How Celiac Disease Affects the Body, and How to Manage It
In celiac disease, the immune system mistakes gluten for a threat and mounts an attack that damages the small intestine. This response causes villus atrophy, where the tiny finger-like projections (villi) responsible for nutrient absorption shrink and flatten [5], [7]. The result? Poor absorption of nutrients, which can lead to fatigue, digestive distress, anemia, and more.
The only treatment is a strict gluten-free diet. With careful planning and label-reading, people with celiac disease can manage their symptoms and prevent complications.
You need to carry the HLA DQ2 or DQ8 genes to develop celiac disease [3], [13], but not everyone with these genes gets sick. Think of these genes as the 'key'—they open the door, but you still have to walk through it. These genetic markers are also linked to other autoimmune disorders, increasing the risk of overlapping conditions.
When gluten is consumed, the immune system produces inflammatory cells and antibodies that attack the intestinal lining. This ongoing inflammation impairs digestion and can lead to widespread issues, including bone weakness and nutrient deficiencies.
The World Journal of Gastrointestinal Pathophysiology notes, 'villous atrophy fundamentally disrupts normal digestion and absorption, resulting in multi-organ impacts' [7].
Celiac disease doesn't look the same for everyone. Symptoms can be obvious or silent:
Digestive symptoms may include:
Non-digestive symptoms might include:
Some people have no gut issues at all, but still suffer internal damage. That's why antibody testing—like the anti-tissue transglutaminase (anti-tTG) test—is vital for diagnosis [4], [6], [8].
American Family Physician explains that 'serologic testing has revolutionized early detection, even in minimally symptomatic patients' [8].
Diagnosis involves a multi-step process:
The American Journal of Gastroenterology notes, 'genetic testing is particularly valuable when the diagnosis remains uncertain' [13].
Untreated celiac disease can lead to:
Celiac disease is also linked with other autoimmune disorders like type 1 diabetes and rheumatoid arthritis. Some patients may develop refractory celiac disease, where symptoms persist despite a gluten-free diet. Others may experience conditions like lactose intolerance or irritable bowel syndrome as coexisting issues. [9]
There's no cure—just one proven treatment: a strict, lifelong gluten-free diet [6], [10], [11]. This means:
Most people feel better within weeks, though full healing may take months or years depending on severity and age at diagnosis [5]. Regular check-ups and guidance from a dietitian can help ensure nutritional balance.
American Family Physician states, 'patients benefit from ongoing nutritional counseling to optimize long-term outcomes' [6].
Gluten is found in:
Reading labels is critical. Avoiding even trace amounts of gluten is essential to prevent symptoms and long-term damage.
Dining out can be tricky, but not impossible. Many restaurants now offer gluten-free options. Ask about preparation methods and cross-contamination risks. Carry a gluten-free dining card to help explain your needs. With planning, eating out can still be safe and enjoyable.
Having celiac disease raises the risk of developing other autoimmune disorders like autoimmune thyroid disease and type 1 diabetes. This is due to shared genetic and immune system triggers. Managing celiac disease with a gluten-free diet not only improves gut health but may help reduce systemic inflammation and lower the risk of additional autoimmune issues.
Celiac disease is a genetic autoimmune condition that causes intestinal and systemic damage when gluten is consumed. Its symptoms vary widely—from digestive problems to silent nutrient deficiencies—but the path forward is clear: early diagnosis, followed by lifelong gluten avoidance. With commitment and proper medical guidance, people with celiac disease can lead healthy, vibrant lives.
