged bag of gluten-free pretzels for me. Being included in snack time by being provided safe food makes us feel SO loved. Odds are, if everyone else is hungry, we are, too.

Prepackaged gluten-free foods can’t have come in contact with gluten, so they give us peace of mind. I didn’t have to ask my friend if my pretzels had been near the muffin, or how they were prepared. You don’t even have to shop at a specialty store to buy gluten-free these days, since most mainstream groceries (and even gas stations!) carry a few things. Even naturally “wrapped” fruit like a banana or an orange will do.

5. Remember it’s just a small part of who they are. I don’t mind talking about my gluten intolerance, but it’s not all I want to talk about. I’m also a writer, a pastor, a mom, a runner and about a million other things. I’m happy to answer questions, but then let’s talk about other things, OK?

On behalf of gluten-free eaters everywhere: Thank you!



Yes, Eating Gluten If You Have Celiac Disease Really Feels That Bad

Hand holding plate of cupcakes outdoors

According to Coeliac Australia, the disease affects roughly one in 70 Australians. Many people — including a lot of celebrities — love the idea of a “gluten-free diet.” Many people adapt to it unnecessarily, thinking it is a healthier way of living.

However — perhaps due to the trend that’s been accelerated by celebrities — many people are ignorant about the seriousness of the disease.

For example, I’ve often had people dismiss me.

“Are you sure you’re a real celiac?”

“There are a lot of people that say they’re allergic to gluten and wheat, but they’re not.”

No, I’m not sure at all. I just woke up one day and thought that my life would be easier if I didn’t eat gluten.

“But it’s not like you’ll have an anaphylactic reaction. Surely you can just eat a small piece of cake?”

Yes, you’re right. I won’t have an anaphylactic reaction. What will happen, however, if I even eat a tiny crumb of said cake, is not pleasant. For anyone. I will be in unbearable pain for at least two days, maybe three.

My stomach will bloat excessively — which makes it hard to walk — and I will not be able to stop going to the toilet and bleeding.

And increase my chances of bowel and stomach cancer because my body can’t handle wheat and gluten because it’s allergic to it.

But sure, at least it’s not an anaphylactic reaction — that’s when it gets real, right?

“It can’t be that bad, though.”

No, it really can. Once, at a party I was hosting, I’d organized that everything was gluten-free (so there would be no risk of contamination).

A friend brought her own crackers. Not realizing this, I ate some of the same dip as her.

That’s all it took.

Not a biscuit.

Not even a noticeable crumb of a biscuit.

Just the contamination.

That was enough to keep me up all night and put a damper on my party spirit.

I honestly have no problem if you want to go gluten-free. This “gluten-free trend” has meant there’s more awareness surrounding a gluten-free diet, more food options, and (most importantly), better tasting food options.

But, for celiacs, it really is that bad.

They are really sure they have celiac disease.

It is hugely painful.

It is not worth it for a small piece of cake — or anything, really.

And while it might not be as serious as an immediate anaphylactic reaction, that doesn’t mean there aren’t serious, long-term consequences as a result.

So no, thank you, I will not eat cake.

(And yes, I’m well aware that there are gluten-free cakes. I’m actually quite good at making them myself. But that’s not my point.)



What is it like to have celiac disease?

Emily Kaufman, Distributing GlutenTox in N. America – gluten detection kits for home and ind…

On the bright side, having celiac disease means being part of a large, growing community. It’s often an instant connection with other people, because they, or someone they love, also avoids gluten (whether diagnosed as celiac or for other reasons).
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I love my work, but came to it in a very roundabout way. One thing’s for sure, I wouldn’t be doing what I do (selling a gluten test kit called GlutenTox here in the US) if I hadn’t been diagnosed with celiac disease in high school. And working within the community has its own rewards: I’ve been put in contact with a number of inspiring business owners, and I also get to hear from a fascinating group of clients. And I suspect I’m better at my job because in many ways, I am my own customer; gluten-free food is just as important to me as it is to them.

Many people feel that celiac disease has allowed them to become closer to their food, because there is more of an incentive to eat whole foods and avoid prepared / processed items. I can’t say whether or not this is true for me; even as a teen I liked to cook and I wasn’t much of a fan of fast food.

