Often patients continue to experience symptoms even on a gluten-free diet (GFD). These symptoms could be due to either cross-contamination with gluten-containing foods or cross-reactivity . Cross-reactivity occurs when the proteins in one substance are like the proteins in another. As a result, the immune system sees them as the same. In the case of food sensitivities or allergies , cross-reactivity can occur between one food and another.
For example, about 50 percent of those who are gluten-intolerant are also sensitive to dairy. A significant immune reaction occurs when these antibodies are applied to cow’s milk, milk chocolate, whey protein, casein, yeast, oats, corn, millet, instant coffee. The consumption of cross-reactive foods as well as gluten-contaminated foods may be responsible for the continuing symptoms presented by gluten sensitive individuals. The lack of response or incomplete recovery may also be due to antibody cross-reactivity with non-gluten containing foods. These should then be treated as gluten-like proteins and should also be excluded from the diet when the GLuten free diets seem to fail.
Surprisingly, researchers are also finding that instant coffee tends to cross-react with gluten and can mimic symptoms of gluten intolerance. The same can be said about all of the foods are - Dairy, Chocolate, Corn, Hemp, Buckwheat, Soy, Sorghum, Spelt, Amaranth, Yeast, Sago, Oats, Instant Coffee, Whey.
The decision to eliminate any of these is based on individual sensitivity or reactions.
Gluten may be hiding in many common foods & ingredients:
• Gulab Jamun, Jalebi, Ghevar
• Heeng (aesofotida)
• Mustard (powder/ paste)
• Ketchup
• Worcestershire sauce
• HP sauce
• Soy sauce & other chinese sauces
• Chocolates (some varieties)
• Icecream (some varieties)
• Malt vinegar
• Haleem
• Processed meats (some varieties)
• Bhel puri
• Rawa in South Indian food
• Coating binding and gravies
• Barfis
• Flours ground in contaminated flour mills
When one has a gluten-related disorder, the treatment is a strict gluten-free diet without exception. One should not let the treatment be the trigger for more problems. In the words of Dr. Tom O’ Bryan, “you can’t be a little pregnant, you can’t have a little gluten”, in the sense that cheating once-per-month increases the risk of early death 6-fold! (ref: Lancet 2001)
Regardless if you have celiac disease or gluten sensitivity, you must take your gluten-free diet seriously.
In fact, people who are “just” sensitive to gluten can and will experience just as much or more inflammation in their bodies as someone with celiac disease, according to Dr. Tom O’Bryan.
Common cheat statements:
1. I’m not celiac, so I can eat just a little gluten here and there.
2. I’m just gluten intolerant, so I’m not worried about cross contamination.
3. I’m on a low gluten diet because I have silent celiac.
4. Gluten doesn’t bother me that much, so I just avoid it but I’m not crazy about avoiding it or anything like that.
5. I always eat gluten free, but since it’s my birthday, I’ll eat the gluten-full cake, just this once.
6. I’m going on vacation, so I don’t have time to be gluten free. I’ll resume my diet when I return.
7. It’s okay, I’ll eat the lasagna you made even though it contains gluten. I’ll just pick away the noodles. I’ll be fine.
People on a gluten-free diet need a sharp eye for labels. Some ingredient red flags are obvious, like wheat, wheat gluten, barley, or rye. But some foods have “stealth” gluten. Two terms to watch for are malt (which is made from barley) and hydrolyzed vegetable protein (it often contains wheat). And while oats do not contain gluten, they may also increase symptoms, including abdominal pain, bloating, and diarrhea.
A healthy diet cannot be arrived at by simply avoiding harmful foods but by the consumption of beneficial ones. Since the beginning of the 21st century, gluten-free diet is among the most popular diets . Clinicians worldwide have been experiencing an increasing number of people with digestive disorders or extra-digestive symptoms which improved removing wheat/gluten from their diet. Some of the common issues which can arise with gluten free diets which are not planned with care are :
Nutritional deficiencies
An unbalanced selection of food and an incorrect choice of gluten-free replacement products may lead to nutritional deficiencies. Gluten free replacements can be high on starches which are low in nutrients. Replacing flour from wheat or other gluten-containing cereals with gluten-free flours in commercial products may lead to a lower intake of important nutrients, such as iron and B-vitamins , folic acid , zinc , calcium & phosphorus and a higher intake of sugars and saturated fats. Some gluten-free commercial replacement products are not enriched or fortified as their gluten-containing counterparts, and often have greater lipid/carbohydrate content. Foods with gluten in them can be a great source of vitamin B, folic acid, iron, zinc, niacin, thiamine, riboflavin, calcium, phosphorus. Many people with Celiac Disease take a gluten free multivitamin to try and make up for this deficit. These people also need to be very diligent about finding alternative ways to get the much needed vitamins and nutrients. Children especially, often over-consume these products, such as snacks and biscuits. These nutritional complications can be prevented by a correct dietary education. Pseudocereals (millets , quinoa, amaranth, and buckwheat) and some minor cereals are healthy alternatives to these prepared products and have higher biological and nutritional value.
Lowered fibre
Whole grain breads are good sources of dietary fibre. By cutting out something that is good for them in appropriate portions, gluten-free dieters choose to forgo the benefits of whole grain products. Other foods can provide these fibres, but generally, they may not be as rich in fibre as whole wheat or whole grains. It would take a lot more effort to make up for the lack of these fibres in your diet. By making sure that one eats plenty of fibre, one will have better overall gut health and receive antioxidant, anti-inflammatory benefits. These benefits can help reduce the risk of cancer and cardiovascular disease.
Type 2 Diabetes risk
While diabetes can be managed efficiently by a healthy gluten-free diet, an ill planned diet can do the opposite. In a study involving healthy men and women, research showed that when participants ate gluten were less likely to be diagnosed with type 2 diabetes. Fibre and other vitamins and nutrients found in healthy foods containing gluten proved to be beneficial to the overall health of these participants. People who voluntarily switch to a gluten-free diet give up foods that are important to maintaining a balanced diet. While there are definitely unhealthy foods that contain gluten, there are also healthy foods that give your body the nutrients it needs to function and properly.
Weight gain
Many people voluntarily switch to a gluten-free diet because they want to lose weight and be healthier. However, just because something is gluten-free, does it mean that it is healthy. In fact, many gluten-free baked items like cookies or brownies are higher in calories and sugar than the gluten-containing counterparts. Also, a lot of junk food that we indulge in is already gluten free. For example, French fries and candy bars are not off-limits. Because people are tricked into thinking they’re making a “healthier” decision when they choose a gluten-free diet, they don’t take the time to check labels and nutrition facts. This can lead to weight gain and unhealthy choices. When we remove wheat from out diet, a large percentage of the good bacteria will likely starve. This may be a contributing factor to the jaw-dropping statistic from the largest study ever done on mortality and Celiac Disease, that being diagnosed with Celiac Disease is associated with an 86% increased risk of mortality from a cardiovascular incident within 1 year.
Stress
Switching to a gluten free diet by choice means that dieters also need to be mindful of what they eat. This makes it more difficult to maintain a balanced diet, which may lead to completely unnecessary added stress.
Conclusion
• Going gluten-free, one must focus on making healthier gluten free choices.
• For instance, eating a high-fibre bread instead of white bread is a wise decision
Seek professional help
One must take measures to protect against nutritional and vitamin deficiencies associated with a gluten-free diet. The benefits of a ‘Coach’ to learn the correct basics through this transition cannot be over-emphasized. Eating different colours of the rainbow in every meal, under the advice of a nutritionist, health coach or a registered dietician will help to restore balance to the gut health and rebalance the immune system.
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