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Celiac.com 04/05/2023 - Over the past few years, the gluten-free food market has grown significantly. However, it is important to question whether these products are actually contributing to balanced diets. A recent study aimed to investigate the nutritional composition of various gluten-free products produced nine years apart. The study also compared the nutritional compositions of 104 gluten-free products currently marketed in Spain with their gluten-containing counterparts. The Researchers The study team included Claudia Mármol-Soler, Silvia Matias, Jonatan Miranda, Idoia Larretxi, María del Pilar Fernández-Gil, María Ángeles Bustamante, Itziar Churruca, Olaia Martínez, and Edurne Simón. They are variously affiliated with the Gluten Analysis Laboratory, Department of Pharmacy and Food Science, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain; the GLUTEN3S Research Group, Department of Nutrition and Food Science, University of the Basque Country, 01006 Vitoria-Gasteiz, Spain, the Bioaraba, Nutrición y Seguridad Alimentaria, 01006 Vitoria-Gasteiz, Spain; and the Centro Integral de Atención a Mayores San Prudencio, 01006 Vitoria-Gasteiz, Spain. The Methods Three descriptive and comparative studies were done on gluten-free products. The first study compared the nutritional information panel (NIP) of 104 gluten-free products from 11 specific brands in 2013 against the same products currently available in 2022. The second study made a nutritional comparison between 104 currently available gluten-free products and their analogs with gluten. Both studies recorded NIP data and analyzed nutrient composition. The third study aimed to highlight the impact on nutritional value of a possible gluten-free product inclusion in a celiac diet by comparing a diet that includes gluten-free products and the same diet with gluten foodstuffs. The Findings Their research showed nutritional differences between gluten-free products produced in 2013 and 2022, particularly in the areas of cookies, breakfast cereals, doughs/puff pastries/pizzas, and breads. Additionally, the pasta group had significant decreases in energy, protein, simple carbohydrates, saturated lipids, dietary fiber, and salt. When comparing gluten-free and similar gluten-containing products in 2022, the major differences were found in protein and salt. This indicates that gluten-free products lead to a diet lower in protein and higher in salt and carbohydrates. Although there have been some improvements in the formulation of gluten-free products, the macronutrient profile still varies greatly, and gluten-free products cannot be considered nutritionally equivalent, let alone superior, to their gluten-containing counterparts. Basically, in many cases, the nutritional value of gluten-free products has gone down over the years. Because of this, celiacs need to update our knowledge, and learn more about the nutritional composition of the foods we eat, especially gluten-free products. This will help us to make better choices, and and to better manage our condition. As always, stay informed, choose carefully, and trust your gut. Read more in Foods 2022.

Celiac.com 01/27/2024 - We've done many articles that cover nutrient deficiencies that are associated with untreated celiac disease, but many people do not realize that celiac disease can also lead to malabsorption of medications and supplements. Celiac disease damages the lining of the small intestine, where both nutrient and certain medication absorption takes place. This damage can result in decreased absorption of various substances, including both over the counter and prescription medications, and supplements. Medications that are taken orally and absorbed in the small intestine may be affected by malabsorption in individuals with untreated celiac disease. As a result, the effectiveness of these medications might be compromised. It's essential for individuals with celiac disease to maintain a strict gluten-free diet to allow the small intestine to heal and improve nutrient absorption, including medications. Common Medications Affected by Celiac Disease Malabsorption Here are some common medications that may be affected by celiac disease-related malabsorption, but many more medications might also be affected: Thyroid Medications: Medications used to treat thyroid disorders, such as levothyroxine, may have reduced absorption in individuals with untreated celiac disease. Certain Antibiotics: Some antibiotics, including tetracycline and doxycycline, are absorbed in the small intestine. Malabsorption issues may affect their effectiveness. Anti-Inflammatory Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, commonly used for pain and inflammation, may have altered absorption in individuals with celiac disease. Certain Anticonvulsants: Medications used to treat seizures, such as phenytoin, might be impacted by malabsorption in untreated celiac disease. Oral Contraceptives: Birth control pills, which are taken orally, may be affected by malabsorption in individuals with celiac disease. Blood Pressure Medications: Calcium Channel Blockers: Medications like amlodipine, which are calcium channel blockers used to treat high blood pressure, may be affected by impaired calcium absorption. Beta-Blockers: Some beta-blockers, such as metoprolol, may have altered absorption due to malabsorption issues. Cholesterol-Lowering Medications: Statins: Medications like atorvastatin and simvastatin, commonly prescribed for managing cholesterol levels, might be impacted by malabsorption in the small intestine. Pain Medications: Opioids: Medications containing opioids, such as codeine or oxycodone, may have absorption challenges in individuals with untreated celiac disease. Diabetes Medications: Metformin: This common medication for managing diabetes may be affected by impaired absorption in individuals with celiac disease. It's important to note that individual responses to medication can vary, and the severity of malabsorption can differ among those with celiac disease. Therefore, open communication with healthcare providers is crucial to monitor medication effectiveness, adjust dosages when needed, and explore alternative treatments if necessary. Common Supplements Affected by Celiac Disease Malabsorption Here are some common supplements that may be affected by celiac disease-related malabsorption, but many more supplements might also be affected: Calcium Supplements: Calcium carbonate or citrate: Individuals with celiac disease may experience difficulty absorbing calcium, impacting bone health. Supplementing with calcium is common to address potential deficiencies. Iron Supplements: Iron sulfate or ferrous fumarate: Celiac disease can lead to iron deficiency anemia due to impaired iron absorption. Iron supplements are often recommended to address low iron levels. Vitamin D Supplements: Cholecalciferol (Vitamin D3): Malabsorption of fat-soluble vitamins, including vitamin D, can occur in celiac disease. Supplementation is often necessary to maintain adequate vitamin D levels. B Vitamins: B12 (Methylcobalamin): Deficiencies in B vitamins, particularly B12, may occur in individuals with celiac disease due to malabsorption. B12 supplements can be prescribed to address deficiencies. Folate (Folic Acid or Methylfolate): Methylfolate: Similar to B12, folic acid absorption may be compromised. Supplementing with methylfolate can be considered. Zinc Supplements: Zinc citrate or picolinate: Zinc absorption may be reduced in celiac disease. Zinc supplementation is recommended for those with zinc deficiencies. Magnesium Supplements: Magnesium citrate or glycinate: Malabsorption issues can affect magnesium levels. Supplementing with magnesium is common to address deficiencies. Omega-3 Fatty Acids: Fish Oil (EPA and DHA): Essential fatty acids may be poorly absorbed. Omega-3 supplements can help maintain a balance of these crucial fats. Summary Individuals with untreated celiac disease may experience malabsorption of various medications and supplements due to damage to the small intestine's lining. This can impact the absorption and effectiveness of certain drugs and supplements that are commonly taken or prescribed for various conditions. It's essential for individuals with celiac disease to be aware of potential interactions and work closely with their healthcare providers, including pharmacists, to ensure appropriate adjustments in medication dosage or explore alternative forms of administration when necessary.