On the negative side, having celiac disease also means frequently being afraid that you are doing irrevocable harm to yourself. Eating can become a bit of a roulette game. It’s not as terrifying as an allergy that induced anaphylactic shock, perhaps, but it’s scary nevertheless. While it’s tempting to compare gluten intolerance with lactose intolerance, the one has a much greater potential to do lasting damage than the other.

I’m not as instantly-symptomatic as many other people with celiac disease, insofar as I cannot always pinpoint the time/source of an accidental glutening and my symptoms are less GI than energy-level related. So for me, it’s less, “If I eat this and there is an accidental crumb in it, will I be in bed for a week?” and more, “Am I inadvertently exposing myself to something that could lead to cancer/osteoporosis/infertility/a schizophrenic child/etc etc etc?”

It does sometimes get tiring needing to ask a million questions when out to eat, and I haven’t had a piece of proper NY pizza in about 10 years. But in general, at least in my experience, having celiac disease is really not so bad.

TUCSON, AZ - APRIL 06:  Loaves of bread sit on racks at Small Planet Bakery April 6, 2008 in Tucson, Arizona.  The cost of staple foods has jumped in the past few years with the price of bread increasing by nearly 30 percent per pound since 2006, according to the Consumer Price Index. A slowing economy combined with continued pricing increases has prompted Americans to be cautious in their consumer spending practices.  (Photo by Chris Hondros/Getty Images)

celiac disease is not caused by early weaning according to recent study

Researchers in Sweden have released the results of an extensive study debunking the long held belief that early weaning is the cause of celiac disease. Instead of ending breastfeeding early, what did the study indicate was the actual trigger for celiac disease?

For years, there was a belief that weening a child from breastmilk early was the cause of celiac disease. Turns out, this is not the case. A recent Swedish study has revealed that the amount of gluten consumed is more apt to cause celiac disease than weening early or giving children gluten at an early age.

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Dietician and doctoral student Andrén Aronson of Lund University in Sweden released a statement based on her thesis that it was the amount of gluten given to a child that triggers the disease.

“The timing of the introduction of gluten, on the other hand, does not seem to be of great significance.”The Local Sweden, reported that the study, entitled the Teddy project, followed 8,700 children in Sweden, Finland, Germany and the United States. In the United States, about one percent of all people have celiac disease, with an estimated two to three million people that have gone undiagnosed. In Sweden, that number jumps to between two and three percent of the entire population that has celiac disease. It is not surprising that there is such an interest in the Nordic country in uncovering the cause of celiac disease

What is celiac disease? According to the Celiac Disease Foundation, celiac is an autoimmune disorder that affects about 1 in 100 people worldwide.

“Celiac disease is a serious genetic autoimmune disorder where the ingestion of gluten leads to damage in the small intestine.”

Those who have celiac disease cannot tolerate the protein gluten. What happens when a person with the disease eats gluten, and where is the protein found?

“When people with celiac disease eat gluten (a protein found in wheat, rye and barley), their body mounts an immune response that attacks the small intestine.”

This incurable disease requires patients to eat gluten-free for the rest of their lives. Found in items from bread to toothpaste, if anyone with celiac consumes gluten, this could become the cause for additional illness, including intestinal lymphoma. Thus, the need for those with celiac disease to adhere to a strict gluten free diet is mandatory.

This is not to be mistaken for the gluten-free bandwagon that has a lot of people – from celebrities to diet books authors – claiming that bread and pasta will make them healthier. For those with celiac disease, consuming even a small bit of gluten is very serious. For anyone else, consuming any amount of gluten does not have the same consequences.

Equipped with this new information, Aronson intends on furthering her study to include other countries. She is focused on trying to uncover why people in Sweden have celiac disease at a much higher rate than in other countries. She is also going to explore how beneficial bacteria, found in such food as Greek yogurt, may play a part in preventing celiac disease.



Celiac Disease The Myth of Big, Bad Gluten

AS many as one in three Americans tries to avoid gluten, a protein found in wheat, barley and rye. Gluten-free menus, gluten-free labels and gluten-free guests at summer dinners have proliferated.

