Gluten Free Diet

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Use: This diet is used for patients with gluten sensitive enteropathy, which is referred to as nontropical sprue, celiac sprue, or celiac disease and for patients with dermatitis herpetiformis. Tropical sprue, a similar diarrheal disease, is not responsive to a gluten free diet. The only treatment for celiac disease is to follow a gluten-free diet--that is, to avoid all foods that contain gluten. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet, and the small intestine is usually completely healed. It may take up to 2 years for older adults. The gluten-free diet is a lifetime requirement.

Tips:

• People with celiac disease cannot tolerate gluten, a protein in wheat, rye, barley, and possibly oats.
• Celiac disease damages the small intestine and interferes with nutrient absorption.
• Treatment is important because people with celiac disease could develop complications like cancer, osteoporosis, anemia, and seizures.
• A person with celiac disease may or may not have symptoms.
• Diagnosis involves blood tests and biopsy.
• Because celiac disease is hereditary, family members of a person with celiac disease may need to be tested.
• Celiac disease is treated by eliminating all gluten from the diet. The gluten-free diet is a lifetime requirement.
• Read food labels carefully and do not use anything that contains the following grains: wheat, rye, barley..
• The following do not contain gluten and can be eaten in any amount: corn, potato, rice, soybeans, tapioca, arrowroot,carob,buckwheat, millet, amaranth, and quinoa.
• It is important to make sure that your medication is gluten free. For each drug used ‚ a check of the filler and coating must be made. Call the pharmacist or call the drug company to find out this information.
• Read the additives in foods. Additives that:
  Contain Gluten: Malt flavoring, Hydrolyzed Vegetable Protein, Wheat Starch.
  Could Contain Gluten: Modified Food Starch, Caramel Color, Caramel Flavor, Dextrin, Dextrinmaltose, Texturized Vegetable Protein, Yeast/Yeast extracts.
  Usually Safe: Annatto color, Distilled alcohol, maltodextrin, mono and di-glycerides, monosodium glutamate (MSG), Natural and Artificial color, starch (when listed by itself), skin products, vegetable gums.
• Keep a food diary and write down foods that give you symptoms.
• See a dietitian to help devise an individual meal plan.
• Celiac Support Groups:
  Greater Philadelphia Celiac Sprue Support Group
  CSA/USA- PO Box 31700, Omaha, NE 68131-0700 402-558-0600 Celiac Disease Foundation, 13251Ventura BLVD, Suite 1, Studio City, Ca 91604-1838 818-990-2354     www.celiac.org
  Gluten Intolerance Group of North America, 15110 10th Ave SW, Suite A, Seattle, WA 98166-1820 206-246-6652
• Companies that sell Gluten Free products
  The Dietary Specialties Shoppe, Inc., 184A E. Evergreen Ave Philadelphia, Pa 19118 215-242-5302
  Ener-G Foods, Inc, 5960 1st Avenue. S. Po Box 84487 Seattle Washington 98124-5797
• Cook Book- The Gluten Free Gourmet, Bette Hagman

Sample Menu for Gluten Free Meal Plan
2200 Calories, 28%Kcal from fat

Breakfast Orange juice (1/2 cup) Puffed Rice Cereal (3/4 cup) Banana (1/2) Gluten Free toast (2) Margarine (2tsp) Jelly (1 tbsp) 1% milk or Lactose reduced 1% milk Lunch Tomato juice (3/4 cup) Lean Hamburger (3 oz) Gluten Free Bread/Roll Pure Mayonnaise (1 tsp) Tomato & Lettuce Fruit Salad (1cup) 1% milk or Lactose Reduced 1% milk

Snack 2 Rice Cakes Columbo Yogurt (8 oz) Juice (1 cup) Dinner Green Salad (1 cup) Oil and Vinegar dressing (1 tbsp) Baked Chicken Breast (3 oz) Rice (1/2 cup) Steamed Spinach (1/2 cup) Gluten free Bread (1) Margarine (2 tsp) Juice (1 cup) Snack Rice pudding (1/2 cup)

Sources:

• National Digestive Diseases Information Clearinghouse
  2 Information Way
  Bethesda, MD 20892-3570
  301-654-3810
  http://www.niddk.nih.gov
• Manual of Clinical Dietetics
  4th Edition
  1992, The American Dietetic Association

By: Emily Rubin, RD
Registered Dietitian for Division of Gastroenterology and Hepatology
To contact for questions or to make an appointment:
e-mail: Emily.Rubin@jefferson.edu
phone: 215-955-4152

Emily Rubin RD ,LDN is a registered dietitian who specializes in Gastrointestinal and Liver diseases. She has been part of the Thomas Jefferson University division of Gastroenterology and Hepatology for 6 years.  She also specializes in weight loss and weight management. She has developed numerous educational materials for patients and health care professionals. She has appeared in the media on local ABC news, local FOX news, local CBS news, and CN-8.