Non-Responsive Celiac Diet: The Fasano Diet
A non-responsive celiac diet is also known as the Fasano diet. It’s a diet used for those who aren’t responding to a typical celiac-safe diet. Additionally, it is extremely restrictive. It’s designed to give the body a chance to heal by eliminating high cross-contact foods.
High cross-contact foods eliminated include most foods with a food-label. Meaning there is a huge focus on only eating fresh food.
What is Non-Responsive Celiac?
To put it simply, non-responsive celiac disease is when your celiac is not responding. It’s defined as having persistent symptoms, elevated celiac blood test results, and intestinal damage despite 6-12 months of following a verified strict gluten-free diet. Essentially, it’s when the body does not respond to a typical celiac-safe diet.
A 2020 study on non-responsive celiac disease estimates that up to 30% of celiacs will continue to experience inflammation in their gut or have symptoms. Causes include frequent accidental gluten exposure, slow healing, refractory celiac, or another condition.
Non-responsive celiac is often diagnosed after ruling out any potential gluten exposures or causes of lingering symptoms.
What is the Non-Responsive Celiac Diet?
The Fasano Diet or the Non-Responsive Celiac Diet was developed by Dr. Alessio Fasano. It’s for people who are not improving on a strict gluten-free diet.
This diet removes trace amount of gluten. This is because a small portion of the celiac population react to trace amount of gluten in our food system. As a result, the Fasano diet is used to help these people heal and identify their triggers.
This diet is extremely restrictive. It involves focusing on fresh food and eliminating most foods with a food label. It also involves avoiding eating out.
This diet is so restrictive that it’s only used temporarily. The goal is to assess for what foods at high-risk for cross-contact may be triggering continued symptoms.
A celiac dietitian will guide you through the steps of this diet. It’s never to be followed long-term.
Who is Dr. Alessio Fasano?
Dr. Alessio Fasano is a world-renowned pediatric gastroenterologist, research scientist and entrepreneur. He directs the Center for Celiac Research. He specializes in the treatment of patients of all ages with gluten-related disorders.
Dr. Fasano is a celiac-specialist dedicating his work to helping the celiac disease community. Part of his work has been to research and develop the Non-Responsive Celiac Diet, which has been dubbed the Fasano diet.
Fasano Diet Foods to Enjoy:
Depending on the phase of the Fasano diet you’re in determines what foods are allowed. Additionally, your dietitian may make modifications to the diet as necessary. In general, all fresh foods are allowed. You might even call this diet, the celiac fresh food diet. Here’s a more complete list of Fasano diet foods to include:
- Fresh meats, poultry, fish, and eggs
- Dried beans and certified gluten-free unsalted nuts (be sure to carefully analyze both for contamination)
- Brown rice and white rice (plain and unflavored)
- All fresh fruits and vegetables
- Oil, vinegar, honey, salt, and fresh herbs
- 100% fruit/vegetable juices, gluten-free supplemental beverages, gatorade, and water
- Gluten-free multivitamin-mineral supplement
A special note on dairy and the Fasano diet: Milk should be avoided for the first 4 weeks. After 4 weeks, reintroduce unflavored milk, yogurt, aged cheeses and butter
Fasano Diet Foods to Enjoy:
In general, avoid foods with a food label on the Fasano diet. This includes avoiding spices, canned foods, nuts, and more. However, this again is all subject to the work you do with your celiac dietitian.
Foods to avoid on the Fasano diet:
- Lunch meats, ham, bacon and other processed, self-basted, or cured meat products
- Gluten grains: wheat, barley, rye, and related gluten grains
- Gluten-free grains: oats, corn, millet teff, and sorghum
- Pseudograins: amaranth, buckwheat, quinoa, and wild rice
- Frozen, canned and dried fruits and vegetables
- All dairy for the first 4 weeks and then any seasoned and flavored dairy products after
- Flavored and malt vinegars and any processed condiment, avoid spices (except salt and pepper)
This list of foods to avoid is long. It might seem like you need to avoid almost the entire grocery store. This is where the term “shop the outside of the store” really applies.
Tips for Surviving the Fasano Diet
The Non-Responsive Celiac Diet, or the Fasano Diet, is extremely restrictive. Thus, it is dangerous for those with a history of eating disorders, disordered eating, or malnutrition. Before starting this diet, make sure you are seeking the guidance of a celiac-specialized dietitian.
Because this diet is so restrictive, it can feel impossible to follow. Some tips to survive include:
- Balance your diet appropriately by working with a dietitian.
- Make this diet more enjoyable by working with a celiac dietitian.
- Get flavor from fresh herbs, fresh homemade salsas, and more.
- Think outside the box. This level of restriction requires that you get creative with your food.
Above all, remember that his diet is temporary. You do not have to eat this way for the rest of your life. You only have to eat this way for a short-while.
Non-Responsive Celiac Diet 3-Day Meal-Plan
Below is an example non-responsive celiac diet meal-plan. Please note, the below meal-plan is not to take the place of a dietitians guidance. This meal-plan is for educational purposes only. Do not attempt to follow this diet alone. Doing this diet wrong can do a lot of harm.
Fasano Diet Day 1
Breakfast: Homemade Rice Porridge with Fruit.
Lunch: A garden salad dressed with olive oil, vinegar, and salt. Topped with grilled chicken breast and served with a side of brown rice and fresh fruit.
Snack: Sesame-Free Fresh Hummus with fresh vegetables.
Dinner: Slow cooker pork chops & white beans with kale (avoid ground cumin, ground coriander, bay leaves, dried ancho chile, avoid the white beans if still in phase 1).
Fasano Diet Day 2
Breakfast: Savory Rice Porridge with fresh fruit and a hard-boiled egg.
Lunch: Stuffed baked sweet potato with diced chicken, fresh salsa, cilantro, and avocado. Serve with a side salad dressed with olive oil, salt, and vinegar.
Snack: Fasano Friendly Guacamole with vegetables.
Dinner: Salmon broiled with olive oil, lemon, and fresh dill. Serve with a side of steamed brown rice and roasted vegetables.
Fasano Diet Day 3
Breakfast: Scrambled eggs, fried rice, and fresh berries.
Lunch: Avocado egg salad with a side of steamed white rice, fresh vegetables, and an orange.
Snack: Fresh fruit with homemade nut butter
Dinner: Taco bowl with ground sirloin, pinto beans (avoid if in phase 1), brown rice, cilantro, avocado, and fresh salsa. Serve with a side of sautéed zucchini & squash.
Non-Responsive Celiac Diet Summary:
Only follow a non-responsive celiac diet if it’s prescribed by your doctor or dietitian. You must do this diet correctly for safe results. Additionally, you need the help of a celiac dietitian to do it correctly.
The Non-Responsive Celiac Diet is also known as the Fasano diet. This diet involves avoiding most foods with a food label. This limits any cross-contact that may be triggering your celiac to be unresponsive.
In most cases, celiac disease does not require a Fasano diet. A generally safe celiac diet is usually enough for most celiacs.
Talk to your healthcare provider if you are still struggling with lingering symptoms. They will be able to tell you what the next steps to feeling better will be.