From a dietary perspective, FODMAPs fermentable oligosaccharides, disaccharides, monosaccharides, and polyols are linked to gastrointestinal distress, and reducing these foods can reduce symptoms of irritable bowel syndrome and non-celiac gluten sensitivity. Indeed, endurance athletes suffer far fewer symptoms of gastrointestinal distress on a low FODMAP diet when compared to a high FODMAP one, as shown by more recent research by Dana Lis , author of many of the papers explored in this article.

A targeted reduction in FODMAPs, as opposed to gluten, may be a better approach for athletes who self-diagnose gluten sensitivity. They should still work with a doctor and a dietician to explore all the potential causes, just in case they do have celiac disease.

Of course, like a gluten-free diet, a low FODMAP diet also has the potential to be nutritionally inadequate, which is why it should be undertaken under supervision by a dietician or nutritionist.

Fortunately people can reintroduce many FODMAP foods until they identify the ones causing the most distress. Athletes also have the option to periodize the low FODMAP diet around races or more intense training sessions, where they reduce FODMAP intake to minimize their symptoms and follow a more standard diet outside this time.

So where does this leave athletes considering a gluten-free diet? If gluten sensitivity is ruled out, other foods components may be causing the gastrointestinal distress.

The most common culprits are FODMAPs. Again, exploring this should take place under the supervision of a dietician. Finally, an athlete may consume low FODMAP foods around competitions and important training sessions, where gastrointestinal distress is more likely, and then follow a more standardized diet at other times.

This may lead to inadequate nutrition or might hide the symptoms of other gastrointestinal issues that should be addressed. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes.

Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics.

Since retiring, Craig has been working as Head of Sports Science at DNAFit, along with a number of other consultancy roles, including sports coaching. This article is nonsense. A study of 7 days? You need months to a year to clean your body from the gluten. My athletes are on a gluten free diet and they are healthier than ever before.

Best regard from Spain. Your email address will not be published. Save my name, email, and website in this browser for the next time I comment. In addition to the analyte-specific microparticles, Aptiva system contains an internal control microparticle that is coated with polyclonal goat anti—human IgA antibodies.

IgA in the sample binds to the beads and mean fluorescence intensity MFI values proportional to the antibody concentration are generated. This serves as a built-in internal control to capture IgA-deficient patient sera, a common occurrence in CD patients. In our laboratory, we use a reflex approach for CD testing.

But if the sample has low IgA values according to age-specific reference ranges, but above the detection limit, then the sample is tested for anti—tTG IgA, anti—tTG IgG, anti—DGP IgA, and anti—DGP IgG analytes. To verify the ability of Aptiva to flag only IgA-deficient samples and not samples with low and detectable levels of IgA, residual sera from samples submitted for CD testing were tested for total IgA in house using Optilite and compared to MFI results obtained from the Aptiva platform.

Clinical performance for each analyte anti—tTG IgA, anti—tTG IgG, anti—DGP IgA, and anti—DGP IgG was assessed using information gathered from medical chart review. Fifty-eight CD—confirmed positive samples were used to evaluate clinical sensitivity and 69 disease control samples were used to evaluate clinical specificity.

Positive predictive value PPV , negative predictive value NPV , positive likelihood ratio LR , negative LR, and odds ratio were also calculated from these clinical data sets.

A receiver operating characteristic ROC curve was generated using Analyse-it Software, version 5. This was further used to assess area under the curve AUC and optimal cutoffs for each CD biomarker.

Youden J statistics were used to select optimal cutoffs with the best balance of sensitivity and specificity. To compare which diagnostic tests improved the outcome to a statistically significant degree between the 2 methods, the McNemar test for significant proportion changes was applied.

test in the base package of R 22 ; UpSet plots and hierarchical clustering dendrogram were generated using the following: Python, version 3. Total percent agreement TPA , positive percent agreement PPA , and negative percent agreement NPA between ELISA QUANTA Lite and Aptiva methods were determined.

Supplemental Figure 1 shows correlations displayed in hierarchical clusters along with the corresponding correlation coefficients from Spearman analysis based on comparisons between analytes tested on both methods. Another 2 samples were IgA-low when compared with the age-specific normal range but above the limit of detection on Optilite.

