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The only treatment for celiac disease is a gluten-free life, so a celiac diet is a gluten-free diet. However, with celiac, it takes the gluten-free diet a little further than some other gluten-related disorders like non-celiac gluten sensitivity.
Here when I use the term diet, I mean eating pattern and dietary needs. I do not mean a temporary meal-plan or way of eating like you might see for weight-loss
Before we get into what a celiac diet is, we need to understand what celiac is.
Celiac is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. When people with celiac disease eat gluten (a protein found in wheat, rye, barley, and contaminated foods like oats), their body mounts an immune response that attacks the small intestine.
These attacks lead to damage to the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.
This inflammatory response to gluten and related nutrient deficiencies can cause a wide variety of symptoms in people with celiac. From bloating, headaches, constipation, joint pain, bone health complications, infertility, weight gain, weight loss, and more.
This can start at any age, and occur in any body, as long as someone is eating gluten and has the celiac genes. If left untreated, celiac disease can lead to additional serious health problems.
A celiac diet is a diet for people with celiac disease. Celiac disease is an autoimmune disease where the small intestine is damaged when the person affected eats gluten.
Thus, this diet involves eating gluten-free 100% of the time, but it also involves avoiding cross-contact, balancing your diet to heal celiac, and managing any other food sensitivities you might have with celiac.
All of those factors combined makes a diet for celiac unique to the individual. So, let’s talk about each of these factors and how they impact the needs of people with celiac.
If you have celiac, you need to avoid gluten containing foods. These foods come from the gluten-containing grains barley, rye, oats (if not certified gluten-free or in a certified gluten-free product), wheat, and spelt (an ancient form of wheat).
You might find it helpful to remember the acronym “BROWS”, which represents the 5 gluten grains to avoid.
For a deep dive on specific foods to avoid if you have celiac, click here.
Cross-contact is when a protein of one food mixes with another food that wouldn’t otherwise have that protein. In the case of celiac disease, cross-contact is when food with gluten touches gluten-free food.
A key difference between celiac disease and gluten intolerance is that a celiac diet can have no cross-contact with gluten. That means absolutely no gluten should touch a celiac’s food.
Whereas, with a gluten-free diet for gluten intolerance, cross-contact needs vary depending on the person.
Basically, if you have celiac disease, it’s very important that your diet avoids gluten and cross-contact with gluten to stay safe.
And some times cross-contact needs to be taken even more seriously (yes, it gets more serious), like with the fasano diet.
A diet for celiac is not only one that is gluten-free but also is one that supports healing.
It also makes sure that no nutrients are missed in the diet. (Check out this post for 5 Common Gluten-Free Diet Nutrient Deficiencies)
In general this looks like a diet free from gluten that is balanced with a variety of fruits, vegetables, protein, gluten-free whole grains and healthy fats.
It’s important to note that everyone’s healing needs will be different so while we have these general guidelines, a balanced diet will look very different for everyone with celiac.
People with celiac often have food sensitivities on top of their gluten-free needs, especially as they heal. This is because the damage in the small intestine impacts what is known as the brush border. The brush border is located on the villi and is where many digestive enzymes, like lactase, are released.
These digestive enzymes help break down food so your body can absorb it. So, when the brush border is damaged, as it often is with celiac, it can cause food sensitivities like lactose intolerance.
It’s also important to note other changes related to the damage can influence food sensitivities as well, so being mindful and of how food impacts you and tailoring your diet to your needs is important.
A celiac diet stops triggering the celiac autoimmune reaction to gluten. This in turn, stops the gut from being damaged and gives it a chance to heal. Thus, this diet helps heal celiac.
There are a lot of claims about curing autoimmune disease out there. These claims make people curious on if celiac can be cured.
Unfortunately, the answer is no. A gluten-free diet can not cure celiac. There is no current cure for celiac.
Many people miss gluten when eating gluten-free. Understandably, this makes them consider “cheating”. In other words, people wonder if they can have gluten every now and then.
Unfortunately, with celiac disease you can not cheat on the diet. This is why many people call it a lifestyle not a diet. It is essential you take every step you can to stay gluten-free. This means eating gluten-free foods and avoiding cross-contact.
If you don’t, you can put yourself at risk for malnutrition, certain cancers, bone disease, infertility, and more.
The length of time it takes to heal celiac varies widely per person. Sometimes it takes a couple of months to heal and feel better, other times it can take a few years.
Things that factor into how long it takes for the diet to work include:
There’s a lot more that plays into it. A dietitian can help if you’re worried about how long it’s taking to heal.
A huge misconception is that celiac and safety is the same for everyone. What I mean is that people assume what is safe for one person with celiac, will be safe for the next.
What I hope this post has conveyed is that the needs of people with celiac vary per person. Not everyone with celiac will or can eat the same thing.
A celiac’s needs encompass a wide-variety of factors like cross-contact, gut health, food sensitivities, comfort-level, knowledge-level, skill-level and more.
While everyone with celiac is gluten-free and avoid cross-contact, the level of cross-contact can change depending on the person’s comfort, skill, and knowledge level.
Every celiac’s balanced diet for healing is going to look different depending on their needs and food sensitivities.
Need help with your diet? Not sure how serious to take cross-contact? Unsure how to balance your gluten-free life? Or need help figuring out what food sensitivities you have? Working with a celiac nutritionist, like myself, can help.