Some of the anti-glutenists argue that we haven’t eaten wheat for long enough to adapt to it as a species. Agriculture began just 12,000 years ago, not enough time for our bodies, which evolved over millions of years, primarily in Africa, to adjust. According to this theory, we’re intrinsically hunter-gatherers, not bread-eaters. If exposed to gluten, some of us will develop celiac disease or gluten intolerance, or we’ll simply feel lousy.

Most of these assertions, however, are contradicted by significant evidence, and distract us from our actual problem: an immune system that has become overly sensitive.

Wheat was first domesticated in southeastern Anatolia perhaps 11,000 years ago. (An archaeological site in Israel, called Ohalo II, indicates that people have eaten wild grains, like barley and wheat, for much longer — about 23,000 years.)

Is this enough time to adapt? To answer that question, consider how some populations have adapted to milk consumption. We can digest lactose, a sugar in milk, as infants, but many stop producing the enzyme that breaks it down — called lactase — in adulthood. For these “lactose intolerant” people, drinking milk can cause bloating and diarrhea. To cope, milk-drinking populations have evolved a trait called “lactase persistence”: the lactase gene stays active into adulthood, allowing them to digest milk.

Milk-producing animals were first domesticated about the same time as wheat in the Middle East. As the custom of dairying spread, so did lactase persistence. What surprises scientists today, though, is just how recently, and how completely, that trait has spread in some populations. Few Scandinavian hunter-gatherers living 5,400 years ago had lactase persistence genes, for example. Today, most Scandinavians do.

Here’s the lesson: Adaptation to a new food stuff can occur quickly — in a few millenniums in this case. So if it happened with milk, why not with wheat?
“If eating wheat was so bad for us, it’s hard to imagine that populations that ate it would have tolerated it for 10,000 years,” Sarah A. Tishkoff, a geneticist at the University of Pennsylvania who studies lactase persistence, told me.

For Dr. Bana Jabri, director of research at the University of Chicago Celiac Disease Center, it’s the genetics of celiac disease that contradict the argument that wheat is intrinsically toxic.

Active celiac disease can cause severe health problems, from stunting and osteoporosis to miscarriage. It strikes a relatively small number of people — just around 1 percent of the population. Yet given the significant costs to fitness, you’d anticipate that the genes associated with celiac would be gradually removed from the gene pool of those eating wheat.

A few years ago, Dr. Jabri and the population geneticist Luis B. Barreiro tested that assumption and discovered precisely the opposite. Not only were celiac-associated genes abundant in the Middle Eastern populations whose ancestors first domesticated wheat; some celiac-linked variants showed evidence of having spread in recent millenniums.

People who had them, in other words, had some advantage compared with those who didn’t.

Dr. Barreiro, who’s at the University of Montreal, has observed this pattern in many genes associated with autoimmune disorders. They’ve become more common in recent millenniums, not less. As population density increased with farming, and as settled living and animal domestication intensified exposure to pathogens, these genes, which amp up aspects of the immune response, helped people survive, he thinks.

In essence, humanity’s growing filth selected for genes that increase the risk of autoimmune disease, because those genes helped defend against deadly pathogens. Our own pestilence has shaped our genome.

The benefits of having these genes (survival) may have outweighed their costs (autoimmune disease). So it is with the sickle cell trait: Having one copy protects against cerebral malaria, another plague of settled living; having two leads to congenital anemia.

But there’s another possibility: Maybe these genes don’t always cause quite as much autoimmune disease.

Perhaps the best support for this idea comes from a place called Karelia. It’s bisected by the Finno-Russian border. Celiac-associated genes are similarly prevalent on both sides of the border; both populations eat similar amounts of wheat. But celiac disease is almost five times as common on the Finnish side compared with the Russian. The same holds for other immune-mediated diseases, including Type 1 diabetes, allergies and asthma. All occur more frequently in Finland than in Russia.

WHAT’S the difference? The Russian side is poorer; fecal-oral infections are more common. Russian Karelia, some Finns say, resembles Finland 50 years ago. Evidently, in that environment, these disease-associated genes don’t carry the same liability.

