What is gluten?

Gluten is a kind of protein that is found in some grains, mainly wheat. It is the ingredient that adds texture to your bread and makes your doughnuts and cookies rise well when baked.

Unlike protein found in grains such as rice, gluten is difficult for humans to digest completely. A small percentage of people are extremely allergic to gluten and develop coeliac disease even if they consume a little bit of it. This condition is also known as gluten-sensitive enteropathy or non-tropical sprue. This causes inflammation in the small intestine, which interferes with the absorption of other nutrients. But even if you don’t have such heightened sensitivity to gluten, it is a good idea to cut back on gluten-loaded foods because in general we are now consuming too much of those in the form of bread, biscuits, pizzas, pastas and the like.

Signs of gluten sensitivity

The most common symptoms in children between 6 months to 3 years of age with gluten sensitivity are diarrhoea, growth failure, vomiting, a bloated abdomen and stools that are abnormal in appearance, odour and quantity. Adults may experience weight loss [despite increased appetite], weakness and fatigue. They may also suffer from anaemia and low calcium in bones [osteopaenia and osteoporosis].

Even if you don’t have coeliac disease, you may have sensitivity to gluten that shows up as a host of symptoms such as dizziness, unexplainable fatigue, heartburn, skin rashes, nausea, arthritis, infertility, PCOD, and psoriasis.

So how do I know if I am sensitive to gluten?

The best way to ascertain whether you are intolerant to gluten is to eliminate it completely from your diet for about a month. Of course, this means you will have to revamp your diet entirely. You will need to have another look at your grocery list to find substitutes for all your usual foods that contain gluten. You’ll also find yourself reading food labels much more than you would before, but that’s a good habit to develop in any case.

If, after 30 days, reintroduction of gluten foods in your diet causes your symptoms to reappear, then it confirms your gluten sensitivity.

The elimination plan

Complete withdrawal of gluten from the diet usually results in prompt clinical improvement. During the first few weeks of gluten omission, the diet should be supplemented with vitamins, minerals and extra protein to remedy deficiencies and replenish nutrient stores. Children on gluten-free diets often find it difficult because of the omission of all foods that children relish, such as biscuits, burgers and pizzas. In such cases, alternatives have to be made available such as rice based noodles or rice pastas.

In a gluten-free diet, wheat, oat, rye and barley are excluded. Products made from corn, potato, rice, soya bean, tapioca, arrowroot, amaranth seeds and millet can be included.

If you are intolerant to gluten, going on a gluten-free diet can have a variety of health benefits, such as improving cholesterol levels, promoting digestive health, and increasing energy levels. This is because almost 80 per cent of unhealthy foods are eliminated from the diet by cutting out gluten. By eating only gluten-free foods, you will also be eliminating unhealthy oils from your diet, as well as unhealthy carbohydrates found in bread products like doughnuts, burgers, pizzas and pastries. A healthy side-effect of going off gluten is that you will have fewer options to choose from, which means that you are likely to munch on more fruits and vegetables.

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Usually most people have some appetite during recovery, but sometimes medication, treatment, or the pain involved, can adversely affect a person’s appetite and energy levels. Your doctor / dietician will help you manage these effects by modifying your diet. Initially, patients are to have small amounts of the new foods to check if they work for them.

In general too, while healing from a surgery / injury, you should begin eating some food as soon as possible, because your body needs energy to recover. It is important to start with smaller portions of food, and gradually increase the portions. This is because for many patients, even the sight of larger portions of food can be a major turn off.

While one should not be forced to eat, s/he should be encouraged to have certain foods. Here are some diet and nutrition guidelines to help convalescence:

Stay hydrated

Consuming fluids in the form of soups, fruit and vegetable juices, milk shakes and porridges is especially important to keep the body hydrated because dehydration makes the body more susceptible to additional ailments. Also, liquids are a rich source of vitamins, minerals and anti-oxidants. Increasing the fluid intake helps keep patients more comfortable, especially when having solid foods is not possible or in the case of seniors or children. Have warm liquids as they are gentle on the throat and have a soothing effect. Furthermore, digesting liquids takes less energy, allowing the body more strength to combat illness.

Eat light

Avoid eating fatty foods during recovery, especially if you have been suffering from nausea and diarrhoea. Plain dal with rice, khichdi, curd rice or dry toast are good first foods. If your body accepts these well, then you may include chapatis with dal, vegetable and curd in the next meal. Choose light dals such as moong [green gram] and masoor [lentil] over pulses such as chole [chickpeas], chana [bengal gram] and rajma [kidney beans] as the latter lead to bloating and abdominal discomfort. Food should be cooked in minimum oil and moderate spices.

Consume a protein-rich diet

Protein is an important component of every cell in the body. It is critical in building bones, muscles, cartilage, skin, and blood. The body uses protein to build and repair tissues. Hence, a diet high in protein helps in an overall speedy recovery. Cow’s milk is a good and easy-to-digest protein source. When recovering, have two glasses of cow’s milk a day on an average.

In case you have diarrhoea, have buttermilk instead. Include a katori of dal, kadhi or soy and curd in both your meals. Chicken soup is an ideal recovery food too. While mutton and beef are to be excluded from the diet, grilled fish and chicken can be included as they are healthier.

Have small, frequent meals

Eat something every 2 – 3 hours rather than having just three square meals. Avoid both fasting and feasting when recuperating.

Dig into fruits and vegetables

Fruits and vegetables contain essential vitamins, minerals, antioxidants, and fibre that boost immunity. Cooked vegetables are easier to digest and are less likely to cause infection as cooking destroys most organisms. Hence, have cooked vegetables rather than raw salads. Have vegetables such as dudhi [bottle gourd], padwal [snake gourd] and pumpkin as they are high in fibre and water content and are also easy to digest. On the other hand, eating vegetables such as cabbage, cauliflower and broccoli should be avoided as they produce gas. Fruits make for good in-between snacks. They are also a source of water for bonus hydration.

Avoid junk food

Most people think that it’s all right to have a samosa or a burger while they are at home, recovering. It is not okay; avoid junk food and stick to a simple home-cooked meal. Junk food is generally high in fat and total calories and devoid of vitamins and minerals. As mentioned earlier, a low-fat diet rich in vitamins and minerals is the best way to get well soon.

Keep these foods in mind as they will help you recover faster and regain normal health.

This was first published in June 2009 issue of Complete Wellbeing.

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