Celiac disease is a chronic disease of the small intestine. Due to an intolerance to gluten, a gluten protein found in grains, the small intestinal bulges shrink. This prevents fats, sugars, proteins, vitamins, minerals and even water from being properly absorbed into the body. So far, the only treatment is complete, lifelong abstinence from foods containing gluten. This is the only way for the mucosa of the small intestine to recover and regain its function. However, even the smallest amounts of gluten cause damage and discomfort again.
Occurrence of gluten
Gluten is found primarily in the cereals wheat, spelt, rye, barley, green spelt and oats. Affected individuals must avoid all foods and medications that contain these grains in any form. This includes above all conventional baked goods and pasta, for example bread, rolls, cakes, pasta and pizza, but also beer, malt beer and grain schnapps. In the food trade, all products containing gluten have had to be labeled accordingly since November 2005.
Gluten-free diet
The cereals rice, corn, millet, buckwheat, amaranth and quinoa are suitable for consumption by sufferers. There are now a large number of manufacturers of gluten-free products with a wide range to suit all tastes, and for some years now gluten-free products have been found in most major supermarket chains with a growing range of products. A number of manufacturers have specialized in the production of gluten-free bread and bakery products. These are made from rice, corn, potato or chestnut flour, for example. Many dietary gluten-free foods are recognizable to consumers by a special seal, a crossed-out ear of corn; consumer-friendly supermarkets also mark the shelves with gluten-free products in addition to the product labeling. However, to protect themselves legally, many manufacturers also note on the packaging that the product may contain traces of gluten, even though it does not actually contain gluten or is below the specified limits. Every year, the German Celiac Society (DZG) compiles detailed lists for its members that provide information on which foods are gluten-free; links to the manufacturers can be found on the DZG website. Since November 2007, a food product with a maximum of 20 ppm (two milligrams/100 grams) of gluten is considered gluten-free. Products containing wheat starch with a gluten content of 20 ppm or less may also be declared gluten-free if the use of wheat starch is listed in the ingredients list.
Gluten-free diet is expensive
A gluten-free diet is still expensive – dietary ready-made products without gluten cost around 30 to 50 percent more than comparable other foods. That’s why many European countries subsidize gluten-free diets. In Germany, only welfare recipients receive a flat-rate allowance of just under 70 euros. All other affected persons can at best declare a hardship case in their tax return, but must indicate the degree of disability (20 percent for celiac disease) and submit a medical certificate.
With celiac disease in restaurants and on trips
The restaurant industry is increasingly adapting to the very different needs of its customers. Many restaurants have recognized that a gluten-free diet appeals to a large target group and have adapted their menus accordingly. Hotels and restaurants are also becoming increasingly flexible when it comes to special requests from their customers. In many countries, people with celiac disease can now “travel without worrying”. If they want to take gluten-free food with them to other countries, i.e. import it, a medical certificate is recommended. Many airlines now offer gluten-free meals on board for intercontinental flights – the relevant information can usually be found on the airlines’ websites. A strict gluten-free diet is the only therapeutic option, but it is not an easy undertaking. Many “normal” foods contain gluten, and this cannot always be identified from the list of ingredients in semi-finished and finished products. Traveling to other countries is particularly difficult. Those affected have no choice but to take a close look at their diet and find out which foods are permitted and which are not. Help is provided by professional societies, nutrition experts and various guidebooks/cookbooks, as well as numerous sources of information on the Internet.