[1] Lindfors, K., Ciacci, C., Kurppa, K., Lundin, K. E. A., Makharia, G. K., Mearin, M. L., Murray, J. A., Verdu, E. F., & Kaukinen, K. (2019). Coeliac disease. Nature reviews. Disease primers, 5(1), 3. https://doi.org/10.1038/s41572-018-0054-z
[2] Catassi, C., Verdu, E. F., Bai, J. C., & Lionetti, E. (2022). Coeliac disease. Lancet (London, England), 399(10344), 2413–2426. https://doi.org/10.1016/S0140-6736(22)00794-2
[3] D'Avino, P., Serena, G., Kenyon, V., & Fasano, A. (2021). An updated overview on celiac disease: from immuno-pathogenesis and immuno-genetics to therapeutic implications. Expert review of clinical immunology, 17(3), 269–284. https://doi.org/10.1080/1744666X.2021.1880320
[4] Green, P. H., Lebwohl, B., & Greywoode, R. (2015). Celiac disease. The Journal of allergy and clinical immunology, 135(5), 1099–1107. https://doi.org/10.1016/j.jaci.2015.01.044
[5] Rubin, J. E., & Crowe, S. E. (2020). Celiac Disease. Annals of internal medicine, 172(1), ITC1–ITC16. https://doi.org/10.7326/AITC202001070
[6] Pelkowski, T. D., & Viera, A. J. (2014). Celiac disease: diagnosis and management. American family physician, 89(2), 99–105. https://pubmed.ncbi.nlm.nih.gov/24444577/
[7] Parzanese, I., Qehajaj, D., Patrinicola, F., Aralica, M., Chiriva-Internati, M., Stifter, S., Elli, L., & Grizzi, F. (2017). Celiac disease: From pathophysiology to treatment. World journal of gastrointestinal pathophysiology, 8(2), 27–38. https://doi.org/10.4291/wjgp.v8.i2.27
[8] Williams, P. M., Harris, L. M., DO, & Odom, M. R. (2022). Celiac Disease: Common Questions and Answers. American family physician, 106(1), 36–43. https://pubmed.ncbi.nlm.nih.gov/35839368/
[9] Lebwohl, B., Ludvigsson, J. F., & Green, P. H. (2015). Celiac disease and non-celiac gluten sensitivity. BMJ (Clinical research ed.), 351, h4347. https://doi.org/10.1136/bmj.h4347
[10] Selimoğlu, M. A., & Karabiber, H. (2010). Celiac disease: prevention and treatment. Journal of clinical gastroenterology, 44(1), 4–8. https://doi.org/10.1097/MCG.0b013e3181b7ead2
[11] Leonard, M. M., Sapone, A., Catassi, C., & Fasano, A. (2017). Celiac Disease and Nonceliac Gluten Sensitivity: A Review. JAMA, 318(7), 647–656. https://doi.org/10.1001/jama.2017.9730
[12] Villanacci, V., Vanoli, A., Leoncini, G., Arpa, G., Salviato, T., Bonetti, L. R., Baronchelli, C., Saragoni, L., & Parente, P. (2020). Celiac disease: histology-differential diagnosis-complications. A practical approach. Pathologica, 112(3), 186–196. https://doi.org/10.32074/1591-951X-157
[13] Brown, N. K., Guandalini, S., Semrad, C., & Kupfer, S. S. (2019). A Clinician's Guide to Celiac Disease HLA Genetics. The American journal of gastroenterology, 114(10), 1587–1592. https://doi.org/10.14309/ajg.0000000000000310
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Yahoo
2 hours ago
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The seven worst drinks for your gut health (and what to have instead)
Every year, new studies are published showing the crucial role played by the gut in our overall wellbeing. Our intestines are home to an ecosystem of bacteria, fungi and viruses collectively known as our gut microbiome which affects everything from our immune system to our mental health. Research is revealing, too, that the modern Western diet can wreak havoc on our gut. Ultra-processed foods kill off our healthy microbes and encourage the growth of harmful ones, resulting in an imbalance – known as gut dysbiosis – that can ultimately lead to disease and illness. Thankfully, the message about consuming gut-friendly foods is beginning to get through. But while many of us are dutifully eating kimchi or taking probiotics, it may not cross our minds that what we drink also has major repercussions on gut health. 'In general, people think less about the drinks they consume than they do about food,' says Prof Tim Spector, an epidemiologist, author and co-founder of science and nutrition company Zoe. 'It might be partially because they can't imagine that a small glass of something can contain as much added sugar as a highly processed chocolate bar.' With many of us now trying to improve our diets with gut health in mind, could what we drink be undoing all our good work? 'Life is all about balance,' Prof Spector says, 'and we shouldn't get too obsessed with 'undoing' our good work. The most important thing is to switch out any unhealthy drinks that you drink regularly. A can of cola once a month or so won't be an issue, but if you're having a few a day, it certainly will.' Here are the eight worst drinks for your gut health, and what to have instead. 