Are the gluten haters correct that modern wheat varietals contain more gluten than past cultivars, making them more toxic? Unlikely, according to recent analysis by Donald D. Kasarda, a scientist with the United States Department of Agriculture. He analyzed records of protein content in wheat harvests going back nearly a century. It hasn’t changed.

Do we eat more wheat these days? Wheat consumption has, in fact, increased since the 1970s, according to the U.S.D.A. But that followed an earlier decline. In the late 19th century, Americans consumed nearly twice as much wheat per capita as we do today.

We don’t really know the prevalence of celiac disease back then, of course. But analysis of serum stored since the mid-20th century suggests that the disease was roughly one-fourth as prevalent just 60 years ago. And at that point, Americans ate about as much wheat as we do now.

Overlooked in all this gluten-blaming is the following: Our default response to gluten, says Dr. Jabri, is to treat it as the harmless protein it is — to not respond.

So the real mystery of celiac disease is what breaks that tolerance, and whatever that agent is, why has it become more common in recent decades?

An important clue comes from the fact that other disorders of immune dysfunction have also increased. We’re more sensitive to pollens (hay fever), our own microbes (inflammatory bowel disease) and our own tissues (multiple sclerosis).

Perhaps the sugary, greasy Western diet — increasingly recognized as pro-inflammatory — is partly responsible. Maybe shifts in our intestinal microbial communities, driven by antibiotics and hygiene, have contributed. Whatever the eventual answer, just-so stories about what we evolved eating, and what that means, blind us to this bigger, and really much more worrisome, problem: The modern immune system appears to have gone on the fritz.

Maybe we should stop asking what’s wrong with wheat, and begin asking what’s wrong with us.



What celiac disease is really like

What it's really like to have celiac disease |

I’m mad.

And sad.

And frustrated.

And ticked off.

Mad at myself.

Mad at this disease.

Mad at those who call my disease “trendy”.

Two weeks ago, I was “glutened” in a restaurant.  I went through all the right steps, asked all the right questions, and still got sick.  Halfway through my meal, I felt the tingling in my brain telling me gluten had entered my system.  Crap.

I decided to write down my symptoms as they happened so I could give you a better idea of what I go through when that happens.  Not all celiacs react in the same way.  In fact, most of us are very different.  But for me, here’s how it goes down.

Immediate reaction: Tingling brain, pinching sensation in my brain, chills, trouble focusing my eyes, trouble focusing my thoughts, trouble getting complete sentences out.

Lingering symptoms (up to 2 weeks) Headaches (constant the first 2 days, then right after meals), swollen fingers, short temper, burning scalp, hot flashes, upset stomach, fatigue.

Today I was finally starting to feel some relief.  And then…

I freaking glutened myself.  Me, the over-careful, million questions for the restaurant manager, bring-my-own-food girl glutened by my own carelessness.  Glutened with a handful of popcorn.  Popcorn that Trader Joe’s proudly touts as “g+” meaning “no gluten ingredients”.  It’s not Trader Joe’s fault.  I love Trader Joe’s.  It was my fault for not turning the package over as I always do to search for those magic words, “processed in a facility with wheat”.

I don’t know why I didn’t look closely at this package when I’ve inspected every singe bit of food over the past year with a microscope.  Maybe I was tired of being so careful.  Maybe I just wanted to feel normal.  I don’t know.  But I do know that a handful of that popcorn sent me right back into feeling like hell.

My brain started tingling, and I couldn’t get rid of the headache.  I couldn’t figure out how to drive through a construction zone.  My brain wasn’t quite right.  I got the chills.  I was scared to drive home with my little Leila in the car.

I came in the house and started wondering what was going on with me.  Why am I reacting this way?  I didn’t eat anything weird, just my leftover frittata and a banana.  What was going on?  Then it hit me, the popcorn.  I ran to the pantry and turned the bag over.  My heart sank.  I glutened myself.

No waiter to blame, no food company to get mad at, it was me.  All me.

I sat on the bed with tears streaming down my face.

Why did I think this was going to be easy, this celiac living?  How could I have celebrated my diagnosis?

I’ll tell you why.  Because they said it would be easy.  “Just cut out the gluten, and you’ll be fine.”  “It’s not a big deal, there are thousands of gluten-free products these days.”  “You’re lucky you were diagnosed now and not 10 years ago!”