Celiac.com 04/15/2023 - Celiac disease is a chronic autoimmune disorder that affects the small intestine, triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. One often overlooked consequence of untreated and undiagnosed celiac disease is the potential for nutrient deficiencies. Due to the damage caused to the lining of the small intestine, absorption of various essential nutrients may be impaired, leading to deficiencies that can have wide-ranging health effects. In this article, we will explore the connection between celiac disease and nutrient deficiencies, focusing on several key vitamins, minerals, and other essential nutrients. The most common nutrient deficiencies associated with celiac disease that may lead to testing for the condition include iron, vitamin D, folate (vitamin B9), vitamin B12, calcium, zinc, and magnesium. Celiac disease can disrupt the absorption of these essential nutrients, potentially leading to anemia, bone health issues, and other health complications. After a celiac disease diagnosis it is important to do follow up testing for these nutrient deficiencies, as well as a follow-up endoscopies/biopsies to make sure that a patient's damaged villi are healing properly. Many of those with celiac disease will need to take vitamin and mineral supplements at the time of their diagnosis, and some will need to continue taking them for life. Note that having nutrient deficiencies alone would not be enough for a definitive diagnosis of celiac disease, and further testing is required to make a formal diagnosis. Boron Boron is a trace mineral that plays a role in bone health, brain function, and metabolism of certain nutrients. Deficiency in boron is rare, but it can lead to symptoms such as muscle weakness, joint pain, and impaired cognitive function. Untreated and undiagnosed celiac disease can cause malabsorption of boron due to damage to the small intestine lining, potentially leading to a deficiency. Supplementation of boron may be needed for individuals with celiac disease, especially if they have prolonged untreated celiac disease or other risk factors for deficiency. Calcium Calcium is an essential mineral that is crucial for bone health, nerve function, and muscle contraction. Deficiency in calcium can lead to symptoms such as weakened bones, muscle cramps, and numbness and tingling in the extremities. Malabsorption of calcium can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of osteoporosis and other bone-related complications in individuals with celiac disease. Measuring blood levels of calcium alone is not always an accurate indicator of calcium deficiency because the body will leach calcium from the bones to maintain normal blood levels of calcium. Therefore, bone density loss and other secondary indicators are often better diagnostic tools for detecting calcium deficiency. Calcium supplementation, along with a calcium-rich diet, may be necessary for individuals with celiac disease to maintain adequate calcium levels and support bone health. Chloride Chloride is an electrolyte that is involved in maintaining proper fluid balance, nerve function, and acid-base balance in the body. Deficiency in chloride is rare, but it can lead to symptoms such as muscle weakness, lethargy, and irregular heartbeat. Malabsorption of chloride can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can disrupt the body's fluid balance and electrolyte levels, further complicating the health of individuals with celiac disease. Proper monitoring of chloride levels and supplementation may be necessary for individuals with celiac disease, especially if they have prolonged untreated celiac disease or other risk factors for deficiency. Choline Choline is an essential nutrient that plays a role in brain development, nerve function, and liver health. Deficiency in choline can lead to symptoms such as cognitive decline, liver dysfunction, and muscle damage. In celiac disease, malabsorption of choline can occur due to damage to the small intestine lining, potentially leading to a deficiency. Supplementation of choline may be necessary for individuals with celiac disease, especially if they have prolonged untreated celiac disease or other risk factors for deficiency. Image: CC BY-SA 2.0--User: Pumbaa (original work by commons:User: Greg Robson Chromium Chromium is a trace mineral that is important for glucose metabolism and insulin function. Deficiency in chromium can lead to symptoms such as impaired glucose tolerance, increased insulin resistance, and poor blood sugar control. Malabsorption of chromium can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. Supplementation of chromium may be needed for individuals with celiac disease, especially if they have poor blood sugar control or other risk factors for deficiency. Copper Copper is an essential trace mineral that plays a role in various processes in the body, including energy production, connective tissue formation, and immune function. Deficiency in copper can cause symptoms such as anemia, bone abnormalities, and impaired immune function. In celiac disease, malabsorption of copper can occur due to damage to the small intestine lining, potentially leading to a deficiency. This can further compromise the overall health of individuals with celiac disease and increase the risk of related complications. Supplementation of copper may be necessary for individuals with celiac disease to maintain adequate copper levels and support overall health. Iodine Iodine is a trace mineral that is essential for thyroid function, metabolism, and brain development. Deficiency in iodine can cause symptoms such as goiter, fatigue, weight gain, and impaired cognitive function. Malabsorption of iodine can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further disrupt thyroid function and metabolism, and impair cognitive development in individuals with celiac disease, especially in children. Iodine supplementation, along with a well-balanced diet that includes iodine-rich foods such as seafood and iodized salt, may be necessary for individuals with celiac disease to maintain adequate iodine levels and support overall health. Iron Iron is an essential mineral that is required for the production of hemoglobin, the protein in red blood cells that carries oxygen to all parts of the body. Deficiency in iron can cause symptoms such as anemia, fatigue, weakness, and pale skin. Malabsorption of iron can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further exacerbate the risk of anemia and related health issues in individuals with celiac disease. Iron supplementation, along with a well-balanced diet that includes iron-rich foods such as meat, poultry, beans, and fortified cereals, may be necessary for individuals with celiac disease to maintain adequate