March is National Nutrition Month, when the Academy of Nutrition and Dietetics reminds everyone to return to the basics of healthy eating. It is also the time of year when the Academy celebrates expertise of registered dietitian nutritionists as the food and nutrition experts.
In addition to suffering from gastrointestinal problems typically associated with celiac disease — such as diarrhea, constipation, abdominal pain and bloating, and nausea or vomiting — some people with celiac disease may experience other diseases and chronic conditions as well. Following a gluten-free diet helps alleviate symptoms from these conditions associated with celiac disease.
A potentially crippling bone disease, osteoporosis is common in individuals with untreated celiac disease. Affected children, adolescents and adults have reduced bone mineral content and bone density, which improves when following a gluten-free diet. Children and adolescents who are treated early and make changes to their diet can achieve normal bone growth. Untreated adults who follow a gluten-free diet can improve, but may not reach normal bone density, especially if they did not follow the diet when they were children or adolescents.
Iron Deficiency Anemia
Anemia is a common condition related to celiac disease, due to intestinal damage that reduces the body's ability to absorb and use iron from food. Following a gluten-free diet helps the intestines heal, therefore improving nutrient absorption and blood iron levels; however, recovery from iron deficiency itself may take longer and iron supplementation may be needed to completely restore blood levels and correct deficiencies. A registered dietitian nutritionist can provide diet and supplementation guidance for iron deficiency anemia.
Several studies have found that women with undiagnosed celiac disease, or who were not following a gluten-free diet, had an increased risk of complications during pregnancy including miscarriage, premature delivery and stillbirth. These studies also indicated a higher risk for breech position and the need for cesarean delivery. Infants of these mothers were at higher risk for low birth weight and smaller than expected size. The infants also had low scores on a test given at birth to determine medical problems requiring immediate care and later experienced developmental delay. In addition, women with untreated celiac disease had a higher risk for earlier onset of menstruation and premature menopause. Adhering to a gluten-free diet reduces the risk of these complications.