You Ask, I Answer: Gluten-Free Diets

I just learned I have celiac disease.

My doctor told me to avoid wheat [and wheat by-products.]

He mentioned to also steer clear of barley and rye.

A family member told me that's only the surface of things I should avoid, since things like soymilk and spelt should also not be eaten.

Can you give me some information?

-- Marie Brilmer
(Location withheld)

Although I am sure this new diagnosis seems initially overwhelming, I am glad you now have a way to explain a lot of the uncomfortable symptons I am sure you were experiencing.

It's a shame your doctor's advice was so vague. Your family member is right -- simply thinking of a gluten-free diet as "no wheat, barley, or rye" is only part of the puzzle.

Her soymilk concern is somewhat on target.

Some soymilks use malt flavorings -- derived from barley -- as flavoring agents. As always, you must read the ingredient label to figure out which brands fit into your celiac-friendly eating plan.

Other things to look out for:

* Soy sauce, which can contain wheat

* Bulgur, which is a wheat product

* Durum flour, also a wheat product (this is what conventional pastas are made with)

* Triticale, a mixture of wheat and rye

* Products containing hydrolyzed vegetable OR hydrolyzed plant protein (this includes canned tuna) -- usually derived from wheat protein

* Items containing wheat starch (including, but not limited to, cake frosting, gravy, pre-sliced cheese, and over the counter drugs)

I should also inform you that many cosmetics companies add wheat starch to their lipsticks as filler.

Since even a tiny amount of wheat can set off all sorts of unpleasant reactions, be sure to research brands that offer celiac-friendly makeup!

You Ask, I Answer: Food Allergies

I have been feeling sluggish and bloated for almost 6 weeks now.

One of my friends thinks it is probably a food allergy, either corn, wheat, or soy.

Do you agree?

-- (Name withheld)
(Location withheld)

Not really.

Let's first begin with some basic definitions.

A food allergy means your body is developing antibodies in response to specific food proteins.

This is different from a food intolerance, which has to do with the body's inability to break down certain substances, often resulting in gastrointestinal distress.

While wheat and soy allergies are common, corn allergies are not.

Additionally, corn allergies trigger symptoms like wheezing, sneezing, and swelling of the throat and face almost immediately. They go far beyond simply feeling "sluggish."

Keep in mind, too, that feeling sluggish and bloated are not necessarily allergic reactions.

Feeling sluggish can be a result of many other things -- stress, iron-deficiency anemia, not consuming sufficient calories, etc.

It concerns me that there is so much self-monitoring happening with allergies. To truly know what is going on, you need to see a specialist who has experience with food allergies.

Otherwise, you run the risk of misdiagnosing or overlooking a more important issue.

Oprah's Reality Check

When we last left Oprah and her "spiritual" vegan cleanse (all I'm saying is, my diet will often be vegan for several days, but that doesn't stop me from getting irritated at the slow person in front of me at the supermarket checkout line who sloooowly counts their pennies), she was enjoying the perks of having a vegan chef ship her foods to Las Vegas (because what's more spiritual than having a private jet deliver your cruelty-free meals?) and absolutely loving every second of her vegan, gluten-free, sugar-free, alcohol-free life.

By now, Oprah has finished her 21 day journey. What happened in the last week and a half is certainly interesting.

No longer armed with a vegan chef, Oprah is forced to endure the rest of the "challenge" as any normal person would.

Off the bat, I notice her entries start to get shorter, and comments along the lines of "just two more days" or "I was really craving some cheese!" begin popping up.

Although Oprah later waxes poetic about what an eye-opening experience this was, and how it provided her with heightened awareness of her food, she forgets to mention a more important point -- that overly restrictive eating plans are doomed for failure.

This entire "project" felt like a silly crash diet. After twenty-one days of strict rules, old eating habits apparently returned, in large part due to constant cravings.

On her last day, Oprah's lunch consists of "a large baked potato with sautéed onions, herbs and olive oil, and [a] fresh green salad with avocado,tomato, lemon, garlic and olive oil."

As two side dishes, those are wonderful, filled with nutrition.

However, as a meal, they are inadequate.

In that same entry, Oprah considers it "progress" that she's just "wishfully thinking" about having some grilled sea bass with it.

