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September 18, 2012 > People With Celiac Disease Must Avoid Wheat

People With Celiac Disease Must Avoid Wheat

Washington Hospital Seminar Offers Tips for Eating a Gluten-Free Diet

Celiac disease may be more common than once thought. More than 2 million people in the United States have the disease, or about one in 133 people, according to the National Institutes of Health.

"In the last several years, there has been more information and public awareness about the disease, which may mean more people are getting a proper diagnosis," said Kim Alvari, a registered dietitian and director of Food and Nutrition Services at Washington Hospital. "Because the disease is systemic and looks different depending on the individual, it can be very hard to diagnose. It takes about 11 years on average from the time someone notices they have a problem to the time they receive a diagnosis of celiac disease."

To help raise awareness of the disease, Alvari will present "Dietary Treatment for Celiac Disease" on Tuesday, September 25, from 1 to 2:30 p.m. The free seminar will be held at the Conrad E. Anderson, M.D. Auditorium, located at 2500 Mowry Avenue (Washington West) in Fremont. You can register online at or call (800) 963-7070 for more information.

Alvari will provide an overview of celiac disease, an autoimmune disorder that damages the small intestine and interferes with the absorption of nutrients in food. People with the disease can't tolerate gluten, a protein found in a long list of grains, including wheat, barley, rye, couscous, matzo, orzo, and semolina.

When people with celiac disease eat gluten, their immune system responds by damaging villi, fingerlike protrusions that allow nutrients in food to be absorbed through the walls of the small intestine into the bloodstream.

Symptoms Can Mirror Other Diseases

"The symptoms often look like irritable bowel syndrome," she said. "Common symptoms include bloating, chronic diarrhea, gas, constipation, abdominal pain, vomiting, and fatigue. In about 40 percent of cases there are no symptoms. But even with no symptoms, it may still be damaging the small intestine."

Without enough nutrients being absorbed, celiac disease can lead to other conditions like anemia, osteoporosis, and malnutrition. It can also cause damage to the teeth.

"People suffering from some of these other related conditions may experience symptoms like headaches, bone or joint pain, and even depression and anxiety, which can make celiac disease even harder to diagnose," Alvari said. "That's why it's so important for people to know about the disease. As we become more aware of celiac disease, diagnosis rates are increasing."

People with celiac disease have higher than normal levels of certain antibodies in their blood. But Alvari said those who are being tested must continue to eat a diet that includes gluten for the antibodies to be present.

Gluten-Free Diet is Only Treatment Option

Eating a gluten-free diet is the only way to treat celiac disease. People with the disease must avoid foods that contain gluten. For most people, adhering to a gluten-free diet will stop the symptoms, heal existing intestinal damage, and prevent further damage, according to Alvari. She will offer tips for avoiding gluten.

"The good news is there are a lot more gluten-free products available today," she said. "But avoiding gluten can still be difficult because it is in a lot of food additives, thickeners, and stabilizers. You have to be diligent about reading labels."

Alvari recommends that people with celiac disease consult with a dietitian, particularly when they are first diagnosed, to learn how to eat a gluten-free diet because it can be so complicated.

For example, rice-based cereals would seem safe because rice does not contain gluten. But some crispy rice cereals use malt flavoring, which contains gluten. Gluten can also be found in some sauces, salad dressings, soups, seasoned tortilla chips, candy, and other processed foods.

"People with celiac disease should focus on eating a basic diet that includes simple foods like lean meats, fresh fruits and vegetables, low-fat dairy products, and avoid processed foods," she said. "That's the healthiest way to eat."

Alvari will also talk about ways to avoid cross-contamination of foods because even the smallest crumb can damage the intestines. She said it's a good idea to have a separate toaster for gluten-free bread, for example.

For information about nutrition counseling services available at Washington Hospital, visit or call (510) 745-6542. To learn about other classes and seminars offered at Washington Hospital, visit

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