You should see a dietitian when you are first diagnosed and have follow-up visits as necessary.
Find a dietitian who’s a member of the Irish Nutrition and Dietetic Institute (INDI).
Your dietitian will help you maintain a gluten-free diet that is nutritionally balanced and meeting your individual needs. They’ll also be able to advise you in relation to other conditions that you may be coping with, for example diabetes or lactose intolerance, or when preparing for pregnancy.
Some things to consider about the gluten-free diet.
- Absorption of nutrients depends upon the presence of a normal healthy gut. In other words, if the gut is damaged (i.e. villous atropy or blunting), nutrients cannot be used by the body and nutrient deficiencies may arise despite a good intake. So complying with a strict gluten-free diet for life is the most important step in achieving good nutrition.
- Remember to choose healthy meal and snack options – treats like gluten-free cakes or biscuits should only be eaten in moderation to avoid developing high cholesterol or weight gain. Healthy eating is as relevant to coeliacs as it is to non-coeliacs.
- The gluten-free diet can be low in fibre so include regular servings of high fibre foods such as gluten-free brown bread, brown rice, jacket potatoes, gluten-free muesli, pulses, fruit, vegetables, seeds and nuts.
- Iron deficiency anaemia is a common sign and complication of coeliac disease. To prevent it, try to take protein sources (i.e. meat, fish, and poultry) twice daily. Of this, at least 3 servings per week should be lean red meat. Other sources of iron, including green leafy vegetables, beans, pulses, and eggs, are poorly absorbed and require vitamin C (eg glass of orange juice) to increase absorption. If you have established anaemia, it may be necessary to take iron supplements.
- Calcium is essential for bone growth and maintenance and osteoporosis is a risk for coeliacs. Dairy products are the richest source of calcium (e.g. milk, cheese, yogurts, milk puddings). If you dislike or cannot tolerate this food group due to lactose intolerance, speak to your dietitian about alternative sources of calcium or a supplement.
- Vitamin D is essential for the absorption of calcium from the gut. Sunlight is the main source of this vitamin so 15-30 minutes of light exposure per day on face and arms is ideal. Dietary sources are limited (i.e. eggs, fortified margarine, oily fish), therefore a supplement may be required to maintain adequate levels.
Your can find out more about diet and nutrition at the Irish Nutrition and Dietetic Institute.