Top FAQs on Celiac Disease : Expert Advice from BC’s Leading Dietitians

Read on to learn more about what Celiac Disease is, get inspired with some gluten-free lunches ideas as well as quick & easy to make recipes from your local BC dietitians nutritionists.  

We will also dive into top gluten-free products that we love.  Keep scrolling down to download our gluten-free toolkit and some delicious surprises(our treat)!

What is Celiac Disease?

Celiac disease is an autoimmune disorder where your own immune system attacks the villi in your small intestine.  Villi are finger-like projections in our small intestine that absorb nutrients (eg. vitamins and minerals) from food. With celiac disease, when people consume gluten, the gluten protein will flatten the villi and if this is left untreated, villi will go flat and will not be able to perform their function of absorbing nutrients.

Some of the symptoms of Celiac Disease may include :

  • chronic or recurrent diarrhea
  • constipation
  • malabsorption
  • unexpected weight loss
  • abdominal pain, distension, bloating
  • unexplained weight loss
  • nutrient deficiencies such as iron, folate, vitamin B12

Diagnosis of celiac disease is confirmed by blood tests (IgA-TTG)  and an intestinal biopsy if the blood test is positive. It is important to note that the testing will only be accurate if you are still eating gluten in your diet regularly.  In Canada, Celiac Disease occurs in approximately 1:100 people. 

What's the Difference between Celiac Disease and Gluten Intolerance ?

Gluten sensitivity is a condition characterized by GI and other symptoms that are associated with eating gluten-containing foods (or wheat-containing foods) when celiac disease and wheat allergy have been ruled out.  Current research suggests that there are no reliable tests or diagnosis for gluten sensitivity and people may be reacting due to different components in these foods such as FODMAPs (Fructans), inflammation status and/or increased intestinal permeability to name a few. 

It is important to rule out a Celiac disease diagnosis if you suspect you have “gluten intolerance” and before you decide to go on a gluten free diet.  This is so that you can get a clear diagnosis, understand and manage your ongoing symptoms, identify your risk for nutritional deficiency, complications of celiac disease, cross contamination risks, to determine how strict and/or how long to follow a gluten-free diet.  This information will also help identify your family members’ risks for celiac disease and associated disorders.

A gluten-free diet can be more expensive and challenging to maintain than a regular diet, getting an accurate diagnosis for celiac disease can help you adhere to the diet and treatment. 

Can Celiac Disease be Cured?

Celiac disease is a lifelong medical condition, unfortunately there is no cure at this time.  The only treatment for celiac disease is to follow a strict gluten-free diet for life.  By removing gluten from the diet, the villi will grow back and absorb nutrients to maintain and support the needs of our body.  This treatment will help you avoid the symptoms and the complications of celiac disease.

What are the Foods I Need to Avoid with Celiac Disease?

The only foods you need to avoid with celiac disease are gluten-containing foods.  In 2012, gluten was added by the CFIA to food labelling regulations.

Gluten is a protein found in barley, rye, oats, wheat and triticale (a cross between wheat and rye) – remember it with the acronym BROW(t). Although almost 1/3 of Canadians are looking for gluten-free products, people may choose to go on a gluten-free diet for a variety of other reasons other than celiac Disease and these may include: gluten sensitivity, gluten intolerance, digestive issues, IBS, a low carb or keto diet. 

With a new celiac disease diagnosis, often people feel a sense of overwhelmed and not really sure where to start.  It’s a big change in your diet and there are loads of information out there, it will take lots of time and experimenting to find your way into a new normal.  A registered dietitian who is experienced with celiac disease can help you get there sooner with a clear path that will lead to your better health.

Do I Have to Worry About Cross Contamination for Gluten?

Yes, you have to take precautions to avoid cross contamination of gluten when you have celiac disease.  As you are cleaning out your kitchen, you need to wash out cupboard where previous gluten flour/products were held and always place gluten-free ingredients above gluten containing foods.

Here are some common places to check for cross contamination at home: 

  • wooden equipment (spoons, cutting boards)
  • pasta strainers
  • cutting board
  • double dipping/condiments (butter/jar and lid items)
  • toaster
  • cast iron skillets
  • waffle iron
  • baking pans, muffin tins, loaf pan, BBQ
  • dish towels and sponges

When Do I Need to Choose Certified Gluten-Free Products?

