This month Margaret Moss looks at what you may be missing on a wheat-free diet - and how you can replace it.

Jack had a biopsy of part of his small intestine. The wall of the gut should not be smooth. It should have villi, or small fingers, that project inwards, to increase the surface area. These were missing. So he could not absorb well. In particular, he could not absorb fats well, and had become deficient in the fat- soluble vitamins A, D and E. He was told he had coeliac disease, and to avoid wheat, rye, oats and barley.

Kathleen’s biopsy was alright, but she had antibodies to gliadin that showed she also had a kind of coeliac disease. Her doctor told her not to have wheat, rye or barley, but allowed oats.

Lawrence was autistic. He was told to avoid the morphine-like substances, glutamorphine in wheat and betacasomorphine in milk, which can have an effect on the brain.

Mary ate lots of additives and no fresh food. She lived on sweets, biscuits, pot noodles, cakes and soft drinks. She was told to avoid wheat. In fact she had no problem with wheat, but she cut out biscuits, pot noodles and cakes, and started to eat more nutritious food (oatcakes, bananas, cheese, dried fruit, nuts and seeds) and her health improved.

Lectins are concentrated in the skins of seeds. Norman had diarrhoea when he ate foods high in lectins, like chapattis, wholemeal bread, bran and kidney beans. He stopped eating wheat and beans, and improved, but he later found he could eat refined bread and red lentils.

Olga had ulcerative colitis, which caused her to be intolerant of wheat. However, her ulcerative colitis was caused by bacteria which like the sulphur amino acids in the protein of meat, fish and eggs. She stopped eating these, and found she could eat wheat.

Peter felt better when he gave up eating wheat, but later found out that it was the yeast in bread, beer and pizza that had upset him. He could eat wheat, if it was in pasta or pastry. He could not eat Marmite or those vitamin B tablets that are made from yeast. He changed to different B vitamins that were yeast free.

Quentin felt better after giving up wheat. It turned out that what upset him was bread that he had allowed to become a little mouldy.

Rachel improved after giving up wheat, because this involved giving up her favourite bread and jam, cakes, biscuits, and treacle pudding. It was reducing the sugar in her diet that took away her violent swings in blood sugar, not reducing wheat.

Stephen took anti-biotics for months, because he had acne. His good bacteria died off, and the fungus in his gut flourished. He had diarrhoea and his brain was foggy. He was unable to tolerate wheat. He stopped the drugs and took zinc for his acne. He took probiotics to replenish his gut bacteria. He stopped having sugar and milk, as they feed fungus. After he recovered, he found he could tolerate wheat again.

Tracy was very sensitive to pesticides. She gave up eating wheat, and improved. Later she found that she could eat wheat if it was organic.

If you feel ill after eating wheat, you may be coeliac. You may be wheat allergic, sensitive to the lectins in whole foods or malnourished, through having a diet that provides little but wheat, or you may be affected by sugars that are contained in foods that also contain wheat. It is useful to find out why you improved when you stopped eating wheat.

What the rest of the world eats

Most of our evolution took place without wheat. So it cannot really be essential for us to eat it. Indeed many people in the world rarely if ever eat wheat.

In Kenya and Zimbabwe the staple food is maize, often eaten with beans, or eaten as polenta or porridge. Other grains are also eaten there, including finger millet, which makes a tasty porridge. Sweet potatoes and arrowroot provide starch.

The Masai in Kenya and Tanzania eat sour milk from a gourd, as their staple. Uganda’s delicious staple is cooked green bananas, often eaten with groundnut sauce. In the Caribbean, plantains are an easily prepared source of starch. In India, some people eat both wheat and maize chapattis, in other areas they eat rice with lentils. In northern Canada, fish is the staple food.

Here, near Manchester, we are lucky to have exotic food shops with foods from all round the world as well as traditional British fare.

Wheat, oats and potatoes are staples in Britain, because they grow in a temperate climate. We eat them because they grow here, and not because they are essential. In Italy, people in some places eat pasta and bread, but elsewhere the staple is polenta, made with maize meal. Unlike pandas, human beings thrive on very varied diets. This is why we can live all over the world, in diverse climates.

Alternative starch...
Those who do badly with wheat may also do better if they avoid the closely related grains, rye, oats and barley. They may be able to tolerate maize, millet, rice and quinoa. Starch can also be obtained from lentils, beans, potatoes, sweet potatoes, parsnips, plantains, green bananas and yams.

...protein & vitamins...
Nuts, seeds, eggs, meat, fish and pulses provide plenty of protein. Wheat is a source of B vitamins, other than B12. These vitamins can be obtained from black-eyed beans, brown rice and Marmite. Nuts and avocadoes are a richer source of vitamin E than wheat.

... and fibre.
Some years ago, it was realised that Ugandans did not suffer from the gut disorders because they ate lots of cooked green bananas with a high fibre content. Unfortunately, the developed world turned to bran as a source of fibre but the lectins in bran can lead to arthritis and irritable bowel syndrome while the phytate in bran can lead to mineral deficiencies. Nuts, seeds, vegetables and fruits can provide us with fibre instead.

Nutritional supplements
Nutritional supplements can help - but not because wheat avoidance makes you deficient. You may be deficient because your gut has been working inefficiently. Coeliacs may need to take essential fatty acids and the fat-soluble vitamins A, D and E. People with irritable bowel syndrome often fail to make enough sulphate, and this process can be improved with vitamins B2, B5, clean fish oil and molybdenum.

No deficiency - but what to eat?
The problem with a wheat-free diet is not that you will be deficient. Giving up wheat may mean giving up a lot of poor quality manufactured food. So overall nutrition may well improve. The main problem is what to eat.

Dinner at home is not a problem for most people. Meat or fish, root and green vegetables, followed by fruit are wheat free, so long as you do not thicken the gravy with wheat.

You could have corn pasta with cheese, onions and tomatoes, followed by liquid-ised banana and blueberry. How about stewing red lentils with leek and coriander leaves, and serving with rice and courgettes?

Breakfast...
The problems are breakfast and packed lunches. You could have toasted gluten-free bread, with cashewnut butter. Lima gluten-free cornflakes and Kallo puffed rice are wheat-free. I advocate using Rice Dream Original rather than cows’ milk, even if you are not milk sensitive, because of the long-term dangers to the arteries of drinking milk. Rice cakes are dull, but corn thins or rice or corn crackers are pleasant. Maizemeal (sometimes wrongly labelled polenta) or quinoa or millet flakes make good porridge. You could have eggs, as these are not related to artery disease. I suggest thin belly pork slices rather than bacon, to avoid the nitrate and nitrite that is even in most organic bacons.

...& lunch
The best tip for a packed lunch is to use left overs: left over chicken and roast potato with some cucumber and tomato; tinned salmon, with leftover new potatoes, Chinese leaves and a stick of celery; kedgeree with diced egg and Cheddar cheese. Or you could put nuts and seeds in instead, or have a handful of nuts with some fruit.

Don’t worry! A wheat-free diet is not going to do you any harm, so long as you do not overindulge in a substitute food that is bad for you.

You can find Margaret Moss at 11 Mauldeth Close, Heaton Mersey, Stockport SK4 3NP 0161 432 0964 www.nutritionandallergyclinic.co.uk

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