iron levels and support overall health. Lutein Lutein is a carotenoid antioxidant that is important for eye health and vision. Deficiency in lutein can cause symptoms such as blurred vision, macular degeneration, and increased risk of eye-related disorders. Malabsorption of lutein can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of eye-related issues and compromised vision in individuals with celiac disease. Lutein supplementation, along with a diet rich in lutein-containing foods such as leafy green vegetables, egg yolks, and corn, may be necessary for individuals with celiac disease to maintain adequate lutein levels and support overall eye health. Lycopene Lycopene is a carotenoid antioxidant that is known for its role in prostate health and reducing the risk of certain cancers. Deficiency in lycopene can cause symptoms such as increased risk of prostate cancer, cardiovascular disease, and oxidative stress. Malabsorption of lycopene can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of prostate cancer, cardiovascular issues, and other health complications in individuals with celiac disease. Lycopene supplementation, along with a diet rich in lycopene-containing foods such as tomatoes, watermelon, and red bell peppers, may be necessary for individuals with celiac disease to maintain adequate lycopene levels and support overall health. Image: CC BY-SA 2.0--User: Pumbaa (original work by commons: User: Greg Robson) Magnesium Magnesium is a vital mineral that plays a critical role in numerous physiological processes, including nerve function, muscle contraction, and bone health. Deficiency in magnesium can cause symptoms such as muscle weakness, tremors, irregular heartbeat, and bone loss. Malabsorption of magnesium can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of muscle weakness, nerve-related issues, and compromised bone health in individuals with celiac disease. Magnesium supplementation, along with a diet rich in magnesium-containing foods such as leafy green vegetables, nuts, seeds, and whole grains, may be necessary for individuals with celiac disease to maintain adequate magnesium levels and support overall health. Manganese Manganese is an essential trace mineral that is involved in various metabolic processes, including carbohydrate metabolism and bone formation. Deficiency in manganese can cause symptoms such as impaired glucose tolerance, bone abnormalities, and altered cholesterol levels. Malabsorption of manganese can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of metabolic issues, bone-related complications, and altered cholesterol levels in individuals with celiac disease. Manganese supplementation, along with a diet rich in manganese-containing foods such as whole grains, nuts, seeds, and legumes, may be necessary for individuals with celiac disease to maintain adequate manganese levels and support overall health. Molybdenum Molybdenum is a trace mineral that is essential for various enzymatic reactions in the body, including detoxification processes and metabolism of certain nutrients. Deficiency in molybdenum is rare but can cause symptoms such as rapid heartbeat, neurological issues, and growth retardation. Malabsorption of molybdenum can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of cardiovascular issues, neurological complications, and growth retardation in individuals with celiac disease. Molybdenum supplementation, along with a diet rich in molybdenum-containing foods such as legumes, whole grains, and nuts, may be necessary for individuals with celiac disease to maintain adequate molybdenum levels and support overall health. Nickel Nickel is a trace mineral that is required in very small amounts for various enzymatic reactions in the body. Deficiency in nickel is rare and typically occurs in individuals with specific health conditions. Malabsorption of nickel can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of compromised enzymatic reactions and related health issues in individuals with celiac disease. Nickel supplementation is not typically necessary, as the body requires only trace amounts of nickel. However, it is important for individuals with celiac disease to maintain a well-balanced diet that includes nickel-containing foods such as nuts, legumes, and whole grains to support overall health. Phosphorus Phosphorus is an essential mineral that plays a crucial role in bone formation, energy metabolism, and cellular function. Deficiency in phosphorus is rare and usually occurs in individuals with specific health conditions or imbalanced diets. Malabsorption of phosphorus can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of compromised bone health, energy metabolism, and cellular function in individuals with celiac disease. Phosphorus supplementation is not typically necessary, as phosphorus is abundant in many foods. However, it is important for individuals with celiac disease to maintain a well-balanced diet that includes phosphorus-containing foods such as dairy products, meat, fish, nuts, seeds, and whole grains to support overall health. Image: CC BY-SA 2.0--User: Pumbaa (original work by commons: User: Greg Robson) Potassium Potassium is a crucial mineral that is involved in numerous physiological processes, including nerve function, muscle contraction, and heart health. Deficiency in potassium can cause symptoms such as muscle weakness, fatigue, irregular heartbeat, and increased blood pressure. Malabsorption of potassium can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of nerve-related issues, muscle weakness, and cardiovascular complications in individuals with celiac disease. Potassium supplementation, along with a diet rich in potassium-containing foods such as fruits, vegetables, dairy products, meat, and legumes, may be necessary for individuals with celiac disease to maintain adequate potassium levels and support overall health. Selenium Selenium is an essential trace mineral that is involved in various antioxidant and immune functions in the body. Deficiency in selenium can cause symptoms such as compromised immune function, muscle weakness, fatigue, and hair loss. Malabsorption of selenium can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of impaired immune function, muscle weakness, and related health issues in individuals with celiac disease. Selenium supplementation, along with a diet rich in selenium-containing foods such as fish, meat, dairy products, nuts, and seeds, may be necessary for individuals with celiac disease to maintain adequate selenium levels and support overall health. Silicon Silicon is a trace mineral that is involved in various processes such as bone formation, connective tissue health, and hair, skin, and nail health. Deficiency in silicon is rare, as it is found in many