Nutrition recommendations for celiac disease in children. Diet for celiac disease: allowed foods, sample menu and recipes

This is a chronic disease that can progress in the absence of dietary therapy. It is characterized by the gradual death of the mucosa of the small intestine due to intolerance to the protein contained in some cereals. Patients with celiac disease need a special diet that will protect the body from the toxic effects of gluten on the body. A gluten-free diet will help not only improve digestion, but also increase immunity.

Nutrition rules

Considering the fact that in celiac disease it is permissible to consume foods with a gluten content of no more than 1 mg per 100 grams, the therapeutic diet involves significant changes in the usual diet. Patients are recommended diet No. 4ag (gluten-free). It fully meets all modern principles of healthy eating and can be observed throughout life.

Features of diet No. 4ag:

• daily calorie intake should be approximately 3000 calories, 120 grams of protein, no more than 100 grams of fat and 400 grams of carbohydrates;
• it is recommended to break the daily diet into several small meals;
• at the beginning of treatment, it is necessary to observe the principle of mechanically sparing nutrition, that is, grind solid foods;
• at the beginning, only stewing, steaming and boiling foods are allowed, after a couple of months, baking can be added;
• in the first months, any food containing coarse fiber is excluded (vegetables, fruits and berries in their natural form, juices, mushrooms, nuts, legumes);
• industrial milk should be limited as much as possible and consumed only as part of ready meals;
• homemade milk is allowed in the absence of lactose intolerance;
• daily intake of sea buckthorn oil and honey is required in the amount of 1-2 tsp. (required at different meals).

Products containing gluten

Prohibited foods for celiac disease include:

From alcohol wine, calvados, cognac, brandy, grappa, sake and tequila are allowed.

In addition, the following food additives are prohibited: E160b, E150a and E150b, E411, E636, E953, E965. In order to exclude the use of substances harmful to the body, it is necessary to carefully read the composition of the products. This is especially true for the food that will be tried for the first time.

Also, for celiac disease, coated drugs and liquid medicines (for example, syrups) are prohibited, as they contain gluten and malt.

We must not forget that just 100 grams of a product that contains gluten can cause atrophy of the intestinal villi and lead to serious digestive disorders. For this reason, it is necessary to strictly adhere to all the rules of a gluten-free diet.

Gluten free products

These products can be included in the daily diet without fear:

• baking based on corn, rice and buckwheat flour;
• soups on a weak broth (vegetable, meat or fish) with the addition of gluten-free cereals;
• millet, rice, corn and buckwheat porridge;
• dairy products;
• soft-boiled, hard-boiled eggs or in the form of low-fat omelettes;
• dietary meats and fish, skinless chicken;
• vegetables, fruits, berries;
• butter;
• vegetable oil;
• jelly, fruit drink, weak tea and natural coffee.

sample menu

When compiling a diet, you can use the following ideas for meals.

On breakfast

1. Cottage cheese casserole without flour with fruits, nuts and dried fruits.
2. Boiled rice porridge in milk diluted with water.
3. Baked omelet with low-fat cheese.

For lunch

1. Soup-puree from potatoes and cauliflower, seasoned with low-fat sour cream; lean fish baked in foil; the vinaigrette.
2. Rice flour pasta with onions, carrots, chicken meatballs and cream cheese.
3. Pancakes made from buckwheat flour with meat filling; soup on vegetable broth with pearl barley.

For dinner

1. Sweet rice porridge with nuts and dried fruits; a glass of any fermented milk product.
2. Vegetables stewed in sour cream, sprinkled with curd cheese.
3. Boiled buckwheat porridge; steamed vegetables.

Snacks

1. Rice or buckwheat bread with honey.
2. Baked apple with honey.
3. Corn flour buns with homemade jam.

Gluten Free Recipes

Rules for making homemade cakes

At home, you can cook various bakery products without using traditional wheat flour. Buckwheat, rice and corn flour have a number of characteristics and require some changes during cooking.

1. Gluten-free flour absorbs more water, so you need to increase the amount a little.
2. If the recipe used says pancake flour, then add 1 tsp to 1 cup of flour. baking powder (can be replaced with soda, slaked vinegar, or baking powder).
3. Such flour is not suitable for use in a bread machine and for making yeast-leavened pastries.

Video: making gluten-free bread

These simple tips help to adapt any recipe for a diet.

homemade noodles

• 60 grams of buckwheat;
• 2 yolks;
• 1/2 glass of water;
• 1/2 tsp sea ​​salt.

Grind buckwheat in a coffee grinder and knead a thick dough. Leave for 30 minutes. Roll out into a thin layer and cut into strips. Lightly dry and cook in boiling salted water. Leftover noodles can be stored in the refrigerator for 1-2 days.

vegetable pie

• 1/2 cup corn grits;
• 1/2 cup low-fat sour cream;
• 1 cup weak vegetable broth;
• 1 medium carrot;
• 100 grams of broccoli;
• 1 medium bell pepper;
• 1 tsp vegetable oil;
• 2 tbsp low-fat cheese;
• 2 eggs;
• white pepper, salt.

Grind the cereal and mix it with warm broth. Boil. Stirring constantly, cook for 15 minutes until the cereal swells. Lubricate the mold with oil. Preheat the oven to 175°C. Wash vegetables, peel and chop finely. Simmer vegetables in water for a few minutes. Stir cheese, eggs and vegetables into swollen cereals. Place in oven and bake for 20 minutes.

