More from the Gluten-Free Gourmet
Delicious Dining Without Wheat
By Bette Hagman, Laura Hartman
Henry Holt and Company Copyright © 2000 Bette Hagman
All rights reserved.
LIVING WELLWITHOUT WHEAT
Almost twenty years ago I was diagnosed with nontropical sprue (one of the older names for celiac disease), and I still feel it's one of the best things that's happened to me.
Most people would never agree that being told they harbored an uncurable disease could be a good thing; but I was elated to find the real reason for the diverse and often debilitating ailments I'd suffered over many years. I was relieved to learn that I had a disease with a name and was not just imagining the symptoms, as the psychiatrists to whom I'd been referred had been telling me; I was even happier to hear I didn't have cancer, the symptoms of which the disease can imitate — weight loss, change in bowel habits, pain, malnutrition, mental fatigue.
I now realize this feeling of relief is common to almost every celiac when finally diagnosed.
When I was given two smudged diet sheets and told that that was all I needed for remission, I could have kissed the doctor. He promised no more bloating, diarrhea, and pain. After the many years of on-and-off suffering, all I had to do was stick to a diet — no wheat, oats, barley, or rye. I could do that, couldn't I?
I soon discovered the diet was not to be an easy one. "No gluten" sounds simple, but the "thou shalt nots" — not eat bread, not have pasta, not taste a cake (even for a birthday) — had thereby consigned me to a lifetime of plainly cooked meats, vegetables, and fruits.
Naturally, I didn't stick to the diet. It seemed too simple; I cheated and ate some bread and — after recovering from the consequences — swore I would never do that again. But I would manage to have bread, somehow. Cakes, as well. That was pure cussedness on my part. I had never been a cake eater, but now that I couldn't have it, I even craved a piece. The only trouble was, at that time, I was a dedicated noncook.
Twenty years ago, I couldn't find any company baking breads for celiacs or those who had to avoid wheat. I discovered some all-diet breads that contained no sugar, no eggs, no milk, no gluten, and very little flavor. But the loaf looked like bread. For several years I ate this plus some dry-as-dust muffins I concocted from potato starch and rice flour. The cookbooks of the time contained no satisfactory recipes for baking with rice flour. This I discovered to my dismay as I turned out inedible mess after mess, consigned, after one taste, to my omnivorous garbage disposal.
I considered myself a writer, kitchen duty a necessary evil. I'd always picked my bread from the grocery shelf and stirred up any party cake from a mix. As for pies, even my poodle — who would eat anything as long as it was "people food" — carried my crusts to the backyard and buried them.
With the diagnosis, I had to make some changes. I joined celiac organizations and exchanged baking-disaster stories with others and listened for any hints on living with this disease. I learned, to my surprise, that if I cheated, even without any symptoms of poisoning, I could still be damaging my gut. Thus, I was forced to cook if I wanted to enjoy eating, and in so doing, got hooked on experimenting. I haven't stopped.
Gluten Free but Still Having Symptoms?
That was my problem. A few months into my diet, I knew I was eating gluten free but still had distress at times. My doctor suggested I stop eating dairy products for a while and test myself later by putting them back into my diet by starting with Cheddar cheese (because of its low-lactose content). Wise doctor!
If you still don't feel well after maintaining a strict gluten-free diet, there can be a logical answer. Perhaps you, too, have another food sensitivity.
One of the most common (at least immediately after diagnosis) is lactose intolerance. The symptoms of bloating and diarrhea after eating milk products may not cause damage to the villi (the lining of the intestines), but they can be most uncomfortable. Lactose intolerance for some can be transient and pass after the villi heal; in others it can persist. For either kind of intolerance, there are products such as Lactaid and Dairy Ease to help overcome the distress. There are also many good substitutes for milk in markets and health food stores. When I specify nondairy liquids in my recipes, they can be soy based, corn based, nut based, or rice based; all work in the recipe.
Certain celiacs have reported to me that they are also intolerant of or allergic to corn and corn products, soy and soy products, and eggs. These basic foods do not contain gluten but, since they are used widely in the celiac's diet, you might be blaming gluten for distress symptoms when they are actually caused by one of these foods.
There are many other foods (chocolate, shellfish, citrus, apples, peanuts, MSG, and so on) that can cause symptoms resembling gluten poisoning. If you think you have an allergy to these or others, the best way to discover the culprit for yourself is to recall all the foods you ate just before the attack and eliminate them one at a time.
A much more unusual problem is one easily corrected. Some celiacs, especially when first diagnosed, reported distress from too much fiber. In their effort to avoid gluten in bread, cakes, cookies, and pastas, they had eaten more nuts, seeds, rice bran, vegetables, and raw fruit than the damaged intestines could comfortably handle. By including gluten-free breads and pasta and changing to white rice for a short period, the symptoms disappeared and they could gradually increase their fiber without distress.
What Does the Future Hold for the Celiac?
