Gluten Free Living

How to Eat Gluten Free

 Gluten Free is the new Vegetarian – almost every grocery store now has gluten free breads and products in their freezer sections, and crackers and baking mixes in the  aisles. Websites abound on not only celiac disease resources (a disease caused by severe gluten allergy) but on gluten free recipes, resources, and restaurants in almost any geographical area.

So, what is all the hype? Why go gluten free, and why are so many people changing their diets? The bottom line is that gluten sensitivity begins with the immune system of the digestive tract becoming hypersensitive to gluten proteins. The body creates antibodies to the sequence of amino acids, which enter the bloodstream and travel throughout the body. Whenever these antibodies see that same sequence (which is repeated as a small part of many tissues of the body exposed to blood i.e. thyroid, joints, brain, lungs, skin) they attack that tissue as if it was gluten. This creates “auto” or “self” antibodies, which are then produced in greater and greater numbers and cause disease.

Therefore, gluten has been linked to autoimmune diseases such as lupus, rheumatoid arthritis, Hashimotos thyroid disease and multiple sclerosis. These are end stage conditions that develop years after smaller warning signals such as headaches, digestive disturbance, asthma, allergies, psoriasis, alopecia, insomnia and various “undiagnosible” ailments. Sometimes eliminating the offending foods or doing testing to assess your body’s immune response is the only way to assess if food is an underlying factor in your ill health.

Gluten is a protein that is found in the following Grains:

  • Wheat
  • Rye
  • Barley
  • Kamut
  • Spelt
  • Oats is technically gluten free but very often contaminated in manufacturing.

Therefore, people with a gluten sensitivity or allergy cannot eat any of these grains, or products that contain them such as soy sauce, gravy, doritos or other gluten based products. Oats are technically not a gluten containing grain, but should be avoided unless it states “gluten free” on the package.

Non Gluten Grains which can be eaten by people with gluten allergies include:

  • amaranth: highly nutritious, tiny seeds available whole or as a
  • rice: including brown and white rice, Arborio, basmati and rice flour
  • corn: including cornmeal, cornstarch and corn flour
  • millet: small seeds, eaten whole or combined with other gluten-free flours
  • quinoa: small seeds that can be eaten whole, as a hot cereal or ground into flour
  • buckwheat: used whole, cracked or ground into flour
  • oats: gluten free oats and oat bran
  • tapioca: made from cassava root, often combine with gluten-free flours
  • teff: very small black grain, contains symbiotic yeast
  • arrowroot: a starch used as a thickener, superior to cornstarch, blends well with gluten-free flours

Potatoes, sweet potatoes, squash, and other starchy vegetables can also generally be enjoyed by those who are gluten free.

For the most thorough information on gluten allergy, see http://www.thedr.com./store.html and order Unlocking The Mysteries of Wheat and Gluten Intolerance for yourself. Dr. Tom DC offers eloquent and thorough evidence based information on why it is worth at least trying gluten free living for one month and then reassess.

Many people have a wheat sensitivity or allergy, but can tolerate other gluten grains like spelt and kamut. Some people with a wheat, but not gluten sensitivity will later develop a gluten sensitivity. Corn, potato, dairy and/or soy sensitivities are also common in addition to gluten. For this reason, it is best to start your food eliminations by eliminating all of the above products, and slowly reintroducing each gluten grain as well as corn, potatoes, and soy separately to judge your individual reactions.

AVOID FOR GLUTEN -FREE SHOPPING:

  • look for labels that say – wheat (or whole wheat) flour, wheat germ, bran, farina, graham flour, semolina, gluten, modified food starch, wheat starch, vegetable starch, vegetable gum
  • Pastas – spaghetti, vermicelli, macaroni…..
  • Soups – commercially canned
  • Desserts – most contain wheat – so read carefully
  • Cereals and breads – as with desserts – read labels carefully
  • It’s probably best to go to health food store in order to find alternatives. Most breads, bagels, wraps, pizza doughs, etc are kept in the freezer sections
  • For persons allergic to wheat, but not to gluten, you can use flour substitutes such as spelt or kamut (these are the most similar to wheat); rye, oats and barley can also be eaten.

TIPS FOR A GLUTEN-FREE DIET:

  • focus on protein, vegetables, fruits, and healthy fats like avocado 
  • Lots of delicious gluten free options abound: Tray various  pasta, breads, crackers, etc until you find what your taste buds prefer.
  • Avoid any food that contains wheat, barley, rye, oats – as well as spelt and kamut. Also, remember that gluten can be found in most processed foods, including soups, sauces, gravies, and of course in breads, cereals, and desserts.
  • 40% of people allergic to gluten are also allergic to soy and/or corn – which are often found in “gluten-free” breads, etc.
  • READ LABELS on everything the first few months to find hidden sources of gluten.

