For people with celiac diease — even those with no obvious symptoms — being on a gluten-free diet can prevent serious, life-threatening complications. But just avoiding gluten doesn’t guarantee that your diet is completely healthy. Here are some things to keep in mind when you shop and plan your meals.
You Will Probably Gain Weight:
Many of us were gaunt and sickly before we were diagnosed. Damage to the villi that line the small intestine — a hallmark of celiac disease — meant that food (and calories) couldn’t be absorbed. After some time on the gluten-free diet, when the intestines start to heal, the nutrients (and the calories) in foods will be absorbed.
Even though we may not be consuming any more calories now than we did when we were eating gluten, it’s likely that we’re going to gain weight. In fact, hard as it may be to imagine for people who were too thin before their diagnosis, studies show an increased risk for obesity on the gluten-free diet. It’s really important to start counting calories.
You’re At Risk for Poor Vitamin Status:
Patients with newly diagnosed celiac disease are usually vitamin deficient. To complicate that problem, gluten-free products are usually low in B vitamins, calcium, vitamin D, iron, zinc, magnesium, and fiber. Few if any gluten-free products are enriched or fortified with these nutrients.
When researchers studied adult celiac patients who had been gluten-free for 10 years, half of the patients had vitamin deficiencies, including low levels of vitamin B-6 or folate, or both, and high levels of homocysteine (a risk factor for heart attacks, vascular disease, and strokes).
Before the study, all the patients had biopsies to prove their intestines were healed and healthy, so these vitamin deficiencies could not be explained by malabsorption. Other researchers have found similar deficiencies in gluten-free adolescents.
When it’s time for an annual check-up, celiac patients should ask their doctor whether their vitamin status needs to be measured, and whether they should be taking folic acid and vitamin supplements.
Your Cholesterol Levels Will Probably Rise:
While I was still eating gluten, my cholesterol levels were always low. I now know why — my intestines weren’t absorbing any of the cholesterol in the foods I was eating. Not any more.
Now I have to watch my cholesterol levels along with everyone else. When I check food labels for the presence of gluten, I also check the fat and cholesterol content. It’s really important to choose low-fat, low-cholesterol foods. Packaged gluten-free products are usually higher in fat than their gluten-containing counterparts.
This is especially true of packaged gluten-free cookies, crackers, and cakes. The American Heart Association says that foods that are high in fiber have been shown to help lower cholesterol — so look for beans, peas, rice bran, citrus fruits, strawberries, apple pulp, and gluten-free oats.
You Might Experience Constipation or Diarrhea:
If you’ve replaced the bread and pasta in your diet with only white rice, the low-fiber diet may lead to constipation. If fiber-rich grains and beans are added to your diet in large amounts too quickly, you might develop gassiness and diarrhea.
Some People Actually Lose Weight:
Changes to your diet to eliminate gluten can also lead to a decrease in caloric intake and weight loss.