The future looks good. With the many wonderful gluten-free flours readily available today and the growing number of companies dedicated to filling our needs, we celiacs can all live very well without wheat (and oats, barley, and rye).
The only requirement is that we stick to our gluten-free diet for life. What other incurable disease calls for such an easy prescription for living well?
The good health we achieve will also help us fight off other ailments and help us live as long as anyone whose health has not been ravaged by the disease.
In the United States we have several celiac associations with local support groups working to dispense information and advice, so the celiac need never feel isolated by a "rare" disease, as described in old medical texts. CD was once considered only a childhood ailment that could be outgrown. Now medical research has discovered that, although symptoms might disappear during adolescence, the disease is still present, and the villi will show damage if gluten is reintroduced into the diet.
Last year the concerted effort of dedicated members of celiac organizations across the country finally brought our little-known disease to the attention of Congress, and a section of an appropriations bill directs the National Institute of Health to allocate funds for research on celiac disease.
Research is confirming some suspected facts about this autoimmune disease. Through checking our own genetic backgrounds, we might find others in our families who have suffered similar symptoms and thus help a doctor reach a diagnosis faster, and perhaps keep others from hearing, "It's all in your imagination."
Although biopsy is still the only definitive diagnostic tool, research has pinpointed certain factors appearing in blood tests that can alert doctors to the possibility of the disease.
The only treatment remains a gluten-free diet, but I still feel fortunate in being diagnosed. Just as the doctor promised, I've had almost twenty years of what I call my second life and a far richer one than my first. The diet is not restrictive anymore. We can have exciting and tasty baked goods, whether we bake them ourselves or buy them from one of the growing numbers of suppliers (see page 343). We can make pastas and casseroles, once thought forbidden, and, thanks to the incredible new bread machines, we can make dozens of freshly baked breads with little more effort than the punch of a button.
Eating Away from Home
All of this is true when eating at home; all of this changes when we step out the door.
Eating in a restaurant is frustrating but not impossible. I've learned to ask the server or chef what is in that soup, that salad, that good-looking meat dish. At first, I felt a bit paranoid questioning this way; however, I not only saved myself from a painful gluten reaction, but discovered that servers are often interested in learning what gluten free means.
Dining in the homes of friends takes more finesse. I often call the hostess ahead of time, suggesting I bring a dish to share. If she declines with her meal all planned, I snack before I go so I can enjoy the company even if I do have to pass on any dish that might contain gluten.
It's easy to plan foods and cook gluten free when traveling in an RV or camping in a park. Another easy way of traveling is on cruise ships. I take my own bread and turn it over to the maître d' to keep in the freezer and bring out at meals, and I keep gluten-free cookies in my stateroom for that sweet snack. For bus tours, I carry my own crackers, pretzels, granola, some bread, many cookies — all made from recipes in this book. I extend these with purchased rice crackers, dried fruit, GF jerky, hard cheese, and carefully selected candies.
Some airlines offer gluten-free meals, but I still carry some bread, cheese, and a few cookies in my carryon in case the order for a special meal never reached the airline kitchen or in case I miss my connection — both of which have happened to me.
The Hospital Stay
One of the hardest visits to plan for is the short one in a hospital. There the celiac or wheat-allergic patient is at the mercy of often-overworked kitchen help who don't always know what is in the dishes on your tray. If you are going to the hospital, here are some suggestions:
If your hospital stay is planned, talk to the head dietician before you enter and ask that some gluten-free breads and cookies (in sealed packages) be ordered from a supplier (and the packages not be opened until you break the seal).
Avoid ordering foods that look like gluten-containing foods. For example, Cream of Wheat and Cream of Rice look alike to a sick person flat in a hospital bed (and to the harried help in the hospital kitchen). Ask for one of the gluten-free dry cereal, and demand it come to you with the seal on the box unbroken.
If you have no chance to plan ahead for your stay, my strongest advice is to ask before you eat, to question anything you don't recognize. Don't eat mixed dishes such as casseroles. Stick to Jell-O, baked potatoes, fruit, plain vegetables and meat, milk (if you are not lactose intolerant), coffee, tea, and juices. It's not a great diet; but getting poisoned in the hospital is not what you came for. Remember, you'll even have to check your medications since many have a gluten or lactose base (see page 12).
For the most recent and complete medical information about celiac disease or to find a local support group, contact one of the following organizations:
American Celiac Society/Dietary Support Coalition, 59 Crystal Avenue, West Orange, NJ 07052-3570; phone (973) 325-8837.
Canadian Celiac Association, 190 Britannia Road East, Unit 11, Mississauga, Ontario L4Z 1W6, Canada; phone (905) 507-6208 or (800) 363-7296.
Celiac Disease Foundation, 13251 Ventura Blvd., Suite 1, Studio City, CA 91604-1838; phone (818) 990-2354; fax (818) 990-2397.
Celiac Sprue Association/United States of America (CSA/USA), PO Box 31700, Omaha, NE 68131-0700; phone (402) 558-0600.
