DEAR DR. BLONZ: A friend of my daughter's has celiac disease and she will be coming for a holiday dinner. My question is: Do oats have to be eliminated from celiac diets, or is wheat the only problem? Is there any problem with the vinegar I might use in my salad dressing? -- S.P., Oakland, Calif.
DEAR S.P.: Gluten is a complex protein found in all forms of wheat, barley, rye and triticale, or any products that might be made from these grains, including modified food starches. Celiac disease, also referred to as celiac sprue, is an autoimmune disorder in which the body has an acute genetic intolerance to gluten. The intolerance is such that the presence of gluten causes severe intestinal inflammation, with the immune system damaging the small intestines in a way that prevents nutrients from being absorbed. Note that celiac disease is a different clinical entity from non-celiac gluten sensitivity, or gluten intolerance, where the body can experience transient negative gastrointestinal reactions to gluten without the severe intestinal tissue damage.
As regards oats and celiac, they were once on the prohibited list, but then there was some research indicating that individuals with celiac disease may be able to tolerate certified wheat-free rolled oats. There have been studies that conclude "yes" to oats, while others have concluded the opposite. There is then the issue of individual differences between celiac patients: Some tolerate oats while others cannot.
The essential element is that the oats have no cross-contamination from handling or processing in plants that also handle wheat or rye. Those with celiac disease should get assurances to that effect, either from the product label or directly from the manufacturer. Your acquaintance should talk about oats with the professional handling this aspect of her health care to decide whether an oat experiment may be in order.
As for vinegars, most tend to be made from other materials, including apples, corn, rice and grapes, and these have no gluten. One vinegar of concern is malt vinegar, as this has gluten-containing malt added. Again, you should check the label or with the manufacturer if you have questions.
For more information, check out the information page from the National Institutes of Health at tinyurl.com/385xee or the website of the Celiac Disease Foundation at celiac.org.
DEAR DR. BLONZ: Is it OK to mix soy and cow's milk together? I searched the Internet and found all kinds of conflicting answers. -- S.L., Moraga, Calif.
DEAR S.L.: Assuming no allergies are present, there's absolutely no problem that I am aware of. After reading your question, I did some Internet searches and found a lot of anti-soy misinformation on this matter, so I am glad you asked.
Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to firstname.lastname@example.org. Due to the volume of mail, personal replies cannot be provided.