Gingerbread

• 1 cup buckwheat flour;
• 1 tbsp Sahara;
• 1 tsp seasoning mixes for baking (cinnamon, nutmeg, cloves);
• 1 tsp grated ginger;
• 1 tsp soda;
• 100 grams of butter;
• 100 grams of dark molasses;
• 50 grams of light molasses;
• 1/2 cup milk;
• 1 egg.

Mix flour, spices, sugar, soda and ginger. Melt butter and add molasses. Combine liquid and dry ingredients. Add milk and egg. Roll out the dough and cut out the cookies. Place on a greased or parchment-lined baking sheet and bake for 1 hour at 150°C.

Thus, a gluten-free diet is a must for celiac disease. It guarantees the gradual restoration of the mucous membrane of the small intestine and the improvement of digestion. A properly composed diet allows you to eat varied and get all the nutrients and vitamins your body needs.

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The diet for celiac disease in children and adults excludes the consumption of the following foods containing gluten:

• All products containing wheat, rye, triticale and barley. Baked goods, pasta, pizza, malt breakfast cereals, and crackers are examples of foods that contain gluten. Even though some products are labeled "Wheat Free", this does not mean they are gluten free.
• All products containing oats (at least initially). Oats can cause symptoms in some people with celiac disease, possibly as a result of cross-contamination with wheat, barley, rye during processing. Many people with celiac disease can eat moderate amounts of oats without symptoms. Health professionals disagree on long-term recommendations for oat foods. But most agree that people who have only recently been diagnosed with celiac disease are best off avoiding oats until their disease is well controlled with a gluten-free diet. Then, they can include up to 50 grams of oats in their daily diet and consume until no new symptoms occur. You should only consume oats that cannot be 100% contaminated with wheat, barley or rye during processing.
• All beer drinks except those that do not contain gluten. Beers (including non-alcoholic) such as Lager, Ale, and Stout contain gluten unless the label says they are gluten-free.

Read the list of ingredients on food labels carefully to be aware of the presence of gluten-containing products in their composition. Gluten can be found in medicines, vitamins and dietary supplements, lipstick and lip balms, and various food supplements. Products labeled with the words "modified starch" or "hydrolyzed vegetable protein" may contain gluten.

Foods and Drugs labeled "Gluten Free" must contain less than 20 parts per million (ppm) of gluten.

What can you eat with celiac disease

The diet for celiac disease in adults and children is based on the use of gluten-free foods, such as:

• Eggs and dairy products. Some dairy products may make your symptoms and signs of celiac disease worse. Read the ingredients on the package carefully. Some processed cheeses contain gluten.
• Flour and porridge made from amaranth, arrowroot, beans, buckwheat, corn, cornmeal, flax, millet, uncontaminated nuts and oat bran, potatoes, quinoa, rice, sorghum, soybeans, lentils, tapioca, or teff.
• Fresh, frozen and canned meat. If you buy canned food, be sure to read the ingredients on the label carefully, as some ingredients may contain gluten.
• Fish, especially fatty fish species (mackerel, herring, salmon, trout, sardines, sturgeon, anchovies, etc.), as these types of fish contain anti-inflammatory omega-3 fatty acids.
• Fresh, frozen, dried or canned fruits and vegetables, unless they contain thickeners or other additives containing gluten.
• Some alcoholic drinks including wine, liqueurs, whiskey, brandy, sherry and cider.
• Soft drinks, including fruit and vegetable juices, flavored water and carbonated drinks.

When to expect relief

When you start on a gluten-free diet to treat celiac disease, you may start to feel better indefinitely, as every body is different. Some people begin to feel significantly better within a few days of starting a gluten-free diet, but some patients may experience gradual improvement in their symptoms.

Healing can take anywhere from six months to five years (or longer in some cases) depending on the damage done to the gut by eating gluten. Several factors are thought to speed up or slow down the time it takes to repair the intestinal mucosa. These factors include:

• person's age
• severity of bowel injury at diagnosis

If your symptoms do not improve or worsen after starting a gluten-free diet, talk to your doctor, nutritionist, and/or gastroenterologist, who specialize in celiac disease and gluten-free treatment.

If you made a mistake

A gluten-free diet for celiac disease is a learning process not only for you, but also for your family and friends. You can make mistakes, especially in the early days after you've been diagnosed.

If you have celiac disease and have mistakenly consumed a product containing gluten, you usually begin to show symptoms of the disease within a few hours after eating, which can last from several hours to several days. However, the effects vary from person to person and depend primarily on how much gluten you eat, how sensitive your body is to it, and how long you have been on a gluten-free diet.

If you do have celiac disease, eating gluten will damage your intestines. If you make the occasional mistake and accidentally eat gluten, it's unlikely to cause major intestinal damage.

What to do about symptoms of celiac disease

• If you have diarrhea or vomiting, it is very important to keep your body well hydrated by drinking plenty of water.
• Some people find that taking medications to treat constipation, diarrhea, or headaches can relieve symptoms, but you should check with your doctor before you start taking them.
• The single most important step in preventing the symptoms of celiac disease is to completely eliminate gluten from your daily diet.
• If your symptoms are very severe or do not improve, talk to your healthcare provider about it.

Some half a century ago, celiac disease was considered a “piece” disease, from which mainly children suffered. Today, the diagnosis is reliably confirmed in 1 person out of 100, regardless of gender and age. Despite the severity of the disease, which can lead to severe and irreversible consequences for human health, the only effective method of treating it is a gluten-free diet.

