Gluten refers to a variety of storage proteins found in grains that cause an autoimmune disorder called celiac disease, or CD. When people with CD ingest gluten from wheat, barley or rye, their immune systems identify the protein as a foreign body and initiate an attack. Although a gluten-free diet is the only effective treatment for CD, it can lead to some nutritional deficiencies.
Features
When gluten-sensitive individuals eat or drink food products containing gluten, the subsequent autoimmune response damages the villi, or tiny finger-like projections on the inside of the small intestine. The damaged villi gradually lose their ability to absorb vital nutrients from the gut, causing deficiencies of vitamins, minerals and sometimes fluid and electrolytes.
Prevention
A gluten-free diet prevents further damage to the villi and allows them to repair. However, even when the villi are back to normal, they may not absorb some nutrients as efficiently as they did before the attack, says the Celiac Sprue Association, or CSA.
Considerations
Knowing that most commercial pasta, breads, cakes, pies, cookies, crackers and other baked goods contain significant amounts of gluten, people with gluten sensitivity avoid these food choices. In the United States, these baked goods are typically enriched with iron, calcium, fiber, thiamin, riboflavin, niacin, folate and other important nutrients. By eliminating enriched grain products from the diet, individuals with celiac disease put themselves at greater risk for nutritional deficiencies.
Recommendations
The Celiac Sprue Association recommends regular blood tests to determine how well the villi are absorbing specific vitamins and other nutrients. Based on these results, people with celiac disease may need to supplement their diet with iron, folate and sometimes one of the B vitamins. Men and women with low bone density might need extra vitamin D. Occasionally, individuals may need fluid and electrolyte replacement that includes calcium, potassium and magnesium.
Tips
The National Foundation for Celiac Awareness hosts a website with an extensive listing of gluten-free enriched food products, as well as online markets and grocery stores carrying these products.
Warnings
People with autoimmune disorders such as celiac disease have a higher risk of developing other autoimmune diseases such as type 1 diabetes and thyroid disorders. These coexisting conditions can cause nutritional deficiencies as well, complicating the picture for gluten-sensitive people.
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