By Julie Garden-Robinson, Nutrition Specialist

NDSU Extension Service

An estimated one in 133 people has this disease, but only 3 percent of them have been diagnosed. Many are of Scandinavian, Irish or English descent.

The disease can appear at any age, from infancy to later adulthood, and isn’t necessarily easy for doctors to diagnose. The symptoms vary. Many people with this disease experience digestive problems, such as gas, diarrhea and bloating. Others experience fatigue, vomiting, loss of appetite, weight loss and/or depression.

If untreated, the disease can damage the small intestine. This can result in malnutrition because nutrients are not properly absorbed. Rash and blisters on their skin may appear and, through time, osteoporosis and anemia can occur.

This fairly common illness is known as celiac disease. You can’t “catch” it like a cold, but you can inherit it from your parents. You may know someone with it.

Remember: You can’t diagnose yourself as having celiac disease by reading about it. Check with your physician for more information.

The treatment is straightforward. Those with celiac disease must avoid all foods containing a plant storage protein commonly called “gluten.” That’s sometimes easier said than done.

Wheat, barley and rye contain the protein that causes digestive problems and other issues for celiacs. Many experts also caution celiacs to avoid oats, partly because the grains may be processed using the same equipment at the manufacturing plant. Corn and rice do not contain the protein.

You may be familiar with gluten. When wheat flour and water are kneaded into dough, gluten is formed. Gluten provides an elastic framework that allows for the expansion of bread during rising and baking. It’s used as a binder in processed foods and as a carrier in spices and medications.

Sometimes it’s difficult to tell if gluten is present by reading the ingredient label. Gluten-type proteins are found in many types of bread, breakfast cereals, pasta, puddings, cheese spreads, salad dressings, spices, breaded meat products, cold cuts, jelly beans, ice cream, coffee creamers and numerous other foods. Even some types of toothpaste, mouthwash and medications need to be avoided by those with celiac disease because they contain gluten.

Despite having to avoid certain foods, celiacs don’t have to feel deprived with all the other naturally gluten-free foods available, such as fruits, vegetables, eggs, cooked dry edible beans and meats without added flavors or coatings. Many grocery stores feature specialty food sections for people on special diets.

Some people with celiac disease must be cautious about dairy products because lactose intolerance commonly occurs. Lactose intolerance is the failure of the intestinal enzyme lactase to digest milk sugar. Cultured products, such as yogurt, usually are well-tolerated, though.

The Red River Celiacs group is having a conference in early November. You can learn more about its conference and local support available by visiting its Web site at http://www.redriverceliacs.org. Here is a recipe shared by a member of the group.

Leila’s Best Gluten-free Chocolate Cake

2 c. gluten-free flour mix* (see following recipe)

1 tsp. baking powder

2 eggs

2 c. sugar

1/2 c. cocoa

1/2 tsp. salt

2 tsp. baking soda

1 1/2 tsp. xanthan gum

1 c. hot water

1 c. vegetable oil

1 c. buttermilk

Preheat oven to 350 degrees. In a large bowl, combine dry ingredients. Stir in oil, buttermilk and eggs. Add hot water and stir until combined. Pour into a greased 13- by 9-inch pan or make cupcakes. Bake the cake for 35 to 38 minutes or the cupcakes for 20 minutes. Frost as desired. A serving (1/16 of the cake recipe) has 270 calories, 16 grams (g) of fat, 34 g of carbohydrate and 290 milligrams of sodium.

• Gluten-free flour mix

2 c. brown rice flour

2 c. white rice flour

1 1/2 c. sweet rice flour

1 1/3 c. tapioca starch or flour

2/3 c. corn starch

1/2 c. rice bran or rice polish

2 tsp. xanthan gum

Sift together three or four times and store in a canister. Use 1 cup of this mixture when the recipe calls for 1 cup of wheat flour. This flour mix works very well in cookies, bars, cakes and rolled-out sugar cookies.

(Julie Garden-Robinson is a food and nutrition specialist and associate professor with the NDSU Extension Service, Fargo.)

NDSU Agriculture Communication