Our expert Irina Savanovich knows everything about diet.

Irina Savanovich

The meaning of the diet lies in the name itself: it is necessary to completely exclude from the diet foods that have at least a hint of gluten. And, categorically, completely and forever. No concessions and indulgences: I will eat today, but I won’t tomorrow, are not allowed. Such a rigid position is due to the disease itself. So, by and large, this is not about the diet as such, but about the lifestyle of a person with celiac disease.

Gluten is a complex protein found in wheat. For ease of perception, proteins and other cereals are also called: barley, rye, oats ... Another name for gluten is gluten.- even more familiar to our ears. It provides the dough with viscosity and elasticity, and this is the key to delicious bread and fluffy rolls. The higher the gluten content of the flour, the better it is.

The body of a person suffering from celiac disease reacts aggressively to gluten, producing toxic compounds that destroy the villi of the lining of the small intestine, which leads to impaired absorption of nutrients (malabsorption). No pills can stop this process. So the only way out is to completely change the approaches to nutrition, deleting gluten-containing foods from the list forever.

Foods not to eat with celiac disease

The "black list" of foods that contain gluten may seem overwhelming at first glance. In fact, most of it is made up of food products made from prohibited cereals, or manufactured at the production facilities of enterprises, where gluten-containing raw materials are also processed.

So, when following a gluten-free diet, it is completely forbidden to useproducts such as:

Of particular danger are products that may contain the so-called "hidden" gluten.

A conscientious manufacturer always indicates on the product label the possibility of traces of gluten in the product. This remark cannot be ignored! "Traces" of gluten are just as aggressive for a patient with celiac disease as gluten in its "pure" form.

As a rule, the manufacturer on the product packaging directly indicates the absence of a dangerous protein with an inscription in Russian or English
transcription: "does not contain gluten", "gluten free products", or a special sign.

If the label does not say gluten-free, you should exclude from the diet:

• bread;
• any muffin and confectionery;
• candies;
• cereals and muesli;
• biscuit;
• crackers;
• oats;
• yoghurts with fillers;
• glazed curds;
• pasta;
• crab sticks;
• instant coffee;
• ice cream;
• sauces, including mayonnaise, ketchup and soy sauce;
• processed meat products: boiled sausages, sausages, smoked meats;
• meat and fish canned food;
• complex multicomponent spices;
• beer and alcohol.

Gluten Free Products

And what, in fact, can you eat with celiac disease? This thought first comes to mind after reading the list of prohibited products. In fact, the list of gluten-free foods is no less. And with the help of them, which is important, you can provide a varied and complete diet without compromising health.

So, The following are considered safe for patients with celiac disease:

• buckwheat;
• corn;
• millet;
• corn, rice, soy flour and products thereof;
• tapioca;
• beans (peas, beans, chickpeas, lentils, etc.);
• quinoa (or quinoa);
• vegetables, including potatoes;
• milk and dairy products without fillers;
• fresh meat, fish and poultry;
• eggs;
• fruits and berries;
• nuts;
• vegetable oil (sunflower, olive, soybean);
• wine and distilled spirits.

Rules of life

In a gluten-free diet, there is no such thing as a little bit.

Even 100 mg of gluten has a destructive effect on the body of a person with celiac disease. For comparison: just 50 g of wheat bread contains 2-3 g of gluten!

Therefore, it is fundamentally important not only to exclude dangerous protein from the diet once and for all, but also to properly organize life. Here are the rules to follow strictly if you or someone in your family has been diagnosed with celiac disease:

Gluten-free dishes in canteens, cafes, restaurants. Selection rules

The “lifetime” seal and the strict restrictions that a gluten-free diet implies make it difficult to follow. This is especially true for children and people in whom celiac disease does not manifest itself with pronounced symptoms that significantly worsen the quality of life.

Irina Savanovich

Candidate of Medical Sciences, Associate Professor of the 2nd Department of Children's Diseases of the Belarusian State Medical University, Chief Freelance Pediatric Gastroenterologist of the Ministry of Health

Every patient with celiac disease is aware of how dangerous gluten is for him and that he should never eat it in any quantity. But, unfortunately, nothing is perfect. When it comes to a child, parents can really keep the situation under control until a certain age. But it grows, pocket money appears ... And there are many temptations around and even more doubts: I ate a bun - nothing terrible happened - so you can still. It is forbidden! Because when a patient undergoes a follow-up examination, it suddenly turns out: there is severe anemia, atrophy of the villi of the small intestine ... And as a result, these are huge risks, including infertility and oncopathologies. In addition, even with a gluten-free diet, there is no guarantee that another autoimmune disease will not occur in the background of celiac disease. But strict control over nutrition at least minimizes such risks.

A special attitude and high self-control requires catering in kindergarten, school and catering points. Remember what rules you need to strictly follow when cooking at home following a gluten-free diet, and you will understand how difficult this condition is to fulfill outside the walls of your own kitchen. So there aren't many options. One of them is to regularly provide the child with safe supplies to kindergarten and school and work to ensure that he is clearly aware of: no food temptations are worth putting your own health at risk. Even tasting forbidden foods is dangerous.