Huh? Grilled sea bass would be a wonderful accompaniment to that potato and salad, offering lean protein, healthy fats, and zinc.

This idea that it is but an indulgent fantasy is rather twisted. We aren't talking about a Twinkie here.

Besides, being vegan is not about subsisting on vegetables. Why not accompany those side dishes with grilled tofu, roasted tempeh, a soy patty, or even some quinoa?

A few days prior to that entry, Oprah mentions craving wheat. I still feel like breaking through the computer monitor and saying, "What is so spiritual about denying yourself wheat? Just have some already!"

Anyhow, I hope her viewers and readers took away the most important lesson -- non-sensical strict rules and banning multiple food groups overnight is not healthy, spiritual, or smart.

Over in Oprah Land....

Time to see what Oprah's blog reveals about her ongoing 21-day vegan diet (remember, she's also shunning sugar, gluten, alcohol, and caffeine).

Last Friday, Oprah stopped by Tom Cruise's Telluride home, where she was met with a "ribs and chicken" (marinated in some sort of Scientology-friendly sauce, I'm sure) lunch.

Granted, this was no vegan-friendly meal, so Oprah opted for salad, corn on the cob (no butter, of course) and kale.

Which brings me to a very important point. Well-balanced vegan mealplans need to be researched and planned.

I believe a vegan lifestyle can be healthy, but it must be looked into carefully prior to taking the plunge.

If anyone reading this is considering going vegan, be my guest -- but speak with a Registered Dietitian or, at the very least, read educational materials (preferably written by RDs) on how to meet your nutrient needs with meat and dairy alternatives.

Becoming familiar with vegan alternatives and always being prepared (i.e.: carrying a source of protein like nuts or seeds in your bag in a small Ziploc bag) sets you up for success.

Otherwise -- especially when attending an event at a non-vegan's house who is not familiar with your "diet," -- you run the risk of piling up on side dishes.

Oprah's lunch offers very little protein, zinc, iron, and fat. Nibbling on corn and greens is simply not nutritious -- or filling!

The next day -- Saturday -- Oprah is in Vegas and begins her entry with the following:

"Tal [the vegan chef 'assigned' to Oprah and her team] has Fed-Exed food to Vegas, so we have egg-less omelets for breakfast and lasagna for the plane ride home."

Alright, I cry foul. Come on -- anyone can do a 21 day vegan/sugar/wheat/alcohol/caffeine cleanse if a vegan chef Fed-Exes them meals!

I would have liked to see Oprah "keep it real" and traverse the meat-laden obstacle that is Las Vegas.

In that same posting, Oprah proudly mentions abstaining from having a celebratory glass of champagne.

I still don't understand how the shunning of alcohol (or gluten or sugar, for that matter) relates to becoming a more spiritually aware being.

Besides, any dietary plan that has you obsessing over certain foods and beverages (the "I would like a drink but I am on this clease so as good as that would be I am just going to have seltzer and lime" sentiment has appeared a few times already) needs to be examined more closely.

Sure, alcohol can be a source of empty calories, so although two drinks a day is not a good idea, not allow yourself one drink two days out of the week?

The next day, a pooped Oprah mentions the vegan chef dropping off gluten and wheat-free waffles at her house just in time for breakfast. Oh goodie, how convenient!

It frustrates me to think that viewers of Oprah's show will blindly follow a similar diet, oblivious of some very necessary nutrients they may miss out on.

Additionally, this idea that wheat and gluten are evil is misleading and completely subjective; it is only a problem for someone with a gluten allergy or celiac disease.

This is a perfect example of something applicable to a small percent of the population being heralded as "general nutrition advice"

Allow me to repeat my plea. Oprah, enough with the fad dieting. You're a smart, accomplished woman with an immense fan base.

Next time you want to tackle nutrition, why not invite a panel of Registered Dietitians to share information, debunk myths, and give people practical information they can apply to their daily lives?

You Ask, I Answer: Corn Flakes/High Fructose Corn Syrup

I was eating Corn Flakes and saw that HFCS is one of the main ingredients but, per serving, it only has 2g of sugar. Is this still an unhealthier choice for breakfast?

-- Anoymous (via the blog)

I must say -- I have been getting some really thought-provoking questions lately.