One of these samples was flagged by Aptiva and did not produce anti—tTG IgA and anti—DGP IgA results. The second sample resulted in an MFI value above the cutoff on Aptiva and produced anti—tTG IgA and anti—DGP IgA results as expected. To assess the overall diagnostic accuracy of both methodologies, ROC curve analysis was performed using the presence or absence of CD as binary classifier.

Also, Aptiva anti—tTG IgG showed a higher AUC of 0. Receiver operating characteristic ROC curve analysis comparing QUANTA Lite and Aptiva assays for celiac disease diagnosis.

ROC curves for each celiac disease analyte: anti—tTG IgA A , anti—tTG IgG B , anti—DGP IgA C , and anti—DGP IgG D , were tested using QUANTA Lite and Aptiva assays. Abbreviations: DGP, deamidated gliadin peptide; FPF, false-positive fraction; IgA, immunoglobulin A; IgG, immunoglobulin G; TPF, true-positive fraction; tTG, tissue transglutaminase.

The PPVs and NPVs are summarized in Table 2. Except for anti—DGP IgG, Aptiva displayed a generally higher specificity versus QUANTA Lite.

Except for anti—tTG IgG, QUANTA Lite assays also demonstrated similar likelihood and odds ratios, as listed in Table 2. Clinical Performance Characteristics of Celiac Disease Antibodies Using QUANTA Lite and Aptiva Assays at the Manufacturer-Suggested Cutoff a.

Table 3 shows the sensitivity, specificity, and predictive values at the manufacturer-suggested and optimal cutoffs. The optimal cutoffs were points with the best balance of sensitivity and specificity derived from ROC analysis. Performance Characteristics at the Manufacturer-Suggested Cutoffs Compared With the Optimal Cutoffs Derived From Receiver Operating Characteristic ROC Curve Analysis a.

Using CD diagnosis as reference, we evaluated the ESPGHAN-recommended use of 10 times greater than or equal to ULN anti—tTG IgA titers at the manufacturer-suggested and optimal cutoffs. The performance characteristics of QUANTA Lite and Aptiva anti—tTG IgA assays at this high titer cutoff were evaluated Table 4.

Serology tests serve as an obligatory tool to guide biopsy decisions, as duodenal biopsy remains the gold standard for CD diagnosis. According to the updated ESPGHAN guidelines, children with high titers of anti—tTG IgA antibodies may be diagnosed with CD without biopsy, provided the anti-EMA antibody is positive in a second sample.

With increasing requests for CD serology tests, automated high-throughput assays are an emerging trend, especially in high-volume laboratories.

In this study, we evaluated the performance characteristics of a novel multianalyte particle-based fluorescence detection system, Aptiva, which received Food and Drug Administration clearance recently.

This platform offers simultaneous and semiquantitative assessment of patient sera for antibodies to anti-tTG and anti-DGP, IgA, and IgG isotypes. The automated Aptiva assays were compared to the manual QUANTA Lite ELISA assays, which only allows for individual detection of these antibodies.

Using total patient samples, our comparison demonstrated excellent qualitative agreement between Aptiva and QUANTA Lite anti—tTG IgA assays. However, the anti—DGP IgG assay only showed moderate agreement and anti—tTG IgG and anti—DGP IgA assays displayed an even lower PPA between the 2 methods.

This prompted comparison of the Aptiva and QUANTA Lite assays with the clinical diagnosis. In total, patients were available with clinical diagnosis as established by the clinician. As expected, clinical performance analysis demonstrated high sensitivity and specificity for anti—tTG IgA, the most efficient serology test for CD diagnosis, by both Aptiva and QUANTA Lite assays.

Among the 58 CD patients, noticeably only 1 patient had false-positive results, which were borderline values on both platforms for anti—tTG IgA. A negative biopsy does not always rule out CD due to the patchy nature of the disease and inadequate sampling.

It is also possible that the patient has an early immune reaction before the onset of mucosal damage that could be evidenced in a biopsy. A large metanalysis study has reported the increased probability of CD in patients with inflammatory bowel disease and increased risk of inflammatory bowel disease in patients with CD.

IgA isotypes are generally regarded as having higher accuracy for CD diagnosis in comparison to the IgG tests, except anti—DGP IgG, which can be useful for screening IgA-deficient patients.

