When first starting a gluten-free diet, you may have difficulties figuring out what you can eat, as well as what you need to eat. This problem is intensified for those with CD who have lost weight and are malnourished, which is more common in children who are gluten intolerant, but can happen to adults.
When working out your diet, you need to make sure you are getting enough calories. You also need to balance your food groups. It may make sense to see a dietitian to get help with this. But you also need to understand it yourself.
Calorie demands are fairly simple to work out. The more underweight you are, the more you need to eat. If your CD is severe enough for you to be underweight, your intestines are not absorbing what you need. As you continue with a gluten-free diet, your intestines will heal and more of what you eat will actually get into your body.
You may remember the food pyramid, which was how the federal government explained the amounts needed of various food groups in the past. The pyramid is now gone, replaced by “MyPlate” in the USA. It graphically illustrates the relative amounts of different food groups on a hypothetical plate. These relationships and suggestions are all part of a generally healthy diet.
This site allows you to input your age, height, weight and physical activity, which then generates a food plan including calories and portions of different food groups. While it will give you a good idea about types of food, it does not give you calorie goals if you are trying to gain weight. You have to increase the calories and portions to gain weight.
In Canada, the food pyramid was changed to the rainbow and similarly illustrates the portion amounts you should be eating from each food group.
Wheat is a carbohydrate. Naturally speaking, the carbohydrate portion of the plate is where you will be making the most changes. You do have to be aware of gluten contamination and its use as a thickener and filler. But it should relatively easy for you to get enough protein, as well as fruits and vegetables, especially if you avoid sauces and marinades.
Your milk consumption does not have to change unless you have lactose intolerance or a milk allergy. You should consider low-fat or nonfat milk. If you do not normally drink milk or eat dairy products like cheese and yoghurt, you will need to take calcium and vitamin D to keep your bones strong.
Carbohydrates will be harder, because so much carbohydrate in a “normal” diet is wheat based. As you substitute with other carbohydrates, you may find that you do not get enough fiber, and that the substitute flours have not been enriched with vitamins the way standard wheat-based cereals and breads are enriched.
If you follow the federal government food guidelines, half your plate will contain fruit and vegetables. If you eat a lot of fresh fruit and vegetables, you will get a lot of folic acid and B vitamins, as well as A and C, from your food. You will also get dietary fiber. If you are not eating enough fruits and vegetables, you can take supplements of B vitamins and any other supplements suggested by your doctor.
If you are significantly underweight, your doctor or dietitian may suggest that you eat relatively more protein, in addition to more calories. If you are overweight, you will need to eat less high calorie food. It is possible to be both overweight and vitamin deficient, which means that in all cases you need to have nutritious, vitamin-rich meals.
If you are having difficulty choosing and/or finding the right foods to eat, your doctor and dietician should be able to help you.