<<Disclaimer: Verify this information before applying it to your situation.>>
Did you know that the gluten-free diet is the same for all celiacs in
the U.S.? All of the national celiac organizations are now on the same
page. Let’s lay the past negative perceptions to rest.
Dietitians can access up-to-date gluten-free diet information in their
6th edition of their manual. CSA/USA, Gluten Intolerance Group, Celiac
Disease Foundation, and American Celiac Society all subscribe to the
same zero tolerance policy for gluten.
I want to share with you my opinions. Unfortunately, there are few
absolutes in dealing with our diet. We celiacs should always avoid
wheat, barley, rye, oats, spelt, triticale and kamut. Although there are
various studies looking at oats for celiacs, the studies have not been
long term enough to give definitive answers, just trends. However, there
is likely contamination of wheat in the fields, storage, and/or
processing. There is no pure retail source of oats in the U.S. at the
present time. No national celiac organization is advocating the liberal
use of oats at this point in time.
Many issues suggest certain answers at the present time depending on
methods in manufacturing, agriculture, pharmaceutical practices, etc. At
the present time corn (subsidized by the government) seems to be cheaper
in many cases to that of wheat. The bottom line for companies is cost.
There is no permanent answer to our questions. We always have to be
vigilant and investigate foods and ingredients for ourselves.
We thought the vinegar/alcohol issue was put to rest a couple of years
ago when various scientists proved that little, if any, gliadin is
allowed into the distillate in the distillation process. This means that
most vinegars, except malt vinegar (where the flavoring from barley is
added at the end of the process), are acceptable to most people on a
gluten-free diet. The single word vinegar on food labels denotes apple
cider vinegar. This all generally means we probably can order a
vinaigrette dressing in a restaurant (not a creamy dressing) and not
have to bother taking along our own bottle of salad dressing, as we once
used to. Unfortunately, I have learned that the FDA also allows
combinations of vinegars for some condiments, such as salad dressing
(mayo type). It is best to find and use good brand names of companies
who know the source of their ingredients.
Some celiacs tend to have other food sensitivities, even to vinegar.
When these individuals have trouble with vinegar, therefore, it is
probably not a gluten problem. Avoid any food that you cannot tolerate.
Canola oil that dietitians tout as being heart-healthy is no longer a
perceived problem. Canola oil was developed in Canada, and now the
companies that make canola oil have tested their products and say there
is no gluten in this oil. If you have a problem with canola oil, it is
probably not due to gluten.
Red or white wine can be enjoyed by celiacs, unless they have individual
sensitivities, possibly to sulfites. Of course, beer is forbidden.
Reacting to certain dyes is more likely to be an individual sensitivity
rather than a gluten problem at the present time.
For best nutrition, we need to be eating a balanced diet using fruits,
vegetables, protein (meat, poultry, fish, tofu, eggs), allowed starches,
and limited fats. We celiacs can use flours from rice, potatoes,
tapioca, cassava, nuts, beans, and Montina.. All national celiac
organizations believe that certain alternative grains and flours are
inherently gluten free. These include quinoa, amaranth, buckwheat,
millet and tef. Just be aware that some of the alternative grains could
be contaminated with wheat, although quinoa and Montina are grown
separately, not with wheat.
CSA now is dating all their publications. If your material does not have
a date, it is probably old. I know a new Handbook is being written.
Their Commercial Product List is revised every year. Write for updated
material in which you are interested (www.csaceliacs.org ).
CSA/USA believes that celiacs should use a three-step method for a
gluten-free diet. The first stage is starting with unprocessed foods
that are inherently gluten free. These would include all meat, fish,
poultry, fruits and vegetables. Then add new products to your diet one
at a time, judging how your body reacts to the new food. It is an
excellent idea to keep a food diary with lists of the foods you try and
your body’s reactions, if any. Again, it is common for celiacs to have
other food sensitivities, and by presenting one new food at a time, you
will probably be able to ascertain if that food gives you a reaction.
CSA says to wait to introduce the alternative grains into your diet at
the end of the expanding stage 2, when you are more comfortable with
the diet and realize how your body reacts to gluten. I believe using
three stages is a reasonable approach to the gluten-free lifestyle that
will benefit all celiacs trying to adjust. Yes, this approach might be
considered a conservative view, but it addresses all levels of gluten
sensitivity. When we are newly diagnosed, we don’t know how sensitive we
ultimately will become.
Practically speaking, however, it may take a long time to expand your
diet one food at a time. Another way to proceed for the average celiac
is just to go strictly gluten free. Then if symptoms persist, go dairy
free. If symptoms still continue, and you have reviewed your diet to
ensure it is gluten free, then try the CSA 3-Step Diet approach.
Remember that some people can be allergic to corn and derivatives, which
is a staple in the basic diet. Everyone’s gluten-free diet will differ
in the same light that everyone’s menus will differ.
Reading labels for gluten is an acquired skill. There are about 20
companies who have full disclosure in terms of the top eight allergens,
including wheat. Calling consumer toll-free phone numbers on food
products is one way to ascertain the gluten status. Using the CSA/USA
Commercial Product list can give you a head start. Lists are also
published by Clan Thompson on the Web, the Denver CSA chapter, and the
Tri-County Michigan chapter. There is help available.
Lactose intolerance is closely associated with celiac disease because
the lactase enzymes are generated at the tips of the villi, and it is,
of course, the villi that are damaged by gluten. Thus the lactase
enzymes do not have full function to digest the milk sugar (lactose).
Fortunately for us, ingesting lactose (if one is lactose intolerant)
does not damage the small intestine just makes us uncomfortable.
Beyond gluten and lactose, celiacs might be sensitive to soy. Just be
aware that other food sensitivities may cause digestive distress as well
as gluten. All gluten type symptoms may not really be attributed to
gluten. Most celiacs who continue to have digestive problems after going
on a gluten-free diet may in fact not be vigilant enough or know enough.
Dr. Peter Green of Columbia University Celiac Disease Center says that
if you find yourself having recurring gluten-type problems, the likely
answer is in your diet itself; you are not being strict enough, possibly
because you do not know enough or products have changed ingredients.
Review your diet. Review your diet. Review your diet. Nothing is all
black or white. The GF diet is essentially the same for all celiacs, but
people themselves are different and have different levels of
sensitivity, different associated disorders, different concurrent
allergies, etc.
The other celiac organizations do not specifically advocate a three-step
approach to the gluten-free diet. However, the ultimate goals and foods
allowed are the same. The point is that you have options and choices in
the way to proceed. Basically, all the celiac organizations have the
same GF diet, but the manner in which they get to the end is a little
different. No big deal! This is my understanding.
Because every little bit of gluten is damaging the villi in the small
intestine, it behooves us to eliminate all the gluten we know about; we
are inadvertently getting gluten particles in areas where we are
unaware. We ourselves are responsible for our own gluten-free lifestyle.
Our best health should be restored in time on a strict gluten-free diet.
I have been attending celiac conferences (CSA, GIG, Am.Celiac Society,
or CCA) for the last 15 years, when I was rediagnosed. I have been a
leader in various capacities for CSA/USA, I have collaborated with other
celiacs, and I am currently chairman and newsletter editor for the
Houston CSA chapter, as well as CSA TX State Coordinator. I have heard
many, many lectures from well respected physicians and dietitians. This
is where I am coming from. I firmly believe in Celiacs Helping
Celiacs. We all need each other.
--Janet Rinehart, Former President, CSA/USA, Inc.
www.houstonceliacs.org
P. S. You may want to use this article in your local newsletter. --
Janet
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