Celiac Disease: Symptoms, Diagnosis, and Gluten-Free Diet
What is Celiac Disease?
Celiac disease is a total and permanent intolerance to a set of proteins called prolamins, which are present in wheat, oats, barley, and rye.
It causes a severe injury to the small intestinal mucosa (villous atrophy), linked to a consequent malabsorption of nutrients important to the body. Population studies in Europe, and preliminary results in Argentina, suggest an incidence of about 1 in 200 people.
Celiac Disease Symptoms
The clinical symptoms of celiac disease can be variable and sometimes unremarkable, so the diagnosis is often delayed or never made. Symptoms can start at the beginning of life or take years to appear:
- In infants: The classic symptom is the appearance of soft stools, but sometimes constipation, anorexia, apathy, and irritability can occur.
- In children: Usually, chronic diarrhea, vomiting, abdominal distension, lack of muscle mass, weight loss, growth retardation, short stature, softening, loss of appetite, and changes in temper are present.
- In adolescents: Symptoms include abdominal pain, lack of energy, rejection of sporting activity, and delayed menstrual cycle.
- In adults: Decalcification, diarrhea, spontaneous fractures, malnutrition, spontaneous abortions, or impotence can occur.
Celiac Disease Treatment and Diagnosis
The only treatment for this disease is a strict, lifelong “Sin TACC” (no wheat, oats, barley, rye) diet. Therefore, the need for analysis and certification of products labeled as such with high-efficiency methods and reliability is crucial. In this regard, the Ministry of Health of the Province of Buenos Aires adopted by Resolution 4370/2000 as an official method of analysis of foods for celiac testing the Immuno ELISA detection level of 1 ppm gliadin. This method was studied in the CIDCA, Faculty of Sciences of the Universidad Nacional de La Plata (Doctors Chirdo, Anon, Fossati, Optimization of competitive Elisa for quantification of prolamins in food. Food and Agricultural Immunology 7 (4) :333-343, 1995).
Gluten-Free Diet: Foods to Eat
Recommended Foods
- Milk and dairy products: Yogurt (both normal and low-fat), curd, natural and sweetened petit suisse, all types of cheeses (registered trademarks of Health), including spreadable cheeses (cheese only, without the addition of herbs and flavors).
- Meat, fish, eggs, and derivatives: Meat, Serrano ham of “extra” or “early” quality (check label), all kinds of fish and seafood, frozen seafood coated in natural and gluten-free flours, canned fish (in olive oil, vegetable oil (soybean or sunflower oil), natural, smoked, brine (water and salt)).
- Cereals and cereal products: Rice, maize, millet, and sorghum. Rice flour, maize, potato, wheat starch, carob, and special flours for celiacs that incorporate the international symbol for gluten-free (ear bars within a circle). Pasta and bread products made using flour for celiacs and allowed cereals. Bran cereals, pure tapioca, “gluten-free” breakfast cereals.
- Potatoes and vegetables: Fresh potatoes, fresh or naturally dried vegetables.
- Vegetables: All fresh vegetables (at least one salad a day), frozen vegetables without precooking, provided they mention the ingredients, canned vegetables (raw, cooked, dried, and salted or those containing permitted additives), tomato sauce.
- Fruits: All fresh or roasted fruits.
- Beverages: Water, tea, pure chicory, natural juices.
- Fats: Olive oil and seed oils (sunflower, corn, soy), butter, and 100% vegetable oil margarine.
Foods Allowed Occasionally
- Milk and dairy products: Homemade dairy products like flan, rice pudding, and custard.
- Fruits: Candied and syrup fruits (which add sugar and citric acid), glazed fruit (fruit, sugar syrup, and glucose).
- Cereals and derivatives: Traditional fries, prepared only with potato, vegetable oil, and salt. Popcorn.
- Meat and derivatives: Medium-fat meat (leg of pork or lamb burger in which all ingredients are known), liver, bacon.
- Fat: Sour cream or whipping cream, butter, tallow.
- Beverages: Coffee, decaf, low-alcohol beverages (wine and cider) in moderation. No beer. Soft drinks: soda, carbonated drinks (lemon, orange, cola, tonic, bitter).
- Other products: Pickles, pickled onions, olives (with or without bone and stuffed), sugar, honey, chocolate and pure cocoa, jams, jellies using apple or citrus pectin (E-440-authorized) and locust bean gum (E-410) as thickeners, nuts.