Working With Your Dietitian to Stay Gluten Free

When you receive a diagnosis of coeliac disease you should be given an appointment to see a dietitian. This appointment may be made through your GP or through a specialist gastroenterologist and in either case the referral is free and the dietitian or nutritionist will normally be based at the outpatients department of your local hospital.

Before The Appointment

Some departments send you a form to complete and bring with you on the day, but if you don’t receive such information it’s still worth doing some ‘homework’. The best way to assist yourself to get the most from your meeting with the nutritionist is to make three lists:

• list one should contain all the foods that you’ve eaten over the previous seven days and counts as a food diary
• list two is simply a list of all the medication that you take on a regular basis and/or any other conditions you have that require medical input (such as ongoing health issues like high cholesterol or infrequent ones like migraine)
• list three is for your questions and concerns, which could be anything from how to cope with big family events like weddings or whether there’s a suitable diet for a gluten intolerant person who wants to run a marathon through to questions about what happens if you get pregnant.

During The Appointment

The nutritionist or dietitian (you may see either) will often ask you if you have any particular likes or dislikes or dietary requirements. They will talk to you about your daily routine and your usual eating habits and tell you more about the foods you can and can’t eat and about what is available to you on prescription. You may be weighed and have your height and blood pressure taken.

This is your opportunity to ask questions about food and supplements – many individuals who are diagnosed with coeliac disease also have other dietary deficiencies such as anaemia which arise from having had undiagnosed gluten intolerance, and it may be wise to boost your nutrition with some supplements in the short or long term. Although the range and nutritional make-up of gluten-free foods is improving rapidly, they are still often lower in B complex and D vitamins, calcium, iron and, zinc than gluten containing foods.

Some research in the USA suggests people with coeliac disease may have an increased risk of obesity and high cholesterol because their diet is lower in fibre than that of somebody who can eat wheat. A nutritionist can make a clinical assessment of your diet and health and tailor dietary recommendations to your specific needs.

Remember to ask about follow up appointments and to ensure that you are included on any mailing lists that are kept for coeliac patients. Sometimes cookery classes are offered to gluten-intolerant people and manufacturers often ask nutritionists to ‘road test’ new gluten free products on their patients: this gives you the chance to try out new gluten free foods at no cost and to learn new ways to prepare and cook gluten free foods. Being assessed annually also allows your nutritionist to decide whether you need a different form of food or an adjusted gluten-free prescription as your circumstances change. Above all it ensures that you have the best information to manage your own condition as easily as possible.