The Medicare Diet: Best Gluten-Free Diet for Celiac Disease in Seniors

Gluten: The Culinary Boogieman

The gluten-free diet has been around since the 1940s. Still, it has become a popular alternative diet over the past two decades, with gluten-free products becoming commonplace on supermarket shelves and restaurant menus nationwide. 

The widespread acceptance of the gluten-free diet plan has been a boon for people living with gluten intolerance, but it’s also led to some confusion.  You may have seen a gluten-free label on products that, logically, shouldn’t contain gluten in the first place, like nuts, olive oil, or meat. Does that mean the normal versions of those products contain gluten? 

You might also see products you think are gluten-free, like salads or chickpea, only to find them conspicuously missing that gluten-free label. Then there’s that “processed in a facility that also processes wheat” warning on that box of your favorite snack. What do you even do?

The truth is, gluten intolerance is so much more than Celiac disease, and a safe, gluten-free diet can take wildly different forms depending on your medical history. In this edition of The Medicare Diet, we’ve compiled information on the best foods for celiac disease, as well as tips for people with other forms of gluten intolerance. Plus, find out how Medicare can help you manage your dietary needs.

What is Gluten Intolerance?

Gluten Intolerance refers to a condition in which you have a negative reaction to foods containing gluten: a type of protein found in wheat, oat, barley, and rye.  The name might remind you of lactose intolerance, and some of the symptoms (bloating, constipation, and diarrhea) may lead you to think these conditions are similar. 

Unfortunately, there’s no pill you can take that allows you to safely consume gluten. Gluten intolerance isn’t an inability to digest so much as it is a health condition that casues an adverse reaction of the villi to the presence of gluten protein in the body.

There are three types of gluten intolerance.

• Celiac Disease: The most well-known form of gluten intolerance. Celiac disease (also known as Coeliac Disease) is an autoimmune disorder affecting the small intestine. In patients with celiac, gluten is seen as an invasive presence in the body and mistakenly attacked by the immune system. This damages the small intestine, leading to gastrointestinal distress, but also malabsorption of nutrients via the villi. Some people with celiac may display no outward celiac disease symptoms, and only have the disease discovered through blood test screening.
• Non-Celiac Gluten Sensitivity (NCGS): One of the most poorly understood forms of gluten intolerance, NCGS has very similar symptoms to celiac, but tests for the disease consistently come up negative. Often, the only way to diagnose NCGS is with a double-blind placebo trial. It is believed NCGS is not a true gluten sensitivity, but a sensitivity to another protein commonly found with gluten, which has yet to be identified and may not even be consistent among patients. Commonly, symptoms like dermatitis herpetiformis (also known as Duhring Disease) are also present, as well as an increased risk of osteoporosis. Regardless, adopting a gluten-free diet is often the most effective way of treating NCGS, as avoiding gluten also avoids the unknown trigger protein. 
• Wheat Allergy:  While not a true gluten intolerance, as wheat is not the sole source of gluten, people with an allergy to wheat often avoid gluten as a safety precaution. The symptoms of a wheat allergy are much more immediate than those of celiac, often occurring immediately upon contact. They can include tingling or numbness on the lips, perceiving foods containing gluten as being ‘spicy’, difficulty breathing, itching, hives, watery eyes, and facial swelling. 

The ideal approach to a gluten-free diet plan depends on the type of intolerance you have. For the purposes of this article, we will be focusing on individuals with Celiac and NCGS, which have very similar presentations. The procedures for dealing with a food allergy are much stricter than the traditional gluten-free diet, and are beyond the scope of this article. Speak with an allergist for more information on how to develop an allergy-safe diet.

The Best Gluten-Free Diet Foods for Celiac Disease

The best gluten-free diet doesn’t necessarily involve any of those gluten-free breads and cookies you’ll find at the store. Instead, the ideal gluten-free diet relies on naturally gluten-free foods. These include things like…

• Gluten-free grains like rice and quinoa
• Fresh fruits and vegetables
• Unprocessed proteins like meats, seafood, legumes, and nuts
• Most dairy products

Generally, unprocessed versions of these foods are always gluten-free. When pre-processed or packaged, however, there’s a risk of gluten being present in some unexpected places, so be extra alert when preparing your shopping list for your next trip to the grocery store! Examples include…

• Sauces, like soy sauce
• Dressings
• Certain seasoning blends
• Flour, when used as a bonding agent

Making your own gluten-free diet foods is usually the best way to avoid accidental gluten contamination. Resources like celiac.org have a variety of recipes that use natural ingredients to create a gluten-free diet meal plan, including:

• Baked Spaghetti Squash Carbonara 
• Glazed Salmon
• Balsamic Glazed Chicken With Mushrooms

As an added bonus, gluten-free recipes like the ones listed above are also great for a weight loss meal plan!

What About Gluten-Free Diet Substitutions?

Generally speaking, foods label ed gluten-free are safe for people with celiac and NCGS to consume. However, it takes a very small amount of gluten (roughly 10 mg) to trigger a reaction. This is the equivalent of a few breadcrumbs. That’s why checking for cross-contamination is very important.

Due to the popularity of the gluten-free diet among people without a gluten intolerance, some manufacturers and retailers have adopted a cavalier attitude toward cross-contamination. Restaurants will offer gluten-free sandwiches,  but prepare them with the same equipment used for ordinary bread. Food manufacturers will use the same equipment to create gluten-free products as their traditional counterparts. As such, it is very important to check all foods label and to inform any staff that you have a medical reason to avoid gluten.

When preparing food at home, avoid using equipment that is also used for preparing gluten-based foods without thoroughly cleaning them first. Do not use toasters for both gluten-containing and gluten-free bread, even if you use separate slots. 

Otherwise, gluten-free substitutions for foods like bread, crackers, and baked goods are acceptable. Be aware, however, that these substitutions may actually be less healthy than their gluten-containing counterparts, and the texture and flavor may be different than what you’d get from their traditional alternatives. It’s always best to consult with a professional dietitian before considering any major changes to your diet plan.

How Can Medicare Help With a Gluten-Free Diet?

Unfortunately, nutrition consultations for celiac disease are not covered under Original Medicare, though you can claim expenses related to your diet as a tax deduction. Medicare Advantage can help a bit more: the grocery benefit allows you to purchase healthy, gluten-free foods.

Typically, these will be raw ingredients, but gluten-free bread and flour may also be covered. Certain plans allow you to order food through an online portal, delivering it directly to your home, which is useful for people who are homebound. A Gluten-free meal plan may also be offered through most meal plan delivery services available through Medicare Advantage plans, which are useful for people who can’t cook for themselves.

If you’re looking for a Medicare Advantage plan, we can help. Our live, licensed insurance agents can guide you through your options and help you find a plan that meets your needs. Call us today at (800) 950-0608, or enter your zip code into our free comparison tool to begin your search today!