If we are talking about adults, there may be options:

• In cafes and restaurants, immediately warn the waiter that you have celiac disease so that he can offer you gluten-free dishes. Emphasize that “clean” meals are important to you, since we are talking about health, not a fashion trend.
• Ask to cook meat, fish or poultry dishes without breading, sauces, gravy and complex spices with permitted side dishes; salads - dressed with vegetable oil.
• If you chose soup on the menu, it should be a vegetarian, vegetable dish..

Sample menu for a gluten-free diet

Breakfast

• porridge (rice / buckwheat / millet) with butter / rice casserole with cottage cheese and sour cream / scrambled eggs with cheese;
• cocoa with milk (tea with sugar);
• cheese / cottage cheese.

2nd breakfast

• fruit juice.

Dinner

• vegetable salad with vegetable oil;
• potato soup with beans (pickle with rice / vegetable soup);
• pilaf with boiled beef (boiled chicken / meatballs with rice / goulash from boiled meat without flour and tomato sauce with a permitted side dish);
• dried fruits compote;
• fresh fruits;
• gluten free bread.

afternoon tea

• natural yogurt / cottage cheese / cheese;
• gluten free cookies.

Dinner

• baked or steamed fish fillet/meatballs with rice/boiled meat with vegetable garnish;
• tea with sugar and milk.

For the night

• kefir.

Following a gluten-free diet is not easy, as it requires a lot of self-organization and self-control. But the most annoying thing is that lately there has been more talk about the diet in the context of a fashion trend aimed at cleansing the body and getting rid of extra pounds than about the system of therapeutic nutrition for celiac disease. Rumors about the benefits of "gluten-free life" for everyone and everyone are greatly exaggerated. But at the same time, they greatly interfere with those for whom diet is the only chance for a long and healthy life. We will definitely talk about this in.

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Food intolerance is an urgent problem in medicine. A special place is occupied by true food intolerance - celiac disease or celiac disease . This disease is characterized by damage to the lining of the small intestine. gluten (a protein found in products from wheat, oats, rye or barley) and the appearance of mucosal atrophy. In celiac disease, the intestinal villi are reduced and atrophied. Degeneration of the intestinal villi is the main danger of this disease.

Currently adhere to the immunological and genetic theories of the occurrence of celiac disease. First of all, it is an autoimmune disease.

The intake of gluten maintains a constant inflammatory response in the intestine, and immune cells form to it. antibodies . Patients have significantly increased production immunoglobulins in the mucosa of the small intestine, in particular, antibodies to gliadin (gluten component) Ig A and IgG. A high titer of these antibodies is a specific sign of the disease, and their detection in the blood makes it possible to establish a diagnosis. There is evidence of a genetic predisposition to this disease.

celiac disease accompanied by indigestion and malabsorption of all nutrients. It proceeds with persistent, weight loss, constant bloating, general weakness and decreased performance. In addition, under conditions of a pronounced atrophic process, increased mucosal permeability develops, and this creates conditions for the occurrence of concomitant food allergies. In patients, an increase in the level of antibodies to proteins of soy, milk, and eggs is detected.

Late diagnosis increases the risk of complications: infertility , cancer and neurological disorders. With strict adherence to the diet, the prognosis is favorable.

The main treatment for this disease is lifelong agliadin diet which must be strictly followed. Diet therapy is the key to maintaining health. Celiac disease does not disappear with age, as morphological changes in the mucosa persist. If the diet is not followed in patients, the risk of tumors of the gastrointestinal tract increases significantly. With impeccable observance, it is possible to restore the function of the villi within 4-6 months.

The diet for celiac disease in adults provides for the complete exclusion of products from wheat, rye, barley, millet, and oats. These include bread, pasta and flour products, all varieties of wheat cereals (semolina, wheat, bulgur, couscous). It is forbidden to prepare sauces with flour, add even a small amount of bread to minced meat and use breadcrumbs when cooking. It is necessary to exclude cakes, pastries, any pastries made from wheat flour, puddings, cookies, ice cream (may contain flour), dough products and pasta.

The diet uses rice, corn, starch, buckwheat, millet, vegetables and fruits, meat and fish, eggs. To expand the menu, wheat flour substitutes are used: corn or rice, and sauces are made based on potato or corn starch.

When compiling the menu, it is necessary to take into account the principles of chemical and mechanical sparing. All products are boiled or steamed. For greater sparing, all dishes are prepared in a pureed form. The principle of fractional nutrition is also taken into account - 6 times, in small portions. Also excluded are products that cause fermentation and increase the secretion of the pancreas and stomach (broths, spicy dishes, spices, seasonings).

It is allowed to eat meat of all varieties, chicken, fish, eggs

With this disease in adults, it is difficult to achieve remission in a short time - this may take up to 5-6 months. However, even then, dietary restrictions must be followed, since the use of even 100 mg (a few bread crumbs) can worsen the patient's condition again.

In this regard, you need to know the products with "hidden gluten", which may not indicate its presence, and also exclude them from the diet. It is these foods that pose the greatest danger when a strict elimination diet is needed.

These products are:

• meat and fish tomato canned food;
• semi-finished soups;
• beer, vodka, whiskey, kvass;
• sausages and sausages;
• instant coffee drinks;
• sauces, ketchups, mayonnaises;
• yogurts, kefir, glazed curds;
• instant coffee, cocoa powder;
• sweets, chocolate;
• coated tablets, syrups with malt.

The recurrence of the disease can cause the use of even a small piece of sausage, semi-finished minced meat or industrial canned food.

