What is coeliac disease?
Coeliac disease is a common autoimmune digestive condition where sufferers are adversely affected by gluten containing products, such as, wheat, barley and rye. Consuming gluten triggers the small intestine which becomes inflamed; over time the damaged lining results in malabsorption which is not something that can be overcome or outgrown, causing a lifelong condition. The only real treatment for coeliac disease is to follow a gluten-free diet and healthy lifestyle.
How many sufferers are there, and how does it affect them?
According to Coeliac UK, 1 in 100 people have coeliac disease, 76% of these are never diagnosed. With the figures surprisingly high, it would be likely to assume that coeliac disease is a genetic condition, however, this is not strictly the case. Studies have shown that if a family member has the condition, there is a 1 in 10 chance of a close relative developing the disease. Coeliac UK confirm ‘people with coeliac disease are born with genes that predispose them to develop the condition but the symptoms can be triggered at any age’. Living with coeliac disease can certainly be challenging; many sufferers are wary about eating out, going on holiday, and even exercising due to pain and sensitivity. Barbara A. Brehm, a professor of exercise and sport studies, echoes the notion that those suffering with digestive disorders may be reluctant to try anything that might make their pain worse, such as, physical activity, in her book Psychology of Health and Fitness. Barbara teaches courses in stress management, nutrition, and health at Smith College in Northampton, Massachusetts, and has worked as a fitness instructor and personal trainer. She mentions that everyone, including those with digestive orders, needs to exercise, but sufferers could look to tailor their routines with more low-impact workouts or strength training. She advises personal trainers should be sympathetic, start slowly, and build gradually to increase client confidence along with fitness.
Can exercise be beneficial for coeliac disease?
Although it appears exercise would certainly benefit someone suffering with coeliac disease, we must be mindful to the damage that this condition can do to ones’ body. Medical writer, editor and educator, Naheed Ali published in his book Understanding Celiac Disease: An Introduction for Patients and Caregivers that there are 4 types of coeliac-induced pain; bloating pain, autoimmunity-related pain, joint pain, and neurological pain (e.g. migraine headaches). These ailments can often cause a barrier between a client who suffers from coeliac disease, and exercise. However, exercise does have the ability to allow the intestinal tract to move more easily; this in turn promotes easier movement, cell nourishment, and maintaining a healthy weight. These factors combined may be enough to reassure a client with coeliac disease that exercise can certainly aid in keeping them healthy, and repairing degenerated organs. Naheed Ali suggests that coeliac clients, when exercising, should wear the right clothes; this is important so as not to confine one’s movements or hinder blood flow. Further suggestions include wearing the right footwear to provide shock absorbency, warming up to prepare the muscles, and cooling down to prevent dizziness.
What exercise is recommended?
The NHS recommends performing physical activity 5 days a week for 30 minutes each session. However, we understand that coeliac clients may not be able to perform the same levels of physical activity as non-coeliac clients, due to sensitivity and potential pain. Before making any exercise plans, it’s essential that clients don’t suffer from a restricted and unhealthy diet, just because gluten is cut out. Take a look at a sample meal plan to begin with:
Sample meal plan:
Breakfast: Gluten free muesli with fresh or frozen fruit
Lunch: Tuna/chicken/turkey salad
Dinner: King prawns/pork/beef with rice noodles (vermicelli) and stir fry vegetables
Snacks: Yoghurts, nuts, fruit
With plenty of energy supplied for a workout, clients should start off with a low-impact total body workout. A low-impact workout will still satisfy performing physical activity, but it will not put too much stress on the client.
Sample exercise plan:
5-minute walking (2.5 – 3.5 mph)
1-minute long-stride walking (4 – 7 mph)
3-minute walking with 5% incline (3 – 3.5 mph)
1-minute long-stride walking with 5% incline (4 – 7 mph)
3 sets / 10 reps squats (addition of 0.5 – 3 kg dumbbells can be included)
3 sets / 10 reps standing dumbbell calf raise (0.5 – 3 kg)
3 sets / 5 reps dumbbell chest press (0.5 – 2 kg)
Many coeliac sufferers also take part in low intensity group exercise sessions, such as, yoga or Pilates, both of which aid with flexibility, abdominal pain, and fatigue. These symptoms are also common in people with irritable bowel syndrome (IBS). In a study of 51 participants, titled ‘Iyengar yoga for adolescents and young adults with irritable bowel syndrome’, who attended a 6-week twice per week Iyengar yoga class; adolescents reported significantly improved physical functioning and young adults reported significantly improved IBS symptoms, disability, sleep quality, and fatigue.
Exercise is essential to everyone, and certainly shows to bring relief to those suffering with coeliac disease. Some may even say that exercise is essential to those with coeliac disease. Malabsorption can cause issues with weight loss, but it can also cause issues with weight gain; exercise is essential to be able to maintain a healthy weight, combined with a healthy eating lifestyle. Concerningly, osteoporosis can often be a consequence of coeliac disease; low impact walking and running have shown to aid in the remodeling of bone (Celiac Disease: A Hidden Epidemic). Overall, opting for a healthy lifestyle which includes exercise, can improve mood, bone health, and circulation, which are key aspects of any persons’ life, especially those suffering with coeliac disease.
- Coeliac UK. (2016, May 14). Coeliac disease key facts and stats 2016. Retrieved from https://www.coeliac.org.uk
- Brehm, Barbara A. Psychology of health and fitness / Barbara A. Brehm, EdD, professor, Department of Exercise and Sport Studies, Smith College, Northampton, MA.
- Ali, Naheed. Understanding Celiac Disease. 1st ed. USA: N.p., 2014. Print.
- Evans S, Lung KC, Seidman LC, et al. Iyengar Yoga for Adolescents and Young Adults With Irritable Bowel Syndrome. J Pediatr Gastroenterol Nutr. 2014; 59(2):244-253.
- Dr. Peter H.R. Green. Celiac Disease : A Hidden Epidemic. 2009
Written by HFE, a leading provider of personal trainer courses and fitness qualifications including yoga, Pilates, sports massage and exercise to music.