How Exercise Can Help You Manage Celiac Disease

There's no way around it — having celiac disease is a bummer. The symptoms can turn a good day into a bad one pretty quickly. More than 2 million Americans have received a celiac disease diagnosis and there are studies that suggest one in every 133 Americans have it — some, however, might not even know it (via Johns Hopkins Medicine). Signs of celiac disease include a wide range of digestive symptoms, as well as stomach and joint pain, which makes the condition hard to diagnose. 

If you suspect you have celiac disease, it's important to visit your doctor so they can order tests to help you find solutions to your symptoms. Celiac is believed to be a genetic disease, and sometimes symptoms don't show up until after you experience high stress levels or a big life event, like pregnancy, childbirth, surgery, injury, or infection. Unfortunately, there is no cure for celiac disease — the best treatment is to avoid eating gluten. 

Celiac disease is an autoimmune condition — when gluten enters the body, it triggers the immune system to start attacking the digestive system. Over time, this damages the villi in the small intestine, which help absorb nutrients from the food you eat. Celiac disease can lead to many complications, like malnutrition, as well as bone weakness, infertility, miscarriage, lactose intolerance, cancer, and nervous system issues (via the Mayo Clinic). Avoiding consuming gluten is the first step for treatment and has proven to be quite effective — however, almost 30% of people with celiac disease still experience symptoms even after following a gluten-free diet, and many share that their quality of life continues to suffer after diet changes (via Global Advances in Health and Medicine). This indicates that diet is helpful for managing celiac symptoms, but there are still other factors at play. 

Exercise has many health benefits, and there is growing evidence that physical activity reduces the chances of experiencing digestive upset. Scientific research has shown exercise to help reduce symptoms of other digestive conditions like irritable bowel syndrome (IBS) and increase the patient's quality of life. A recent study on celiac disease revealed that participants in a 12-week program involving exercise and mental health support experienced both a reduction in symptoms and improved quality of life. This study was nicknamed MOVE-C, short for "understanding the relationship between the MicrobiOme, Vitality, and Exercise in Celiac disease."

In celiac disease, when the immune system malfunctions due to the presence of gluten, it creates an inflammatory response in the body. This inflammation harms the digestive tract, resulting in celiac disease symptoms and other gastrointestinal complications (via U.S. Department of Health and Human Services). One way that exercise can help manage celiac symptoms is by reducing inflammation. A recent scientific study revealed that just 20 minutes of exercise can have anti-inflammatory effects on the body. While there have been many studies that suggest working out reduces inflammation, the significance of this study is that it showed even moderate physical activity can be beneficial. 

According to researcher Suzi Hong, Department of Psychiatry and the Department of Family Medicine and Public Health, "Our study shows a workout session does not actually have to be intense to have anti-inflammatory effects. Twenty minutes to half an hour of moderate exercise, including fast walking, appears to be sufficient. Feeling like a workout needs to be at a peak exertion level for a long duration can intimidate those who suffer from chronic inflammatory diseases and could greatly benefit from physical activity" (via Medical News Today).

Another important aspect of exercise is that it helps build strong muscles. As you age, your muscle mass slowly shrinks, and those with celiac have a higher chance of muscle weakness due to the disease (via Gluten Free Therapeutics). After age 30, those who aren't physically active begin to lose an average of 3-8% muscle mass every 10 years, according to the Academy of Nutrition and Dietetics. 

Participating in physical activity that involves strength training at least twice a week is one of the best ways to help maintain and build healthy muscles. You don't need a gym membership or fancy equipment. Some examples of strength training include push-ups, pull-ups, sit-ups, squats, and yoga. You can also do weightlifting with dumbbells or incorporate resistance bands into a workout to add-in a strength training element (via Academy of Nutrition and Dietetics). If you've never done strength training before, it may be helpful to get advice from a personal trainer on the best exercises for your specific needs.

Over time, celiac disease can lead to malnutrition and bone fragility, so it's important to consistently exercise to help keep your bones as healthy and strong as possible. Unfortunately, osteoporosis and other bone issues are commonly seen in those with celiac disease (via National Institutes of Health). This is because the digestive system has a hard time absorbing calcium, which is an important nutrient for keeping your bones strong. 

Any type of weight-bearing exercise or resistance training can help build bone density. Some examples of weight-bearing exercises — which is any workout that has you move against gravity — include weightlifting, walking, hiking, jogging, stair climbing, playing sports, and dancing. Not only do these exercises help strengthen your muscles and bones, but they can increase your mobility, flexibility, and balance, which may decrease your chances of falling and breaking a bone.

Keep in mind that low-impact workouts like swimming or cycling are great cardio and helpful for building muscle strength, but don't work as well for strengthening bones (via the National Institutes of Health). 

Working out regularly has also been known to help increase blood circulation, which not only supports digestion but also helps heal the digestive tract from the harm that celiac disease has caused (via Pain Assist). This is especially important upon diagnosis of celiac and the start of a gluten-free diet. Gluten is found is many different types of foods, from pasta and bread to cans of soup and even candy. Before a diagnosis, it's very likely that you have consumed a good amount of gluten in one form or another — resulting in a lot of intestinal damage. 

Avoiding gluten helps to stop more damage from happening, while exercising can help improve circulation that supports the healing of your intestines (via Fitness and Wellness News). Some of the most efficient exercises for increasing circulation are aerobic activities that cause you to feel slightly out of breath, like swimming, jogging, dancing, cycling, dancing, cardio classes, rock climbing, or even walking fast (via AXA Health).

