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Coeliac Disease


Star foods for coeliac disease: almond, amaranth, apple, apricot, banana, beans, brazil nut, broccoli, buckwheat, cantaloupe melon, carrot, cashew nut, Corn, dried apricot, game, lentils, lettuce, linseed, mango, millet, molasses, pear, pea, potato, poultry, pumpkin seed, quinoa, raisin, raspberry, rice, seafood, sesame seed, strawberry, sunflower seed, sweet potato, sweetcorn, tomato, watermelon

Coeliac disease is a hereditary digestive disorder that affects about one in 1500 people in the UK and up to one in 500 in the US. It is caused by a sensitivity to gluten in certain grains. Gluten is the protein found in wheat, kamut, spelt, triticale, barley, oats and rye. Causal factors are unknown but it seems mostly to affect white Europeans or those of European descent and it does run in families.

Coeliac disease is often described as an autoimmune disease. This is because when a food containing gluten is consumed by the sufferer, the body recognizes it as an antigen, or foreign substance, and launches an immune assault. As a result, the lining of the small intestine, which is covered by small hair-like projections called villi, gets damaged and starts to atrophy. This leads to poor absorption of vital nutrients, resulting in malnutrition. Coeliac disease is a serious condition and if left untreated can be life-threatening.

A Dutch doctor during the Second World War first made the connection between gluten and the symptoms of coeliac disease. As a result of rationing and lack of flour (and therefore bread), most children were undernourished and thin. A small minority, however, appeared to thrive on the diet. These children had suffered from stomach illnesses before rationing began. Once the food situation improved these children fell ill again. The doctor experimented with their diet and discovered that wheat and rye were the cause of their problems. Later research identified the culprit as gluten.

Coeliac disease can first strike either in childhood or in adulthood. In children with a hereditary susceptibility, it usually occurs with the introduction of cereal products between four and eight months of age. In an infant, the symptoms are foul-smelling diarrhoea, failure to thrive, poor appetite and resulting lack of weight gain. With older children and adults the disease may be caused by emotional stress, a viral infection or a physical trauma such as surgery. The symptoms include abdominal pain and swelling, pale and foul-smelling diarrhoea, muscle cramps and aches, extreme tiredness and weight loss.

Coeliac disease is difficult to diagnose in children, as symptoms can be very similar to other common childhood disorders such as gastroenteritis, irritable bowel syndrome, food allergies or anaemia. Diagnosis is based on a blood test followed by an intestinal biopsy.

Another complication of coeliac disease can be an increased susceptibility to food allergies. This can occur as a result of the damage that the disease causes to the villi of the small intestine, making the intestine more permeable. A suspected food allergy (see food allergies) is quite a separate condition to coeliac disease but one that needs, equally, to be promptly addressed. The good news is that, if caught early, the damage to the intestines caused by coeliac disease does repair, as long as a gluten-free diet is adopted and maintained on a permanent basis.

The coeliac diet
Once diagnosed, children with coeliac disease will need to avoid gluten for the rest of their lives. This means avoiding any form of food made from wheat, rye, oats and barley, and triticale, kamut and spelt (old forms of wheat). This does not just mean avoiding bread, pasta and flour made from these grains. There are many hidden sources that also have to be eliminated to protect a coeliac child. It is important to learn to read food labels. Here are a few helpful hints:

  • Avoid bread, pastas, flour, biscuits, cakes, crackers and pastry made from wheat
  • Avoid rye breads, crackers, and pastas made from rye
  • Avoid lemon barley water, malt and malt products, barley enzymes used to make rice milk and some brands of soya milk
  • Avoid sauces and soups thickened with wheat flour
  • Avoid food additives manufactured from the culprit grains such as caramel, MSG, maltose, malt, malt flavouring, gum base, citric acid, vegetable gum, maltodextrin and modified starch.
  • Avoid hydrolyzed vegetable protein, textured vegetable protein, some soy sauces, beer, mustard, tomato ketchup, gravy powders, stock cubes, curry powder and seasonings

    Oats contain a protein called avenin, which is similar to gluten. Recent studies have shown that people with coeliac disease may be able to tolerate avenin as it differs in structure from gluten. However, the oats must be grown, milled, packaged and transported away from wheat to avoid cross-contamination. Seek further advice from your doctor on this subject if any of your children are coeliacs.

    Coeliacs need a diet high in non-gluten fibre, iron and B-vitamins. Good sources of fibre are fresh vegetables and fruit, beans, pulses and lentils, seeds and dried fruits. Molasses is an excellent source of iron as are game, poultry and dried fruits. Foods rich in B-vitamins include nuts and seeds, pulses, eggs, milk, fish, lean meat, dried fruits and green leafy vegetables. Also offer foods that contain high levels of beta-carotene and vitamin A, as these help to protect the mucous membranes in the small intestine. Foods that are a good source of beta-carotene include apricot, carrot, butternut squash, broccoli, sweet potato, spinach, watercress, cantaloupe melon, pumpkin, mango and papaya.

    Some gluten-free recipes in my book Immunity Foods for Healthy Kids include: watercress soup; coconut and cauliflower soup; seafood paella; millet porridge with date purée; chicken casserole; handy hummus with baked potato; venison shepherd's pie; baked apple with raisins and spices; parsley eggs; turkey and cranberry burgers; tuna fishcakes; pheasant paysanne; sweetcorn patties; strawberry smoothie; kiwi and banana smoothie; venison burgers; chicken and almond satay with carrot and sesame stir-fry; tuna and prawn brochette with coriander marinade; cod and parma ham parcels with red pesto; salmon lollipops; papaya and lime smoothie; rustic saturday soup; stir-fry duck strips with orange and ginger; family paella; queen scallop stir-fry.


    Extracted from Immunity Foods for Healthy Kids by Lucy Burney, text © 2004, published by Duncan Baird Publishers, London.


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