The diagnosis of celiac disease is typically based on clinical symptoms, serological markers, and small intestine biopsies. Celiac guidelines recommend serological screening for individuals with suspected symptoms or high-risk factors, with the condition that a gluten-containing diet is followed. Screening asymptomatic individuals without risk factors is generally not recommended. The decision to perform an endoscopic biopsy depends on the findings of serological tests and the severity of clinical symptoms. A temporary diagnosis of celiac disease is made for individuals who test positive for specific antibodies and exhibit characteristic histological changes in the intestinal mucosa. If a gluten-free diet normalizes the antibodies and improves clinical symptoms in individuals with suspected celiac disease, a diagnosis can be confirmed.
Treatment of celiac disease
The standard treatment for celiac disease is a lifelong gluten-free diet. A gluten-free diet helps alleviate symptoms, improve intestinal damage, and enhance quality of life. However, adhering to a gluten-free diet can be challenging for patients as gluten is present in many food products. Wheat, rye, and barley are the main sources of gluten, so individuals with celiac disease should avoid foods containing these grains as well as other gluten-containing ingredients. Despite its apparent simplicity, following a gluten-free diet can be difficult in reality, especially as the general population consumes increasing amounts of wheat and Western-style diets become more prevalent. Another concern is that a gluten-free diet may lead to inadequate and unbalanced nutrition. Some nutritional deficiencies in individuals with celiac disease can be corrected through dietary adjustments, although such diets are often restrictive, typically low in protein and fiber, and high in fat and salt. Therefore, incorporating pseudo-grains into the diet can be an alternative approach to diversify and optimize the gluten-free diet, improving the nutritional status and overall health of individuals with celiac disease.
Role of pseudo-grains in a gluten-free diet
Pseudo-grains are gluten-free, non-grass plants. While grains belong to the monocot class, pseudo-grains are classified as dicots. They are referred to as grain-like due to their starch content, taste, and characteristics. Amaranth, quinoa, buckwheat, and millet are examples of pseudo-grains. These pseudo-grains are increasingly recognized as attractive options for a gluten-free diet due to their high nutritional value. They are rich in minerals and vitamins, including complex carbohydrates and essential dietary fiber important for our bodies. Studies have shown that amaranth and quinoa contain more digestible proteins and contribute to balanced nutrition. Similarly, buckwheat is high in fiber content. Pseudo-grains contain various minerals such as iron, calcium, and zinc. Amaranth, in particular, is rich in calcium and beneficial for individuals with celiac disease who are prone to nutritional deficiencies.
Pseudo-grains consist of 60% to 80% carbohydrates by dry weight, with starch being the primary carbohydrate type. They also serve as a good source of dietary fiber. Additionally, pseudo-grains are valuable plant-based protein sources with higher protein quality compared to grains. They contain balanced essential amino acids. In terms of vitamin content, pseudo-grains are particularly rich in B-group vitamins, including B6, B2, and B9. They also contain vitamins E and A. In terms of minerals, they are abundant in magnesium, potassium, and phosphorus. Furthermore, they have higher selenium, iron, and zinc content compared to grains such as corn, wheat, and rice.
As pseudo-grains are gluten-free, they are considered a good alternative for the treatment of celiac disease. Commercially available gluten-free products often use processed gluten-free flour or starch, which may result in deficiencies of B vitamins, magnesium, iron, calcium, and fiber. Including pseudo-grains in the diet or adding them to gluten-free products can provide a more balanced and adequate nutrition for individuals with celiac disease.
