1) Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. It affects approximately 1 in 100-150 people worldwide. 2) Left untreated, celiac disease can cause nutrient deficiencies, bone loss, fatigue and other issues. The only treatment is a strict lifelong gluten-free diet. 3) The document discusses two case studies of college athletes diagnosed with celiac disease and how identifying and treating the condition helped improve their athletic performance and health.

1. Celiac Disease in Athletics: An Under-recognized Condition? James E. Leone, Ph.D., LAT, ATC, CSCS,*D, CHES The George Washington University Department of Exercise Science School of Public Health and Health Services Email: jleoneatc@yahoo.com

6. Common Differential Dx with CD Addison Disease Pernicious Anemia Celiac Disease Crohn’s Disease Diverticular Disease Fibromyalgia (CRPS) Lactose Intolerance Leone et al. (2005) J Athl Train ; 40(4):365-369

7. Histology

8. Normal vs. Pathological Villi

9. Comparison

10. Crypt Hyperplasia

20. CD: Signs & Sx’s

24. Essentials of the GFD Thompson T. Celiac Disease Nutrition Guide , 2nd ed. Chicago: American Dietetic Association; 2006. © American Dietetic Association. Adapted with permission. For a complete copy of the Celiac Disease Nutrition Guide , please visit www.eatright.org . Allowed Foods Amaranth Arrowroot Buckwheat Cassava Corn Flax Indian rice grass Job’s tears Legumes Millet Nuts Potatoes Quinoa Rice Sago Seeds Soy Sorghum Tapioca Wild Rice Yucca

26. GFD (Cont.) Thompson T. Celiac Disease Nutrition Guide , 2nd ed. Chicago: American Dietetic Association; 2006. © American Dietetic Association. Adapted with permission. For a complete copy of the Celiac Disease Nutrition Guide , please visit www.eatright.org . Other Wheat Products Bromated flour Durum flour Enriched flour Farina Graham flour Phosphated flour Plain flour Self-rising flour Semolina White flour Processed Foods that May Contain Wheat, Barley, or Rye Bouillon cubes Brown rice syrup Chips/potato chips Candy Cold cuts, hot dogs, salami, sausage Communion wafer French fries Gravy * Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer.

29. Cow’s Milk Gliadin Gluten Rye Wheat Leone et al. J Athl Train . 2005;40(4):365-369.

30. Leone et al. J Athl Train . 2005;40(4):365-369.

32. Athlete’s Blood Panel Eberman & Cleary. J Athl Train . 2005;40(4):360-364.

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