These weren’t celiac patients telling me these things.  These were medical professionals.  Doctors, nurses, dietitians.  All, apparently without the disease themselves.

The truth is, celiac disease is hard.  It is SO hard.  I’m a freaking dietitian and I can’t even handle it.

A friend asked me last week if I think I will ever have peace with my disease.  I told her I hope so, but I’m not sure what that looks like.  This is something I have to think about every time I put food in my mouth, lotion on my hands, chapstick on my lips.

So I’m going to let myself have a pity party tonight, especially knowing I have a week of headaches and hot flashes to look forward to.  But I refuse to let this all be negative.  My prayer is that by sharing my story, I can open your eyes to what it’s really like to have celiac disease.  If it’s this hard for me, a nutrition professional, think of how hard it is for those who’ve never even heard of this condition.

I hope my story helps you understand what a friend or family member goes through.  Though we all suffer differently with celiac disease, we all suffer.



I Didn’t Find Out I Had Celiac Disease Until I Started Miscarrying

Alice Bast didn’t have luck on her side. Starting around the age of 26, she just kept getting sicker. She had constant diarrhea, chronic migraines, extreme fatigue, canker sores, and bloating, and her fingers and toes tingled.

“I would go to the doctor for my GI issues,” Bast remembers, “but they treated me for that symptom, rather than looking at a cause.”

Medication seemed to help in the short-term, despite her lack of a diagnosis, and she began to feel OK. That was when she got pregnant, and her GI symptoms made a raging comeback.”I knew something was wrong,” she says. “But the doctors kept telling me everything seemed fine.”

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Tragically, Bast’s instincts proved correct: In utero, her baby eventually suffered from a condition called intrauterine growth restriction, in which the fetus grows at a very delayed rated or ceases growing altogether. While the reasons can range from infection to high blood pressure, the cause in her case was unclear.

At nine months pregnant, she delivered a stillborn baby.

Her heartbreak was unbearable, but Bast pushed on, desperate for another child. She went on to grieve three miscarriages in a row — their causes all indeterminate.

Finally, she got pregnant with an embryo that stuck and would eventually become her daughter Linnea. But her pregnancy was far from smooth. She was put on bed rest for the last 2 1/2 months, required an emergency C-section, and delivered a 2-pound baby.

“[Linnea] proceeded to grow stronger and I proceeded to grow weaker,” Bast recalls. “I am 5-foot-9 and ended up 105 pounds.”

Bast knew she needed answers, but no one was providing them. Her ob-gyn was so weary of her mysterious case that he even told her she would have to find another doctor if she got pregnant again.

As she bounced from doctor to doctor, they told her she had postpartum depression or irritable bowel syndrome. Of the many gastric and blood tests she underwent, nothing showed up.

“People have diarrhea,” one doctor told her condescendingly.

Her concerns went ignored until she visited the dentist one day. He took one look at her mouth and told her there was something seriously wrong with her. Her teeth were brittle, her gums bleeding.

Meanwhile, her GI doctor had put her on a high-carbohydrate diet, which made her symptoms spiral out of control.

“I couldn’t even walk around the block without having to run to the bathroom,” she says.

Recounting her troubles to a friend who was a veterinarian, Bast received advice that would change her life: “Sometimes animals have trouble with grains,” her friend said. “Ask your doctor to test you for a disease associated with gluten. It’s called celiac.”


By this point, Bast was 34 years old and meeting with doctor no. 22, another GI specialist. She told him her friend’s suspicions about celiac disease, an autoimmune disorder triggered by consuming the gluten protein, which is found in wheat, barley, and rye.

When a person with the disease eats gluten, it triggers the immune system to fight back, leading to damage in the intestine; nutrients have a harder time getting absorbed and symptoms like diarrhea, vitamin deficiencies, and malnutrition are common.

Despite Bast’s insistence that she was a candidate for testing, the doctor at first denied her, telling her she was “too tall” to have celiac, citing a common misconception that celiac always shows up initially in childhood and stunts the child’s growth.

But Bast begged him for the simple blood antibody test that can diagnose celiac.

“Here’s my arm,” she told him. “I’ve had every other test known to man.”

