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wheat allergy

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Breaking Bread

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This past Christmas Eve, I listened to the soft sounds of Ave Maria and Silent Night waft through candlelit pews. My father has sung in a church choir ever since I was a child, like his father before him, so from a young age I was instilled with an appreciation for robed singers harmonizing centuries-old Latin hymns. I’m also a sucker for Christmas carols. 😉

As the communion bread was passed around among the pews, I thought about people who could not eat the bread—not because they weren’t baptized, but because they were allergic or intolerant.

Growing up, our family belonged to a small stone Episcopalian church on a grassy hill that could have been pulled out of the Scottish Highlands or a child’s storybook. At one point, we had a female priest, which was something of a rarity back then. Sermons routinely invoked global current affairs and the common values shared across religions, and everyone, regardless of creed, was welcome. We were a progressive church. The communion bread was also baked in the church kitchen and tasted heavenly. I’d walk up to the altar, cup my hands, and receive a hunk of doughy bread, which I’d dip into a chalice of wine. I can’t remember ever worrying about my food allergies during Sunday communion growing up. Plain bread as a kid was always considered safe. That has since changed. 

Today, 1 in 13 kids has a food allergy, and millions more have a gluten intolerance. We live in a different world from a couple decades back. The communion bread I ate growing up definitely contained wheat, although I never knew anyone that had a problem with gluten back then. These days, however, it seems as though at least one person at every dinner party is gluten-free. To accommodate, many churches now offer gluten-free bread with communion.

The rise of gluten-free products has been a double-edged sword for the nut-allergic like me: on the one hand, it has helped increase awareness and accommodations for those with food allergies and intolerances; on the other hand, nut substitutes (like almond flour) for wheat have become increasingly common. 

Years ago, I admittedly thought the spike in gluten-free products was more fad than the result of a growing severe medical condition. That all changed when I spoke to a woman at a food allergy conference years back who relayed the harrowing experience of her young son and how their family discovered his gluten intolerance. On Sundays, her son would develop debilitating migraines that would keep him bed ridden for days. As she described her experience, and his symptoms, I was horrified. Her family connected the dots back to the communion bread. “Gluten did that to your son!?” I thought. Unfortunately, their church wasn’t able to accommodate his gluten intolerance, and her family was forced to join another parish. 

At the Scottish storybook church, if you declined the bread or wine, you could fold your arms across your chest and receive a blessing from the priest. At the church I attended this Christmas Eve, communion bread was passed between parishioners in pews on trays, and wine (which turned out to be grape juice), was served in small plastic cups. Surprisingly, an individual blessing did not appear to be an alternative option. You’d think a simple blessing like this would be an option at all churches, allowing everyone to partake in communion and ensuring that the food allergic and intolerant aren’t left out.

Religion, like food, should bring people together. Breaking bread has long been a symbol of community and peace. That community piece is lost, however, if everyone isn’t afforded a seat at the table. 

- Abi & the Allergy Amulet Team

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FOMO: Fear of Missing Out… On Nutrients

Part II: Wheat, Soy, Peanuts, and Tree Nuts

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Welcome to Part II of our FOMO series! Here we’re discussing how to replace nutrients lost from eliminating wheat, soy, peanuts, or tree nuts from your diet. You can find Part I here covering dairy, eggs, fish, and shellfish.

If you’re used to eating toast, cereal, pancakes, or other baked goods for breakfast, avoiding foods that contain wheat will likely be a hard adjustment. Or maybe you fed peanut butter and jelly sandwiches to your first child with no issue and your second child cannot eat peanut butter. It is an adjustment, to say the least! 

As a pediatric nutritionist, my work focuses on making sure kids with special dietary needs are getting the nutrients their growing bodies need. As you can imagine, many of my patients have multiple food allergies and have a fairly limited diet. The silver lining for these patients is that these children tend to have healthier diets because they’re avoiding lots of processed foods! 

I like to start by looking at each food that’s avoided and its corresponding nutrients side by side. As we discussed in Part I, this approach can make it less intimidating to identify other food sources for those lost nutrients.  

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Let’s take a closer look at a few of the nutrients needed when avoiding wheat, soy, peanuts, and tree nuts.

Wheat products in America are fortified with B vitamins, thiamin, riboflavin, and niacin. 

Thiamin is important for maintaining a healthy metabolism and key function of cells. The major thiamin food sources are whole grains, meat, and fish. In the US, breads, cereals, and infant formulas are enriched with thiamin as well as other B vitamins. If you’re avoiding wheat and most breads and cereals, you may want to ensure your wheat-free products are enriched with these key nutrients as well!

Niacin is another B vitamin—B3 to be specific. Niacin helps our bodies use fat, protein, and carbohydrates to create energy. This vitamin is also enriched in processed wheat products and can be found naturally in most meats as well as mushrooms, avocados, and sunflower seeds, to name a few. 

If you’re a meat eater and wheat-avoider, I’m not typically concerned that you’re missing out on B vitamins (thiamin, riboflavin, and niacin) or iron. However, you may want to think about how much fiber is in your diet. Many people substitute rice, potatoes, and corn-based products for wheat. However, these are mostly low in fiber.

Fiber is a carbohydrate that your body does not digest. There are two types of fiber: soluble fiber and insoluble fiber. Soluble fiber dissolves in water and helps to regulate blood cholesterol and glucose levels. Insoluble fiber does not dissolve in water and works to move food through the digestive tract. Many people experience symptoms like constipation after making a change in their diet. In these cases, I tell my patients to increase their fiber intake and add fruits, vegetables, legumes, brown rice, and other whole grains like oatmeal and quinoa. 

If you are not a meat eater, and you’ve eliminated wheat or soy, this next one is for you.

Iron is found in red meat, fish, and poultry, but there are many plant-based sources of iron outside of wheat and soy, including spinach, beans, lentils, nuts, seeds (e.g., pumpkin, chia, sunflower, and hemp), dried fruits, quinoa, and some fortified breakfast cereals. Iron is better absorbed with vitamin C, so I recommend adding an orange alongside your trail mix for your next snack. Calcium inhibits iron absorption, so whether you get your calcium from dairy or a dairy substitute, try to avoid eating them together. 

Avoiding soy is not easy because it is in so many foods. Both peanuts and soy belong to the legume family and contain many of the same nutrients such as B vitamins, protein, magnesium, and phosphorus. 

Magnesium helps normalize blood pressure and keeps our bones strong. Phosphorus also helps to keep our bones strong and helps our bodies make energy and move our muscles. Both of these minerals are found in abundance in beans, seeds, and tree nuts. Phosphorus is also found in dairy, eggs, in meat products, whole grains, potatoes, and dried fruit.

The goal for everyone should be to expand their diet and add more variety! A more diverse diet will lead to greater nutrient intake, and hopefully more delicious meals. If you feel like you’re in a food rut, take a chance and add something new to your routine. Your body (and likely your taste buds) will thank you!   

 

Tara McCarthy is a Registered Dietitian Nutritionist who has a passion for pediatrics. She has worked at Boston Children’s Hospital for over 15 years as well as a private practice and specializes in nutrition for children with special dietary needs such as food allergies, celiac disease, FPIES, EoE, allergic colitis, and sucrose isomaltose deficiency. 

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