Gluten Intolerance and Celiac Disease: Differences, Insights, and Solutions in the Kitchen

When discussing gluten intolerance and celiac disease, people often confuse the two terms, considering them synonymous, but the difference is substantial and important to clarify, even for a correct diagnosis. Celiac disease is indeed a true autoimmune disease that requires those who suffer from it to follow a strict gluten-free diet for life. It has an Italian reference association, the Aic and the National Health Service (SSN) recognizes it as a chronic condition that entitles specific exemptions and benefits. Gluten intolerance, on the other hand, implies a sensitivity to this protein complex without a defined autoimmune reaction and does not cause permanent damage to the intestine. Gluten intolerance, therefore, can be a temporary disorder with symptoms similar to celiac disease, but less severe and of a different nature.

Two Different Diagnoses

The diagnosis of the two conditions is also different: celiac disease can be precisely identified through scientific tests such as blood analysis for specific antibodies and intestinal tissue biopsy. As for gluten intolerance, there are no specific and rigorous tests to identify it, but often the diagnosis is based on the exclusion of other conditions and the response to a gluten-free diet trial.

Summarizing the key points:

• Gluten intolerance and celiac disease are often confused, but they represent two different conditions: intolerance is generally less severe and can be transient, while celiac disease is a permanent autoimmune disease.
• The symptoms of gluten intolerance, such as abdominal pain and fatigue, are similar to those of celiac disease, but do not cause permanent damage to the intestine as occurs in celiac disease, where the intestinal mucosa is seriously compromised.
• The diagnosis of celiac disease requires invasive procedures such as biopsy, while intolerance can be assessed through the exclusion of other pathologies, making the diagnosis of the latter more complex and less precise.

The Situation in Italy: Data and Insights

In Italy, it is estimated that about 1% of the population is affected by celiac disease, which corresponds to about 600,000 people. However, until 2022, official diagnoses were 251,939, indicating that a significant percentage of cases remain undiagnosed. This disease is more common in women, who represent about 70% of diagnosed cases.

Many famous personalities in entertainment and sports are also affected. For example, Italian actress Laura Torrisi has made her experience with celiac disease public, sharing the challenges and strategies adopted to manage her diet. In the sports world, former Italian national rugby player Martin Castrogiovanni has shared his experience with the disease, emphasizing how an adequate diet has allowed him to maintain high athletic performance.

Regarding non-celiac gluten sensitivity (NCGS), prevalence estimates vary greatly due to the lack of standardized diagnostic criteria. Some studies suggest it could affect up to 12% of the Italian population, but these data need further confirmation.

Gluten-Free Diet and Nutrition: It Can Be Done!

A gluten-free diet must exclude gluten-containing grains such as wheat, barley, rye, and derivatives (flour, bread, pasta, cookies, etc.), but can include many naturally gluten-free foods such as rice, corn, quinoa, buckwheat, amaranth, millet, teff, sorghum, certified gluten-free oats. Protein sources like meat, fish, eggs, and legumes are naturally gluten-free, as are dairy products if they do not contain risky additives. Fruits and vegetables can be consumed freely, preferably fresh and unprocessed. Healthy fats, such as extra virgin olive oil, butter, nuts, and seeds, are also a great choice. As for beverages, there are no particular restrictions: water, tea, coffee, and natural fruit juices are fine, while for plant-based drinks, it's better to check that they do not contain additives derived from gluten-containing grains. No, however, to traditional beer (contains barley malt), sauces thickened with forbidden flours, some sausages, and non-certified industrial products.

Essential Precautions

There are, however, important differences between those who follow this diet for celiac disease and those who do so for intolerance. Celiacs must be much more strict: even minimal traces of gluten can cause intestinal damage, so it is essential to choose certified products and pay attention to cross-contamination, both in packaged foods and in meal preparation. This means, for example, not using utensils that have come into contact with gluten and carefully checking the labels of industrial products. Those with gluten sensitivity, on the other hand, can have more flexibility. Since there is no autoimmune reaction, the diet must be adapted based on one's tolerance: some people need to eliminate it completely, while others can consume small amounts without particular problems. The issue of contamination is also less stringent compared to celiac disease, although it is still advisable to avoid it to reduce symptoms.

Solutions and Alternative Ingredients

Dietary restrictions, especially compared to a few decades ago, are no longer an insurmountable obstacle, also because gluten-free products are becoming increasingly available in supermarkets and specialized stores, whereas they were once found only in pharmacies (and were not great in terms of taste). Today, in addition to the existence of a network of dedicated sales points, there are many mainstream brands offering a wide range of foods, from cereals to sweets, suitable for such a diet. For those who eat gluten-free, home cooking can also be a positive and creative experience. By using alternative ingredients and specific products, such as rice, corn, or buckwheat flours, it is possible to prepare tasty and varied dishes while maintaining a balanced and healthy diet. Want to try some gluten-free recipes that are great for your taste buds and your figure? Check out those from our expert food creators below! 😊