In the acute period, in addition to the main diet, a diet that excludes milk sugar (milk and dairy products) and common allergens (chocolate, citrus fruits, eggs, fish, strawberries, etc.) is recommended. More protein is introduced into the diet (140-160 g / day) due to meat, poultry, cheese, cottage cheese, legumes (subject to good tolerance).

The amount of fat increases to 100 g per day. At the same time, you need to limit carbohydrates (no more than 200 g), temporarily exclude fruits and vegetables. Upon the onset of remission (formed stool), the amount of carbohydrates is increased to 400 g, and the energy value will increase accordingly.

Patients are advised to use specialized products. Certified products of foreign production are presented in Russia ( Dr. Sher , Galletas Gullon , Semix ) and domestic ( BioFoodLab , healthier , Dietetics , D&D , KhlebProm , Sugaroff , Garnets , McMaster ). These are bread, pasta, rice noodles, waffles, cookies, various types of flour (corn, pumpkin, rice, lentil, amaranth, nut, soy, almond).

Approved Products

Designed to feed patients Diet No. 4A / G which includes:

• Corn grits, rice, buckwheat, millet, oatmeal. Oats do not contain gluten but may cause due to protein content avenina , which has similar properties, so the attitude to oatmeal is twofold. With a deterioration in health, it is excluded from the diet. Porridges are cooked in water with the addition of milk and rubbed. From the same cereals you can cook casseroles or steam puddings. Also, in the preparation of any dishes, you can use corn and potato starch.
• Bread made from permitted types of flour (corn, rice, soy, amaranth, pumpkin) or special gluten-free bread. From flour you can cook any pastries, pancakes, pancakes, cookies and bread.
• Low-fat meat and fish of all varieties, chicken, turkey, eggs, canned fish (in oil and own juice). Excluded - in a tomato, since flour is used as a thickener. When preparing cutlets, rice or cornmeal is used. Meat and fish dishes are consumed at any stage of the disease.
• All vegetables without restriction in any form (boiled and baked are better tolerated) and legumes (with normal tolerance). Vegetable puree can be prepared from potatoes, zucchini, pumpkin, carrots, cauliflower. During the period of exacerbation of enteritis, cabbage, onions, beans, green onions, parsley, dill are limited or excluded.
• Pickled, pickled and canned vegetables (peas, beans, corn) are also limited during this period.
• Soups on a weak meat and fish broth, vegetable broth with meatballs, egg flakes. Allowed cereals and finely chopped vegetables are added.
• Fresh and cooked fruits (kissels, jelly, mousses, compotes), baked pears, apples, quince. The diet contains jam, marmalade, jams, marmalade and homemade marshmallows. With an exacerbation of enteritis, the consumption of fresh fruits and juices (fruit and vegetable) is limited. Dried fruits and compote mixture can be consumed at any stage of the disease.
• Vegetable oil, homemade butter.
• Eggs (omelette, soft-boiled) can be consumed at any stage of the disease.
• Sour cream 15 g per dish, cream up to 50 g also per dish. When using these products, you need to make sure that they do not contain flour-based thickeners.
• Non-acidic cottage cheese, products made from cottage cheese (steam puddings, casseroles with cereals and vegetables). Cheeses prepared at home. Fermented milk products are also allowed only home-made. With good tolerance, you can drink kefir, yogurt and yogurt. Milk and cream - only in dishes, for example, with tea in a small amount (50 g per glass). Non-acidic sour cream (15 g per dish). It should be borne in mind that with concomitant lactase deficiency, which occurs in 75% of patients, dairy products are limited or excluded.
• Sugar, honey, natural tea without additives, coffee from whole coffee beans, rosehip infusion, diluted fruit, vegetable and berry juices.
• Homemade fish and meat preserves.
• Specialized products: dry protein mix.
• Industrial canned food (seaweed, peas, corn).

Table of allowed products

Wholly or partially restricted products

• Wheat (bulgur, couscous, kamut, semolina and wheat groats, triticale, spelt, wheat flour, spelled), rye (rye flour bread and pastries), barley (barley and pearl barley), oats (oat groats and flour) . These types of flour should not be included in dishes and breading.
• Dairy and sour-milk products with flour and decoctions (oatmeal and wheat).
• Industrial canned food with the addition of flour, ham, sausages, sausages, sausages.
• Semi-finished products (cheesecakes, cutlets, meatballs, nuggets, fish, zrazy), breaded in breadcrumbs. Everything can be cooked at home using permitted flour.
• Any confectionery products made from unauthorized types of flour and with the addition of barley.
• Canned vegetables with additions of flour and cereals.
• Caramel, chocolate, dragees, sweets.
• Barley products - talkan flour, drinks, milk.
• Corn flakes that contain the addition of wheat flour.
• Kvass, drinks with gas, from alcoholic drinks - vodka, beer and whiskey.

The following products may contain unauthorized flours or malts:

• Yoghurt, packaged cottage cheese, ice cream, curd mass, condensed milk, dried cream and milk, crispbread, corn sticks, chips.
• Cheese, mayonnaise.
• Tomato paste and ketchup.
• Instant coffee, drinks (Pepsi, Cola), cocoa powder, granulated tea.
• Marshmallow, halva, Turkish delight, industrial production of jam, marmalade and marshmallow.
• Frozen semi-finished products should be discarded. If the finished product contains dextrin , modified starch, seasonings, flavorings, or vegetable protein, then it is likely to contain gluten.
• Homemade tomato paste and rosehip decoctions are limited during exacerbation.