foods, but it can cause symptoms such as compromised bone health, weak connective tissue, and brittle nails. Malabsorption of silicon can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of compromised bone health, connective tissue issues, and related health concerns in individuals with celiac disease. Silicon supplementation is not typically necessary, as silicon is abundant in many foods. However, it is important for individuals with celiac disease to maintain a well-balanced diet that includes silicon-containing foods such as whole grains, fruits, vegetables, nuts, and seeds to support overall health and prevent deficiency. Vanadium Vanadium is a trace mineral that has been suggested to play a role in blood sugar regulation and bone health, although its exact functions are not yet fully understood. Vanadium deficiency is rare, as it is found in small amounts in many foods, and its requirement in the body is low. However, malabsorption of vanadium can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of compromised blood sugar regulation and bone health in individuals with celiac disease. Vanadium supplementation is not typically necessary, as the body's requirement for vanadium is minimal, and excessive intake can be toxic. However, it is important for individuals with celiac disease to maintain a well-balanced diet that includes foods rich in vanadium, such as seafood, mushrooms, whole grains, and vegetable oils, to support overall health. Vitamin A (Preformed) Vitamin A is a fat-soluble vitamin that plays a crucial role in vision, immune function, and cellular growth. Deficiency in vitamin A can lead to night blindness, dry skin, and increased susceptibility to infections. Untreated celiac disease can cause malabsorption of vitamin A due to damage to the small intestine lining, leading to a deficiency. It is important for individuals with celiac disease to monitor their vitamin A levels and consider supplementation if necessary. Vitamin A (Betacarotenes) Vitamin A in the form of betacarotenes is a precursor that is converted to vitamin A in the body as needed. Betacarotenes are found in colorful fruits and vegetables, and they play a role in maintaining healthy skin, vision, and immune function. Deficiency in betacarotenes can result in similar symptoms as vitamin A deficiency, including impaired vision and weakened immune system. In celiac disease, impaired absorption of betacarotenes can occur due to damage to the small intestine lining, leading to a potential deficiency. Vitamin B1 (Thiamine) Vitamin B1, also known as thiamine, is a water-soluble vitamin that is essential for energy metabolism, nerve function, and brain health. Deficiency in thiamine can cause symptoms such as muscle weakness, fatigue, and mental confusion. Severe, prolonged thiamine deficiency can result in beriberi, and symptoms include loss of sensation in extremities, symptoms of heart failure, swelling of the hands and feet, chest pain, feelings of vertigo, double vision, and memory loss. Untreated celiac disease can impair thiamine absorption due to damage to the small intestine lining, potentially leading to a deficiency. It is important for individuals with celiac disease to monitor their thiamine levels and consider supplementation if needed. Vitamin B2 (Riboflavin) Vitamin B2, also known as riboflavin, is another water-soluble vitamin that plays a key role in energy production, growth, and red blood cell formation. Deficiency in riboflavin can lead to symptoms such as cracked lips, sore throat, and skin rash. Celiac disease can cause impaired absorption of riboflavin due to damage to the small intestine lining, leading to a potential deficiency. Supplementation may be necessary for individuals with celiac disease to maintain adequate riboflavin levels. Vitamin B3 (Niacin) Vitamin B3, also known as niacin, is essential for energy metabolism, nervous system function, and DNA repair. Deficiency in niacin can result in a condition known as pellagra, characterized by symptoms such as diarrhea, dermatitis, and mental confusion. Malabsorption of niacin can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. It is important for individuals with celiac disease to monitor their niacin levels and consider supplementation if necessary. Vitamin B5 (Pantothenic Acid) Vitamin B5, also known as pantothenic acid, is involved in energy production, hormone synthesis, and nerve function. Deficiency in pantothenic acid can lead to symptoms such as fatigue, numbness and tingling in the hands and feet, and difficulty in coordination. In celiac disease, malabsorption of pantothenic acid can occur due to damage to the small intestine lining, potentially leading to a deficiency. Supplementation may be necessary for individuals with celiac disease to maintain adequate pantothenic acid levels. Vitamin B6 Vitamin B6, also known as pyridoxine, is a water-soluble vitamin that is important for brain development, immune function, and protein metabolism. Deficiency in vitamin B6 can cause symptoms such as depression, irritability, and weakened immune system. Untreated celiac disease can impair the absorption of vitamin B6 due to damage to the small intestine lining, potentially leading to a deficiency. It is important for individuals with celiac disease to monitor their vitamin B6 levels and consider supplementation if needed. Vitamin B7 (Biotin) Vitamin B7, also known as biotin, is essential for healthy skin, hair, and nails, as well as for metabolism of carbohydrates, fats, and proteins. Deficiency in biotin can result in symptoms such as hair loss, brittle nails, and skin rash. Malabsorption of biotin can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. Supplementation may be necessary for individuals with celiac disease to maintain adequate biotin levels. Vitamin B8 (Inositol) Vitamin B8, also known as inositol, is involved in cell signaling, nerve function, and brain health. Deficiency in inositol can lead to symptoms such as mood swings, anxiety, and difficulty in concentration. In celiac disease, impaired absorption of inositol can occur due to damage to the small intestine lining, potentially leading to a deficiency. It is important for individuals with celiac disease to monitor their inositol levels and consider supplementation if necessary. Vitamin B9 (Folate) Vitamin B9, also known as folate, is important for DNA synthesis, red blood cell formation, and fetal development during pregnancy. Deficiency in folate can result in symptoms such as anemia, fatigue, and neural tube defects in newborns. Malabsorption of folate can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. Supplementation of folate may be necessary for individuals with celiac disease, especially during pregnancy. Vitamin B9 (Folic Acid) Folic acid is the