Celiac.com 06/02/2009 - Celiac disease is an autoimmune disorder that is triggered by gluten, and it is being diagnosed more often than in the past. Previously considered quite rare, it is now estimated to occur in 1 in 100-150 people in all societies (with the possible exception of Japan). Physical activity counters some of the lasting symptoms of celiac disease, but some of the symptoms actually may inhibit physical activity. Older adults (+55) with celiac disease may have positive or negative attitudes toward physical activity. As it stands, we’re not sure whether celiac disease helps or hinders their will to exercise.

There are many symptoms associated with celiac disease. They may include neurological symptoms, physical symptoms and overall feelings of fatigue or depression. This makes celiac disease difficult to identify, but also forces individuals with celiac disease to find their own individualized balanced lifestyles. Balanced lifestyles are especially important for older adults with celiac disease because, as anyone diagnosed with a disease knows, they must maintain their physical wellbeing in order to heal. Older adults with celiac disease are also at risk of gaining weight after starting a gluten free diet because their bodies absorb nutrients so much more efficiently than before, and because many gluten-free breads and desert substitutes may be higher in calories than their gluten-containing counterparts.

Because each person with celiac disease exhibits different symptoms, each older adult with celiac disease must find their own way of living with the disease. Their will to excercise depends on how celiac disease has affected their appetite, energy level, mental health, nervous system and overall body functions.

Research about the attitudes of older adults with celiac disease toward physical activity will help to understand:

• The general attitudes of older adults with celiac disease toward physical activity;
• The symptoms of celiac disease that directly or indirectly affect older adults’ attitudes toward physical activity;
• How physicians, recreation centres, celiac associations and the Canadian Government can work with people with celiac disease to maintain or increase their levels of physical activity, and;
• Provide literature on nutrient deficiency and physical activity to patients in need of information or reassurance about their attitudes toward physical activity.
  

Celiac disease may negatively affect the attitudes of people with celiac disease toward physical exercise and activity in two different ways. First, celiac disease symptoms inhibit exercise. Chronic and acute pain, fatigue, bruising and other symptoms associated with nutrient deficiency and celiac disease recovery could easily affect the motivation that people with celiac disease have to exercise. Second, the exercise may exacerbate symptoms of celiac disease. 

Certain studies have shown that allergies can exacerbate or induce food-dependent allergy symptoms (Sampson, 2003). If someone with celiac disease were to experience symptoms as if they were having an allergic reaction to gluten when they conducted certain exercises, they would either try to push through, stop, or change their exercise program or schedule. They could exercise only in the morning, before breakfast and after a long period of not eating, or they could choose activities with less physical impact, such as walking/hiking, or biking.

Symptoms of celiac disease may also encourage exercise. If an older adult with celiac disease finds out that they have low bone density, they may choose to increase their weight bearing activity to encourage bone growth.

There is a long list of symptoms that are associated with celiac disease. Some of the symptoms of celiac disease that are documented in literature about include:

•  No obvious physical symptoms (just fatigue, overall not feeling well)
• gastrointestinal symptoms
• Fatigue
• Weight loss
• Pallor (unhealthy pale appearance)
• Flatulence
• Borborygmi (stomach rumbling)
• Nausea
• Vomiting
• Anorexia
• Voracious appetite
• Iron deficiency anemia
• Failure to thrive
• lymphocytic gastritis
• Vitamin B12 deficiency
• Vitamin D deficiency
• Hypocalcaemia/ hypomagnesaemia
• Vitamin K deficiency
• Coetaneous bleeding
• Epitasis (nose bleeding)
• Hematuria (red urine)
• Gastrointestinal hemorrhage
  

Celiac Disease affects the nutrient absorption level of the small intestine, and people diagnosed with celiac disease should therefore be tested for vitamin deficiencies. Side effects of nutrient deficiency vary from person to person, but the level of nutrient deficiency may affect the amount that someone with celiac disease will exercise. For example, a person's calcium absorption rate may affect their bone density, and a person's iron absorption rate may affect their energy levels. In general, weight-bearing exercise is associated with stronger bone density. Anemia (lack of iron), though, decreases a person’s energy levels. Depending on the person, the two opposing influences of fatigue and bone density loss may sway the person’s attitude toward exercise in different ways.

This is the subject of a human geography honours project at the University of Victoria. If you have any comments on the subject, please contact me by using the comment form below this article.

Related Articles:

• Sampson, H.A. (2003). Food Allergy. Journal of Allergy Clinical Immunology. 111:2, S540-S547.
• Sategna-Guidetti, C. et al. (2000). The effects of 1-year gluten withdrawal on bone mass, bone metabolism and nutritional status in newly diagnosed adult coeliac disease patients. Alimentary Pharmacology & Therapeutics. 14, 35-43.
• Palosuo, K. (2003). transglutaminase-mediated cross-linking of a peptic fraction of w-5 gliadin enhances lgE reactivity in wheat-dependent, exercise-induced anaphylaxis. Journal of Allergy and Clinical Immunocology: 111:6, 1386-1392.
  

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