Is a Gluten-Free Diet Enough for Celiac Disease
As your fellow celiac dietetic professional, I feel the need to address the following question:
Is a Gluten-Free Diet enough to treat Celiac Disease?
Keep reading to find out why I don’t think it is.
Celiac Disease is Serious
Celiac, also known as Sprue, is an autoimmune disease. This means that your immune system is compromised, especially when you eat gluten because your body is essentially attacking itself.
Science is finding that autoimmune disease don’t like to be by themselves. They are lonely diseases, so they like to invite their friends to join the party in your body. Meaning, when you have one autoimmune disease, you are far more likely to develop another one. This is called poly-autoimmunity, the development of more than one autoimmune diseases. In fact, About 25 percent of patients with autoimmune diseases tend to develop another one (Cojocaru).
Think about that, if you have celiac disease, that means you could be 25% more likely to develop another autoimmune disease (if you haven’t developed another one already). Diseases that might not have a treatment plan as simple as avoiding gluten.
Is Going Gluten-Free Enough?
Is just buying gluten-free pasta, gluten-free pizzas, bread, and cereal enough? Not by a long shot. The idea of just simply consuming a western diet but just gluten-free will not help anything. You need to pursue a healthy lifestyle as well.
Why? Because a healthy lifestyle can help better manage symptoms of celiac disease, reduce the risk of developing another autoimmune disease, and help repair gut health. All of these things are important goals for people with celiac disease to have.
A healthy celiac disease lifestyle should involve:
Balanced dietary patterns that support your body and honor your needs
A balanced dietary pattern can support your body and its needs by improving gut health and balancing your gut microbiome. Not only that, but a healthy balanced diet can lower the risk of getting another autoimmune disease.
This can mean following a gentle nutrition approach by following choose MyPlate guidelines (of course only eating gluten-free grains). It can mean following a gluten-free modified Mediterranean or DASH diet. Ultimately, it should involve making sure you are balancing your diet with a healthy amount of fruits and vegetables.
I want to emphasize that here I say you want a balanced diet, not a perfect one. Meaning, I am not (and you should not be) against gluten-free alternatives. You should absolutely enjoy a gluten-free pizza or a bowl of gluten-free cereal occasionally. It’s just important not to let these foods overrun your entire dietary pattern. Remember, all foods fit and moderation is key.
You want to focus on whole foods and supplement with gluten-free processed ones.
Physical activity that you enjoy
Physical activity has been proven to improve the microbiome and thus, improve gut health. Something that is much needed when you have an autoimmune disease like celiac disease.
You don’t have to go to the gym everyday or attend a Zumba class regularly if that is not something you enjoy. Something as simple as walking (perhaps mindfully) for 30 minutes a day is enough. Whatever you enjoy and can squeeze is what you should do.
For me, this means walking my dog in the afternoons and dancing while cooking or putting away laundry. I also try to opt for the stairs whenever possible as opposed to elevators and escalators. These little things can help you get the benefits of physical activity without you dreading and forcing yourself to go walk on a treadmill for 30 minutes.
Find what gets the blood pumping that you enjoy, and try to incorporate it into your daily life.
Self-Care and Respect
Self-care is so important to practice when you have celiac disease. When you are living a restrictive lifestyle like a gluten-free lifestyle, your cup can empty fast. That’s why it’s important you routinely filling it (check out this post on how to create a self-care routine).
When we don’t love ourselves we become harsh and judgemental critics of ourselves and of everyone around us.
Judgemental and harsh behavior feeds into negative cycles. Think about it, you go out with friends and you get some gluten-free pizza, you eat a few slices and you start to feel guilty. You realize this pizza doesn’t follow your current diet, and you think to yourself “I just ruined my entire diet, why not eat the whole thing?” and so you do and the cycle continues when you get home.
This can happen in other settings too.
Perhaps you ordered a soup you thought was gluten-free and mid-bowl your server tells you it’s not. Feeling upset that you didn’t do more research, or thinking to yourself you should have known, you decide that you’ll never eat out again. Restricting yourself from enjoying a prepared meal out with friends.
You are human, you are bound to mess up. With the danger of gluten around literally every corner and hand you shake, it’s bound to happen occasionally. It’s important in these instances to not be hard on yourself.
Accept that it happened and take care of yourself as you recover from exposure.
When a Healthy Lifestyle Isn’t Enough
On top of what a healthy lifestyle looks like for people with celiac disease, sometimes following a gluten-free diet doesn’t alleviate all of your symptoms. As mentioned before, a healthy balanced gluten-free diet that focuses on whole foods and is supplemented by gluten-free processed foods is important. And many times is a good first step, however, sometimes it’s not enough.
Sometimes symptoms of celiac disease are persistent and that means it’s time to reevaluate your gluten-free lifestyle. Do you need to follow an elimination diet like the paleo, AIP (which involves the elimination of nightshades), or low-fodmap diet (with the guidance of a dietitian of course). Do you need to be more strict about cross-contamination? Are you reacting to gluten-cross reactive foods?
There are so many other factors to consider on top of a healthy diet when celiac symptoms are improving.
Following a Gluten-Free Diet is Not Enough
Ultimately, just following a gluten-free diet is not enough when you have celiac disease. Granted it’s better than not following a gluten-free diet at all. However, living a healthy lifestyle and taking steps for better symptom management are important for overall health and wellness.
Comment below how you are taking steps to live a healthier diet!
Allen, J M, et al. “Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Apr. 2018, www.ncbi.nlm.nih.gov/pubmed/29166320.
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