An estimated one per cent of Canadians have celiac disease, an autoimmune disorder that makes it difficult, and even dangerous, for them to eat wheat.
In people with such a sensitivity, gluten, a protein that is found in wheat, rye, triticale and barley damages the surface of the small intestine, making it impossible for it to absorb nutrients from food. There is a genetic component as well; celiac disease is linked to certain genes. Diagnosis is important. If left untreated, celiac disease can cause malnutrition, severe weight loss, osteoporosis and anemia.
A gluten intolerance is a lifelong disorder for which there is no cure. "The only current treatment for people with celiac disease is a gluten-free diet," says Bruce Maddox, executive director for the Canadian Celiac Association (CCA).
With increased awareness and more sophisticated diagnostic testing, more and more Canadians are being properly diagnosed with the disease.
So how do you accommodate a gluten-free diet in a world saturated with wheat products? It isn't easy, but here are some tips to help you live wheat-free.
1. Consult a dietitian
It can be tricky arriving at the correct diagnosis, since the classic symptoms for celiac disease – cramping, weight loss and diarrhea – accompany many other gastrointestinal disorders. "Many people are malnourished by the time they're diagnosed," says Charlotte Varem-Sanders, a registered dietitian in Sherwood Park, Alta. Once a person is diagnosed, all foods containing wheat are off limits, says Varem-Sanders. She encourages clients with celiac disease to consult with a dietitian when mapping out a gluten-free lifestyle.
2. Experiment with new products
Making meals for friends and relatives with celiac disease is getting increasingly simple now that gluten-free foods are available in grocery stores across Canada, says Janet Dalziel, vice-president at the CCA. Dalziel herself was diagnosed with celiac disease at the age of 53. There's now gluten-free pasta, cereal and snacks such as pretzels and cookies. There's even gluten-free beer – La Messagère, from the Canadian brewery New France Beers – available at select stores across the country.
The newer gluten-free products taste better, too. In the past, many gluten-free foods were very dry, but not any more. "We have brownie mixes that have a wonderful taste and are really soft and moist," says Cristina Cicco, a dietitian with The Specialty Food Shop located in The Hospital for Sick Children in Toronto.
Page 1 of 2 – Find great online shops for gluten-free products, plus food-ordering tips for those with celiac disease when eating at restaurants on page 2.
3. Shop online
If you can't find a gluten-free product on the grocery shelf, try an online store, such as The Specialty Food Shop, that ships nationwide. "We have some really innovative foods, such as white rice pizza crust and lots of cookies that are great food ideas for kids," says Cicco. Another online option is glution.com. It carries a wide variety of gluten-free products, including the new Glutino pizza breadsticks ($6.99) and Glutino corn bread ($5.99). In addition to shipping costs, be prepared to pay more for gluten-free alternatives; a small loaf of bread can cost $6, says Dalziel.
4. Always check the label
There are many hidden sources of gluten in food. For instance, even if wheat is not listed on the label there could be wheat byproducts present. Look closely at products that have sauces and dressings. There is also gluten in foods that you wouldn't expect, such as some soy sauces and breakfast cereals. "Corn Flakes, for instance, are sweetened with malt, a derivative of barley," says Varem-Sanders.
5. When in doubt, call the manufacturer
If you're not sure whether a particular food contains gluten even after you read the label, don't hesitate to contact the company that makes it. "Manufacturers are continually updating their product lines, so it's important to get their current ingredient listings," says Varem-Sanders.
6. Avoid cross-contamination
Some celiac disease sufferers can have a reaction to the tiniest trace of gluten, so it's important to store your gluten-free products separately from other foods and to use separate utensils when preparing meals. Contamination can occur in bulk bins at grocery stores or in restaurants where gluten-free foods come into contact with tools used to prepare wheat products.
7. Plan a restaurant outing in advance
Some restaurants are not aware of the severity of the disease, so the threat of contamination makes eating out difficult. As well, restaurants may not offer many healthy gluten-free foods. This makes preplanning meals outside the home all the more important. Dalziel recommends calling ahead to a restaurant if you're unsure about their gluten-free options or kitchen capabilities. "Most high-end restaurants are good because the chef and staff make everything themselves. Even chain restaurants can be accommodating. For example, The Outback Steakhouse restaurants [14 locations across Canada] are celiac friendly and offer a brownie dessert that is gluten-free."
8. Hook into a good support system
Find a friend or colleague who shares your gluten sensitivity. This can help make living a gluten-free lifestyle a whole lot easier.
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