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Celiac Sprue: Nutritional Considerations
The following nutritional steps are key to managing celiac disease:
- A gluten–free diet
Gluten–containing foods include wheat, barley, and rye, among others.
Careful reading of food labels is important. Patients should consult
with an experienced dietitian to identify these foods and ensure
adequate consumption of essential nutrients.
Although gluten is also found in oats, some studies suggest that
pure oat flour can usually be tolerated. Many doctors allow celiac
patients to introduce small amounts of oats into their diets once
the disease is under control. Initially, patients are limited to
less than 2 grams per day, building up to 40–60 grams per day).
However, consumers should be aware that commercial oat products
may be contaminated with other gluten–containing grains.
- Preventing nutrient deficiencies
Patients who follow a gluten–free diet are at risk for
deficiencies of B vitamins (including folate), calcium, vitamin
D, iron, zinc, magnesium, and fiber. Further, because celiac disease
damages the ability of the small intestine to absorb fat, nutritional
deficiencies of fat–soluble vitamins (vitamins A, D, E, and K)
may occur. Daily multiple vitamins may be helpful, and dietitians
can assess whether additional dietary supplements are required.
- A consultation with a dietician is advisable to assist with dietary
changes.
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