Coeliac disease

Dietitians are the main health professionals within the service that are responsible for monitoring patients and supporting them with the gluten free diet. However, if there are any medical issues, access to a gastroenterologist is available when needed.

We will do our best to support you every step of the way, from diagnosis to ongoing follow-up. We offer different types of appointments to suit your needs, and this includes in person appointments, telephone appointments and the use of digital questionnaires.

We will support you with following a gluten free diet, learning how to ensure your gluten free diet is balanced, monitoring your blood tests and offering regular contact and support for many other things.

Our Bradford coeliac disease newsletter has been created by the dietitians in the dietetic-led coeliac service in Bradford Teaching Hospitals NHS Foundation Trust to support people living with coeliac disease in Bradford.

Following the gluten free diet can be difficult and our newsletter has been extremely supportive for many of our patients who have appreciated knowing about more gluten free eateries, new food products in supermarkets as well as recipes to cook at home.

Calcium is an important nutrient to help support your bone health and reduce the risk of developing osteoporosis. Compared to the general population, people with coeliac disease require a higher daily calcium intake.

Adults with coeliac disease should aim for at least 1000mg of calcium daily.

It is important to ensure you are having adequate amounts of calcium daily from your diet. Take a look at the Coeliac UK Calcium resource and videos to see which foods contain calcium.

It is also important that you have sufficient vitamin D levels for your body to be able to absorb calcium.

Your body needs vitamin D to absorb calcium.

Interestingly, vitamin D is a hormone, rather than a vitamin and is made by your skin in response to sunlight.

During the winter months, it is important to take a vitamin D supplement. Although some foods contain a small amount of vitamin D it is not sufficient to maintain adequate levels of vitamin D in your body.

Your dietitian will monitor your levels annually and provide recommendations based on your blood results.

For more information, visit Calcium and vitamin D – Coeliac UK.

Iron is an important mineral with many functions. Some people with untreated or undiagnosed coeliac disease may be iron deficient as the body is unable to absorb iron when the lining of the gut is damaged. This can sometimes continue to happen whilst on a gluten free diet.

Depending on your gender and age, you may have different iron requirements.

There are many foods which contain iron that you can incorporate within your diet.

It is important to note that animal sources are better absorbed by the body however, there are non-meat sources of iron which you can include in your diet.

Visit Coeliac UK to find out more about iron and how to ensure you’re getting enough.

There is strong research evidence that there are many benefits to fibre including support with digestion, preventing constipation as well as lowering the risk of many conditions such as heart disease, type 2 diabetes and bowel cancer.

Current recommendations for fibre intake are 30g per day. At present, the UK consumes less than the recommended daily amount with average intakes of 15-20g per day.

Coeliac UK has noted that a gluten free diet can be low in fibre and wholegrains due to the removal of the cereals wheat, rye and barley. Therefore, it is important to ensure that you are consuming enough fibre from gluten free sources daily. You can do so by including more gluten free grains, nuts, seeds and pulses daily into your meals and snacks.

It is also important to note when you are buying pre-packaged foods like gluten free breads, pastas or ready meals you can check the nutritional information on the packaging. Foods must contain at least 3g per 100g to be called a source of fibre and 6g per 100g to claim to be high in fibre.

You could start by adding fruit, nuts, linseeds and/or chia seeds to breakfast cereals, swapping half of your meat in hot meals for legumes and pulses such as lentils, peas and chickpeas. As well as trialling different grains with meals i.e. switching white rice and white gluten free pastas for brown rice, buckwheat, quinoa and brown gluten free or chickpea pastas.

For more information, visit Fibre – Coeliac UK.

There is also a helpful list of the fibre content of gluten free foods (PDF) created by our Specialist Coeliac Dietitian, Cristian.

Folic acid is the synthetic version of the vitamin folate, also known as vitamin B9.

Folate helps the body make healthy red blood cells and is found in certain foods. It is sometimes not well absorbed in untreated coeliac disease, and it can also be low in people with coeliac disease following a gluten free diet if certain food choices are not made.

Folic acid is also important during pregnancy to protect against neural tube defects such as spina bifida. Therefore, since it is common to see folate deficiency in people with coeliac disease, it is important to mention that those who are actively trying to conceive and up to the first 12 weeks of pregnancy take a folic acid supplement.

A higher dose of folic acid is recommended by the Health Advisory Council for women with coeliac disease who are trying to conceive or who are pregnant. These high levels are not available over the counter, so it is important to mention this to your dietitian during clinic or contact your GP if you do not have an imminent appointment with us.

For more information, visit Gluten free when pregnant – Coeliac UK.

It is very important to follow a strict gluten free diet if you have coeliac disease and are either planning to get pregnant or are pregnant and want to have a healthy pregnancy. This is because there is some research to suggest that untreated coeliac disease is associated with subfertility and miscarriage.

We would suggest speaking to a health professional if you are planning for pregnancy and taking other general steps to help fertility and pregnancy outcomes.

British Dietetic Association – helpful diet and lifestyle advice to improve female fertility (PDF)

Please note: this is not a resource designed specifically for those with coeliac disease following a gluten free diet. Please therefore make the appropriate dietary adjustments.