If your child has celiac disease, you will need two of everything in your kitchen: just a source of extra expenses for the most common autoimmune disorder in Canada.
A new guide for parents, Grow Celiac, recommends that food for celiac children be prepared using a toaster, a plate of butter, a chopping board and separate utensils at home, in kindergarten and at school.
Eight foods that may contain hidden gluten
Gluten is a generic name for proteins found in wheat, barley and rye, but is found in many products in addition to cereals and baked goods. Gluten is often used as a binder or leavening agent in other processed foods.
People with celiac disease are advised to read the "Contains or may contain" section of food labels. Although pure oats do not contain gluten, they are often contaminated with gluten and are not recommended for celiac diets if not labeled as gluten-free.
People with celiac disease should also be wary of these foods that may contain hidden gluten:
Source: Growing celiacs: a workbook for parents who raise children with celiac disease, Canadian Celiac Association, 2019
Everything from yeasts, school lunches, birthday party delicacies must be gluten-free.
"Everyday things that most of us would not normally think twice, celiac families have to think a lot more deeply and the costs can add up," said the pediatric gastroenterologist of the University of Alberta Justine Turner, who was the scientific advisor for the publication, developed by and offered free of charge through Canadian Celiac Association.
Prevention of long-term health effects
About one in 100 Canadians will develop the disorder in which the body over-reacts to gluten in foods such as barley, rye and wheat, damaging the lining of the intestine so that the nutrients are not absorbed properly.
It was once thought that celiac disease affected only a few children who could not thrive, Turner said. Now some Scandinavian countries control their entire population for the disease because it has become so widespread.
"People with celiac disease may seem very healthy and have exceptionally mild symptoms that are easy to ignore for a doctor or individual," he said. "They can only feel tired or have occasional belly pains."
Turner said it may take between 5 and 12 years to get a correct diagnosis with a blood test and a biopsy of the intestine.
The long-term impact of untreated celiac disease and related nutritional deficiencies can include fertility problems, osteoporosis and a high risk of developing other autoimmune disorders such as diabetes.
"For the most part, what interests us is to prevent health consequences along the way, as well as helping people with symptoms to feel better," Turner said.
People with celiac disease should always avoid ingesting gluten and will not grow it.
The work book aims to share accurate and accessible information on the diet with the families of children who have recently been diagnosed, said Turner, medical director of the pediatric clinic for multidisciplinary celiacs at the Stollery Children's Hospital in Edmonton.
"Even many doctors do not understand the diagnosis and give their patients misinformation," he said. "They could say that it is not necessary to completely eliminate gluten or that you can return to gluten later. It is not so."
Don't go gluten-free if it's not necessary
Turner said the cost of processed gluten-free foods can be 10 times higher than that of normal foods. And although the growing popularity of gluten-free foods among non-celiacs has helped reduce prices, it advised against the practice.
"If you don't need to follow a gluten-free diet, there's no advantage in following it," Turner said.
In fact, he said, many gluten-free products are not as healthy as wheat-based foods because they are not enriched with added nutrients like vitamin D, folic acid, iron and calcium. Extra fat or sugar is often added to gluten-free products to increase their flavor.
Turner said some people may believe they have celiac disease because they experience bloating when they eat gluten-rich foods like cereals, but this is usually just a natural part of digestion. He encouraged people to ask their doctors for the screening test, which must be done before the patient eliminates gluten from their diet.
"It is very common to hear people claiming to have lost their gluten and to feel better but have not been tested," he said. "If they really have celiac disease, they do not help themselves because they are not diagnosed."
Turner is researching drugs that can temporarily reduce the immune response to gluten, allowing people with celiac disease to eat in restaurants or participate in birthday parties without fear.
He said that completely eliminating gluten from a child's diet can be very stressful for parents.
"Every year we will report some families and children to a psychologist because they have difficulty adapting to the diet," Turner said. "It is not a minor thing to go through this degree of dietary change."
/ Release of the University of Alberta. View in full Here.