The use of “Gluten-Free” claim is regulated by Health Canada.  Both certified gluten-free products OR simply a gluten-free claim on the product means that the product must not contain more than 20 ppm of gluten, and is at a level that is safe for the majority of people with Celiac disease.  Certification means the gluten-free products have been tested by a third-party and went through the application process to contain gluten less than 20 ppm.

You want to choose certified gluten-free products, look for a GF logo or claim for these high risk items

  • Gluten free oats
  • Gluten free grains EXCEPT whole rice grains
  • Gluten free flours and starches
  • Products made with gluten free flours and starches (breads, pasta, cereal, bars etc)
  • Dried pulses (beans, lentils, peas) : sort & rinse
  • Hemp hearts
  • Flax seeds
  • Corn flour or corn meal if it’s in the first two ingredients of the products

For other foods not listed here, you can simply read the ingredient list and the “contain” statement and look for and avoid foods that contain BROW(t) as ingredients.  Avoid foods that may contain wheat except in the presence of a gluten-free claim.

Gluten Free Lunchbox Ideas for Kids

Tired of coming up with lunch ideas for your kids?  It even makes it that much more challenging when you are following a gluten-free diet.  Selena Devries, a celiac dietitian, shared her formula in this blog to assembling easy & balance, gluten free lunch boxes: 

  • 2x protein options : tzatziki, sunbutter, pumpkin seed butter, or tahini along with veggies or including a hard-boiled egg, cottage cheese, edamame,  ricotta cheese
  • 1x vegetable: carrot sticks, pepper slices, vegetable skewers, cherry tomatoes, avocado, jicama, cucumber rounds
  • 1x fruit : banana, apple slices, berries, melon cubes, pear slices, canned/packaged unsweetened fruit sauces
  • 1x starch or grain product : whole grain wraps, whole grain bread, whole grain crackers, homemade whole grain muffins/loaves, quinoa, brown rice, granola, buckwheat
  • 1x fun food or snack (optional but these really makes the lunchboxes fun!) : air popped popcorn, granola bar, energy balls, cookies, piece of chocolate

7 Dietitian-Approved Gluten Free Recipes

These are just a small taste of what dietitians can offer! Tag us @bcdietitians if you cook up any of these recipes!  If you or someone you know has been diagnosed with Celiac Disease and/or just needing help with the gluten-free diet, book an online appointment with Find BC Dietitians today! 

References

  1. Clare Douglas. UBC Food, Nutrition and Health Student. 

  2. Compliance and enforcement of gluten-free claims.  Health Canada. Available from : Compliance and enforcement of gluten-free claims – Canadian Food Inspection Agency (canada.ca)

  3. Food Labelling: Guidelines for Individuals with Celiac Disease Following a Gluten-Free Diet.  Canadian Celiac Association. Available from : CCA-Labelling-Document-SEP22.pdf (celiac.ca)

  4. Healthbean Nutrition: What is Celiac Disease?  Available from: https://www.youtube.com/watch?v=LwG4f-zEC7o

  5. Jess Nourishes: Gluten Free Chickpea Pancakes. Available from: Breakfast (jessnourishes.com)

  6. Jess Nourishes: Gluten Free: Tofu King Cute” Roasted Red Pepper Lasagna. Available from: Mains (jessnourishes.com)

  7. Jess Nourishes: The Uncomplicated Buddha Bowl with Tahini Chive Dressing. Available from: Mains (jessnourishes.com)

  8. Recent advances in understanding non-celiac gluten sensitivity.  Available from : Recent advances in understanding non-celiac gluten sensitivity – PMC (nih.gov)

  9. Whitney Hussain: 3 Ingredient Cauliflower Pizza Crust. Available from: https://whitneyhussain.com/2016/08/29/3-ingredient-cauliflower-pizza-crust/

  10. Whitney Hussain: 7 Ingredient Garlicy Rosemary Purple Yam Soup (V+GF). Available from: https://whitneyhussain.com/2017/12/11/7-ingredient-garlicy-rosemary-purple-yam-soup-vgf/

  11. Whitney Hussain: Nom of the Month: Ooey Gooey Gluten Free Black Bean Brownies. Available from: https://whitneyhussain.com/2014/09/30/nom-of-the-month-ooey-gooey-gluten-free-black-bean-brownies/

  12. Selena the Celiac Dietitian. Gluten Free Almond Pulp Blueberry Muffins. Gluten Free Almond Pulp Blueberry Muffins | The Celiac Dietitian (selenard.com)

  13. Screening & Diagnosis of Celiac Disease – Canadian Celiac Association
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