Sure enough, the test came back positive. She then had her first endoscopy, a procedure in which a camera attached to a tube explores a person’s digestive tract, to confirm the diagnosis.

“I was so relieved,” Bast says. “I thought I was dying of cancer.”

Doctors didn’t know it then, but left untreated, the disorder is now known to be associated with reproductive health struggles like hers, in addition to anxiety, depression, thyroid disease, and osteoporosis. Bast suffered from all of these except osteoporosis.

“For many women, unexplained infertility is the only sign of undiagnosed celiac disease,” says Dr. Michelle Pietzak, an assistant professor of clinical pediatrics at the University of Southern Keck School of Medicine, and head of the Division of Pediatric Gastroenterology and Nutrition at Los Angeles County Hospital. “Some studies indicate that celiac disease may occur in as many as 4 to 8 percent of women with unexplained infertility.”

Specific genes may confer a higher risk of developing celiac — but it doesn’t just show up in childhood. Environmental triggers such as pregnancy, surgery, infection, or severe emotional distress can trigger the onset of the disease. In Bast’s case, her doctors now suspect that a parasite infection she got on a trip to Mexico around the age of 26 triggered it, though no one can say definitively.

About 1 percent of the U.S. general population suffers from the disease, though Pietzak says that around 83 percent of those people are not currently diagnosed or are misdiagnosed with conditions like irritable bowel syndrome and lactose intolerance.


“As soon as I went on a gluten-free diet, I started to feel better and better,” Bast says.

But when she was diagnosed back in 1994, the availability and affordability of gluten-free food was limited and she had to order some from Canada. Eating out was practically impossible.

Bast’s background was in business development, and with her newfound lifestyle, she set out to improve the food options and raise awareness for patients like herself. She went back to school to gain expertise in running a non-profit, then launched her now-famous foundation called Beyond Celiac.

Thanks in part to her efforts, gluten-free food has become mainstream. The organization is also heavily involved in promoting further research about this serious genetic disease.

Today, Bast is doing well managing her symptoms, though not perfectly. Even though she advocates for herself in restaurants, she still gets served gluten once or twice a month, which can lead to a burning sensation on her skin, stomach upset, and migraines. It can be socially isolating to follow such a diet, she says, but “it’s worth it to be able to restore my health as much as possible and get back to living.”

And to get one’s fertility back.

“Doctors have observed that many women successfully conceive after a year or more upon receiving a diagnosis, maintaining a strict gluten-free diet, and taking vitamin supplements,” Pietzak says.

Bast and her foundation are looking ahead toward the biggest payoff of all: They have set out to cure celiac. Luckily, there are a few drug treatments being developed that could potentially replace or supplement a gluten-free diet, and clinical trials are underway.

Until then, Bast advises people who suspect they might have celiac to get tested by a doctor and not just try cutting out certain foods on their own, without proper medical instruction. For those struggling to adapt to new dietary restrictions, she offers reassuring words:

“Embrace a gluten-free diet. The world is a lot better than it was 25 years ago. You can do it, and there’s hope for the future.”



Gluten-free diet gains popularity, despite no rise in celiac disease

Though the prevalence of celiac disease in the United States has remained steady, more Americans are adopting a gluten-free diet. This is the finding of a new study published in the journal JAMA Internal Medicine

Celiac disease is an autoimmune condition characterized by an intolerance to gluten – a protein naturally present in wheat, rye, and barley, and which acts as a “glue” in foods such as bread, cereal, and pasta.

When an individual with celiac disease consumes foods containing gluten, the body’s immune system attacks the small intestine, damaging finger-like projections called villi, which are important for absorption of nutrients from food.

[A gluten-free diet]

Symptoms of celiac disease include bloating, chronic diarrhea,constipation, stomach pain, and nausea and vomiting.

The only way for people with celiac disease to avoid these symptoms is to adopt a gluten-free diet, but – as the new study affirms – it seems that even people without the condition are moving toward a preference for gluten-free foods.

The gluten-free diet has gained enormous popularity in recent years; according to market research company NPD, around26-30 percent of adults in the U.S. claim to be reducing their gluten intake or avoiding gluten completely, despite not being diagnosed with any form of gluten sensitivity.