Table of prohibited products

Menu (Power Mode)

For patients, the best way out is to cook at home using fresh products. At the beginning of the diet, it is recommended to exclude dairy products in view of the possible intolerance to milk sugar. With the normalization of the stool, the disappearance of swelling, you can try to gradually introduce them.

If it is not possible to buy gluten-free bread all the time, you can replace it with home-made bread from sorghum, corn, buckwheat, flaxseed, rice flour.

Pancakes, pancakes, various unsweetened pastries are prepared from these types of flour, and almond flour is most often used for pastry baking. Be sure to include daily fruits and vegetables (tolerance can be raw or processed), meat, chicken or fish, eggs (chicken and quail).

For kids

A typical form of the disease is observed in 70% of young children (from 8 months to a year). It usually manifests itself 2-3 months after the introduction of semolina and oatmeal, bakery products and mixtures with wheat flour into the diet.

It is gluten-containing cereals and foods that induce the occurrence celiac disease . It has been proven that the likelihood of developing this disease depends on its amount in the diet and the age of the child when he first had contact with gluten, which has a toxic effect on the intestinal mucosa.

In children, the disease occurs with malabsorption syndrome and initial manifestations are profuse frequent stools, vomiting, abdominal pain, and impaired weight gain. Already after 5-6 months, a large belly is formed, rickets-like changes, convulsive syndrome, short stature, degeneration of the skin and nails. Anxiety, excitability, aggressiveness, emotional lability predominate in the behavior of children. On the face of deficiency manifestations, To , D and micronutrients.

The main diet for celiac disease in children is gluten-free, but it can be combined with low-lactose and even dairy-free.

To reduce the impact gliadin on the intestines, the timing of the introduction of commercially produced complementary foods into the diet is determined:

• from 4 months - gluten-free: buckwheat and rice porridge;
• from 5 months - corn, a mixture of corn with buckwheat or rice;
• from 6 months - gluten-containing and gluten-free multi-cereal cereals;
• from 9 months - muesli.

Any types of cereals may include additional components: fruit fillers, honey (after 6 months), cocoa (from 9 months). For children of the first year of life, therapeutic mixtures are presented by Glutano and Doctor Sher. In addition to them, the product is "Bebiki" biscuits.

For older children, it is fundamentally important to refuse not only products with "obvious" gluten, but also those that contain "hidden" - as food additives (sauces, chips, kvass, confectionery).

Children can eat meat, fish, eggs, vegetables, fruits, homemade dairy products, buckwheat, corn grits, millet, legumes, rice, chocolate, marmalade, jam, honey, sugar, marshmallows. Restrictions apply to industrial milk - flour may be present in it. Fats the child should receive from vegetable oils.

During the period of exacerbation, intolerance to soy and rice may occur, which requires correction. Food during this period is given in a pureed form. Culinary processing - stewing and boiling. During an exacerbation, fruits and vegetables are excluded, then they are introduced in a peeled and grated form.

Lactase deficiency, which also manifests itself during an exacerbation, requires compliance lactose-free diet (without milk and its products). Milk is replaced by mixtures based on hydrolyzed proteins with a fat component: Nutrilak Peptidi MCT , Alphare , Nutrilo Pepti Gastro , Peptamen Junior . It is possible to prescribe lactase preparations that break down lactose ( Lactase Baby ).

Celiac disease in children leads to a secondary lesion of the pancreas with a violation of its function, which dictates the need for replacement therapy with enzyme preparations (,). At the same time, digestion improves in children, and they gain weight.

If necessary, correct violations of the intestinal microflora. With anemia, iron preparations are prescribed and. For calcium deficiency, calcium supplements and vitamin D . With strict adherence to the diet, the disease has a favorable prognosis. A child who is on a diet does not need hospitalization and can lead a normal life.

Celiac disease is a fairly serious hereditary disease. One of its features can be called the compilation of a specific diet for the patient. In the article we will talk about this in detail. Consider which foods are good for a celiac diet, which foods should be limited, and which should be avoided. Consider examples of menus, recipes.

What is it?

Why is there a special diet for celiac disease? This is a hereditary pathology in which the human body does not tolerate gluten. This is the name of the gluten protein of cereal grain crops. If, however, food containing it enters the stomach, and then the intestines of the patient, this will cause inflammation in these organs and lead to a general disruption of the gastrointestinal tract.

Celiac disease also has other names:

• Glutenenteropathy.
• Guy-Herter-Heibner disease.
• Intestinal infantilism.

The causes of this disease are as follows:

• hereditary predisposition.
• Weakened immune system.
• Congenital features of the small intestine, due to which there is an increased sensitivity of its cells.
• Intestinal infections, which lead to a change in the receptor intestinal apparatus.

Celiac disease is diagnosed by the following symptoms:

• Lagging behind in growth, physical development (in relation to children).
• Hypotrophy (the name of the eating disorder).
• Decreased blood glucose.
• Changes in the composition of the blood.
• Anemia.
• Dysbacteriosis.
• Hypovitaminosis.
• Lack of such elements in the body as zinc, calcium, iron, phosphorus.
• Rickets.
• Pain in the region of the stomach.
• Defecation disorder.
• Fetid feces of a characteristic green or white color.
• Vomit.
• Nausea.