However, limited evidence advocates for the use of anti—DGP IgG in children younger than 2 years old due to its overall lower accuracy compared with anti—tTG IgA, unless confirmed IgA-deficient.

Anti—tTG IgG and anti—DGP IgA assays may benefit from a higher specificity due to only a secondary use of these assays to verify anti—tTG IgA screening results in selected situations. Both these assays demonstrated better specificity on Aptiva compared to QUANTA Lite.

Since our study cohort included patients submitted to CD testing, there is potential for preselection bias. Because predictive values are dependent on the prevalence of the disease, we also calculated the likelihood and odds ratios, which are independent of the pretest probability of the disease.

A high odds ratio was observed for anti—tTG IgA on both platforms and for anti—tTG IgG on Aptiva, indicating a strong association between test positivity and CD diagnosis. Anti—DGP IgA, with a sensitivity of Despite superior performance of CD serology assays in these platforms, recommendations based on larger validation studies do not favor combining several tests in lieu of anti—tTG IgA and total IgA screening tests.

Previous studies have favored the use of anti—DGP IgA in patients with borderline anti—tTG IgA results. Recent data show only limited value for anti—DGP IgA in these settings due to its high false-positivity rate and suggest cautionary use. In a study performed in pediatric patients with moderately increased anti—tTG IgA titers, anti—DGP IgA only showed a moderate improvement in performance when screening for CD in patients without type 1 diabetes but showed a high false-positivity when screening type 1 diabetes patients for CD.

To maneuver appropriate test utilization, the Aptiva system has capabilities to link with a laboratory information system and report results specific to reflex testing panels designed by the laboratories.

To evaluate whether optimal cutoffs derived from ROC analysis showed improved performance characteristics compared to the ones suggested by the manufacturer, we compared the clinical performance characteristics at 2 different sets of cutoffs on the Aptiva system. Anti—DGP IgA and anti—tTG IgG assays are not recommended as first-line screening tests and higher specificity may be beneficial to correctly identify patients free of disease after the initial screening.

Therefore, in our analysis, the manufacturer-suggested cutoffs met the expected clinical performance characteristics for all 4 biomarkers using the Aptiva system.

Current NASPGHAN and ESPGHAN guidelines suggests testing for total IgA in addition to anti—tTG IgA to ensure the presence of sufficient IgA antibodies, which could impact the results of CD tests involving the IgA isotype. The combination of anti—tTG IgA and total IgA has been regarded as the most reliable screening strategy for CD diagnosis.

The Aptiva system has built-in internal control microparticles to detect IgA and the system flags the result in the event of very low or undetectable IgA levels.

Only 1 patient sample was discrepant between the 2 methods Supplemental Table 2. This was a patient sample with IgA values lower than the reference interval but above the detection limit of the turbidimetric measurement for IgA.

All other patient samples displayed excellent agreement between the 2 methods. These results demonstrate the acceptability of the internal control microparticles for IgA detection built into the Aptiva system and essentially eliminates the need to utilize a separate analyzer for the actual IgA quantitation by nephelometric and turbidimetric methods during CD screening.

Serologic diagnosis of CD is extremely desirable because it precludes the need, costs, and risks of an invasive procedure. Currently, the American College of Gastroenterology suggests a positive anti—tTG IgA result, or IgG-based test in cases of IgA deficiency, plus a duodenal biopsy as the criteria for CD diagnosis.

Experts have raised concerns about the lack of harmonization and variability involved in the currently available anti—tTG IgA assays when using them for a biopsy-free CD diagnosis.

Werkstetter et al 31 found a specificity of Similar observations were made by Gidrewicz et al 34 ; using the EUROIMMUN EUROIMMUN US, Mountain Lakes, New Jersey assay they reported specificity of Notably, specificity Such a diagnosis should be accompanied with close monitoring to corroborate the reversal of serology and reconstitution of villi upon initiation of a gluten-free diet.

Additionally, CD diagnosis without a biopsy should be avoided in patients with type 1 diabetes. Both ESPGHAN recommendations and other studies have cautioned the use of a biopsy-free approach on these patients due to the high false-positivity observed, possibly due to the higher CD screening frequencies of this population.

Singh P, et al. Who to screen and how to screen for celiac disease. World Journal of Gastroenterology. What is celiac disease? Celiac Disease Foundation. Accessed April 26, Feldman M, et al. Celiac disease. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management.

