Question

Andrew has been a vegan for about 1 year and does not consume any animal products. He avoids all meats, fish, dairy and eggs. Earlier this year, Andrew began experiencing gastrointestinal problems such as bloating, cramping, and occasional diarrhea. He read that these symptoms may be caused by the gluten in his diet, so he is now also avoiding gluten altogether by eliminating bread, cereals, pasta, and all other products made from enriched or whole wheat. Within a week of eliminating gluten, Andrew’s GI tract is feeling better, but his mouth and tongue have become very sore and inflamed. He also has developed open sore and cracks at the corners of his mouth. Answer the following questions.

1. What nutrients may be low or deficient in Andrew’s current vegan, gluten-free diet?
2. What nutrient(s) deficiency is most likely causing the symptoms Andrew is experiencing around the mouth?
3. What foods could Andrew add to his vegan, gluten-free diet to help to alleviate his nutrient deficiencies?

Answer 1

Here Andrew is following a Vegetarian Gluten free diet which may lead to deficiency of various Vitamins and minerals. Thus Gluten free diet which improves Gastrointestinal malabsorption may lead to other long standing complications.

1) Nutrients which are low in Andrews Vegan Gluten free diet are :

B vitamins particularly Vitamin B6, B12 and Folic acid.

Vitamin D

Iron, Calcium, Magnesium , Zinc , and

DIETARY FIBRE.

2) Nutrient deficiency Causing Angular Chelitis and Stomatitis : Deficiency of

Vitamin B2 (Riboflavin)

Vitamin B3 ( Niacin)

Vitamin B6 ( Pyridoxine)

Vitamin B12 ( Cobalamin) and

Iron

3) Foods to improve Nutrient deficiency in Vegan Gluten free diet :

Vitamin B12 deficiency : Fortified Gluten free cereals as well as Soy milk and Almond milk fortified with B12.

Vitamin D deficiency : Gluten free Cereals and Soymilk or Almond milk fortified with Vitamin D.

Calcium deficiency : Kale and Turnip green, Calcium fortified Soy milk, Almond milk and Orange juice, tofu made of calcium sulfate.

Iron deficiency : Legumes , Spinach and Amaranth are rich sources of iron. Gluten free Cereals also provide Iron.

Vitamin B6 deficiency : Chick pea, Potatoes, winter Squash and bananas. Fortified Gluten freeCereals.

DIETARY Fibre deficiency : Whole grain gluten free Cereal products like breads.

Folic acid deficiency : Asparagus, Spinach, Black eyed peas and Brussels sprouts.

Zinc deficiency : Chick pea, Cashew, Fortified yogurt , cereals and cheese.