Celiac disease comes in two varieties:

• Typical.
• Atypical. It affects only the upper half of the small intestine. This, in turn, leads to diseases such as anemia and osteoporosis. They are caused by nutritional deficiencies in the body.

Treatment Method

Let's talk now about diet and treatment of celiac disease. What is the main thing here? This is a gluten-free diet. Such treatment becomes a vital necessity for patients with intestinal infantilism.

At first glance, the diet for celiac disease seems to be somewhat complicated due to the need to eliminate all food containing gluten. After all, cereals are found not only in flour products from wheat, barley, oats, and rye flour. They are included in certain proportions in other common products: sauces, instant coffee, confectionery treats, canned food, etc.

Depending on the individual course of the disease, the doctor includes some types of cereals in the diet for celiac disease of a certain patient. For example, during the period of remission of the disease, oats are very well absorbed. At the same time, other patients react extremely sharply to it. In the acute phase of celiac disease, it is better to exclude all cereals from the diet in general.

Why is such an exception made when choosing a diet menu for celiac disease specifically for oatmeal? The fact is that they contain a large (in comparison with other cereals) amount of dietary fiber (fiber), which manifests itself in a laxative effect and increased motility of the intestinal tract.

Some patients tolerate a small inclusion of gluten in the diet quite well - this does not lead to an exacerbation of the disease. But still, for most people suffering from this disease, even the content of a small amount of gluten in food is toxic. Within a few hours of eating gluten meals, they develop massive "watery" diarrhea that can go as far as gliadin shock.

Characteristics of the diet

What are the features of the diet for celiac disease in adults? Most importantly, it is gluten free. But at the same time, it is full-fledged, despite the exclusion of wheat, barley, and rye. It is characterized by a high content of protein and calcium salts. There is an increased energy value.

By its composition, such a diet is chemically and mechanically sparing. In particular, due to the fact that dishes that provoke fermentation processes are excluded. There are usually two main types of such a gluten-free diet: for patients with normal weight and for patients with overweight.

As for cooking, the products are boiled or the dishes are steamed. Depending on the functional state of the patient's intestinal tract, food is either crushed, wiped (especially during the period when a person suffers from diarrhea), or prepared without grinding (at the stage of stool normalization). During persistent remission of the disease, baking and even light frying of food is recommended.

As for the diet, it is introduced fractional. Up to 5-6 meals a day. It is important to observe the maximum / minimum food temperature. As for hot dishes, the highest value is 57-62°C. For cold dishes - at least 15 ° C.

Now let's decide on the chemical composition and energy value (per day) for a diet for celiac disease in children and adults:

• Proteins: within 100-120 g.
• Fats: within 100-110 g.
• Carbohydrates: within 400-450 g.
• Calorie content: from 2950 to 3250 Kcal.
• Table salt content: no more than 5-7 g.
• Free fluid intake: at least 1.5 liters.

Approved Products

Consider foods that can be introduced into the diet for celiac disease in adults and children:

• Bread. Based on corn, potato or wheat starch or rice, soy, buckwheat, corn flour.
• Soup. Prepared in a weak fish or meat broth. Meatballs, egg flakes, flourless quenelles, rice, if tolerated, oatmeal can be included in the dish. Do not forget about vegetables: potatoes, cauliflower, carrots, pumpkin, zucchini.
• Meat and poultry. Low-fat varieties of lamb, beef, veal and pork are allowed, as well as chicken, turkey and rabbit meat. Both in individual pieces and in chopped form.
• Vegetables. Both boiled and mashed (like puree): cauliflower, zucchini, potatoes, pumpkin, carrots.
• Cereals. Porridges are prepared on water with the addition of no more than 1/3 of the total composition of milk. These are buckwheat, corn, rice groats, millet, sago, quinoa, soybeans. Or products from them, including flour. Casseroles, puddings from such cereals.
• Eggs. Soft-boiled, as well as omelettes - baked or steamed.
• Fruits, berries or treats. Here you can highlight jelly, mousses, kissels or mashed compotes from sweet varieties of fruits and berries. It is also acceptable to make homemade jam from quince, pears, apples, raspberries, blueberries, black currants, strawberries. You can eat baked apples and pears. Among the delicacies in the diet for celiac disease in children, you can include marmalade, honey, marshmallows, natural chocolate, marshmallow.
• Milk products. Patients can choose fresh calcined non-acid curd either fresh or in the form of a pudding with fruits or vegetables. Ryazhenka, mild cheeses are also recommended.
• Seasonings and sauces. Milk sauce based on starch, rice flour or weak meat, vegetable or fruit broth will be safe. Pepper, vanillin, bay leaf, cinnamon, wine and apple cider vinegar, garlic, as well as herbal natural mono-spices.
• The drinks. Herbal and fruit tea, decoctions of wild rose, bird cherry, black currant or blueberry are recommended. Natural coffee and cocoa. As well as kissels, compotes, homemade juices, mineral water.
• Fats. Butter - both to the table and as an additive to dishes.

A gluten-free diet for celiac disease can also be supplemented with protein composite dry mixes and vitamin complexes.

What needs to be excluded?

The list of allowed products is quite extensive. Like the forbidden ones. Every patient should be familiar with the latter, because a violation of the diet for celiac disease can lead to unpleasant, if not serious, consequences.