Elsevier; National Institute of Diabetes, Digestive and Kidney Diseases. Ami TR. AllScripts EPSi. Mayo Clinic. March 24, Khanna S expert opinion. May 12, Related Celiac disease. Associated Procedures Capsule endoscopy. News from Mayo Clinic Coeliac disease vs gluten intolerance: Mayo Clinic Healthcare expert explains the difference Sept.

Learn more about this top honor. Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book.

Show the heart some love! Give Today. Help us advance cardiovascular medicine. Find a doctor. Explore careers. Sign up for free e-newsletters. About Mayo Clinic. About this Site. Contact Us. Health Information Policy.

Media Requests. News Network. Price Transparency. Medical Professionals. Clinical Trials. Mayo Clinic Alumni Association. Refer a Patient. Executive Health Program.

Study concept and design : van der Windt, Jellema, Mulder, Kneepkens, van der Horst. Critical revision of the manuscript for important intellectual content : Jellema, Mulder, Kneepkens, van der Horst. Role of the Sponsor: The funding organization played no role in the design and conduct of the review; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

full text icon Full Text. Download PDF Top of Article Abstract Methods Results Comment Article Information References. Table 1. Characteristics of Primary Diagnostic Studies on Diagnosing Celiac Disease CD. View Large Download. Table 2. Diagnostic Performance of Individual Symptoms and Symptom-Based Classification Systems.

Table 3. Results of Subgroup Analyses and Pooled Estimates of Diagnostic Performance a. Table 4. Diagnostic Performance of Serological Tests a. van der Linden MW, Westert GP, De Bakker DH, Schellevis FG. Tweede Nationale Studie Naar Ziekten en Verrichtingen in de Huisartspraktijk: Klachten en Aandoeningen in de Bevolking en in de Huisartsenpraktijk.

Creed F, Ratcliffe J, Fernandez L, et al. Health-related quality of life and health care costs in severe, refractory irritable bowel syndrome.

Ann Intern Med. van den Heuvel HAM. Non-Specific Abdominal Complaints in General Practice: Health Status, Clinical Course and Burden of Illness [master's thesis]. Maastricht, the Netherlands: Maastricht University; Chand N, Mihas AA. Celiac disease. J Clin Gastroenterol. National Guideline Clearinghouse Web site.

World Gastroenterology Organisation Practice guideline on celiac disease, Accessibility verified April 2, Sanders DS, Patel D, Stephenson TJ, et al. A primary care cross-sectional study of undiagnosed adult coeliac disease.

Eur J Gastroenterol Hepatol. Dubé C, Rostom A, Sy R, et al. The prevalence of celiac disease in average-risk and at-risk Western European populations.

Hin H, Bird G, Fisher P, et al. Coeliac disease in primary care. Schweizer JJ, Von Blomberg BME, Bueno-De Mesquita HB, Mearin ML. Celiac disease in the Netherlands. Scand J Gastroenterol. Green PH. The many faces of celiac disease. Cranney A, Rostom A, Sy R, et al.

Consequences of testing for celiac disease. Peters U, Askling J, Gridley G, et al. Causes of death in patients with celiac disease in a population-based Swedish cohort. Arch Intern Med. Rostom A, Dubé C, Cranney A, et al.

The diagnostic accuracy of serololgic tests for celiac disease. Jellema P, van der Windt DA, Bruinvels DJ, et al.

Value of symptoms and additional diagnostic tests for colorectal cancer in primary care. Jellema P, van Tulder MW, van der Horst HE, et al. Inflammatory bowel disease [published online November 13, ].

Colorectal Dis PubMed Google Scholar. Whiting P, Rutjes AW, Dinnes J, et al. Development and validation of methods for assessing the quality of diagnostic accuracy studies.

Health Technol Assess. Reitsma JB , ed , Rutjes AWS , ed , Whiting P , ed , et al. Deeks JJ , ed , Bossuyt PM , ed , Gatsonis C , ed.

Chapter 9: Assessing methodological quality. In: Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy, Version 1. Oxford, UK: Cochrane Collaboration; Rutjes AW, Reitsma JB, Di Nisio M, et al. Evidence of bias and variation in diagnostic accuracy studies. Lijmer JG, Mol BW, Heisterkamp S, et al.