This dietary shift has been attributed to studies that claim avoiding gluten can have significant benefits for the average person, such as weight loss and reduced risk of cardiovascular disease. The gluten-free diet has even been touted by celebrities, including Gwyneth Paltrow and Jenny McCarthy.

Some studies, however – such as one published in the journal Gastroenterology in 2013 – claim that a gluten-free diet has no health benefits for people without celiac disease.

Assessing prevalence of celiac disease, adherence to gluten-free diet

For this latest study, co-author Dr. Hyun-seok Kim, of Rutgers New Jersey Medical School in Newark, and colleagues set out to determine the prevalence of celiac disease in the U.S. in recent years, as well as adherence to a gluten-free diet.

The team assessed 2009-2014 data from the National Health and Nutrition Examination Surveys (NHANES), which included 22,278 individuals aged 6 years and older.

Diagnosis of celiac disease among participants was established through blood tests, and information on adherence to a gluten-free diet was gathered through interviews.

A total of 106 (0.69 percent) participants were diagnosed with celiac disease during the study period, the team found, while 213 (1.08 percent) subjects reported following a gluten-free diet, despite not receiving a diagnosis of celiac disease.

Applying these numbers to the U.S. population, the team estimated that 1.76 million people have celiac disease, and 2.7 million people without celiac disease adhere to a gluten-free diet.

Looking at the prevalence of celiac disease over the 6-year period, the researchers found it remained steady; prevalence was 0.70 percent in 2009-2010, 0.77 percent in 2011-2012, and 0.58 percent in 2013-2014.

However, adherence to a gluten-free diet among individuals without celiac disease increased over the same period, with 0.52 percent following a gluten-free diet in 2009-2010, 0.99 percent in 2011-2012, and 1.69 percent in 2013-2014.

The researchers note that the small number of NHANES participants diagnosed with celiac disease is a major limitation, as is the small number of people without the condition who reported following a gluten-free diet.

Why are more people going gluten-free?

The team says it is possible that adherence to a gluten-free diet has increased because gluten has been identified as a risk factor for celiac disease, and in turn, this could explain why prevalence of celiac disease has not risen.

However, the researchers say it is also possible that more people without celiac disease are adopting a gluten-free diet because of widespread perceptions that it is healthier.

What is more, greater availability of gluten-free products may have also spurred greater adherence to a gluten-free diet.

“[…] there is also an increasing number of individuals with self-diagnosed gluten sensitivity but not the typical enteropathic or serologic features of celiac disease who have improved gastrointestinal health after avoidance of gluten-containing products,” the authors add.

In an editorial linked to the study, Dr. Daphne Miller, of the Department of Family and Community Medicine at the University of California-San Francisco, says these findings should not dismiss gluten-free as a beneficial diet for people without celiac disease.

“Although the choice to be gluten-free may be driven in part by marketing and a misperception that gluten-free is healthier, it is important that this choice not be dismissed as an unfounded trend except for those with celiac disease and wheat allergy,” she notes.

“Instead, researchers and clinicians can use this as an opportunity to understand how factors associated with this diet affect a variety of symptoms, including gastrointestinal function, cognition, and overall well-being.”



6 Unexpected Signs You Actually Have Celiac Disease

Family History

A  study, found that first-degree relatives of a patient with celiac were five times more likely than the national average to be diagnosed

Celiac disease is an autoimmune disorder that is triggered by the intake of gluten — a protein inherent in wheat, barley, and rye. The body responds by attacking the small intestine, which damages the nutrient-absorbing villi that line it. As a result, many people with celiac disease report bloating, diarrhea, gas, weight loss, or fatigue after consuming gluten.

But symptoms of celiac disease tend to differ by age. Only a third of adults are aware of their gastrointestinal issues, and many others instead report unexplained fatigue, joint pain, or depression. Digestive symptoms such as constipation, abdominal bloating, and vomiting are more likely to be present in children and adolescents.

The diverse range of symptoms associated with celiac disease makes it difficult to properly identify. As a result, it’s estimated that 80 percent of the celiac disease population is undiagnosed. That’s why it’s important to be able to recognize the less commonly publicized symptoms. If celiac disease goes untreated it can become dangerous or even life-threatening with long-term complications including cancer, osteoporosis, and iron deficiency.

