You all know that Registered Dietitians (RD) are nutrition experts! Not only that, but there are a certain group of dietitians who focus specifically on oncology (cancer). Those of us who work with cancer clients and have passed an exam are called Board Certified Specialists in Oncology Nutrition (CSO).
Before I wrote my gluten article (Is a Gluten-Free Diet for Everyone? Should I be on it?, I asked for feedback from other RD’s who work with cancer clients.
I loved this statistic from Cheryl Harris, MPH, RD, LD (www.harriswholehealth.com) who says ” If 1% of
the population has Celiac and 10% is gluten sensitive, that still leaves
a good 89% unaffected by gluten… A Gluten-Free diet can be super
healthy but is often very processed.”
If you don’t have celiac disease and aren’t gluten sensitive, it’s probably not the healthiest choice to eliminate gluten. However, If you are looking for more resources on a gluten-free diet, Cheryl’s website has a lot of great information!
Do you know if there is any evidence on whether cancer survivors have higher risk for celiac disease?
I received some good, evidence based responses!
From Jacalyn A. See, R.D., L.D. (Jacalyn works for the Celiac Clinic at the Mayo Clinic)
“No relationship to chemo. Untreated celiac disease is a risk factor for Non-Hodgkin’s Lymphoma”
[reference: Increased risk for non-Hodgkin lymphoma in individuals with celiac disease and a potential familial association.Gao Y, Kristinsson SY, Goldin LR, Björkholm M, Caporaso NE, Landgren O.Gastroenterology. 2009 Jan;136(1):91-8.]
From Suzanne Dixon, MPH, MS, RD (An accomplished oncology RD who has written many articles related to cancer nutrition):
“One thing to note is that the reverse holds true: people with celiac are at higher risk of certain cancers. This risk is mainly evident in people who do not follow a gluten-free diet. The continued exposure to gluten increases the risk of lymphoproliferative intestinal cancers.
Again, the key is to note that so long as people follow a gluten-free diet, risk does not appear to be increased. A JNCI published study shows this association:
Elfström P, Granath F, Ekström Smedby K, Montgomery SM, Askling J, Ekbom A, Ludvigsson JF. Risk of lymphoproliferative malignancy in relation to small intestinal histopathology among patients with celiac disease. J Natl Cancer Inst. 2011;103(5):436-44.
A few studies suggest celiac increases risk for other GI cancers, such as esophageal and possibly stomach cancers, and possibly lymphoma.”
What About Cancer Survivors Who Have Celiac Disease?
I also got some responses from other RD’s who emphasized the special needs of cancer survivors who have celiac disease.
From Cheryl Harris, MPH, RD, LD (www.harriswholehealth.com)
“Celiacs are prone to osteopenia/ostoporosis, and breast cancer
treatments/chemo often alter estrogen, which can exacerbate this
problem. Many Celiacs are also low in Vit D, which may be linked to increased cancer, too.”
In addition, many cancer survivors are low in Vitamin D, so it’s even more important for cancer survivors WITH celiac disease to know their Vitamin D level! The bone health issue seems to be a theme as Suzanne had similar sentiments:
From Suzanne Dixon, MPH, MS, RD
“And of course, for a cancer survivor, if he or she does develop celiac, it’s important to note how this may affect risk of other late-effect complications from cancer treatment. For example, some childhood cancer survivors may be at increased risk of bone loss and celiac also increases risk of bone loss, so it’s even more important to receive a proper diagnosis and manage risks appropriately, keeping in mind the complete medical history.”
A Gluten-Free Recipe
In honor of the celiac’s out there, here’s a recipe that we can all enjoy! Quinoa is a gluten-free grain, cooks in 15 minutes and has the highest amount of protein of any grain. A winner!
- ¾ cup quinoa
- 2 T canola or other oil
- 1 yellow onion, chopped
- 4 cloves garlic, minced
- 1½ teaspoons cumin
- 1 teaspoon paprika
- ½ teaspoon cayenne pepper (to taste)
- ½ teaspoon sea salt
- 1½ cups veggie or chicken broth
- 1 cup cherry tomatoes
- 1 can of black beans, rinsed
- ⅓ cup (packed) chopped cilantro (optional)
- 1 yellow, orange or red bell pepper, chopped
- ½ semi-firm avocado
- ½ lime
- ¼ jalapeño pepper (optional)
- salt and pepper to taste
- Toast the quinoa for 15 minutes over medium heat in a dry skillet or until you start to smell a toasty aroma and the kernels darken slightly (optional, but brings out a nice nutty flavor). Put quinoa aside.
- Sauté the onions for 3-4 minutes over medium heat, stirring occasionally.
- Add in the minced garlic and sauté 2 minutes more.
- Add in the quinoa, broth, cumin, salt, cayenne and paprika, bring to a boil, cover, and let simmer for 20 minutes or until the broth is absorbed.
- Allow to cool.
- Toss quinoa mixture with rinsed beans, sliced tomatoes, yellow pepper, cilantro and jalapeño, if using.
- Add salt and pepper to taste.
- Slice avocado and put on top.
- Squeeze a half of a lime on the salad.
It sounds delicious to me!! Let me know what you think and post pictures to the my facebook page