Gluten Intolerance Group of North America (GIG), 15110 10th Avenue SW, Suite A, Seattle, WA 98166; phone (206) 246- 6652.
Internet: http://email@example.com/. http://rdz.acor.org/lists/celiac/index.html
Most celiacs quickly learn to recognize gluten in the wheat-flour base of breads, crackers, baked goods, and pastas. They learn to put on magnifying glasses in order to read labels on condiments and products like corn bread (made with some wheat flour), hot dogs with grain fillers, cereals that include barley malt. All of those product labels list a grain containing toxic glutens.
What celiacs new to the diet often don't realize is that toxic grains can hide under different names and labels. Some are not labeled at all and often are not discovered until a celiac reports a reaction to a researcher. Others have found there is enough gluten in their work environments to cause toxic reactions — some to the point of having to change employment.
In this chapter I am repeating my list of hidden glutens from The Gluten-free Gourmet and adding newly uncovered sources for gluten in foods and the environment. Some of these are, admittedly, very low in toxic content and might not cause trouble except to those who are exceptionally intolerant; but anyone on a gluten-free diet should be aware of the possibility of getting poisoned from sources they never expected.
Those who must avoid wheat or gluten should also be aware that although some condiments such as mayonnaise, pasta sauces, and soy sauces are gluten free, many contain a form of hidden gluten. We must read labels from one purchase to the next, since manufacturing companies often change formulas, and sometimes the light or cholesterol-free version will contain gluten while the regular style of the same brand is gluten free.
For a complete list of foods that are safe for a gluten-free diet and foods to avoid, please see the Gluten-free Diet on page 339.
(Listed in The Gluten-free Gourmet)
The ingredients in candy must be listed on the label, but currently companies are not required to list any product that may dust the block on which the candy is rolled for shaping. Some do use wheat flour.
Caramel color can be made from dextrose (corn), invert sugar, lactose, molasses, or sucrose (beet or cane). These are gluten free. Caramel color made in the United States and Canada is made from these sources. Imported items containing caramel color can be made from malt syrup or starch hydrolysates, which can include wheat. If in doubt of the caramel color used in an imported food product, contact the company for information.
Coffee (Instant or Powdered)
There should be no gluten in plain instant coffee manufactured in the United States or Canada, but some flavored coffees may contain the forbidden grains. I discovered on a European trip that powdered coffees sometimes caused distress symptoms. Freeze-dried coffees seem less apt to cause problems.
Although the process of decaffeinating should not include the use of gluten, some celiac sufferers have felt distress upon drinking decaffeinated coffee. Rather than gluten, the culprit could be the chemicals used in the process. Water-processed decaffeinated coffee does not seem to provoke symptoms. The warning about flavored coffee applies to flavored decaffeinated coffee also.
Can be made from corn, potato, tapioca, rice, or wheat; it might be wise to avoid dextrin unless it is labeled as corn dextrin, tapioca dextrin, and so on. To confuse one even more, malto-dextrin is made from cornstarch. It is often found in hot dogs, spaghetti sauce, and so on.
Envelopes and Stamps
Some pastes and glues can contain wheat products. It will not take many licks on envelope flaps that contain a wheat paste before one starts feeling distress. To be safe, buy a sponge-topped bottle made for sealing envelopes, fill it with water, and let it do the licking for you. (The U.S. post office now issues some self-adhesive stamps requiring no wetting.)
Flavorings and Extracts
Some of these are made with grain alcohol from a forbidden grain. You can easily substitute ethyl vanillin or dried orange or lemon peel for these flavors. There are also several lines of gluten-free flavorings. Look for them in health food stores or order by mail (see page 343).
Plain french-fried potatoes made at home or ones cooked in separate oil in a restaurant should be safe, but beware of any place that fries the potatoes in hot oil also used for breaded products such as fish or chicken. Some of the bread particles may transfer to the potatoes. Beware, too, of spicy fries or other seasoned potatoes. They can contain bread or wheat crumbs. Note also that some frozen potato products list wheat on the labels. This is used to preserve the fresh look of the frozen product. Some restaurants use this trick to keep them white before cooking. Ask!
Hash Browns, Eggs, and Hamburger Patties
These could be gluten free, but, when ordering in a restaurant, be sure they are cooked on a clean griddle, not on one that has been used for frying pancakes and french toast or browning hamburger buns. Again, the gluten can transfer to your food. Be sure the hamburger is pure meat that doesn't include any questionable additives and that your hash browns don't contain wheat flour. Again, ask!
Hydrolyzed Vegetable Protein (HVP) and Hydrolyzed Plant Protein (HPP)
These can be derived from soy, corn, rice, peanuts, or casein from milk. They could also come from wheat. If you wish to use a product containing HVP or HPP, check with the manufacturer to find the source of the protein. HVPs and HPPs are found in many canned mixed foods — soups, sausages, and hot dogs, for example. (Continues...)
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