1. Bottled iced tea Tea, which is rich in beneficial polyphenols, is a gut-friendly drink. Ready-made, bottled iced teas, on the other hand, are at the opposite end of the health scale. 'Almost all the commercial iced teas are full of sugar, or artificial sweeteners, emulsifiers, stabilisers and artificial flavourings,' says Stephanie Moore, a clinical nutritionist, health coach and author of Eat Your Brain Happy. 'All these additives are increasingly seen as gut disruptive, even at very low levels. Most iced teas are essentially no better than fizzy drinks, even if they do contain tiny amounts of tea.' What to have instead: home-made iced tea or tea infusions You can make your own, gut-friendly iced tea by mixing tea, lemon and water in a jug with lots of ice cubes. Moore recommends adding slices of lime or fresh ginger root to boiling water, allowing it to steep and then either drinking it as a tea or allowing it to cool. 'You get all the anti-inflammatory compounds and the polyphenols and the various compounds that are present in both. I often advise people to experiment with taking a big jug of water and adding cucumber, berries or mint, or small pieces of fruit, and letting it infuse. That way, you get the flavour without the sugar.' 2. Fizzy drinks 'Fizzy drinks – whether they contain sugar or artificial sweeteners – are robustly associated with poorer health,' says Prof Spector. Their high sugar content disrupts blood-sugar levels and feeds the pathogens in our gut. 'We all have lots of good microbes and probably a few bad microbes hanging around in our microbiome,' Moore explains. 'The bad ones thrive on sugar. So if you're regularly consuming sugary drinks, these pathogens are being fed. They proliferate and crowd out your good microbes. That's when we become prone to bloating and general digestive problems.' Diet drinks, she warns, are no better for your gut. 'They are now believed to disrupt the gut microbiome quite dramatically,' says Moore. 'They're man-made chemicals, so the gut microbes have no idea how to cope with them. It appears that in the process of breaking these chemicals down, which is the job of the microbes, some kind of toxic or noxious by-product is emitted that causes die-off of good microbes.' What to have instead: kombucha or water kefir 'Water kefir or kombucha are great alternatives to boring water or sugary sodas and squashes,' says Moore. Kombucha is a cold, sparkling drink made from fermented tea, while water kefir is made with water and kefir grains. 'I particularly like the lemon and ginger water kefir made by a company called Agua De Madre. It's a really refreshing and healthy option.' 3. Oat milk Oat milk has seen a dramatic rise in popularity, with sales jumping by 77 per cent in the past five years, mainly because people see it as a healthier option than dairy. Moore, however, is unconvinced. As far as I'm concerned, it might as well be a fruit juice,' she says. 'In the process of making it, you're squeezing out the sugars in the same way you do with a fruit juice, and removing all the beneficial fibre. Then, to make it suitable to use in tea and coffee, they add rapeseed oil or sunflower oil, and some kind of emulsifier. So you end up with a horrible combination of sugar and fat.' What to have instead: full-fat dairy milk 'For those who are able to tolerate it, I always recommend regular milk,' says Moore. 'Some people can't have dairy because of digestive or genetic issues, but for most people, milk – organic, ideally – is fine in small amounts. I would always say full-fat, because it means you don't lose the fat-soluble vitamins contained in whole milk. And where people can, I would recommend unhomogenised. Homogenisation breaks down the fat particles in milk, which makes the fat less digestible and can cause indigestion and unpleasant side effects.' Prof Spector is also a fan of dairy milk in small doses. 'Fermented milk drinks [such as kefir] are the best option for gut health,' he says, 'but consuming dairy in moderate amounts is also fine. There is evidence that drinking milk can strengthen your gut barrier, making sure that compounds that aren't supposed to reach your blood stay within the confines of your gut.' 4. Protein shakes 'These types of drinks tend to contain a wide variety of additives and flavourings that will not support gut health,' says Prof Spector. 'They also tend to contain no fibre or healthy plant compounds to feed your microbes.' Moore is equally scathing about protein drinks that are usually highly processed, artificially flavoured and contain surprising amounts of sugars. 