Celiac Disease

Celiac Disease

Mildred’s Celiac Disease

Mildred is among four people I know who have Celiac disease. Three of those people have comfortable incomes and cope well with the limitations of their diet and lifestyle. Mildred (a real person with a fictitious name) is not among the three.

Celiac Disease

Perhaps you remember Celiac disease from previous posts about autoimmune disease. Mildred’s immune system perceives gluten found in wheat, barley, and rye as something that doesn’t “belong” and mounts an allergic attack. The autoimmune part is that her immune system goes haywire, confuses the lining of her intestines with gluten and attacks it too — leading to major inflammation, symptoms, and nutrient mal-absorption – all bad news.

As is often true with autoimmune diseases, Mildred has other allergies including eggs and something else in wheat beyond gluten. Dang, eggs are usually the most nutritious and inexpensive source of protein. But not for Mildred.

Celiac disease is particularly difficult because wheat/gluten are ingredients that could be in pretty much everything including commercially processed food, makeup, toiletries, medications, and plastic. Even the tiniest amount of gluten is a trigger for Celiac. Thus avoiding gluten/wheat requires a constant state of vigilance.

Financial and Resource Limitations

Mildred’s income is minimal, her living situation is very difficult, and her cooking tools are limited to a microwave.

She now comes to the food pantry and we help her identify food in in our “store” that she can eat. The typical food pantry client leaves the pantry with three to four sacks of food plus meat. Mildred does well to get one sack. And when the pantry meat is processed (e.g. battered chicken nuggets) and thus includes wheat, her meat options are also limited.

One of her best dietary options from the pantry are dried legumes (beans, peas, lentils, etc.) as good sources of protein. But you have to cook legumes so how can she be expected to eat beans?

Next to a stove, the best cooking alternative is a crock pot. So we purchased a crock pot for Mildred and provided directions on how to soak/cook beans to maximize the nutritional value and minimize digestive problems. This is actually pretty important.

Legumes don’t seem made to be the primary food source of humans because they are difficult to digest. Chapter 13 of my book, It’s All About the Food, explains all that and describes proper soaking and cooking to minimize the digestive issues. The last thing that Mildred needs is a new digestive problem.

I should point out that Mildred doesn’t have an ounce of extra body fat on her. That actually makes sense because the foods most likely to add body fat (anything with flour/gluten) are things she cannot eat. While most legumes are high starch and calorie, they don’t hold a candle to the amount of starch and sugar in typical wheat products. Adding a few pounds of body fat would actually be to Mildred’s advantage.

Anyway, the crock pot allows her to make soups and stews. We know which meat options are good for her. She can come back to see us when her food situation is dire.

The existence of chronic symptoms says something is wrong. In some extreme cases (such as Celiac) the diagnostic skills of a doctor may be needed. There is a difference between eating less of something problematic and NEVER eating something problematic. The fix will not be medication but rather identifying and eliminating dietary triggers.

Dr. Diulus’ Type 1 Diabetes

A few weeks ago I introduced the Perfect Diet series with the story of Dr. Carrie Diulus, a type 1 diabetic eating a vegan diet. A proper vegan diet is a good combination of food while totally absent animal food. I mention “proper” to acknowledge that there can be really bad vegan diets.

For example I wrote in my book about an overweight vegan woman I knew and observed at a restaurant buffet. We can call her Sadie.

True, she did not eat any meat. However, she ate multiple servings of potato salad, fried tater tots, fried okra, rolls, a tiny bit of salad, and a slice of cherry pie. Actually I think Sadie might not quite understand vegan as I’m betting the cherry pie crust did have animal fat in it. I wasn’t close enough to see if she put butter on the roll.

Sadie’s meal, vegan or not, was a high carbohydrate(sugar)/high fat/low nutrition meal. That isn’t “proper” by any definition. And it certainly helps explain her weight.

Anyway, back to Dr. Diulus. At some point she was obese. So we probably ought to see what that has to do with her story.

Type 1 Diabetes

Type 1 diabetics is also an autoimmune disease. The patient’s pancreas doesn’t make insulin, a hormone essential to the human body. Type 1 Diabetics get their insulin through shots. The higher the carbohydrates in their diet, the more insulin is required.

Chronically high levels of insulin create “insulin resistance,” a condition normally associated with Type 2 diabetes. With insulin resistance, a Type 1 diabetic can easily become a Type 2 diabetic as well. Overweight is sort of inevitable. Dr. Diulus didn’t want to be there.

The Error of Her Ways

Eventually Dr. Diulus saw the error of her ways and adopted a low carb/higher fat diet. She chose a vegan diet because she wanted to. She doesn’t like meat. Low carbohydrate is not an easy choice for a vegan because plants ARE essentially carbohydrates.

But she worked it all out – which foods would minimize insulin necessity (manage blood sugar), control her weight, and meet all her nutritional requirements. Plus which supplements she would have to take with a vegan diet. There are some.

The Major Vegan Challenge

The really huge challenge of a vegan diet is getting enough complete protein (having all the essential amino acids). Meat is the easy choice but since she doesn’t eat meat, her protein of choice is soy. Soy is the one plant in the legume family with complete protein coupled with lower net carbohydrates (which means lots of fiber.) Over time her extra pounds went away along with any other symptoms.

Technically soy isn’t the only way to get complete protein on a vegan diet. All you have to do is combine the protein in legumes and grains or nuts. However all legumes (except soy) and grains are very high carb, not acceptable on a low carb diet. So that option was out for Dr. Diulus.

Anyway this worked for Dr. Diulus because she is a doctor and went to the trouble to figure it out. She is a healthy weight with no symptoms. She says if she had to add meat she would add shellfish.

If she did have symptoms, however, she would need to identify the food(s) creating the problem. Soy and shellfish, her first and second choice for protein, are both on the top eight list of allergens. Life could get difficult for a “proper” vegan like Dr. Diulus if soy proves to create an allergic reaction.

In Summary

So far we have considered two people with different goals. Mildred whose goal was to stop the wash of symptoms tied to her Celiac disease. And Dr. Diulus whose goal was to manage Type 1 diabetes blood sugar and weight with a vegan diet. Note that their food choices had to be thoughtfully made.

Deciding your personal perfect diet requires you to know your goals and be prepared to make thoughtful choices. More help with thoughtful choices over the next few weeks.

Pat Smith is the author of “It’s All about the Food,” a book that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. Proceeds from her book benefit the Montgomery County Food Pantry. Her website is http://www.allaboutthefood.org/ She can be contacted at patsmith2@live.com, 870-490-1836. Her Facebook page is www.facebook.com/patsmithbooks.