One cup of Kellogg's Corn Flakes contains a mere 1.8 grams of sugar (that's half a teaspoon). When the amount is so small, I don't think too much weight should be placed on the particular sweetener listed on the label.

It's also worth mentioning that when it comes to the artificial high-fructose corn syrup, it's important to place it within the context of dietary patterns.

If Corn Flakes are your only source of high fructose corn syrup each day, there is no need for concern.

If, however, you are also having a few cans of regular soda and lots of processed sweet foods, I would recommend taking certain steps to cut back on your consumption of the infamous corn-based sweetener.

My real issue with Corn Flakes is that they are far from nutritious. They aren't "unhealthy", but I can think of much more nutritious, filling -- and tastier! -- choices for breakfast.

For starters, they are fat-free and contain an almost non-existent 1.3 grams of fiber and 1.9 grams of protein per serving. Why am I pointing this out? Remember: fat, fiber, and protein are the three pillars of satiety ("feeling full").

Foods like Corn Flakes -- which lack these three nutrients -- will not help you feel full. In fact, you'll very likely be hungry again just one hour after having your bowl of cereal (unless it is an accompaniment to a more substantial breakfast).

Anyone interested in weight loss -- and maintenance -- should think about consuming healthy and nutrition foods that, in small amounts, satiate.

Nuts, for example, contain healthy fats, fiber, and protein. This is why a handful of nuts as a snack can hold you over much better than a handful of pretzels (which, lacking these nutrients, will not help you feel full until you have consumed a significant amount of calories).

Another eyebrow-raising fact? A cup of Corn Flakes has more sodium than a one-ounce bag of Lay's potato chips (266 milligrams vs. 180 milligrams)!

As I mentioned in my Small Bites newsletter on sodium, one way to get an idea if something we are eating is heavily processed or closer to nature is by looking at the sodium to potassium ratio.

The more processed/artificial the product, the more sodium (and less potassium) it has.

Corn Flakes? 266 milligrams of sodium in one cup, and a feeble 24.6 milligrams of potassium (we should be aiming for approximately 4,000 milligrams of potassium each day).

If you can't live without your cereal in the morning, opt for a wheat-bran based type (wheat bran is high in potassium) and have it with a banana, mango, or raisins (three breakfast-friendly fruits also high in that mineral).

Simply Said: "wheat-free"/celiac disease

The past five years have produced an increase in wheat-free products such as breads, pastas, crackers, and cookies.

Although the claim "wheat-free" also accompanies other health-related ones such as "Low in saturated fat!" or "No added sugar!", you should only be concerned with avoiding wheat if you have been diagnosed with an allergy to it or a genetic disease known as celiac disease.

Celiacs can not tolerate gluten, a protein mainly found in wheat as well as barley and rye. When gluten is consumed -- even if it's as little as 1/8 of a teaspoon -- the small intestine is damaged, and symptoms vary from extremely uncomfortable bloating and diarrhea to fatigue, mouth sores, and muscle cramping.

Although approximately ten percent of celiacs don't appear to show any symptoms, they are not immune from the nutrient malabsorption that occurs as a result of damage in the small intestine.

Avoiding wheat, rye, and barley is not as easy as it sounds. Many medicines have traces of gluten, and cross-contamination can often happen in factories (which is why you will often see food labels for products that don't contain either of those three ingredients warning consumers that the respective food was made in a factory that processes wheat).

Once diagnosed (after a simple blood test), the lifestyle change can be hard, especially when dining out. A fish and vegetable stew might sound harmless, but that tomato sauce on top might have a little flour in it to thicken it. Frozen yogurts often use gluten as a stabilizing agent! Remember, even the slightest trace of gluten is enough to set off some very uncomfortable symptoms.

Luckily, celiacs have more options than ever. Although all sorts of wheat flour (all-purpose, whole wheat, durum, farina, etc.) should be avoided, experimenting with other types (ie: chickpea, tapioca, rice) is recommended.

Celiacs often end up introducing their palate to a variety of flavors -- quinoa, amaranth, and flax often become a regular addition to their diet, rather than the "funky grain" they have once a month.

Unfortunately, the only "cure" to celiac disease is avoiding foods that damage the small intestine.