'They do often contain nutrients and minerals, but at levels that are so negligible, they really don't deserve a place there. They also contain artificial flavourings and artificial sweeteners. It's really important to check the ingredients.' What to have instead: home-made protein drinks 'It's much better to make your own,' says Moore. 'Use a protein powder – whey or flavourless bone-broth powder – and just whizz that together with a bit of good quality milk and an egg yolk. Add some berries, a little bit of cocoa powder. You've got everything you want in there and it costs a fraction of the price.' 5. Fruit juice 'When I was a young doctor, I would drink orange juice virtually every morning, considering it a healthy option,' Prof Spector recalls. 'Sadly, as delicious as fruit juices are, they're not great for our overall health. The juicing process removes almost all the fibre, so the sugar is absorbed rapidly into your bloodstream, which can cause health issues in the long run.' One 2025 study published in Nutrients found that juicing increased inflammation in the gut and permeability in the gut lining, negatively affecting the microbiome. The same applies to smoothies, which may be filled with entirely natural ingredients but contain concentrated amounts of sugar and fructose. 'There is no such thing as a good fruit juice,' Moore says categorically. 'It's a sugar bomb.' What to have instead: kefir Kefir usually contains around 30 different strains of microbes, compared with yogurt, which only has four. It makes a good alternative to fruit juice as a breakfast drink and is high in protein. 6. Lager The message is very simple: alcohol is damaging to your gut health. Lager may contain less alcohol than other drinks, but it has a very high sugar content, which brings with it a range of negative repercussions to the gut microbiome. As Moore points out: 'While a lot of alcohol will be absorbed before it reaches the gut microbes, some will get through. The effect on your microbes will be loss of number and potentially loss of diversity. These microbes replace themselves very quickly, but if someone is drinking alcohol every night, say, it will be very damaging to the gut microbiome.' What to have instead: Guinness or alcohol-free beer 'Sadly, alcohol in general is bad for your gut,' says Prof Spector. 'However, darker beers tend to have more polyphenols, so if you enjoy an occasional tipple, opt for something dark.' A good example is Guinness which is known to have high levels of polyphenols. Alcohol-free beers are also growing in popularity, though Moore points out that they tend to have a high sugar content. 'The debate is then, 'Is the alcohol or the sugar worse for the gut microbiome?' I think either is probably fine in real moderation, but neither are great on a regular basis.' 7. Dark spirits Dark spirits like whisky, brandy and rum are particularly harmful because they contain high levels of congeners, natural compounds that are associated with more hangover severity and gut inflammation. 'These congeners are chemical compounds that come from the process of making darker spirits, as opposed to vodka and gin,' says Moore. What to have instead: tequila/mezcal 'All spirits, regardless of colour, are bad for your gut health,' warns Prof Spector. However, if you're looking for a slightly less destructive option, studies suggest that tequila and mezcal could be a comparatively healthier choice. 'Both are made from the agave plant, which is full of inulin, which is a very potent prebiotic fibre,' says Moore. 'If you want to drink a spirit, your best option is to drink tequila mixed with some water kefir. That way you've actually got live microbes in the water kefir and prebiotics in the tequila. So you could potentially be getting something beneficial from an alcoholic drink.' What should we be drinking to maintain optimal gut health? Water is the ideal option, but it can get boring so it makes sense to find tasty, healthy alternatives. 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Sugar should be cut out, ideally, and if you're drinking multiple cups per day, add only a small amount of milk – though Moore does point out that for some people, drinking black coffee on an empty stomach may not be advisable: 'It can be quite acidic and disruptive to the digestive system, so adding a bit of milk can soften it and help the body manage the acidity better.' Broaden your horizons with award-winning British journalism. Try The Telegraph free for 1 month with unlimited access to our award-winning website, exclusive app, money-saving offers and more.