Empirical evidence of design-related bias in studies of diagnostic tests. Zamora J, Abraira V, Muriel A, et al. BMC Med Res Methodol. Reitsma JB, Glas AS, Rutjes AWS, et al. Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews.

J Clin Epidemiol. Littenberg B, Moses LE. Estimating diagnostic accuracy from multiple conflicting reports. Med Decis Making.

Bodé S, Gudmand-Hoyer E. Evaluation of the gliadin antibody test for diagnosing coeliac disease. Carroccio A, Vitale G, Di Prima L, et al. Comparison of anti-transglutaminase ELISAs and an anti-endomysial antibody assay in the diagnosis of celiac disease.

Clin Chem. Catassi C, Kryszak D, Louis-Jacques O, et al. Detection of celiac disease in primary care. Am J Gastroenterol. Dickey W, McMillan SA, McCrum EE, et al. Association between serum levels of total IgA and IgA class endomysial and antigliadin antibodies. Dickey W, McMillan SA, Hughes DF.

Identification of celiac disease in primary care. Grisolano SW, Oxentenko AS, Murray JA, et al. The usefulness of routine small bowel biopsies in evaluation of iron deficiency anemia. Hadithi M, von Blomberg BM, Crusius JB, et al. Accuracy of serologic tests and HLA-DQ typing for diagnosing celiac disease.

Hopper AD, Cross SS, Hurlstone DP, et al. Pre-endoscopy serological testing for coeliac disease. Rashtak S, Ettore MW, Homburger HA, et al.

Combination testing for antibodies in the diagnosis of coeliac disease. Aliment Pharmacol Ther. Comparative usefulness of deamidated gliadin antibodies in the diagnosis of celiac disease.

An athlete may also be experiencing improved performance with a gluten-free diet because it spurs an overall healthier eating plan. These additives are often used as thickeners, sweeteners, or fillers.

When gluten is eliminated, the athlete must stop eating many of these foods and find alternatives. Thus, when an athlete consumes cereal, bread, pasta, or crackers made from these grains instead of refined grains, nutritional intake is improved.

When these foods are combined with others that are naturally gluten-free, such as fruits, vegetables, lean proteins, nuts, and seeds, the diet is extremely rich in nutrients. Finally, when an athlete is interested in improving performance through dietary changes, their entire diet receives greater attention.

In the process of learning about a gluten-free diet, they spend more time planning and preparing healthy meals, reading nutrition labels for sources of added sugar and salt, and eating more fruits and vegetables. In general, this often leads to the development of fueling strategies that support better training, performance, and recovery.

In other words, gluten-containing grains are not required for optimal health. However, potential problems could arise if gluten-free dietary changes are not carried out carefully and thoughtfully.

For example, carbohydrate intake must continue to be adequate. Most athletes require six to 10 grams of carbohydrates per kilogram of body weight on a daily basis.

Endurance athletes may need more during certain phases of training and competition. In addition to fruits, vegetables, and dairy, athletes depend heavily on grain products for carbohydrate. If they do not regularly consume enough gluten-free grains, then their total carbohydrate intake may decline, resulting in glycogen depletion, fatigue, and poor performance.

A gluten-free diet must also include good food choices. While unprocessed gluten-free products are available, there are also many highly processed, refined gluten-free foods.

The same is true for many types of candy and snack foods. Some types of gluten-free bread consist mainly of white rice flour and cornstarch, which are both poor nutrient sources. A variety of gluten-free cakes and cookies have also entered the marketplace.

While they are wonderful for a special occasion, they are no healthier than their gluten-containing counterparts. In addition, when an athlete embarks on a gluten-free diet, they are faced with the challenge of finding substitutes for their favorite foods.

Many grocery stores are increasing their gluten-free offerings, but some may not have a wide selection. While the taste and variety of gluten-free products have improved dramatically in recent years, some of the new foods will seem different in flavor, texture, and appearance.

And some gluten-free foods can be significantly more expensive, creating additional challenges, especially for college athletes. Perhaps the most profound problem with attempting a gluten-free diet is that it could potentially delay the proper diagnosis of CD or another medical condition.

While fatigue, headaches, bloating, constipation, diarrhea, abdominal pain, skin rashes, muscle pain, and joint pain have all been associated with CD and sometimes non-celiac gluten sensitivity, these symptoms have also been connected to many other medical conditions.

