Could It Be Celiac Disease?
Intestinal problems that linger despite
adherence to the McDougall Diet may be the result of celiac
disease (CD). As many as one in every hundred people—1% of
the population—is affected by CD, a condition caused by
gluten—protein molecules most commonly found in wheat,
barley, and rye.1 Celiac disease prevents the
small intestine from effectively absorbing necessary
nutrients. This malabsorption then leads to diarrhea,
abdominal pain, flatulence, weakness, and weight loss. These
symptoms are often confused with irritable bowel syndrome
and 10% of people who receive this diagnosis actually have
CD.2 In late stages nutritional deficiencies can
So who gets CD? There is a genetic
tendency to develop CD, but breastfeeding and the
introduction of gluten-containing foods after the first
three months of life reduce future risk of suffering from
this kind of intolerance.3 Therefore, attention
to early nutrition is the best form of prevention. Children
should be breast-fed exclusively until 6 months of age. (No
other foods, not even additional water or juice.) The
intestinal tract does not fully mature until age 2 years and
therefore, extra care should be taken with your child’s diet
during this vulnerable period—introduce non-gluten starches
and fruits at about 6 months of age—continue partial breast
feeding until 2 years of age, ideally. Food proteins from
the mother’s diet are present in her breast-milk; therefore,
in cases where there is a family tendency for CD, mother’s
diet should be gluten-free during her nursing
sugar, gluten is the second most prevalent food
substance in Western civilization. Traditionally,
gluten is defined as a cohesive, elastic protein
that is left behind after starch is washed away from
wheat flour, and is actually made up of many
different proteins. A wheat grain consists of 3
layers: the outer husk, the germ and the endosperm
or “white flour.” This “white flour” portion, which
constitutes about 70% of the grain, contains the
potentially toxic gluten for those people with CD.
The rubbery strands you see when you knead dough to
make bread is gluten. Pure wheat gluten, made by
rinsing wheat flour with water until all that
remains is the concentrated protein, is used as a
meat substitute, and is called seitan (say-tan). On
a vegetarian menu you will see this replacement
referred to as mock-duck, -chicken, -fish or
Diagnosing Celiac Disease
The first step in confirming a clinical
suspicion of celiac disease, based on the patient’s story,
is a blood test to measure levels of specific
antibodies—Immunoglobulin A (IgA), anti-tissue
transglutaminase (tTGA), or IgA anti-endomysium antibodies (AEA).
If the patient has been eating gluten regularly and all
three tests come back positive, there is a very high chance
that the patient has celiac disease.5 However,
the suspicion is only confirmed after a biopsy of the
intestine shows classic changes characteristic of CD. (In
medical terms the characteristic changes are villous
atrophy, hyperplasia of the crypts and increased
intraepithelial lymphocytes.) However, the connection
between gluten and this disease is so close that the
diagnosis can also be made when the patient experiences
dramatic improvement of symptoms upon following a
Celiac Disease Leads to Many Other
The intestinal tract must perform two
diametrically opposed functions—it must allow nutrients
(including food proteins) into the body and at the same time
defend against invading proteins from bacteria, parasites,
and viruses.6 This meeting of needs is
accomplished by a single cell layer forming the “gut
barrier.” In people with CD, the gluten protein damages
this barrier creating a “leaky gut.” Now “foreign proteins”
from microbes and food are indiscriminately allowed to pass
through the intestinal wall—causing all kinds of troubles.
People with untreated celiac disease have two to six times
greater risk of dying, mainly due to an increase in the risk
of lymphoma, and a much greater risk of suffering from
autoimmune diseases, like type-1 diabetes and thyroiditis.1,2,5,7
Problems Common with CD
Herpetiformis (skin burning, prickling, itching or
Bone loss (osteopenia/osteoporosis)
dysfunction (elevated enzymes)
disorders (cerebellar ataxia, migraine, neuropathy,
Diet: The Only Treatment for Celiac
Celiac disease is a lifelong
condition—therefore patients must stick to a diet low in
gluten in order to regain lost health and remain
disease-free. As with all dietary treatments, lack of
compliance, usually due to insufficient motivation and
information, is the greatest obstacle against success.
Fortunately, strict adherence to a gluten-free diet allows
the intestine to heal, stopping the malabsorption, and
plugging the “leaky gut,” which in turn reduces the risk of
future autoimmune and non-autoimmune diseases.1,2,5-10
Offending Foods for CD10
durum and semolina
and malted drinks contain considerable gluten.
*Lactobacilli bacteria are used to make sourdough
bread, which will remove (hydrolyze) most of the
gluten and make the wheat tolerable for most people
Acceptable for CD10
vegetables, like potatoes, yams, sweet potatoes, and
legumes**, more specifically, beans (including soy
and chickpeas), peas and lentils
and yellow vegetables
* Oats have
been demonstrated in multiple studies to be free of
toxic proteins and tolerated by most (but not all11)
people with CD, but there is worry that commercial
oat products may be contaminated with wheat.
make extra gas, sometimes causing bloating and bowel
discomfort. This reaction may be confused with
symptoms of CD.
The McDougall Program (with the above
adjustments) works very well for people with gluten
intolerance as well as almost all other health problems.
Once diagnosed with celiac disease, people attempt to
replace familiar foods, like breads and noodles, with
gluten-free varieties. You might try “spaghetti” noodles
made from rice, corn, quinoa, or buckwheat. Use corn
tortillas instead of wheat flour wraps. Though it may take
some time to find suitable gluten-free substitutions for
favorite foods, the result is well worth the effort—simple,
cost-free, side-effect-free relief from a serious lifelong
You will also find considerable help on
the internet by searching for celiac disease. Many
gluten-free products are sold and most companies seem to
have concern for other dietary issues, including vegetarian
A Wheat-Free Diet: Your Next Step to
Celiac disease is only one reason to
consider eliminating wheat and similar grains (barley, rye)
from your diet. Of all plant foods, wheat is the most
common cause of food allergies and therefore will need to be
eliminated when the basic McDougall Diet (which contains
wheat) fails to solve problems, such as inflammatory
arthritis, colitis, sinusitis, and asthma.
The most common and delicious way wheat is
served is as flour made into breads, bagels, and pastas.
However, additional nutritional problems are created by
turning the whole wheat berry into a powdery material, the
flour. This grinding process changes the physical
properties so that the flour’s calories are absorbed more
rapidly and completely than calories in the original whole
grain—making weight loss difficult for some people.
Therefore, in the McDougall Program for Maximum Weight Loss
all flour products are eliminated.
This simple modification of eliminating
foods from the wheat family, and especially those processed
into flours, may be the final essential step for some people
to regain their lost health. So, if you are still having
problems with weight loss and/or you’re not feeling as well
as you should, try centering your diet around potatoes,
sweet potatoes, whole grain rice and beans with plenty of
yellow and green vegetables and fresh fruits.
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Howdle PD. Advances in celiac disease. Curr
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Rewers M. Risk of celiac disease autoimmunity
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Fossati CA. Presence of high levels of
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B. Coeliac disease. Lancet. 2003 Aug
Monteleone G. Immunity, inflammation, and
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Collin P. Coeliac disease, autoimmune diseases
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Connell-Jones G. Gluten- and casein-free diets
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