What is Celiac Disease and why is a Gluten Free Diet Essential for it ?

This is a question I am commonly asked as a dietitian. I have partnered with Americord to bring you answers to this controversial area.

First of all, let’s talk about what gluten is, then how it relates to Celiac Disease, and steps your family can make to accommodate a family member who has been diagnosed with this disease.

Gluten is a form of protein found in wheat, barley, rye, triticale, and many other grains  it is also found in many condiments via addition of grains such as most soy sauces, BBQ sauces, and salad dressings.

Celiac Disease (CD) which is an autoimmune disease which includes an allergy to gluten. If someone has CD, then it is essential they follow a strict gluten free diet. Even trace amounts of gluten can evoke a negative reaction. Individuals have usually had less than optimal vitamin and mineral absorption prior to diagnosis so it is always good to have a proper assessment done and determine if any supplements are advised to help with any deficiencies. In terms of food preparation, here are a few tips to keep your home GF if a family member is diagnosed with CD.

  1. Read ingredient lists well. Watch for words that indicate wheat, rye, barley, or any other grain that may contain gluten. A common one is “hydrolyzed wheat protein” in many salad dressings and other condiements. Even soy sauce contains wheat and a GF version must be used.
  2. Have a toaster that is dedicated to GF bread only. Label it and set it in a separate area than you regular toaster.
  3. Switch out wheat based pasta for rice pasta, lentil pasta, chickpea pasta, cauliflower rice, or spiralized zucchini
  4. Always have quinoa on hand that can be offered hot or cold.
  5. For oatmeal try Bob’s Red Mill GF steel cut oats. Their GF pancake mix, pizza crust mix and other mixes are also great options for a quick and easy meals
  6. For baking use a mix of GF flours as one kind alone may lead to a dense baked product but mixing a few together can be quite nice. If you are looking for a GF muffin recipe you could try this one that I have been making for years.
  7. If using luncheon meats, be aware of any fillers that contain gluten. 
  8. Offer lots of fresh fruits and vegetables as these are always free of gluten.
  9. Be sure to ask at restaurants if they offer GF options and if they ensure proper preparation techniques of these away from any products that contain gluten.
  10. If travelling, take your own GF snacks from home to ensure adequate nourishment along the way. We really like taking fruits, veggies, GF hummus, GoGoQuinoa biscuits, and BohoBars in our home.

Also, remember that consulting an RD upon diagnosis is a great idea. You can contact your local College or Dietitians to find one in your area. And as always, feel free to leave questions in the comment section below.

 

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Choosing Lactose Free Milk Alternatives for Children

This post was sponsored by Americord. All content was written by me, Noelle Martin MScFN RD.

We recently chatted about the Breastmilk and Lactose Intolerance in Babies. Today I wanted to take this one step further and talk about how to handle lactose intolerance once a baby stops nursing to ensure that their GI system is happy and they are well nourished.

Ideally children 2 and up will drink 16 oz. of milk per day for the nourishment they need…but how can we reach this goal for a lactose intolerant child?
The first thing to consider is the age of the child. If they are under one year of age, then a lactose free formula is best. From 12-24 months there are two main options. One is to continue with the lactose free formula. The other is a lactose free whole milk. Whole milk (or homogenized) is 3.25% fat. This is the best milk choice for children age 12-24 months who are no longer breastfed due to its high fat content. Fat is essential for brain and eye development in children and choosing a lower fat milk product at this age would take away from the fat in their diet. For lactose intolerant children ages 2 and up, lactose free 2% milk is a good choice as it has sufficient fat. So how does this lactose free milk work? Let me explain.

Cow’s milk contains lactose which is a sugar made up of glucose and galactose. During digestion our intestinal villi secrete lactase, an enzyme, to break down lactose back into glucose and galactose. Lactose free cow’s milk has lactose added to it so the breakdown occurs in the milk rather than our guts. There are many micronutrients that naturally occur in cow’s milk such as calcium, magnesium, and vitamin B12 (among others), and then vitamin A and D are added as per government regulations. The nutrients in milk work together to help us build and maintain strong bones and teeth, but also serve many other purposes as well. For some children they may have further restrictions, such as a casein allergy. From there it gets a little more complicated.

Here are a few important points about milk alternatives:
Soy milk: Soy milk has the same fat percent as 2% milk so it is a suitable option for children over 2 years of age. It is recommended to avoid soy formula and soy milk for infants. Soy milk also provides the same amount of “complete protein” as one cup of cow’s milk. It does not, however, contain all the micronutrients (vitamins and minerals) as cow’s milk. So if you are choosing soy milk, then please ensure that you choose one that is fortified with calcium, vitamin D, and vitamin B12 at least and ideally others as well. Because the micronutrients are added, they do not stay suspended in the milk very well so it is best to shake the carton of soy milk very well before pouring it to ensure that you are actually ingesting what you have paid for. Some people do not want to consume soy milk because of its estrogenic properties, so then we have to look at other milk alternatives.
Coconut milk: Coconut milk is the next best option for children as it has the same fat content as 2% milk and soy milk. However, that is where the similarities end. Coconut milk is not a source of protein or any micronutrients. If a parent is choosing coconut milk for their child, then they need to replace the 16-18 grams of protein that would be provided by 2 cups of cow’s milk or soy milk each day AND ensure that the coconut milk is fortified and (as I said above) shake the carton well. A nice way to add a complete protein into coconut milk is to blend in hemp hearts. These are packed with complete protein and omega 3 and just add to the creamy nutty flavour that is already in coconut milk.
Two other milks that are commonly considered are almond and rice milk. These milks are not a source of fat or protein and are only a source of micronutrients if fortified. These milks are not suitable for young children unless they are mixed with higher fat and protein sources such as hemp hearts and chia seeds.