synthetic form of folate, often used in dietary supplements and fortified foods. It is converted to folate in the body and plays similar roles in DNA synthesis, red blood cell formation, and fetal development during pregnancy. Deficiency in folic acid can lead to the same symptoms as folate deficiency, including anemia and neural tube defects in newborns. Malabsorption of folic acid can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. It is important for individuals with celiac disease to monitor their folic acid levels and consider supplementation if needed. Vitamin B12 ( Cobalamin) Vitamin B12, also known as cobalamin, is essential for nerve function, DNA synthesis, and red blood cell formation. Deficiency in vitamin B12 can cause symptoms such as fatigue, weakness, and numbness and tingling in the hands and feet. In celiac disease, malabsorption of vitamin B12 can occur due to damage to the small intestine lining, potentially leading to a deficiency. This can further exacerbate the symptoms of celiac disease and affect overall health. Supplementation of vitamin B12 may be necessary for individuals with celiac disease to maintain adequate levels and prevent deficiency-related complications. Vitamin C (Ascorbic Acid) Vitamin C, also known as ascorbic acid, is a powerful antioxidant that plays a critical role in immune function, collagen synthesis, and wound healing. Deficiency in vitamin C can cause symptoms such as fatigue, weakened immune system, and slow wound healing. A severe vitamin C deficiency can also result in scurvy, and early symptoms of scurvy include weakness, feeling tired and having sore arms and legs. In celiac disease, malabsorption of vitamin C can occur due to damage to the small intestine lining, potentially leading to a deficiency. Supplementation of vitamin C may be necessary for individuals with celiac disease to maintain adequate levels and support immune function. Vitamin D3 Vitamin D3, also known as the "sunshine vitamin," is crucial for bone health, immune function, and mood regulation. Deficiency in vitamin D3 can cause symptoms such as bone pain, muscle weakness, and increased susceptibility to infections. Malabsorption of vitamin D3 is common in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of osteoporosis, weakened immune system, and mood disorders in individuals with celiac disease. Vitamin D3 supplementation, along with adequate sunlight exposure and a vitamin D-rich diet, may be necessary for individuals with celiac disease to maintain adequate vitamin D levels and support overall health. Vitamin E (Food Sourced) Vitamin E is a powerful antioxidant that protects cells from damage, supports immune function, and helps with DNA repair. Deficiency in vitamin E can cause symptoms such as muscle weakness, impaired vision, and increased oxidative stress. Malabsorption of vitamin E can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of oxidative stress and related health issues in individuals with celiac disease. Vitamin E supplementation, along with a vitamin E-rich diet, may be necessary for individuals with celiac disease to maintain adequate vitamin E levels and support overall health. Vitamin E (Alpha-Tocopherol) Vitamin E, specifically alpha-tocopherol, is the most active and common form of vitamin E in the body. It plays a crucial role in protecting cells from damage, supporting immune function, and maintaining cardiovascular health. Deficiency in alpha-tocopherol can cause symptoms such as muscle weakness, vision problems, and increased risk of cardiovascular disease. Malabsorption of alpha-tocopherol can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of cardiovascular issues and other health complications in individuals with celiac disease. Supplementation of alpha-tocopherol, along with a vitamin E-rich diet, may be necessary for individuals with celiac disease to maintain adequate alpha-tocopherol levels and support overall health. Vitamin K Vitamin K is a fat-soluble vitamin that plays a crucial role in blood clotting and bone metabolism. Deficiency in vitamin K can cause symptoms such as easy bruising, prolonged bleeding, and weakened bones. Malabsorption of vitamin K can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of bleeding disorders and weakened bones in individuals with celiac disease. Vitamin K supplementation, along with a well-balanced diet that includes vitamin K-rich foods such as leafy green vegetables, may be necessary for individuals with celiac disease to maintain adequate vitamin K levels and support overall health. Zinc Zinc is an essential mineral that is involved in various enzymatic reactions, immune function, and wound healing. Deficiency in zinc can cause symptoms such as impaired immune function, delayed wound healing, hair loss, and skin issues. Malabsorption of zinc can occur in celiac disease due to damage to the small intestine lining, potentially leading to a deficiency. This can further increase the risk of compromised immune function, delayed wound healing, and related health issues in individuals with celiac disease. Zinc supplementation, along with a diet rich in zinc-containing foods such as meat, fish, dairy products, nuts, and seeds, may be necessary for individuals with celiac disease to maintain adequate zinc levels and support overall health. Conclusion In conclusion, untreated and undiagnosed celiac disease can lead to deficiencies in various nutrients due to malabsorption caused by damage to the small intestine lining. These deficiencies can result in a wide range of symptoms and health effects, including compromised bone health, impaired immune function, nerve-related issues, skin, hair, and nail problems, and other related health concerns. Therefore, it is crucial for individuals with celiac disease to be vigilant about their nutrient intake and work with healthcare professionals to ensure proper monitoring and management of their nutrient levels through a well-balanced diet and, if necessary, appropriate supplementation. Proper management of celiac disease, including adherence to a gluten-free diet, regular monitoring of nutrient levels, and appropriate supplementation when needed, can help individuals with celiac disease maintain optimal health and prevent nutrient deficiencies. Vitamins and Minerals Generally Safe in Excess of Recommended Daily Allowance (RDA): Vitamin C (Ascorbic Acid): Excess vitamin C is usually excreted in the urine and is considered safe in higher doses. However, very high doses may cause digestive upset in some individuals. Vitamin B1 (Thiamine): Water-soluble, excess thiamine is generally excreted through urine. It is considered safe in higher doses but consult with a healthcare professional. Vitamin B2 (Riboflavin): Water-soluble, excess riboflavin is excreted in the