celiacs: NOT SO SLENDER

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PEOPLE with celiac disease traditionally have been thought to be underweight because of nutrient malabsorption. But celiacs are overweight more often than underweight and the majority who go on a gluten-free diet gain additional weight, according to a study in the American Journal of Gastroenterology.

Celiac disease is an autoimmune disorder caused by an intolerance to gluten, a protein found in wheat, rye, barley and other grains. The study reviewed data on 371 patients diagnosed with celiac disease over a 10-year period in a clinic in Northern Ireland. Only 4 percent of the patients were underweight when diagnosed while 39 percent were overweight and 57 percent were normal weight. After strictly eliminating gluten from the diet for two years, 81 percent of the patients gained weight, including 82 percent of the initially overweight patients. The proportion of patients in the overweight category jumped to 51 percent.

To avoid missing or delaying diagnosis of celiac disease, physicians need to be aware that many celiacs are overweight and less likely to have the so-called classic symptoms: diarrhea, severe gut damage, reduced hemoglobin levels and low bone mineral densities.

The typical gluten-free diet needs to be modified to prevent weight gain. The authors of the study did not say how, but a safe bet is to avoid gluten-free refined flours, high-sugar foods and partially hydrogenated oils. Instead, emphasize low-calorie, nonstarchy vegetables, lean proteins and gluten-free whole grains. It's also important to watch your intake of gluten-free "goodies," such as cookies, cakes and muffins. While these treats are fine on occasion, regular consumption can show up on the scale.

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By Melissa Diane Smith

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