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Yahoo
23-07-2025
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7-Day High-Protein, Gut-Healthy Meal Plan, Created by a Dietitian
Reviewed by Dietitian Jessica Ball, M.S., RD If a healthier gut is your goal, then fiber and probiotics are key. They help the community of friendly bacteria in your gut to grow and thrive, promoting overall digestive wellness. It's also worth limiting your intake of added sugars. Studies show that Western diets rich in added sugars can lead to an unhealthy balance of bacteria in your gut that increases chronic inflammation. We've taken this into consideration to create a high-protein, gut-healthy meal plan. In addition to being rich in fiber and probiotics, each day has at least 80 grams of protein to keep you satisfied and support muscle growth, especially if you're incorporating resistance training in your week. Meal Plan at a Glance Protein shake/ Nuts & berries Tzatziki bowl/ Yogurt Salmon with salad Chia pudding/ Yogurt Veggie sandwich/ Tuna salad spread Tzatziki bowl Chia pudding/ Nuts & berries White chicken chili/ Cottage cheese Baked Brie pasta Chia pudding/ Apple & nut butter Veggie sandwich/ Tuna salad spread One-pot chicken orzo Chia pudding/ Apple & nut butter White chicken chili/ Yogurt Sheet-pan tacos Protein shake/ Cottage cheese White chicken chili/ Nuts & dates One-pot pasta/ Nice cream Smoothie One-pot pasta/ Yogurt & dates Chicken & veggies/ Nice cream Day 1 Breakfast (337 Calories) 1 serving Chocolate-Cherry Protein Shake Morning Snack (256 Calories) ¼ cup unsalted dry-roasted peanuts ½ cup blueberries Lunch (514 calories) 1 serving Roasted Potato Tzatziki Bowls Afternoon Snack (202 Calories) 1 cup nonfat plain Greek yogurt 2 clementines Dinner (514 Calories) 1 serving Salmon with Cucumber & Avocado Salad Daily totals: 1,824 calories, 96 g fat, 95 g protein, 167 g carbohydrates, 36 g fiber, 1,392 mg sodium To make it 1,500 calories: Omit peanuts from morning snack and omit clementines from afternoon snack. To make it 2,000 calories: Add 2 hard-boiled eggs to breakfast. Day 2 Breakfast (422 Calories) 1 serving Strawberry Chia Pudding Morning Snack (202 Calories) 1 cup nonfat plain Greek yogurt 2 clementines Lunch (534 calories) 1 serving Beet & White Bean Sandwiches Afternoon Snack (149 Calories) 1 serving Tuna Salad Spread 1 cup sliced cucumbers Dinner (514 Calories) 1 serving Roasted Potato Tzatziki Bowls Daily totals: 1,821 calories, 74 g fat, 87 g protein, 213 g carbohydrates, 43 g fiber, 1,611 mg sodium To make it 1,500 calories: Reduce to ½ serving of Strawberry Chia Pudding for breakfast and omit clementines from morning snack. To make it 2,000 calories: Add ¼ cup unsalted dry-roasted peanuts as an evening snack. Day 3 Breakfast (422 Calories) 1 serving Strawberry Chia Pudding Morning Snack (284 Calories) ¼ cup unsalted dry-roasted peanuts 2 clementines Lunch (403 calories) 1 serving Instant Pot White Chicken Chili Freezer Pack ⅓ avocado Afternoon Snack (124 Calories) ½ cup 1% cottage cheese with probiotics ½ cup blueberries Dinner (547 Calories) 1 serving Baked Brie, Sun-Dried Tomato & Spinach Pasta Daily totals: 1,779 calories, 93 g fat, 84 g protein, 175 g carbohydrates, 42 g fiber, 1,976 mg sodium To make it 1,500 calories: Reduce to ½ serving of Strawberry Chia Pudding for breakfast and omit clementines from morning snack. To make it 2,000 calories: Add 2 pitted Medjool dates with 1 tablespoon natural peanut butter as an evening snack. Day 4 Breakfast (422 Calories) 1 serving Strawberry Chia Pudding Morning Snack (193 Calories) 1 serving Apple with Cinnamon Almond Butter Lunch (534 calories) 1 serving Beet & White Bean Sandwiches Afternoon Snack (149 Calories) 1 serving Tuna Salad Spread 1 cup sliced cucumbers Dinner (536 Calories) 1 serving Cheesy One-Pot Chicken-Broccoli Orzo Daily totals: 1,834 calories, 73 g fat, 95 g protein, 212 g carbohydrates, 45 g fiber, 1,796 mg sodium To make it 1,500 calories: Omit snacks. To make it 2,000 calories: Add ¼ cup unsalted dry-roasted peanuts as an evening snack. Day 5 Breakfast (422 Calories) 1 serving Strawberry Chia Pudding Morning Snack (193 Calories) 1 serving Apple with Cinnamon