urine and is generally safe in higher doses. Vitamin B3 (Niacin): Water-soluble, niacin has a well-defined upper limit, but moderate excess is often excreted. Consultation with a healthcare professional is advisable. Vitamin B5 (Pantothenic Acid): Water-soluble, excess pantothenic acid is generally excreted through urine and considered safe in higher doses. Vitamin B6 (Pyridoxine): While excessive intake from supplements can lead to nerve damage, moderate overages are generally excreted through urine. Vitamin B7 (Biotin): Water-soluble, excess biotin is typically excreted and is considered safe in higher doses. Vitamin B9 (Folate): Excess folate is usually excreted, but extremely high levels from supplements may have potential risks. It's generally safe when consumed through natural food sources. Vitamin B12 (Cobalamin): Water-soluble, excess B12 is typically excreted in the urine and is considered safe in higher doses. Consultation with a healthcare professional is advisable. Choline: While not a true vitamin, choline is water-soluble, and excess is usually excreted. It's considered safe in higher doses but consult with a healthcare professional. Vitamins and Minerals with Potential for Toxicity in Excess of Recommended Daily Allowance (RDA): Vitamin A (Retinol): Excessive vitamin A intake, especially from supplements, can lead to toxicity, causing symptoms like nausea, dizziness, and, in severe cases, organ damage. Vitamin D - While moderate excess may be excreted, prolonged high doses can lead to vitamin D toxicity, resulting in hypercalcemia, kidney damage, and other complications. Vitamin E (Tocopherols): Excess vitamin E is usually excreted, but high doses from supplements may have adverse effects. Obtaining it through a balanced diet is preferable. Vitamin K: Excess vitamin K from supplements can interfere with blood thinning medications and cause issues in some individuals. Iron: Excessive iron intake, especially from supplements, can lead to iron toxicity, causing symptoms like nausea, abdominal pain, and, in severe cases, organ failure. Zinc: While zinc is essential, excessive intake can lead to zinc toxicity, affecting the immune system and causing digestive issues. Copper: High copper levels, often from supplements, can lead to toxicity, causing symptoms such as nausea, vomiting, and liver damage. Selenium: Excessive selenium intake, especially from supplements, can lead to selenosis, causing symptoms like hair loss, gastrointestinal issues, and neurological problems. It's crucial to note that individual tolerances can vary, and supplementation should be done under the guidance of a healthcare professional. Sources: National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Celiac Disease. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease Rubio-Tapia, A., Hill, I. D., Kelly, C. P., Calderwood, A. H., & Murray, J. A. (2013). ACG clinical guidelines: Diagnosis and management of celiac disease. The American Journal of Gastroenterology, 108(5), 656-676. doi:10.1038/ajg.2013.79 Complementary Medicine, Penn State Hershey. (n.d.). B vitamins. Retrieved from https://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000336 National Institutes of Health, Office of Dietary Supplements. (2021). Vitamin B5 (Pantothenic Acid) - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Vitamin B12 - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Chloride - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Iodine - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Magnesium - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Phosphorus - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Silicon - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Vanadium - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Manganese - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Lycopene - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Lutein and Zeaxanthin - Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Nickel - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Selenium - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Iron - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Calcium - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Zinc - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/ National Institutes of Health, Office of Dietary Supplements. (2021). Chromium - Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/list-all/

Celiac.com 06/01/2023 - The rising popularity of gluten-free diets has captured public attention in recent years. With claims of weight loss, improved digestion, and increased energy, many individuals have jumped on the gluten-free bandwagon. However, it's important to base dietary decisions on scientific evidence, rather than mere trends. To shed some scientific light on the subject, a team of researchers conducted a controlled study to investigate the effects of gluten intake on body weight, body composition, resting energy expenditure, and the changes in nutrient intake caused by gluten-free diets. Study on Effects of Gluten Intake The research team included Hirla Karen Fialho Henriques, Luana Moreira Fonseca, Karine Silva de Andrade, Nitin Shivappa, James R. Hébert, Adaliene Versiani Matos Ferreira & Jacqueline Isaura Alvarez Leite. They are variously affiliated with the Department of Biochemistry and Immunology - ICB, Federal University of Minas Gerais, Belo Horizonte, Brazil; the Department of Nutrition, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil; the Department of Biochemistry and Immunology - ICB, Federal University of Minas Gerais, Belo Horizonte, Brazil; and the Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA. Their study enrolled twenty-three women, who adhered to a gluten-free diet for a duration of six weeks. During this period, the participants were provided with muffins containing either 20 grams of gluten isolate (known as the gluten period) or gluten-free muffins (the gluten-free period) in a crossover, single-blind, non-randomized trial. The researchers assessed the subjects' habitual diet, including gastrointestinal symptoms, food frequency questionnaires, body composition, resting energy expenditure, and recorded daily food intake for the entire six-week duration. The Findings - Increase in Fat and Sodium Intake Surprisingly, the data showed that body weight, body composition, gastrointestinal symptoms, and resting energy expenditure remained similar during both the gluten and gluten-free periods. These results indicate that consuming up to 20 grams of gluten per day does not affect body weight or composition in healthy women without caloric restriction, at least over a relatively short period of three weeks. However, the team saw some concerning changes when the nutrient composition of the gluten-free