The following stands out here:

Limited use

When choosing suitable recipes for a diet for celiac disease, remember that there are a number of foods, dishes, whose use should be strictly limited:

• Soups. Vegetable soups during the period of exacerbation must be rubbed.
• Meat and poultry. It is not recommended to eat in lumps during an exacerbation.
• Fish. Do not abuse fatty fish.
• Vegetables. It is allowed to eat up to 100 g of fresh tomatoes, provided there is no diarrhea. You can add small amounts of blanched onions to dishes. During the period of remission, blanched garlic is also allowed.
• Cereals. Only under the condition of good tolerance of the dish is it allowed to use pureed oatmeal.
• Eggs. No more than 1-2 pieces per day.
• Fruits, berries and treats. Only under the condition of tolerance is it allowed to eat grated raw apples without peel, as well as strawberries, raspberries, strawberries - no more than 100 g per day.
• Milk products. It is allowed to consume milk and cream in small quantities (up to 50 g), add them to dishes. Sour cream - no more than 15 g per dish. You can also add it to sauces in small quantities. With good tolerance, kefir is allowed.
• The drinks. It is possible to use natural sweet juices. It is best to drink them by mixing 1:1 with ordinary water. With caution, you can drink the following alcoholic beverages: cognac, grape wine, rice and corn vodka (tequila and sake).
• Fats. Caution is allowed to add refined vegetable oils to the diet - up to 5 g per dish and only during remission.

sample menu

We have analyzed the symptoms of celiac disease, diet for adults and children. Now we give an approximate menu for a few days.

First day:

• Breakfast. Milk viscous buckwheat porridge with added sugar, natural omelet, cocoa with sugar and milk.
• Lunch. Mild cheese, ripe seasonal berries, jelly.
• Dinner. Potato soup with meatballs, natural chopped steak, carrot puree, boiled apple and dried fruit compote.
• afternoon tea. A piece of boiled meat, a baked apple.
• Dinner. Meat and rice meatballs, boiled potatoes with blanched onions, fresh cottage cheese, tea.
• For sleep. Kissel.

Second day:

• Breakfast. Rice viscous milk porridge with added sugar, two soft-boiled eggs, natural coffee with milk.
• Lunch. Emmental cheese, pear, jelly.
• Dinner. Fresh tomato soup with boiled chicken, squash with butter stewed, pieces of boiled chicken meat, Apple juice.
• afternoon tea. Meat puree, orange.
• Dinner. Meat cutlets with rice, boiled broccoli, millet viscous milk porridge, tea with jam.
• For sleep. Kefir.

The third day:

• Breakfast. Buckwheat porridge on water, a piece of carbonate, tea with jam.
• Lunch. Fresh cottage cheese with sour cream, one banana, jelly.
• Dinner. Cauliflower puree soup, pilaf with pieces of boiled meat, fresh tomato, berry drink with added sugar.
• afternoon tea. Boiled meat, applesauce from the category of baby food.
• Dinner. Boiled fish, mashed potatoes with butter, marshmallows, tea.
• For sleep. Ryazhenka.

When planning a diet for exacerbation of celiac disease and during the period of remission, take into account these tips:

• Store gluten-free products in a separate locker.
• A child on a gluten-free diet should have his own dishes: a cup, plate, cutlery. They must be distinguished by a particular color or pattern.
• For gluten-free cooking, use separate cutting boards, pans, pots, baking dishes, plates. If this is not possible, be sure to wash these accessories thoroughly after eating gluten.
• Get a separate butter knife if you or your child is also allergic to milk.
• Always wash your hands before preparing or eating gluten-free food. Especially in the case when you touched gluten food.
• If your child has celiac disease, do not allow him to try gluten foods. If he likes it, such a product can be a strong temptation.
• Growth on a diet with celiac disease is possible in the same way as in children with gluten tolerance. But the fact that the child is supposed to have specialized nutrition must be warned both by the kindergarten teacher and the class teacher at school.
• Do not give children foods that you doubt the composition of. Let the baby also learn this rule: if in doubt, then you can’t eat food.

Some recipes

Recipes for a diet for celiac disease for adults and children are quite diverse. You can cook delicious and healthy food that is as good as gluten-free.

You can make bread with cornmeal. Required Ingredients:

• 2 eggs.
• 1 teaspoon of baking soda.
• 400 g cornmeal.
• 1.5 cups of milk.
• A pinch of salt.
• A pinch of cumin.

Cooking:

1. Sift corn flour, add milk, soda, cumin, eggs to it.
2. Mix the mass thoroughly, leave for 15-20 minutes.
3. Lubricate the form with butter, then pour the dough into it.
4. Bake for about 40 minutes at 40 degrees.

Now - a delicious soup with cauliflower. You will need:

• Chicken or turkey fillet - 200 g.
• Water - 2 liters.
• Cauliflower - 300 g.
• Carrot - 1 pc.
• Onion - 1 pc.
• Finely chopped dill or parsley - 30 g.
• Potatoes - 150 g.
• Garlic - 1 clove.

Meal preparation:

1. Wash the fillet, place in a saucepan, cover with water and cook over moderate heat.
2. After the broth boils, add finely diced potatoes to it.
3. Ten minutes later, add the cauliflower, grated carrots and chopped onions.
4. Let stand for another 10 minutes, then add chopped greens and a rubbed garlic clove.
5. You can grind the finished product in a blender to a creamy mass.

Other recipes are presented in the video in this article.

A gluten-free diet is indicated for celiac disease. She excludes a number of products from the diet. But this is not a reason to give up healthy and tasty food.