Last updated on June 15th, 2023
It’s estimated that 2 million people in the United States have celiac disease. Celiac disease is a genetic, autoimmune disorder triggered by eating foods containing gluten. Gluten is found in wheat, rye, and barley and is commonly found in foods like bread, pasta, and cookies. It’s important to understand that celiac disease is not a food allergy. Those with celiac disease are unlikely to have an allergic reaction such as itchy eyes or difficulty breathing when they ingest gluten. Instead, celiac disease causes long-lasting damage to the small intestine, malnutrition, and anemia. People with celiac disease are more likely to develop other autoimmune disorders such as type 1 diabetes and thyroid diseases like Hashimoto’s disease and Graves’ disease.
Celiac Disease on the Rise for Those Over 60
There is a growing incidence of celiac disease in elderly adults. A recent study showed that in 1960 only 4% of diagnosed celiac disease patients were over 60 years of age. But by the early 2000’s somewhere between 19-34% of all new cases of celiac disease were in patients over the age of 60.
Why? What’s causing the increase in celiac disease in older adults? Dr. Alessio Fasano, MD is a researcher who led a 2010 study that found that celiac rates rose as people aged. In the study, researchers analyzed stored blood samples taken between 1974 and then again in 1989. In 1974, one in 501 people showed blood markers for celiac disease, but by 1989 that rate rose to one in 219. Dr. Fasano believes changes to the composition of intestinal bacterial in people who are predisposed to celiac could trigger an autoimmune response. Surgery, antibiotics, infections, or stress can all change the gut’s bacterial composition.
Autoimmune diseases, in general, become more prevalent in the US, especially for those age 50-plus. Today, 23.5 million people in the US have an autoimmune disorder. While autoimmune diseases vary, they all involve your immune system attacking some part of you; an organ, nervous system, joints, or skin. Researchers aren’t sure what’s causing the increase in autoimmune disorders, but believe it may be linked to the environment and changes in diet. Dr. Frederick Miller, MD scientist emeritus with the Environmental Autoimmunity Group at the National Institutes of Health observes, “In the past 30 years, we have had more than 80,000 chemicals approved for use in this country,” he says. “We have a totally different diet, with processed foods, additives, and fast foods. We’re more sedentary. There’s an obesity epidemic. We have a different pattern of infectious agents, even pre-COVID-19, with more emerging yearly. The environment is noisier, and there are more stressors.”
Diagnosing Elderly Onset Celiac Disease
Celiac disease can be hard to diagnose, especially in the elderly. Older patients are less likely to present the intestinal symptoms of malabsorption like diarrhea, weight loss, and abdominal pain. And those that do have these symptoms are more likely to be diagnosed with irritable bowel syndrome than celiac disease. Many elderly celiac patients have little to no symptoms of the disease at all. Some patients may develop a skin condition called dermatitis herpetiformis, itchy bumps on the elbows, lower back, buttocks, knees, and back of the head. But often severe malabsorption and micronutrient deficiencies such as anemia, and calcium and vitamin D deficiencies may be the only signs that an elderly person has the disease. Another sign an older person may have celiac disease is the presence of another autoimmune disorder. Autoimmune thyroid disorders like Hashimoto’s disease or Grave’s disease, are often common in elderly celiac patients.
Gluten-Free Golden Years
Celiac disease is a growing concern in senior care communities. Because it’s a disease directly influenced by diet, your dining program should have a good understanding of the ins and outs of celiac disease. It’s not easy to embrace a new diet in your golden years, but removing gluten is the only treatment for celiac disease right now.
Skipping gluten can mean big changes to someone’s diet. Gluten is found in many common foods like bread and pasta, but also soups, salad dressings, and sauces. An anti-inflammatory diet is also often recommended for those with autoimmune diseases. Increasing fruits and vegetables, as well as lean meats like fish and poultry, are easy changes to make to someone’s diet. What may be more challenging, is reducing excess sugars, carbohydrates, and red meat, but experts agree these changes can have a huge impact on celiac disease and autoimmune disorders in general.
Supporting Celiac Disease Through Your Dining Program
At Culinary Services Group our Registered Dietitians will work with the community’s care planning team to create a diet that is gluten-free but still enjoyable for the resident. Menus should provide plenty of substitutions that ensure the resident is still getting plenty to eat while providing the right levels of nutrition too.
Managing the wellness of residents with celiac disease in your community should include menu planning software that can track micro and macronutrients because malnutrition is often one of the first signs of celiac in elderly patients. Culinary Services Group offers this technology as part of all our contracts. We can ensure tray ticket accuracy and nutrient intake for all residents with special diet needs through this tool.
If you’re interested in learning more about how CSG can help your community support those with celiac disease, autoimmune disorders, or other special diet needs, please contact us today.