period was compared to the participants' habitual diet. The gluten-free diet led to an increase in fat and sodium intake, while reducing the intake of fiber, as well as vitamins B1, B6, B12, and folate. This imbalance in nutrient intake resulted in an elevated dietary inflammatory index, indicating a higher inflammatory potential associated with gluten-free diets. These findings highlight the importance of considering the overall nutritional quality of a diet, rather than focusing solely on the absence of gluten. While a gluten-free diet may be necessary for individuals with specific medical conditions, such as celiac disease, the results suggest that adopting a gluten-free diet without medical necessity may have adverse effects on nutrient intake and potentially contribute to inflammation. The study offers some potentially valuable insights into the impact of gluten intake and gluten-free diets on health, especially with regards to nutrient intake, but it's important to note that it has certain limitations. The small sample size and the short duration of the trial invite further research with larger populations and longer intervention periods, to validate and expand upon these findings. Additionally, the study focused solely on healthy women, so the results may not be generalizable to other populations, or those with specific health conditions. It's also important to note that following a gluten-free diet can lead to imbalances in nutrient intake, particularly a reduction in fiber and essential vitamins, and an increase in dietary inflammation potential, even in non-celiacs. As with any dietary decision, it's best to consult with a healthcare professional or registered dietitian to ensure a well-rounded and nutritionally adequate diet that suits individual needs. Read more in the J Am Nutr Assoc. 2022 Nov-Dec;41(8):771-779.

Celiac.com 04/03/2023 - People with celiac disease must follow a gluten-free diet for their entire lives in order to stay healthy. But, gluten-free foods are traditionally high in salt, sugar and fat, among other things. So, what's the impact of a gluten-free diet on the nutritional levels of people with celiac disease? A team of researchers recently looked at studies of adults and children with celiac disease who followed a gluten-free diet, to see if they were getting the proper nutrients in their diets. The Research Team The research team included Monica Gessaroli, Leonardo Frazzoni, Usama Sikandar, Gabriele Bronzetti, Andrea Pession, Rocco Maurizio Zagari, Lorenzo Fuccio & Maria Luisa Forchielli. They are variously affiliated with theDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; the IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; the Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; and the Health Sciences and Technologies Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy. The Gluten-Free Diet Nutritional Study The researchers searched through several databases for studies, conducted through October 2022, that looked at the nutrient intake of celiacs who followed a gluten-free diet. They used statistics to combine the results from different studies and see if there were any patterns. They found thirty-eight studies covering a total of 2,114 patients. On average, people with celiac disease on a gluten-free diet consumed 1,995 calories per day. Almost half of these calories came from carbohydrates, 16% from proteins, and 36% from fats. Teenagers consumed the most fats, while adults did not get enough dietary fiber. Calcium, magnesium, and iron intake was particularly low in teenagers, while vitamin D intake was low for all age groups. Conclusion In conclusion, people with celiac disease who follow a gluten-free diet may not get enough essential nutrients, and may consume too much fat. Since a gluten-free diet is a lifelong treatment, it is important to regularly check on people's nutrient intake to prevent other health problems, and to take supplements if needed. That means that people with celiac disease should work with their doctors to create a plan for monitoring their nutrition over time. Read more in European Journal of Clinical Nutrition

Celiac.com 02/22/2023 - When people with celiac disease consume wheat or gluten, they typically suffer damage to the lining of the small intestine, along with associated symptoms of the damage, including nutritional deficiencies. Most women with celiac disease follow a gluten-free diet. But, we still don't know very much about the potential long-term impact of a gluten-free diet on the nutritional, body composition, and other factors in women with celiac disease. To better understand the issue, a team of researchers took a closer look at this issue. The team studied a group of just over fifty adult Saudi females with celiac disease, all of whom had followed a gluten-free diet for more than one year. The study included a complete analysis of anthropometric data, levels of vitamins B12 and D, and a complete blood count. Even though it's a small study, the results are concerning. That's because all of the patients were deficient in micro and macro-nutrients, including vitamin D, folate, calcium, and iron. Moreover, nearly half of the patients had reduced total body fat, while nearly two out of three had decreased levels of visceral fat. We already know that most adult celiacs suffer from micronutrient deficiencies. We also have a good idea of which deficiencies are the most common. The team's findings echo those of earlier studies, which have shown that gluten-free foods often have poorer nutritional quality than similar non-gluten-free foods. This means that people with celiac disease who follow a gluten-free diet may be at risk for poor nutrition or malnutrition. To ensure proper nutrition for people with celiac disease, especially women, it's important to remain extra vigilant about getting food with enough nutrition, fiber, and other essential nutrients to promote good health. This may include working with a dietitian or nutritionist to create a well-balanced meal plan, and supplementing with vitamins and minerals, as needed. Women with celiac disease who are following a gluten-free diet, and those who care for them, should take this study seriously, share it with your doctor or nutritionist, and take steps to make sure they remain healthy. Read more in Nutrients

