Nutrition Related Diseases

GLUTEN SENSITIVITY
A strict gluten-free diet is a key treatment for CD & DH. Lifelong elimination of all foods containing gluten, i.e. wheat, barley, rye, related cereal grains, triticale, spelt, and commercial oats are essential to be symptom-free and maintain a healthy gut.

Furthermore, the gluten-free diet helps prevent further complication, i.e. osteoporosis, fertility problems, lymphoma and other autoimmune diseases. Even if you are symptom-free, you must continue on a gluten-free diet to reduce the risk of these long-term complications.

Symptoms of celiac disease or dermatitis herpetiformis:

  • Diarrhoea
  • Constipation
  • Stomach pain
  • Weight loss
  • Tiredness
  • Low iron levels
  • Skin rash (in DH)

Gluten sensitivity/ Gluten intolerance: According to the AAAAI: Patients may experience the same symptoms as celiac disease, but their blood tests and endoscopies are negative or normal. This condition has been called non-celiac gluten sensitivity (NCGS). Symptoms improve when gluten is eliminated from the diet and return when gluten-containing foods are reintroduced. Someone with a gluten sensitivity or intolerance may be able to handle gluten in small amounts.

Are oats safe for those with gluten intolerance? Avenin is the storage protein found in oats and is not harmful in CD. Commercial oats, however, can be contaminated with wheat, barley, rye and related cereal grains. Pure, uncontaminated oats in moderate amounts for the majority of people with CD are considered safe. A small number of people with CD may not tolerate even pure, uncontaminated oats, but the reason for this is unknown.

Top tips for gluten-free eating:
  1. Choose food with minimum or no added ingredients, e.g. fresh/ cooked vegetables, fruits with no added sauces, plain yogurt, unflavoured soy beverages, meat, poultry, seafood, dried beans, peas and lentils - unflavoured.
  1. Gluten-containing foods are generally good sources of vitamins and minerals. When excluding gluten-containing products ensure sufficient intake of vitamin B, magnesium, iron, zinc and fiber by ensuring sufficient consumption of the following:
  • Gluten-free breakfast cereals topped with ground flaxseed/ chia seed
  • Brown, black, red or wild rice
  • Quinoa, buckwheat or teff
  • Oatmeal (made with pure oats)

Bread made with whole grain gluten-free flours (e.g. pure buckwheat, brown rice or almond flours)

  1. To save time and effort, make a bigger batch of your favourite gluten-free recipes. Put extra portions in the freezer for another day.
  1. Label reading: Check the ingredient list EVERY time, even if it is a natural, gluten-free product as recipes may change.
  1. Medications can contain gluten (check with your pharmacist)
  1. Avoid cross-contamination

Clean preparation tools and surfaces before preparing your food/ use separate utensils (this include pots, plates, knives forks, toasters etc.). Keep different containers of spreads and condiments (peanut butter, butter/, margarine, mustard, apple mouse cottage cheese etc.).

  1. Wrap and store gluten-containing food separately
Example of a meal plan
DAY 1 DAY 2 DAY 3
Breakfast (343 calories)
  • 3/4 cup gluten-free oats cooked in 1 1/2 cups water
  • 1/2 cup raspberries
  • 1 1/2 Tbsp. sliced almonds
  • 1 tsp. drizzle of honey
Top oatmeal with raspberries, almonds and honey.

A.M. Snack (102 calories)
  • 2 medium carrots
  • 2 Tbsp. hummus


Lunch (373 calories) Apple-Cheddar Cheese Toast
  • 1 slice gluten-free bread
  • 1/2 apple, sliced
  • 1 1/2 oz. Cheddar cheese
Top bread with apple slices and cheese; toast until the cheese begins to melt.
  • • 2 cups mixed greens topped with 1 1/2 tsp. each red-wine vinegar and olive oil


P.M. Snack (152 calories)
  • 1/2 apple
  • 1 Tbsp. peanut butter


Dinner (506 calories)
Breakfast (333 calories)
  • 1 slice gluten-free bread
  • 1 1/2 Tbsp. peanut butter
  • 1 medium banana


A.M. Snack (205 calories)
  • 1 oz. Cheddar cheese
  • 1 medium apple


Lunch (362 calories) Tuna & White Bean Spinach Salad
  • 2 cups spinach
  • 2 1/2 oz. chunk light tuna in water, drained
  • 1/2 cup canned white beans, rinsed
  • 1 cup veggies of your choice (try cucumbers & tomatoes)
Combine ingredients and top salad with 1 Tbsp. each balsamic vinegar & olive oil.

P.M. Snack (77 calories)
  • 1/2 cup fresh raspberries
  • 1 1/2 cups unsweetened almond milk


Dinner (504 calories)
  • 4 oz. pork chop, cooked with 2 tsp. olive oil and seasoned with a pinch each of salt and pepper
  • 1 cup Garlic Rosemary Smashed Potatoes
  • 1 cup steamed broccoli
Breakfast (344 calories)
  • 3/4 cup gluten-free oats cooked in 3/4 cup each water and unsweetened almond milk
  • 1/2 cup raspberries
  • 1 1/2 Tbsp. sliced almonds
Top oatmeal with raspberries and almonds.

A.M. Snack (62 calories)
  • 1 medium orange


Lunch (362 calories) Tuna & White Bean Spinach Salad
  • 2 cups spinach
  • 2 1/2 oz. chunk light tuna in water, drained
  • 1/2 cup canned white beans, rinsed
  • 1 cup veggies of your choice (try cucumbers & tomatoes)
Combine ingredients and top salad with 1 Tbsp. each balsamic vinegar & olive oil.

P.M. Snack (241 calories)
  • 1 hard-boiled egg
  • 1 oz. Cheddar cheese
  • 5 gluten-free crackers


Dinner (490 calories)

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