Coeliac Disease: Considerations for Athletes  

What is Coeliac Disease? 

Coeliac disease is a genetic condition, which causes damage to the small intestine and other organs. When someone is diagnosed with coeliac disease, it means they have a hypersensitivity to the protein gluten, which is found in wheat, rye, oats and barley. An adverse reaction to the digestion of gluten causes intestinal villi damage and leads to an inflammatory response. This results in a reduced ability to absorb nutrients, and cause damage to other organs and systems including the skin, bones and the brain. 

Symptoms related to coeliac disease may differ from person to person. Undiagnosed and untreated coeliac disease may cause: 

  • Lethargy – drowsiness, lack of energy
  • Gastrointestinal symptoms – bloating, constipation and/ or diarrhoea, abdominal pain, nausea, vomiting
  • Symptoms specific to nutrient deficiency – iron, vitamin D, folate, zinc, vitamin B12
  • Infertility – in long-term untreated coeliac disease 

What causes Coeliac Disease?

While coeliac disease is a genetic condition, it can be triggered at any time by eating foods containing gluten. An individual with diagnosed or undiagnosed coeliac disease will usually experience the above adverse symptoms after gluten consumption. This includes consumption of all products containing wheat, barley, rye and oats. Some examples include:

  • Bread
  • Cereal
  • Pasta 
  • Biscuits. 
  • Wheat thickeners/ starch/ flour 

The treatment for coeliac disease is therefore a strict lifelong gluten free diet. This prevents further damage to the intestinal lining and promotes villi regeneration allowing for proper nutrient absorption. 

How do you know what foods are Gluten Free? 

People with coeliac disease will experience less symptoms and a better quality of life if gluten is avoided in the diet. A lot of foods are naturally gluten free including fruits, vegetables, legumes, beans, unprocessed meats/ poultry, seafood, dairy, nuts and some grains. These foods are all safe to consume and are recommended as part of a healthy diet.  

Currently there are gluten free options of most gluten containing foods available, including pasta, bread, biscuits, cereal, other baked goods, and sauces. It is important to read the ingredients of a food and check the gluten allergen status. Hidden gluten may be present in products such as sauces or cereals, so knowing what to look for on a food label is great skill to have. 

So how can you tell a food is gluten free?

Look for a gluten free label. In Australia a Coeliac Australia label should be present, or the food must be labelled ‘gluten free’. This will be present on the front of a food package, on products that normally contain gluten. 

Check the allergen listing. If a product doesn’t state that it is gluten free, the allergen list can be a quick way to check if the product is potentially safe to consume. An allergen list will declare whether wheat and other typical allergies such as egg, soy, nuts and milk are present in a product. You may also see some products declare gluten as an allergen. However, barely, rye and oats which all contain gluten are not required to be listed as allergens. Be sure to check to ingredients list for these hidden sources of gluten. 

Check for obvious or hidden ingredients. The ingredients list will help to identify sources of gluten in a product. Ingredients to look out for include:

  • Wheat
  • Barley
  • Rye
  • Malt
  • Oats – unless specifically labelled gluten free 
  • Brewer’s yeast 

These ingredients will often be bolded to stand out as allergens. You should also look for ingredients ‘derived from’ the above foods to ensure what you are consuming is safe. 

Consuming enough Carbohydrates 

Gluten is mostly found in carbohydrate foods. Carbohydrates are an essential macronutrient for the body. They are the main source of energy which allows for daily functioning. Carbohydrates are also essential for athletic performance because they replenish energy stores in the muscles quickly. Consuming adequate amounts of carbohydrates may be a challenge for people with coeliac disease. It is important to be prepared with adequate snacks and meals especially surrounding training or competing. Having appropriate options available will ensure you are properly fuelled with energy and have a reduced risk of experiencing uncomfortable symptoms. 

Types of Carbohydrates for Performance

There are two different types of carbohydrates: simple and complex carbs. Research has proven different types of carbohydrates to improve performance and energy levels. 

Simple carbohydrates have been shown to quickly supply energy to the body because they are digested more easily. Simple carbohydrates contain less fibre, fat and protein when compared to complex carbohydrates or other foods. For this reason, it can be beneficial to consume simple carbohydrates before or in between training sessions. 

Some examples of pre-training or in between training snacks include:

  • Gluten free bread/toast and honey
  • Gluten free banana/ berry muffins
  • Fruit 
  • Corn thins and honey/ spread of choice
  • Gluten free muesli bar

The second type of carbohydrate is a complex carb. These carbohydrates contain more fibre and protein which means they are slower to digest. Ultimately increasing energy levels at a slower rate and increasing periods of satiety. For this reason, it is most beneficial to consume complex carbohydrates after training and outside of training sessions.

Following a training session, it is also important to include protein into your meal or snack. During exercise, muscles are damaged and broken down. Protein rich foods are made up of amino acids essential for rebuilding and repairing muscles. After a training session and outside of training it is important to eat protein rich foods to promote muscle recovery and future performance. 

Therefore, it is helpful to consume complex, low GI carbs paired with protein rich foods after or outside of training. 

Some examples of post-training or outside of training snacks include:

  • Rice and tuna
  • Eggs on gluten free toast/ sourdough 
  • Cottage cheese on gluten free toast/ sourdough with tomato/ strawberries/ cucumber
  • Baked potato and chicken/ beef/ lamb/ beans 
  • Quinoa porridge sachets 
  • Gluten free cereal with yoghurt and fruit 

Living with coeliac disease can be managed through avoiding foods that contain gluten, but this doesn’t mean you have to consume a plain diet. If you need help with understanding how to go gluten free or to plan a gluten free diet, make sure you get in touch to see how we can help you.