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Understanding Celiac Disease and Navigating Gluten-Free Diets

Celiac disease is characterized by an immune response to gluten, a protein found in wheat, barley, and rye. Upon gluten ingestion, individuals with celiac disease experience inflammation and damage to the small intestine, leading to a range of symptoms such as abdominal pain, diarrhea, fatigue, and nutrient deficiencies.
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May marks Celiac Disease Awareness Month, a crucial time to shed light on the intricacies of celiac disease and the dietary challenges it presents. Celiac disease, an autoimmune disorder triggered by gluten consumption, affects approximately 1% of the global population. In this comprehensive guide, we’ll delve into the complexities of celiac disease, examine the impact of gluten-free diets on blood sugar levels, and explore the benefits of incorporating high-fiber, protein-rich alternatives into one’s diet.

 

What is Celiac Disease?

Celiac disease is characterized by an immune response to gluten, a protein found in wheat, barley, and rye [1]. Upon gluten ingestion, individuals with celiac disease experience inflammation and damage to the small intestine, leading to a range of symptoms such as abdominal pain, diarrhea, fatigue, and nutrient deficiencies [2].

Managing celiac disease requires strict adherence to a gluten-free diet, which can pose challenges due to the prevalence of gluten in many staple foods. Gluten-free products, including baked goods, often rely on alternative flours such as rice, corn, or potato starch [3]. However, these flours tend to be higher in starch and have a higher glycemic index compared to gluten-containing counterparts [4].

The glycemic index (GI) measures the rate at which carbohydrates in food raise blood sugar levels. Foods with a high GI can lead to rapid spikes and subsequent crashes in blood sugar, impacting energy levels and long-term health [5]. For individuals with celiac disease who consume gluten-free baked goods regularly, these fluctuations in blood sugar can contribute to overall well-being.

 

Benefits of High-Fiber, Protein-Rich Alternatives:

Fortunately, there are alternatives to traditional gluten-free baked goods that offer numerous benefits for individuals with celiac disease and anyone seeking to improve their diet. High-fiber, protein-rich bread made with almond flour, coconut flour, psyllium husk powder, and flaxseed meal provides a nutritious alternative to starch-heavy options.

Unlike refined starches found in many gluten-free products, these alternative flours are rich in fiber, which slows down carbohydrate absorption and helps stabilize blood sugar levels [6]. Additionally, incorporating protein-rich ingredients such as eggs, Greek yogurt, or protein powder into bread recipes enhances satiety and promotes stable energy levels [7].

High-fiber, protein-rich bread offers benefits beyond blood sugar management. Fiber supports digestive health by promoting regular bowel movements and nourishing beneficial gut bacteria [8]. Protein plays a crucial role in muscle repair and growth, making high-protein bread an excellent option for individuals with active lifestyles [9]. By opting for high-fiber, protein-rich alternatives, individuals with celiac disease can enjoy delicious, nutritious options that support their overall health and well-being.

 

Psyllium Husk Rolls Recipe: 

A favorite recipe of mine was created by Maria Emmerich, featured on Diet Doctor. By making one change to the ingredients and using Almond Flour Protein rather than regular Almond Flour, you get a recipe that has more protein and more fiber than a regular gluten-containing or gluten-free bread. You can make one batch and have one a day as a sandwich or alongside a soup or salad. (Make sure you store the extra rolls in the refrigerator.)

Ingredients

  • 13 cup (1¾ oz.) ground psyllium husk powder
  • 1¼ cups (5 oz.) almond flour protein
  • 2 tsp baking powder
  • 1 tsp sea salt
  • 1 cup water
  • 2 tsp cider vinegar
  • 3 egg whites
  • 2 tbsp sesame seeds (optional)

 

Instructions

  1. Preheat the oven to 350°F (175°C).
  2. Mix the dry ingredients in a large bowl. Bring the water to a boil.
  3. Add vinegar and egg whites to the dry ingredients and combine well. Add boiling water while beating with a hand mixer for about 30 seconds. Don’t over-mix the dough, the consistency should resemble Play-Doh.
  4. Moisten hands with a little olive oil and shape dough into 6 separate rolls. Place on a greased baking sheet. Top with optional sesame seeds.
  5. Bake on a lower rack in the oven for 50-60 minutes, depending on the size of your bread rolls. They’re done when you hear a hollow sound when tapping the bottom of the bun.
  6. Serve with toppings of your choice.

In conclusion, Celiac Disease Awareness Month offers a pivotal opportunity to deepen our understanding of celiac disease and its dietary implications. By exploring the effects of gluten-free diets on blood sugar levels and highlighting the advantages of high-fiber, protein-rich alternatives, we empower those affected by this condition to manage their health more effectively.

Embracing these nutritious alternatives not only aids in stabilizing blood sugar but also enhances overall digestive health and supports an active lifestyle. As part of my practice, I work with many celiac sensitive patients to help them navigate their eating habits and share recipes to help support their needs. If you are living in Washington State, I would be excited to work with you! I accept most major insurances.

 

References:

[1] Rubio-Tapia A, Ludvigsson JF, Brantner TL, Murray JA, Everhart JE. The prevalence of celiac disease in the United States. Am J Gastroenterol. 2012;107(10):1538-1544. doi:10.1038/ajg.2012.219

[2] Leffler DA, Green PH, Fasano A. Extraintestinal manifestations of coeliac disease. Nat Rev Gastroenterol Hepatol. 2015;12(10):561-571. doi:10.1038/nrgastro.2015.131

[3] Missbach B, Schwingshackl L, Billmann A, et al. Gluten-free food database: the nutritional quality and cost of packaged gluten-free foods. PeerJ. 2015;3:e1337. Published 2015 Oct 27. doi:10.7717/peerj.1337

[4] Larsen J, Dall M, Antvorskov JC, Weile C, Engkilde K, Josefsen K, Buschard K. Dietary gluten increases natural killer cell cytotoxicity and cytokine secretion. Eur J Immunol. 2014 Oct;44(10):3056-67. doi: 10.1002/eji.201344328. Epub 2014 Aug 7. PMID: 24943802.

[5] Brand-Miller J, Hayne S, Petocz P, Colagiuri S. Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care. 2003;26(8):2261-2267. doi:10.2337/diacare.26.8.2261

[6] Vuholm S, Nielsen DS, Iversen KN, Suhr J, Westermann P, Krych Ł, Andersen JR, Kristensen M. Whole-grain rye and wheat affect some markers of gut health without altering the fecal microbiota in healthy overweight adults: A 6-week randomized trial. J Nutr. 2017 Nov;147(11):2067-2075. doi: 10.3945/jn.117.254789. Epub 2017 Sep 27. PMID: 28954884.

[7] Paddon-Jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-Plantenga M. Protein, weight management, and satiety. Am J Clin Nutr. 2008 May;87(5):1558S-1561S. doi: 10.1093/ajcn/87.5.1558S. PMID: 18469287.

[8] Makki K, Deehan EC, Walter J, Bäckhed F. The impact of dietary fiber on gut microbiota in host health and disease. Cell Host Microbe. 2018;23(6):705-715. doi:10.1016/j.chom.2018.05.012

[9] Phillips SM, Van Loon LJ. Dietary protein for athletes: from requirements to optimum adaptation. J Sports Sci. 2011;29 Suppl 1(Suppl 1):S29-S38. doi:10.1080/02640414.2011.619204

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