An interview with Julia Bracken, MD, Children’s Mercy Hospital
The only way to treat celiac disease is complete and total avoidance. But this avoidance is of one thing in particular: gluten. “We don’t have any medicines in the traditional sense to treat celiac disease. I think that is good and bad. It is wonderful that we can treat an autoimmune disease without having to use immunosuppressive medications, without having to worry about being immuno-compromised. But that also means doing the hard work everyday of navigating around gluten, which is so common in the American diet.” Gluten-free food is medicine.
Gluten is a protein in grains such as wheat, rye, and barley. It is in items such as bread and pasta. But gluten also hides in products such as soy sauce and some tablet medications; it is a binding agent or thickener.
“Because celiac is an autoimmune disorder, if left untreated it opens up the door for more serious health problems down the road. Untreated celiac or partially treated celiac increases the chance for more autoimmune diseases, nutritional deficiencies, anemia, osteoporosis, and increases the chance of malignancy. In order for a lot of our patients to fully understand the gravity of that, it needs to be treated in a healthcare setting.”
Going Gluten Free Safely
Not only are the potential health risks severe, but going gluten-free is not as simple as not eating gluten. Whenever you eliminate a food from your diet, it is important to keep essential nutrients in mind. “It really takes collaboration with a registered dietician to learn not only how to eat gluten free, but how to eat gluten free in a way that nourishes the body, so we are making sure that we are not missing out on any of the vitamins and minerals that would normally be coming from those glutenated grains.”
Julia Bracken wants everyone to know that a grain-free diet is not necessarily the healthiest diet for everyone. We must remember that healthy food looks different for everybody. “Even though in our clinic we avoid those grains that contain gluten, we know that everyone needs grains. They might be gluten-free grains, but we encourage our clients to eat quinoa and brown rice and other sources of whole grains that give all those vitamins and nutrition. A varied diet is the best strategy for long-term health and long-term success.”
What can happen if someone with celiac disease takes gluten completely out of their diet?
“Amazing things. As we take gluten out of the diet, the intestine can regrow itself back to health. But they need to stay gluten free to stay healthy.” And that is where it gets difficult. Gluten-free food is expensive but it is so vital for the health of individuals with celiac disease.
“I know I’m going to sound just like Emily Brown right now, but health insurance companies also need to view food as medicine. There needs to be a way to help support families financially with these diagnoses so that they have the access to the treatment that they need, just like health insurance companies will subsidize costs of medications or surgeries for conditions that are treated in more traditional ways.”