On nutrition: What celiac is and isn't

May is National Celiac Disease Awareness Month. And this condition — also called celiac sprue and gluten intolerance — does appear to require our awareness. Here are some facts about celiac and gluten in particular:

Celiac disease ...

... is not a wheat allergy. It is an intolerance to gluten, a protein found in wheat, rye, and barley.

... is an autoimmune disease where gluten triggers the body's immune system to attack the lining of the small intestine and destroys "villi" — the areas that normally absorb nutrients.

... can cause severe nutrition deficiencies including iron, folate, calcium, and vitamins A, D, E and K.

... has been estimated to affect 1 in 133 people in the United States. Most people who have celiac don't know it.

... is more common in people with other autoimmune disorders, such as type 1 diabetes.

... is 2 to 3 times more common in women than in men.

... is less common in individuals who were breast-fed as babies and were not fed gluten-containing foods before the age of 4 months.

... is not always easy to diagnose. Common symptoms include stomach pain, bloating, diarrhea, constipation, and poor appetite.

... is best diagnosed with a biopsy (tissue sample) of the small intestine. Blood tests are also being refined to identify celiac.

... is effectively treated with a gluten-free diet for life.

Gluten ...

... is a protein found in wheat, rye and barley.

... is not found in oats. However, if oats are processed alongside wheat products, they may be "contaminated" with gluten.

... is found in spelt, triticale (grain that is a cross between wheat and rye) and couscous.

... is not found in flax, quinoa, potato, rice or corn.

... is not found in pure fruit and vegetable juices or fresh fruit (although some wax coatings may contain gluten).

... is not found naturally in artichokes or other fresh vegetables.

... is not naturally present in milk, eggs, nuts, unprocessed meat, poultry, fish or eggs.

... can be present in barley-brewed beer.

... is not normally present in wine.

... may still be present in "wheat-free" foods if they contain rye or barley.

"Gluten-free" ...

... is in the process of being defined by the US Food and Drug Administration (FDA) for use on food labels.

... products are becoming more common in food markets. Kellogg's Rice Krispies, for example, will soon be introducing a gluten-free option. (Regular Rice Krispies is made with barley malt flavoring which contains gluten.)

... is not guaranteed for everything you may want to eat at the Artichoke Festival.

Medical nutrition therapy ...

... is the only effective treatment for celiac disease.

... can be made less confusing with the help of nutrition professional.

— — —

(Barbara Quinn is a registered dietitian, certified diabetes educator and certified health and wellness coach at the Community Hospital of the Monterey Peninsula. Email her at bquinn@chomp.org.)