Ask the Dietitian: Gluten-Free, Lactose Intolerant & Reacting to Fruits & Vegetables
I have had celiac disease for 4 years now and wondering if I can return to eating normal food yet. My doctor doesn’t really tell me much except to keep eating the way I have been. You’re supposed to lose weight doing this but I haven’t. Why? I also have IBS and lactose intolerance. Fruits and veggies blow me up. What to do?
Hi Joni. Thanks so much for all your questions. I’ll address each concern individually below.
First, regarding your question about when you can return to “normal” eating, I’m guessing you’re referring to your “pre gluten-free” diet. If this is the case, the answer is that you must remain on your gluten-free diet for the rest of your life. While this may not be the answer you were hoping to hear, at this time the only treatment for celiac disease is 100% adherence to a gluten-free diet. The good news is that by following a gluten-free diet you should be able to live a very healthy life.
In regards to your question about weight loss, this is a very common misconception people have about the gluten-free diet. There is no evidence to suggest that a gluten-free diet, in and of itself, promotes weight loss. When you do hear about people losing weight (desired weight loss) while on a gluten-free diet, it usually occurs for one of two reasons. First, the person might simply be eating a healthier diet, consisting of more fruits and vegetables, lean proteins, and complex carbohydrates (i.e. quinoa, gluten-free oats, and sweet potatoes), and fewer sugars and simple carbohydrates (i.e. white bread, sugary desserts, and pasta). Second, when beginning a gluten-free diet, sometimes people will unintentionally consume fewer carbohydrates, often in conjunction with fewer calories, which can lead to weight loss.
Finally, in regards to your question regarding lactose intolerance, IBS, and symptoms with eating fruits and veggies, and assuming your doctor has ruled out other GI problems, it is possible you have some food sensitivities or intolerances in addition to celiac disease. Lactose intolerance is not uncommon in people with celiac disease. However, in many cases it resolves after several months on a gluten-free diet, as the villi in the gastrointestinal (GI) tract begin to heal.
If you have been following a strict gluten-free diet for 4 years, and are still having GI symptoms, you may want to consider working with a physician or registered dietitian who specializes in food sensitivities and intolerances. One approach I have used successfully for clients with constipation/bloating predominant IBS in my practice is the FODMAPs diet, which eliminates certain “fermentable” carbohydrates from the diet such as lactose (in dairy products), beans, and certain fruits and vegetables. You can read here to learn more about the FODMAPs diet for IBS and other functional gut disorders. You can also read these previous Q&As about FODMAPS:
I hope you are able to find relief from your IBS soon.
In good health,
EA Stewart, MBA, RD
This article was originally posted by the National Foundation for Celiac Awareness, find it here.