Gluten + Dairy, a Double Whammy

One in 133 Americans are diagnosed with Celiac Disease, and many more may have a milder form of gluten intolerance. Celiac Disease, as you may have read, is a genetic condition where a person's immune system calls mutiny and begins attacking itself whenever gluten (a protein found in all forms of wheat, barley and rye) is consumed. The genes that cause Celiac Disease are usually dormant at birth but can 'turn on' at any point in a person's life, from the introduction of solids at 6 months to 100 years of age. There is no way to predict when it will 'turn on' or what will trigger the development of this condition. However, the one thing we know without a doubt is that once Celiac Disease begins there is not way to turn it 'off' again. The only known treatment is total avoidance of all gluten grains.

Many individuals embark on their gluten free journey and discover new symptoms that they weren't able to focus on before. They soon realize that in addition to giving up their morning toast, they need to forego the the milk on their now gluten-free cereal.

No, the body isn't attacking the proteins found in milk. But the problem is related to Celiac Disease. You see, the digestive tract is lined with little hair like tentacles called 'villi'. These villi wave back and forth, gently moving food in the right direction. When the Celiac Gene turns on, and the immune system begins waging a war against the toast and saltines you use to calm a queasy stomach, these villi get caught in the crossfire and are damaged. When a doctor diagnoses Celiac Disease, they start with blood work and do a biopsy. The biopsy will show that instead of those nice, bumpy, healthy villi, your digestive tract looks smooth.

All very interesting, you say, but what about that milk? Well, it just so happens that in order to digest lactose (the sugar found in milk and other dairy products), your body needs an enzyme called "lactase". This enzyme is produced by your digestive tract, in the very tip of those little villi. You know, the ones that are flattened by Celiac Disease. In essence, that little part of the villi that produces the lactase disappears and suddenly you become lactose intolerant.

No, no, you're life isn't over. Giving up gluten is a big step. Giving up dairy...well, dairy seems like the one thing you had going that would make gluten free goodies taste good. But it isn't the only thing, trust me. (Yes, I know...ice cream is gluten free! Which doesn't matter much if it bites back anyway)

First off, don't despair. Although gluten-free is for life, gluten intolerance-invoked lactose intolerance is often short lived. A year is a long time, but after a year or so of healing you might be able to tolerate small amounts of your favorite ice cream, or a bit of real cheese. And, since eating dairy won't be causing you the type of damage that eating gluten would, you get to simply experiment and find out if it hurts or not. (That's not quite as simple as it sounds, especially when you find out the hard way that you aren't ready for dairy. But it is reassuring to know that the war going on in your intestines isn't going to leave any lasting damage.) Some people will even be able to get away with having a bit of real butter by using lactase supplements, frequently found in the antacid aisle of well stocked grocery and drug stores. If you have Celiac Disease, and suspect a lactose intolerance, talk to your doctor for advice.

Like I said, a year is a long time to wait for that comforting touch of something creamy. Thankfully, there are a variety of dairy free alternatives on the market.

Cheeses: My family likes the Daiya brand of shredded cheese. It melts a little, tastes good and satisfies that creamy craving. It's also free of both lactose and casein, so it's safe for people with both a true dairy allergy and a simple lactose intolerance. You don't have to live without cream cheese, either. Whenever there's a sale on Tofutti brand Better than Cream Cheese (better known as BTTC in our household), people stop me to comment that they've tried it and like it as much as regular cream cheese, if not better. My daughter has tasted their Tofutti sour cream as well and claims it passes her taste test with flying colors.

Ice Cream: Life simply isn't the same without ice cream. But, you can still have sorbet at most ice cream parlors (ask for a scoop from the back, so that the container isn't contaminated with any of the other flavors. Sure, it looks clean and a few drops of dairy won't hurt you. But if a few cone crumbles fell in, it could trigger another bout of symptoms with the Celiac Disease. Or, worse, just flatten out those villi without even causing symptoms so you think you're home free. If the damage continues, not only will you continue to be at risk for malnourishment and cancer, but the whole lactose intolerance thing is never likely to go away.) For home enjoyment, look up So Delicious brand frozen dessert. Many folk who can indulge in the real thing seem to enjoy this brand when served at our house. And I don't know a kid who doesn't clamor for Tofutti brand Fudgesicles.

Milk in a Carton: There really is no substitute for milk itself. There are lots of wannabees, and as drinks, they stand alone just fine. But they don't taste like the original. Try some Silk Chocolate Milk, or Rice Dream Nog, or heat up some Rice Dream Peppermint Chocolate rice milk this holiday season. There are also coconut and almond 'milks' on the market. Buy the smallest size you can to experiment, or ask an employee if they offer samples. Some stores are happy to open up a few cartons and pass out paper cups for their customers to give a few taste tests. Others may act like you've grown an extra head, but leave those worries to the extra head...the cost of alternative items is enough to risk asking. And how will you know what to buy if you don't taste a few different options?

Substitutions are not the same as the original. That's why they are called 'substitutions'. The object isn't to replicate your old standbys, at least, not in the beginning of your journey. Your primary concern is to satisfy your cravings so you aren't tempted to cheat on your health-condition mandated diet.

Rather than trying to live the same old life, following the same old diet with substitutions, start by focusing on old favorites that might still be safe. Make fried rice using gluten free soy sauce. Roast a chicken with some potatoes. Eat eggs. I like to serve Mexican style foods when hosting a food centric event. Corn or rice tortilla wraps, beans cooked multiple ways, rice, tomatoes, salsa, olives and guacamole...no one even notices that there isn't any cheese or sour cream on the table. Actually, guacamole frequently fills that craving for a creamy texture that cheesy sauce or sour cream creates. Just make sure that there aren't a lot of preservatives, or make your own. Guacamole may be a 'high fat' food, but since it's mostly just avocados and lemon juice, it's a good-fat. And when you're dealing with the double whammy of losing two major American food groups (wheat and dairy), you deserve to indulge in a bit of high fat comfort food. Maybe not a LOT, but at least a little.

Life is never really the same after diagnosis. And having to give up dairy on top of gluten seems like a death sentence for some. But it's not. Life gets better once you feel better, and there are lots of food options, look at what you CAN eat, not what you can't. Experiment with substitutions and splurge once in awhile on really good dark chocolate. You'll be fine.