For Those with Celiac Disease, Eating Without Fear is Especially Difficult During the Holiday Season

Holiday time is a happy and exciting time of year, but people living with celiac disease and non-celiac gluten sensitivity know that sometimes the joy of spending time with family and friends can be overshadowed by anxiety and fear of getting sick. Parties, cookie exchanges and dinners out are fraught with land mines that require skill, grace and confidence.

While many individuals with celiac disease often find diagnosis to be a relief, research has also found that those with celiac disease are at an increased risk for anxiety. An Italian study found that women with celiac disease reported higher levels of anxiety than women in the general population. Similarly, a 2011 study found that children with celiac disease following a gluten-free diet had higher rates of anxiety and depression.

Depression and anxiety in individuals with celiac disease is often related to the challenges of disease management. The constant attention to ingredients and risks of cross-contact can lead to phobias related to eating or dining out. Others may develop obsessive compulsive disorder around cleaning surfaces or utensils before eating.

I know firsthand how tough the holidays can be, especially when a diagnosis is new. Eating without fear requires those on the gluten-free diet to be prepared, proactive and ready to ask questions.

In the 10 years since I founded the National Foundation for Celiac Awareness, I have met so many people on a lifelong gluten-free diet. I’ve learned that among the many concerns during the holiday season, three consistently rise to the top: Families that do not understand the need for a gluten-free diet, the fear of accidentally eating gluten and the temptation to cheat on the gluten-free diet.

Family Dynamics

At a time when family is all around us, it’s imperative that those we love provide emotional support as we struggle to stay physically and emotionally healthy during this challenging season. Educating family members on the seriousness of celiac disease can be difficult, but is especially important for those wishing to avoid social alienation and for those who are interested in taking the opportunity to ensure family members are aware of their risk for developing celiac disease and the need to be tested.

Unfortunately, not everyone is open to listening. When that’s the case, it’s imperative that those with celiac disease take their health into their own hands, even potentially bringing their own meal, if necessary.

Fear of getting glutened

It’s natural to be concerned about accidentally eating gluten during parties or at an unfamiliar restaurant. Even a minute amount of gluten can make someone with celiac disease sick, so they must feel comfortable about food preparation and ingredients. I feel blessed with an outgoing personality and I always speak up about my concerns. Even so, I have had my fair share of gluten exposure, especially when dining out. When people are not confident or are unempowered, however, they do take risks. Even when you are diligent, it’s very easy to be crippled by fear and anxiety when the prospect of getting sick while at a dinner party, shopping for gifts and traveling is a real concern requiring heightened awareness and attention to every detail.

Resisting temptation

It can be easy to be tempted by all the gluten-containing dishes and desserts during the holiday season, especially if a diagnosis is new.  It can be hard to resist Grandma’s famous stuffing or an aunt’s pumpkin pie, but that’s where communication comes in.  I suggest that families work together to make a gluten-free version of favorite holiday dishes so those on the gluten-free diet won’t feel like they’re missing out. The explosion of the gluten-free marketplace means that it’s not so difficult to prepare an entirely gluten-free meal if you’re so inclined.

When I hear of family and friends going the extra mile to fully include their gluten-free loved ones, I applaud them. With more awareness, it will continue to get easier to live life 100% gluten-free. I ask for your help in getting there. If we each do our part to help friends, family members and colleagues feel more comfortable in expressing their needs, I hope that we can encourage more people with celiac disease and gluten sensitivity to adhere to the diet, which will have positive health outcomes for millions of people in the United States.

To our GREAT health,


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