Celiac.com 07/22/2020 - Currently, the only effective treatment for celiac disease is a permanent gluten-free diet. Many commercial gluten-free foods are low in fiber, and high in fat, salt, sugar. Many health professionals question the nutritional adequacy of a gluten-free diet. To date, there has been no large case-control study regarding the nutritional adequacy of the gluten-free diet on children with celiac disease. To try to better understand the nutritional value of a gluten-free diet, a team of researcher set out to assess nutritional status, dietary intake, and adherence to a gluten-free diet in children with celiac disease. The research team included Elena Lionetti, Niki Antonucci, Michele Marinelli, Beatrice Bartolomei, Elisa Franceschini, Simona Gatti, Giulia Naspi Catassi, Anil K. Verma, Chiara Monachesi, and Carlo Catassi. They are variously affiliated with the Department of Pediatrics at Marche Polytechnic University in Ancona, Italy; and the Division of Pediatric Gastroenterology and Nutrition and Center for Celiac Research at Mass General Hospital for Children in Boston, MA, USA. The study included children diagnosed with celiac disease following a gluten-free diet for two or more years. The team matched control subjects for age and gender against healthy, non-celiac children, and enrolled 120 children with celiac disease, and 100 healthy non-celiac children. For each subject, the team recorded physical measurements and energy usage. Dietary assessment was performed by a 3-day food diary. The team used the KIDMED index to assess adherence to the Mediterranean diet. They found no differences between celiac children and control subjects in either physical measurements or energy expenditure. Overall, kids with celiac disease ate much more fat and much less fiber than the control group. Children with celiac disease showed a median KIDMED index of 6.5, while healthy non-celiac control kids showed a median of 6.8. The results of this study show that, compared with healthy control subjects, kids with celiac disease are eating a diet that is nutritionally less balanced, higher in fat, and lower in fiber. Because of this, children with celiac disease may benefit from dietary counseling to help steer them toward a more nutritious gluten-free diet. However, it's fair to say that both groups in this study were far from a Mediterranean diet, and both could stand to see some improvement. That said, kids with celiac disease have even further to go to achieve a more nutritious diet. Here are some tips on how to get more nutrition in your gluten-free diet. How to Get Better Nutrition on a Gluten-Free Diet Eat more natural, whole foods The list of natural, whole gluten-free foods is too long to delineate here, but it includes all fresh fruits and vegetables, along with numerous nutritious foods like peas, beans and oats. Eat more high fiber foods There are plenty of high fiber foods that are naturally gluten free, including beans, peas, and more. Here's list a of thirty great gluten-free high fiber foods. Read product labels Many commercial gluten-free foods are low in fiber, and high in fat, sugar and salt. Read more at Nutrients. 2020 Jan; 12(1): 143

Celiac.com 09/12/2019 (Originally published 04/05/2010) - All of us with celiac disease or gluten sensitivity share something in common: we started eating gluten free to improve and protect our health. But many of us focus on gluten free and few or no other aspects of good nutrition and end up making mistakes with our diet that lead to unhealthy weight gain or other new health problems. Some people can adopt the type of gluten-free diet that is commonly eaten and feel well. But for most people the gluten-free diet is a great starting point but not an end-all. It’s an eating plan that we can gradually adapt in individual ways to form the best diet for each of us. If you want to eat gluten free for what it was meant for – promoting long-term good health – give your diet an upgrade by following these dietary guidelines from my new book Gluten Free Throughout the Year: Go gluten free naturally. It’s tempting to buy a lot of food products that are labeled gluten free, but the main foods that you should purchase are those that are naturally gluten free, such as vegetables, fruits, poultry, fish, and meat. Stocking up on whole foods and creating meals with them is the best way to avoid even trace amounts of gluten and to eat a diet rich in nutrients that support health. Be choosy about the food products you buy. When selecting foods, look for those that are labeled gluten free and that don’t contain hidden sources of gluten. But also look for those that aren’t made with refined white rice flour (often labeled as rice flour as opposed to brown rice flour) and starches, such as potato starch or tapioca starch. Regular eating of nutrient-poor refined ingredients sets us up for nutrient deficiencies, unhealthy weight gain, and chronic diseases such as heart disease and type 2 diabetes. Become more unrefined. Don’t just avoid refined flour. Do your best to steer clear of foods with other refined ingredients known to promote degenerative disease – namely, refined sugars and refined fats. Refined sugars include sugar (typically listed as “evaporated cane juice” on food labels), high-fructose corn syrup, and fructose. Refined fats include vegetable oils, such as corn oil, soybean oil, cottonseed oil, safflower oil, sunflower oil, and partially hydrogenated oil. Personalize the diet for you. It’s common for gluten-sensitive people to be allergic or sensitive to other foods, such as cow’s milk, soy, eggs, or yeast, and to develop uncomfortable symptoms, including gastrointestinal distress, nasal or sinus congestion, joint aches, or other ailments, from eating them. The only way to clear up the health problem is to avoid the offending food. Customize the diet for your best health by identifying and avoiding the particular foods that are problematic for you. Eat more against the grain than you’re used to. The Western diet we have grown up on and are accustomed to is high in high-carbohydrate, wheat-based grains, which sets us up for weight gain and insulin-related health conditions such as type 2 diabetes. When we go gluten free, we tend to think we just have to switch the wheat-based bread, pasta, baked goods, and snack foods we were eating with gluten-free versions of those foods. Gluten-free grains are free of gluten but they are still high in carbohydrates and relatively low in nutrients compared to the carbohydrates and calories they provide. Most vegetables, on the other hand, have considerably fewer carbohydrates and are much higher in vitamins and minerals. It goes against the type of diet most of us are used to, but for many nutritional reasons, it’s important to fight the tendency to trade a standard high-grain diet for a gluten-free, high-grain diet. Instead, eat more vegetables. That is the overlooked secret to long-term weight control and optimal health that many people, including most who go gluten-free, miss. * This article was excerpted and adapted from Gluten Free Throughout the Year: A Two-Year Month-to-Month Guide for Healthy Eating (Against the Grain Nutrition, 2010) by Melissa Diane Smith.