Celiac disease. When we should follow a gluten-free diet?

Surely you know or you have heard someone who removes gluten from diet. But many of them do it without having a specific purpose. Some may remove it because they have heard that gluten is bad for health or that thanks to its elimination we will lose weight… That is why it is important to know what celiac disease is, what gluten is, what effect it has and for whom its removal may be useful.

¿What is celiac disease?

Celiac disease is an immune disorder caused by eating gluten. The immune system reacts adversely to the entry of gluten into the digestive system and consequently damages the intestinal mucosal barrier. This involvement in the intestinal mucosa causes nutrient malabsorption.

Celiac disease can manifest itself at any age, and its symptoms, such as weight loss and appetite, fatigues, nausea and vomiting, diarrhoea, abdominal pain and bloating, anaemia, among others; they can vary according to the individual, and it can even be asymptomatic.

¿What is gluten?

Gluten is a protein found in the seeds of some cereals such as wheat, barley, rye, triticale, kamut, spelt, and some oat varieties.

Fuente: FACE (Federación de Asociaciones de Celíacos de España)

Its main functions in gastronomy are the elasticity, consistency and fluffiness that it contributes to the food product. This means that gluten can not only be found in cereal flours mentioned above, but also artificially added in other food products such as meat.

One of the disadvantages of gluten-free products, unlike traditional products, is that they are highly manipulated products made up of multiple ingredients. This characteristic causes nutritional quality loss to the product. This is why we, dietitians-nutritionists prefer that patients do not follow a gluten-free diet without our supervision.

¿For whom it would be convenient to remove gluten from the diet?

Individuals with celiac disease, allergy, intolerance or gluten sensitivity are the ones who should really follow a gluten-free diet since it is the only treatment for these conditions. It is autoimmune disease, a chronic disease for which no cure ha yet been found and its treatment focuses on reducing symptoms and controlling the immune system.

The gluten-free diet for this population allows a rapid improvement (in few days) of appetite, mood, diarrhoea and constipation. Other changes will also be recovered more gradually, such as bone mineralization due to a lack of iron.

The removal of gluten, in these cases, achieves a recovery of the damaged intestinal barrier and normalizes the absorption of nutrients.

¿What would happen if this population does not follow a gluten-free diet?

For celiacs, the intake of any amount of gluten, even a minimal one, is highly harmful. They could have serious consequences such as the appearance of osteoporosis, anaemia, diabetes, thyroid disorders, and above all, impairment in the growth of children.

Unfortunately, only 1% of the European population is diagnosed with celiac disease. There are many people who suffer from this disease and do not know it because they may not have any symptoms.

Celiac individuals are usually more likely to develop other autoimmune type diseases such as arthritis, Hashimoto thyroiditis, diabetes, Crohn’s disease, or multiple sclerosis, among others. On the other hand, for years it has been studied how gluten can influence these diseases without being celiac.

In addition, people with celiac disease develop Diamine Oxidase (DAO) activity deficiency, or any type of affectation related to the absorption of nutrients in the intestinal mucosa since untreated celiac disease person has a less functional intestinal barrier.

That is why it is important to make a correct diagnosis and follow as a treatment a healthy diet adapted by a dietitian-nutritionist.



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