If specific, unexplained symptoms are present, an athlete should have a complete physical exam to determine the cause—including appropriate testing for CD before starting a gluten-free diet. Athletic trainers can play a major role in helping athletes determine if a gluten-free diet is right for them, while also helping them evaluate other important aspects of health and performance.

So when an athlete tells you they are considering a gluten-free diet, it is important to have an open, non-judgmental conversation with them, refer them for medical treatment if necessary, educate them with practical and accurate information, and above all, offer ongoing support.

Showing genuine interest in the topic of gluten-free diets, or any other nutritional strategy, will open the door for discussion. Many athletes are embarrassed to talk about gas, bloating, diarrhea, or constipation, and may fear being sidelined if they report symptoms such as headaches, skin rashes, fatigue, or joint pain.

If it seems that their interest in a gluten-free diet stems primarily from a desire to alleviate physical symptoms like these, it is essential to recommend or require a thorough medical evaluation. Ask about any changes in symptoms or performance as a result. For example, the athlete may not be following a fully gluten-free diet or have a different or additional food intolerance or allergy that needs to be diagnosed by a medical professional.

There may be a medical condition present that is unrelated to gluten, a nutrient deficiency such as iron deficiency , or inappropriate intake of calories or carbohydrate relative to needs. And other aspects of training can be a culprit, such as inadequate rest periods.

When an athlete begins a gluten-free diet, remind them of the many sources of gluten. You can provide a list of ingredients to avoid, and show them where to look on the food label. Common sources of gluten include bread, bagels, cereal, English muffins, cookies, donuts, cake, pasta, pizza, many granola bars, pretzels, and most fast food items.

Show the athlete their many options as well. Learn tips for maintaining your gluten-free diet and athletic performance. Properly fueling for your training and competitions with good nutrition is important for supporting your athletic performance. As an athlete living with celiac disease, you will also need to plan ahead for competitions, especially competitions away from home, to maintain your strict gluten-free diet, prevent symptoms and reach your top athletic abilities.

At the beginning of the season, communicate your celiac disease diagnosis and the importance of following a gluten-free diet to your coaches, trainers and teammates. The more they know about you and your diagnosis, the better they can support you on and off the playing field.

To help your team better understand, you may want to highlight some key terms—like 'celiac disease', 'gluten-free' and 'cross-contact' or 'contamination'—and what they mean.

You may want to provide them with some suggestions of gluten-free food options that you know are safe and will support your athletic performance.

Carbohydrates are the most important fuel source for an athlete. Carbohydrate foods, like vegetables, fruits, grains and dairy, break down in the body and provide it with its preferred source of energy, glucose sugar. While there are naturally gluten-free sources of carbohydrates, many carbohydrates like breads, pastas and grains contain gluten and are traditionally used to fuel athletes.

This can sometimes be challenging for someone who has celiac disease. Planning ahead for training and competitions by packing suitable meals and snacks, or researching food options at your sports venue, are all ways to help you maintain your gluten-free diet, avoid symptoms on the day of your competition and perform at your best.

For more information on sports nutrition, visit the AboutKidsHealth Sports nutrition page. These nutrients are especially important to athletes who have recently been diagnosed with celiac disease.

Celiac disease can make it hard for your body to absorb nutrients like calcium, vitamin D and iron. When these nutrients are low, you may be at higher risk of injury and poor athletic performance.

If your health-care provider has asked you to take a supplement for these nutrients, it is important that you follow their instructions and take the supplements as prescribed.

Eating well-balanced meals and snacks can ensure that you get enough calcium, vitamin D and iron from the foods you eat. Here are some foods you can try:. To learn more about the important roles of calcium, vitamin D and iron, visit these AboutKidsHealth pages:.

Bone health: The role of calcium and vitamin D. Travelling with your sports team can be an exciting way to see new places with teammates and compete against new teams.

Planning ahead for away games, tournaments or competitions is important so that you have something safe to eat to fuel your athletic performance. Here are some tips and considerations as a travelling athlete with celiac disease:. Skip to main content.

share this page clear Share. It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again. Celiac disease Learning Hub Celiac disease is a life long condition that needs to be carefully managed through maintaining a gluten-free diet.

What is celiac disease? The gluten-free diet.