Celiac Disease or an Irrational Fear of Gluten?
What exactly is celiac disease anyway? As a trainer, it’s important to have a basic understanding of health conditions, especially those that impact a client’s nutrition and fitness.
Celiac disease is an autoimmune disorder. Even if you’ve never heard the term “celiac” before, you have heard of the ubiquitous diet term “gluten-free.”
People diagnosed with celiac disease must follow a strict gluten-free diet because this protein triggers an immune response that causes symptoms and ultimately damage to the small intestine.
According to the Celiac Disease Foundation, 1 in 100 people is affected by this disease worldwide. Statistics also show that approximately 2.5 million Americans are living with this disease without realizing it, and this puts them at risk for serious health issues in the future.
What is Gluten?
As a trainer, it’s important to keep up to date on everything nutrition. Gluten is a big buzzword these days, and some people genuinely need to avoid it, while others simply skip out on gluten due to a belief that it is unhealthy.
Knowing the facts about gluten as a food ingredient and what it is will allow you to help better your clients, both those with celiac disease and those who are just trying to avoid it.
Gluten is naturally found in three grains:
These grains, wheat especially, are found in a lot of different foods. Gluten is often used as the “glue” that helps preserve the shape of foods, so they don’t fall apart. You may find wheat and gluten in a variety of processed foods like bread, baked goods, pasta, cereals and even salad dressings.
Barley can be found in a lot of different foods too, especially those with ingredients related to malt. These include soups, some food colorings, and beer. Rye is used less commonly but may be found in bread and cereals.
For a list of naturally gluten-free groups, check out What Can I Eat? from Celiac Disease Foundation
When Someone with Celiac Eats Gluten…
Bad things happen, unfortunately.
To better help your clients understand what celiac disease is and why people with this diagnosis need to avoid gluten, it is important to understand what happens in the body when someone with the disease eats it:
- Gluten triggers an immune response against the body of a person with celiac disease. This is why it’s called an autoimmune disorder.
- The immune system mistakes gluten for a pathogen. Normally, the immune system only attacks foreign pathogens, like viruses.
- The immune response to gluten occurs in the small intestine.
- Over time this immune system attack destroys the villi. The villi are small folds in the interior of the intestines that absorb nutrients from the food we eat.
- Damage to the villi causes digestive and other symptoms, but it can also lead to serious malnutrition over time.
- Damage caused by the gluten-triggered immune response will repair itself in time, but only if the person with celiac disease cuts gluten out entirely.
If you have a client with celiac disease, impress upon the person how he or she need to avoid gluten indefinitely. Some people try to start eating it once the symptoms disappear and they start to feel better, but this will start up the immune response, and the intestinal damage will begin all over again.
If You Suspect Your Client Has Celiac Disease
As a trainer, you are not a doctor qualified to make a diagnosis of celiac disease in a client. But if you understand more about this disease, you can help your clients recognize some of the signs of celiac and encourage them to see their doctor for a possible diagnosis.
Some of the more common symptoms of celiac disease in adults are:
- Fatigue and anemia,
- Bone and joint pain,
- Depression and anxiety,
- Loss of bone density,
- Mouth ulcers,
- Acid reflux,
- And numbness and tingling in the hands and feet.
The symptoms of celiac disease can vary a lot from one person to another, and the signs often associated with celiac—diarrhea, bloating, constipation, weight loss—are more common in children than adults.
Many of the symptoms seen in adults, like bone pain, fatigue, and headaches, will impact your clients during workouts. If you notice these symptoms, you can point out that your client may need to see a doctor and that celiac could be a potential cause.
According to the article “A Nutritionist’s View: Treating Clients with Celiac Disease,” athletes who are diagnosed with the Celiac disease tend to have trouble with the absorption of essential vitamins such as iron, vitamin D, and calcium. Vitamin D deficiencies can cause all kinds of problems, like anemia and poor bone health.
Ask your client if he or she has a family history of celiac disease. It seems to have a hereditary component and anyone with a first-degree relative with the condition has a one in ten chance of being diagnosed with celiac as well.
Working with a Celiac Client
Having a client with celiac disease may mean that you need to help him better understand the role nutrition plays in training.
As a trainer, you know how important nutrition is and the role it plays in living a healthier and fitter lifestyle. It’s critical to make certain that your client is aware of the importance of nutrition alongside a workout routine.
With celiac disease, nutrition becomes even more important because your client may suffer from deficiencies or malnutrition. Even if he is now gluten-free, his body may still be recovering and not absorb as many nutrients as it should.
Going gluten-free can also lead your client to consume fewer calories overall, or even to miss out on nutrients while trying to avoid wheat and other gluten-free foods. As a trainer, you need to help your client be aware of the balance between calorie intake and expenditure so that he stays safe while working out and can meet his fitness goals.
As a personal trainer, you do so much more than leading training sessions. You can be an important part of helping a client transition to a new, gluten-free way of life. While these changes may be quite significant and difficult to incorporate, you as a trainer can help guiding your client to choose the right foods and helping him monitor his weight are important ways you can make this easier and healthier for him.
Just remember to remind your client that you are not a doctor, but you are someone knowledgeable about health and fitness. You may not be able to diagnose him, but once he gets a diagnosis of celiac disease, you can be there to help him make healthier choices and maintain good fitness.
"What is Gluten?" Celiac Disease Foundation. N.p., n.d. Web. 06 Mar. 2017.
"What Is Celiac Disease?" Celiac Disease Foundation. N.p., n.d. Web. 07 Mar. 2017.
Volpe, Stella Lucia. "Treating Clients With Celiac Disease." ACSM's Health & Fitness Journal 16.1 (2012): 29-30. Ccm. Web. 7 Mar. 2017.
"Celiac Disease." Mayo Clinic Health Letter 33 (2015): 1-8. Consumer Health Complete on EBSCOhost. Web. 7 Mar. 2017.
Mancini, Lee A., Thomas Trojian, and Angela C. Mancini. "Celiac Disease and the Athlete." Current Sports Medicine Reports (American College of Sports Medicine) 10.2 (2011): 105-08. SPORTDiscus with Full Text. Web. 7 Mar. 2017.
When a client wants to know if they should eat gluten-free, what is your response? In certain cases, this should be encouraged. In other cases, not so much. This explains when each situation applies.