Eating Out and Travelling:

Most cream based soups and chowders are made with a gluten base. Boone’s in Portland has a gluten free chowder, bisque, crab cakes etc if you are craving those.

It is pretty easy being gluten free in restaurants once you get the hang of it. Focus on protein and vegetables, fancy salads and avoid gravies, pasta, gnocchi and sandwiches. If you are craving a burger, ordering it without the bun is pretty standard in today’s low carb world. Steak and arugula salad is always a good choice.

Sadly, fried treats are out the window like calamari, fried clams, fish and chips… once it gets battered it is almost always a wheat base. French fries are also often battered. Best to ask ahead of time instead of getting a delicious plate of inedible fries. Frontier restaurant in Brunswick has delicious GF fish and chips, and rice flour calamari.  Not cheap but delicious!

Fish options and mussels or raw oysters rarely have gluten unless they are fried or pan fried. Eating fish at home with rice and salad is a great nutritious option too.

Some places have gluten free sandwich bread but most places don’t. In a pinch on the road, subway will make a “chopped salad” which is basically a sub in lettuce/salad. Planning your food and having fruit, yogurts, nuts & seeds or trail mix, protein bars, and even leftovers or sandwiches on GF bread you make yourself before you leave become important while travelling.

What else? Gluten free breads and crackers abound.  I personally like Millet breads the best – available in Whole Foods GF freezer section. Rice breads tend to be very dense and gummy, but are the most common across the board. Mary’s Gone Crackers are the best GF crackers, followed by Nut Thins and Glutino brand. Glutino also makes a great pretzel. Rice cakes can have a bad reputation but are a quick tasty snack and great vehicle for dips, cheese, avocado and almond butter.

Sweets: Lots of gluten free cookies and treats are available! Any ice cream or candy without “cookie dough” or brownies or cones is usually GF. Many coffee places have at least one GF option. Flourless chocolate torte, chocolate mousse, crème brule or pannacotta are restaurant dessert options that are usually safe.

 

Tips for Gluten-Free Baking

FLOUR

GOOD TO KNOW

Equivalent to 1 Cup of Wheat Flour
 

Amaranth Flour

 

-best combined with other flours that  have more cohesion (arrowroot, tapioca, bean)

-add to baked goods, pancakes/waffle recipes

 

1 cup

 

Arrowroot Starch

 

-add 1tbsp to an equal parts of cold water before adding to dishes as a thickener

-combines well with gluten-free flours to give them cohesion

 

1/2 cup

 

Bean Flour

 can be gassy. Often used in Paleo cooking.  

3/4 cup

 

Buckwheat Flour

 

-makes a dark, heavy bread

-use with rice flour

 

7/8 cup (1 cup minus 2 tbsp)

 

Chestnut Flour

 

-used to sweeten baked goods

-adds lightness and creaminess

-use alone or mix w/ other flours

 

Chickpea Flour

 

-too dense and rich to use on its own

 

7/8 cup (1 cup minus 2 tbsp)

 

Cornmeal

 

-makes a light bread

-mix with equal parts of cold water before adding as a thickener

-best combined with small amounts of other flours

-stone ground is more nutritious

 

1 cup

 

Cornstarch

 

thickener

 

3/4 cup

1 cup corn flour

 

Millet Flour

 

-always combine with other flours

 

1 cup

 

     Potato Flour/Starch

 

-best combined with other flours

thickener

 

5/8 cup flour

3/4 cup starch

 

Quinoa Flour

 

-best combined w/ other flours. May have a beany taste.

 

Rice Flour

 can be grainy, does not rise.  

7/8 cup

(1 cup minus 2 tbsp)

 

Soy Flour

    -makes bread or baked goods more moist and smooth

-best if add small amounts to other flours

-u       -use only 20% soy flour in recipe, decrease temperature by 25 degrees

 

 

3/4 cup

 

Tapioca Starch

 

-thins if reheated

-combines well with gluten flours to give them cohesion, thickener

 

1 cup

 

Teff Flour

 

-do not add to yeast breads because it has its own symbiotic yeast

 

Flour Combinations: equivalent to 1 cup of white or whole wheat flour

1 cup soy flour + 1/4 cup potato starch

1/2 cup soy flour + 1/2 cup potato starch

5/8 cup rice flour + 1/3 cup potato flour

1/2 cup corn starch + 1/2 cup rice/potato flour

1/2 cup arrowroot + 1/2 cup potato flour

For 2 cups of flour good for baking cookies:

1 cup of brown rice flour + ½ cup of tapioca rice flour + ½ cup white rice flour + 1 tsp of xanthan gum.