Here are 6 unexpected signs you actually have celiac disease.


The lining of the small intestine responsible for absorbing iron can be damaged by celiac disease. The autoimmune response triggered by gluten can completely erode the nutrient-absorbing microvilli. Low amounts of iron in the body can be a sign that the small intestine isn’t properly absorbing nutrients.

Discolored Teeth

White, yellow, or brown blotches on adult teeth are symptoms of celiac disease. Tooth discoloration cannot be reversed with the adoption of a gluten-free diet. Erosion of teeth enamel and calcium deficiency are serious problems for celiac patients that can lead to frequent trips to the dentist’s office.

Family History

A  study, found that first-degree relatives of a patient with celiac were five times more likely than the national average to be diagnosed, and suggested that first-degree relatives be screened for the disease.

Lactose Intolerance

Celiac disease damages the small intestine and erodes the microvilli lining responsible for producing lactase, the enzyme needed to break down the lactose found in milk.

Skin Rash
 Dermatitis herpetiformis is a skin rash commonly associated with celiac disease that appears on individuals between the ages of 20 and 45. About 10 to 25 percent of celiac patients develop dermatitis herpetiformis, but the itchy rash often comes without the typical gastrointestinal issues most often associated with the disease. The rash is caused by an immune system response that releases antibodies into the blood

Weak Bones

Celiac disease can lead to a reduction in calcium absorption. Individuals diagnosed as celiac have a 30 percent higher chance of fracturing a bone and as much as a 69 percent higher chance of suffering a hip fracture.



Could Celiac Disease be Affecting Your Sex Life?

Partner Burden’ has been identified as having a negative impact on relationships with more than one-third of partners experiencing poorer sexual and relationship satisfaction. In an overview of  topics covered at Digestive Disease Week 2016, a national meeting for gastroenterologists held in San Diego, California, Dr. David A. Johnson(1) related:

celiac disease sex life

“One of the interesting abstracts that was presented from a group at Columbia University in New York looked at the care burden for the spouse or partner of whomever had sustained illness. They looked at 94 patient-partner pairs, with the patients having celiac disease. They found that there was a sizeable percentage of partners who had had really poor quality of life and poor sexual satisfaction.”

“Something that I think we need to do a better job of is looking at the impact of disease on family life and diseases that partners or spouses may have. Partner burden certainly increases the likelihood that these people without the disease may be having ongoing problems.”

Partner Burden: A Common Entity in Celiac Disease. (2)

Caregiver burden is documented in several chronic diseases, but it has not been investigated in celiac disease (CD).

We aim to quantify the burden to partners of CD patients and identify factors that affect the perceived burden.

94 patients with biopsy-proven CD and their partners completed CD-specific questions, including the validated Celiac Symptom Index (CSI) survey. Partners also completed the validated Zarit Burden Interview (ZBI) and questions regarding sexual and relationship satisfaction.


  • Fifteen patients (16 %) reported a CSI score associated with a poor quality of life, and 34 partners (37 %) reported a ZBI score corresponding to mild-to-moderate burden.
  • Twenty-two partners (23 %) reported moderate-to-low overall relationship satisfaction, and 12 (14 %) reported moderate-to-low sexual satisfaction.
  • The degree of partner burden was directly correlated with patient CSI score (r = 0.27; p = 0.008), and there were moderate-to-strong inverse relationships between partners’ burden and relationship quality (r = -0.70; p < 0.001) and sexual satisfaction (r = -0.42; p < 0.001).
  • On multivariable logistic regression, predictors of mild-to-moderate partner burden were low partner relationship satisfaction (OR 17.06, 95 % CI 2.88-101.09, p = 0.002) and relationship duration ≥10 years (OR 14.42, 95 % CI 1.69-123.84, p = 0.02).

Partner burden is common in CD, with more than one-third of partners experiencing mild-to-moderate burden. Partner burden is directly correlated with patient symptom severity, and it increases with poorer sexual and relationship satisfaction. Healthcare providers should address relationship factors in their care of patients with CD.

celiac disease marital relationship