Better eating puts celiac symptoms on the shelf

The autoimmune disease causes inflammation in the small intestine when gluten proteins from wheat, rye, barley and related grains are ingested. Celiac disease once was thought rare, but now is believed to affect 1 in 133 Americans.

``I'm seeing a lot more kids with celiac disease, but it's because of increased awareness of patients and pediatricians,'' said Dr. Gary Russell, a pediatric gastroenterologist at Massachusetts General Hospital.

Though celiac disease is genetically inherited, it flares up at different points in people's lives, and symptoms vary. Children typically have diarrhea, weight gain or loss, or abdominal extension. Celiac adults often have diarrhea, malnutrition, chronic fatigue and iron deficiency.

``When it comes down to it, any symptom can be a feature of celiac,'' Russell said.

The disease has no cure, and to live with it, celiacs must cut products containing gluten out of their diets. For many celiacs, the diagnosis means the end of pizza, beer, pasta and doughnuts as they knew it.

``I cleaned out my whole pantry and refrigerator, labeled everything, and threw a ton of stuff out,'' said Katharine Braun-Levin, a 23-year-old preschool teacher from Brighton who was diagnosed with celiac disease in March.

Celiacs like Braun-Levin would once have had a hard time filling their pantries with gluten-free food, but increased awareness about the disease has caused food stores to stock their shelves with celiac-friendly food.

``We've seen the demand go up in the past three to four years and adjusted our inventory accordingly,'' said Robert Keane, a Stop and Shop spokesperson. ``We expect this category to continue to grow.''

The chain carries more than 50 gluten-free items in its stores.

Whole Foods is another popular shopping destination for celiacs. The company's Web site carries information about the disease and gluten-free recipe cards, and a pamphlet listing more than 500 gluten-free products is available to shoppers in stores. According to Whole Foods, the stores' bakeries offer more than three dozen varieties of bread, cookies, muffins, scones and brownies.

Shopping for gluten-free products soon will be even easier. Last August, a federal law was passed requiring wheat and seven other allergens to be labeled on food products. The Food and Drug Administration is also in the process of establishing a standard for foods labeled gluten-free.

But everyday activites such as ordering take-out and attending dinner parties are still challenging for celiacs.

``The hardest thing is going out to restaurants and birthday parties,'' said Erivania Santos of Taunton, who has two children with celiac disease. ``If I'm going to go out, I have to think ahead. And for birthdays, I usually plan ahead to make a cake or cupcakes for my kids and bring them with me.''

She said her older son, Issac, 7, sometimes asks when the gluten-free diet will end, so she tries to emphasize positive points of the disease.

``They don't need to be on medication and they're eating healthier now,'' Santos said. ``If they see the good side of it, it's easier.''

Heather Eng