There's no doubt that living with celiac disease can be mentally and emotionally taxing. Unfortunately, anxiety and depression are some of the most common side-effects of having celiac disease. In fact, those with celiac have a 91% chance of experiencing some type of mood disorder (via Gluten Free Therapeutics). Exercise has been shown to help boost mood and reduce feelings of anxiety and depression because it causes your body to release endorphins — the "feel-good" hormones (via the Mayo Clinic). 

Even if you don't have the capacity for a full workout routine, some research suggests that any type of physical activity, like walking, can help ease anxiety and depression. Exercise can help shift your perspective and might also distract your mind from falling into unhealthy thought patterns. Not only does working out help relieve feelings of anxiety and depression in the moment, but it also has the potential to improve your overall outlook on life and quality of life in general, as seen in the MOVE-C scientific study.

Whether directly or indirectly, exercise is linked with a healthy diet, which is key for managing symptoms of celiac disease. Some people find that when following a balanced, gluten-free diet, they experience an improvement in their overall health as well as a reduction in their digestive issues (via the Mayo Clinic). A study released in the International Journal of Obesity reports that the participants in a 15-week exercise program were also more likely to eat a healthy diet. 

The study looked at 2,680 young adults that didn't have a previous track record of exercising or dieting. Each participant was asked to do cardio for 30-60 minutes three times a week and not change their diet. The researchers found that the participants that completed the full program ended up choosing healthier foods anyway — eating more fruits, vegetables, lean meats, fish and nuts, and consuming less fried foods, soda and snack foods overall (via TIME). The study didn't look at exactly why this phenomenon occurred, but they theorize both psychology and biology has something to do with it.

It's no secret that exercise can help you manage your weight. Many people with celiac disease have a hard time maintaining a healthy weight — patients often struggle with either losing too much weight or gaining weight (via Pain Assist). Weight loss is a common side-effect of celiac disease due to malnutrition (via the Mayo Clinic). But surprisingly, weight gain can also be an issue in celiac patients. Often, initial weight gain after diagnosis and starting a gluten-free diet is expected; as the digestive system is healing and able to begin absorbing nutrients again, gaining weight is normal. 

However, some people find they gain too much weight for a variety of reasons. One theory is that before a patient receives a diagnosis, they were eating larger portions to try to make up for the fact that their body couldn't fully digest food or absorb nutrients. But as the digestive tract heals and is able to absorb nutrients again, weight gain can happen if meal sizes are still at pre-diagnosis amounts. More food equals more calories. 

Another theory is that many people wrongfully assume a gluten-free diet is healthy — however, many processed gluten-free foods can be high in calories, fat, carbs, and sugar, which can lead to weight gain (via Beth Israel Deaconess Medical Center). When making food choices, be sure to not only read ingredient lists, but also nutrition facts as well. 

Those with celiac disease also inherently struggle with an imbalance of their gut microbiome, which is the collection of bacteria that live inside your digestive tract (via Forever Fit Science). When your gut microbiome is out of balance, it can negatively impact many facets of your health, including your immune system, cardiovascular system, weight, blood sugar, and brain health (via Healthline). 

Exercise has been linked with maintaining a healthy gut microbiome, which was one of the main purposes of the previously mentioned MOVE-C study. One of the head researchers of this study, Justine Dowd, health psychology researcher at the University of Calgary in Alberta – who also has celiac disease — said, "We know that people with celiac disease often have a dysbiosis [microbial imbalance] in their gut microbiome and new research is showing that exercise can help promote a healthy balance of the gut microbiome" (via Allergic Living). The study produced favorable results — participants experienced both symptom improvement and an increase in their quality of life. 

If you struggle with sleep problems, you are not alone — almost 70 million Americans experience chronic sleep issues (via the Centers for Disease Control and Prevention). And unfortunately, research has confirmed that sleep disorders are common in people who have celiac disease, both before and after diagnosis. The good news: Exercise helps you sleep better at night. 

According to Dr. Charlene Gamaldo, medical director of Johns Hopkins Center for Sleep, "We have solid evidence that exercise does, in fact, help you fall asleep more quickly and improves sleep quality." Gamaldo shares that it doesn't take weeks or months of exercising to start seeing results, either. Researchers have not been able to confirm exactly why this is the case, but they have found that participating in at least 30 minutes of aerobic activity in a day can help you sleep more soundly that same night. And it doesn't have to be a high-intensity workout — even moderate exercise will do the trick.  

So far we have covered a wide range of exercises that can help manage celiac disease symptoms, including low-impact, moderate aerobic activity, strength training, and weight-bearing exercises. There is also evidence that high-intensity interval training, commonly referred to as HIIT, can be helpful for celiac. In the MOVE-C study, participants engaged in high-intensity interval training instead of lower-intensity or low-impact exercise to help support the gut microbiome. Participants worked out on ellipticals, treadmills, jump ropes and bikes in 30-60 second high-energy cycles (via Allergic Living).

Yoga is another type of exercise that can help improve both your mental and physical health. Whitney Caudill, certified yoga instructor with celiac disease, shares that yoga helped her with stress relief and provided support for her symptoms. "When I am experiencing gastrointestinal symptoms I rely on balasana (child's pose), apanasana (knees into chest or full gas release pose), viparita karani (legs up the wall), malasana (squat), and supta baddha konasana (reclining butterfly) to assist in elimination and relief," Caudill told the The Huffington Post. 

Whatever exercise you choose, it's okay to start small and build from there. The ideal workout routine is the one that works best for you.