Almond Butter Lunch (403 calories) 1 serving Instant Pot White Chicken Chili Freezer Pack ⅓ avocado Afternoon Snack (202 Calories) 1 cup nonfat plain Greek yogurt 2 clementines Dinner (535 Calories) 1 serving Crispy Sheet-Pan Black Bean Tacos Daily totals: 1,756 calories, 67 g fat, 92 g protein, 214 g carbohydrates, 54 g fiber, 1,540 mg sodium To make it 1,500 calories: Omit morning snack and omit clementines from afternoon snack. To make it 2,000 calories: Add ¼ cup unsalted dry-roasted peanuts as an evening snack. Day 6 Breakfast (337 Calories) 1 serving Chocolate-Cherry Protein Shake Morning Snack (124 Calories) ½ cup 1% cottage cheese with probiotics ½ cup blueberries Lunch (403 calories) 1 serving Instant Pot White Chicken Chili Freezer Pack ⅓ avocado Afternoon Snack (347 Calories) ¼ cup unsalted dry-roasted peanuts 2 pitted Medjool dates Dinner (478 Calories) 1 serving One-Pot Spinach, Chicken Sausage & Feta Pasta Evening Snack (128 Calories) 1 serving Chocolate Strawberry Nice Cream Daily totals: 1,817 calories, 67 g fat, 89 g protein, 240 g carbohydrates, 44 g fiber, 2,039 mg sodium To make it 1,500 calories: Omit afternoon snack. To make it 2,000 calories: Add 2 hard-boiled eggs to breakfast. Day 7 Breakfast (448 Calories) 1 serving Raspberry-Peach-Chia Seed Smoothie 2 tablespoons walnuts, blended into smoothie Lunch (478 calories) 1 serving One-Pot Spinach, Chicken Sausage & Feta Pasta Afternoon Snack (266 Calories) 1 cup nonfat plain Greek yogurt 2 pitted Medjool dates Dinner (502 Calories) 1 serving Sheet-Pan Chicken Thighs with Red Cabbage & Sweet Potatoes Evening Snack (128 Calories) 1 serving Chocolate Strawberry Nice Cream Daily totals: 1,822 calories, 70 g fat, 95 g protein, 227 g carbohydrates, 46 g fiber, 1,716 mg sodium To make it 1,500 calories: Omit walnuts from breakfast, omit dates from afternoon snack, and omit evening snack. To make it 2,000 calories: Add ¼ cup unsalted dry-roasted peanuts as a morning snack. Frequently asked Questions Is it OK to mix and match meals if there's one I don't like? Yes! This meal plan is meant to serve as inspiration. It doesn't need to be followed exactly to reap the benefits. When choosing recipes, we made sure to check the calories, fiber, protein and sodium to align with the parameters of this plan and be within our sodium limits. If you're making a recipe swap, it may be helpful to choose a recipe with similar calories, fiber, protein and sodium levels. For more inspiration, check out these delicious gut-healthy recipes. Can I eat the same breakfast or lunch every day? Definitely, it's fine to eat the same breakfast or lunch every day. The breakfasts range from 337 to 448 calories while the lunches span 403 to 534 calories. These ranges are fairly close, though if you're closely monitoring your calories or other nutrients, like protein, you may want to adjust a snack or two. Why is there not a 1,200 calorie modification? We no longer provide modifications for 1,200-calorie days in our meal plans. The 2020-2025 Dietary Guidelines for Americans suggests that limiting calories to 1,200 per day is too low for most people to meet their nutritional needs, plus it's unsustainable for long-term health and well-being. Health Benefits of This Meal Plan Supports gut health. This meal plan contains at least 30 grams of fiber per day. It's also rich in probiotics and low in added sugars. This makes it great for gut health. These nutrients help the bacteria in your gut to grow and thrive, and maintain a healthy balance of different strains of bacteria. Promotes satiety. Protein and fiber take longer to digest than other nutrients, so they help you feel fuller longer. Since the meals and snacks in this meal plan are high in these nutrients, they can help you stay satisfied for longer so you're not hungry again an hour after eating. Supports muscle growth. Since this meal plan is also high in protein, with at least 80 grams per day, it can also help you build muscle. Protein helps repair and rebuild your muscles after you do resistance training. Just know that eating protein alone won't lead to muscle growth; you need to do regular resistance training, too. Read the original article on EATINGWELL