Namaste company also makes a “Perfect Flour” gluten free mix of flours that you can buy and use with any recipe. Makes cookies really easy!! They also have a great pancake mix if you love pancakes.

Tips for substituting wheat flour:

  • do not be concerned if batter appear thinner than wheat batters, this is common
  • add 1/2 tsp baking powder per cup of substitute flour; add just before cooking because it loses its potency when mixed with liquid and allowed to sit
  • refrigerating dough 1/2 hour helps improve texture
  • do not bake anything thicker than 4 inches
  • when baking, lower the temperature a little
  • baking time is usually longer, especially if egg or milk is eliminated from the recipe
  • experiment with your options – buy small quantities from a bulk food store and make half recipes first

For thickening, the following quantities equal 1tbsp of wheat flour:

*Arrowroot 1 tbsp = 2 tbsp wheat flour

*Corn starch 1 tbsp

*Potato flour/starch 1/2 tbsp

*Rice flour 1/2 tbsp

*Tapioca flour 1/2 tbsp – my favorite

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Navigating the Holidays with a Special Diet

This blog post was originally written for Apothecary By Design – a premium quality specialty, retail and compounding pharmacy in Portland, Maine. http://www.apothecarybydesign.com/blog/

I remember when I was a kid going to my Aunt’s house for Thanksgiving, my mom would always show up with a box of special food for us with brown rice, special breads and other jars of rattling, unappealing looking things. I always felt slightly embarrassed, wishing we could just blend in with everyone else. Now, I am that person. I always travel with special bread, usually my brown rice pasta in case of dinner emergency, and other ingredients and snacks that I know I can eat.

Food allergies are on the rise world-wide. It is estimated that 15 million Americans have food allergies, and this potentially deadly condition affects 1 in 13 children. Another study found that 3 out of 4 children had a food reaction. Symptoms can range from an itchy mouth or runny nose, to asthma attacks, skin eruptions, behavioral changes, anaphylaxis and more.  The Center for Disease Control released a study in 2013 stating that food allergies increased 50% between 1997 and 2011. With these kinds of numbers being evidenced in clinical studies, it is likely that many of our readers will be figuring out how to manage this holiday’s season with at least one family member on a restricted diet. For more information on food allergies, please see the following links:

http://newsinhealth.nih.gov/issue/aug2012/capsule1

http://www.foodallergy.org/facts-and-stats

So, what is your plan for managing these holidays that are full of delicious foods that don’t work for you? The first step is to strategize. Complete restriction is unlikely for most of the population, and can lead to binge eating behaviors as a reflexive backlash. This is the “no-strategy” strategy that usually fails. Instead, make some educated choices, and make a plan. Some people can get away with small amounts of some allergenic foods, and can’t get away with others. So, making choices to suffer a little on some fronts so you can stay strong on others may be a safe plan. If you need to stay on a strictly narrow regime for health reasons, it will be more important than ever to plan ahead and bring tasty alternatives to the traditional choices so you have a meal you can enjoy as well.

For example: You really suffer when you eat gluten, but you can get away with eating dairy occasionally.

Thanksgiving Plan: Bring gluten free crackers for the crackers/cheese hour. Bring Imagine brand gluten free turkey gravy (not incredible but good enough.) Bake a gluten-free apple crisp. Plan on skipping the stuffing, but eating the mashed potatoes and dessert with ice cream.

Some families are willing to substitute key ingredients to make some elements of the meal safe for the whole family. For example, mashed potatoes could be made with Earth Balance margarine and an alternative (unsweetened) milk option to be dairy free. Again, a gluten free gravy could be used in addition to the traditional recipe, and a small amount of oven baked stuffing could be set aside for the vegetarians.

If you or a family member has an anaphylactic response to a particular food, it is best to inform all guests ahead of time. Make sure you have an epi pen available as well if you or your child has this kind of severe allergic reaction. There are some supplements that can help balance the overindulgence for mild to moderate food reactions . Gluten-ease was mentioned in our last newsletter as a simple occasional digestive support. This product contains high potency enzymes that ensure complete digestion of gluten, gliadin and casein proteins, reducing allergenic effect and potentially reducing symptom onset. This product is not recommended for celiac disease or people with severe gluten or dairy reactions.

Other products that help quiet an inflammatory food response are quercetin, bromelain, and nettles. These products can often be found combined together in products like D-Hist and D-Hist Jr by Ortho Molecular, and are best taken for 2-3 weeks before the food is introduced to minimize systemic inflammation.  Quercetin is not safe in pregnancy, but nettle tea is a safe, simple remedy that everyone can use. Carminative teas like peppermint, fennel, and ginger can also help ease digestion for everyone after a large meal.

 

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Mediterranean Adventure II

We were concerned that traveling Gluten Free would be tough. And not even just gluten free – I can’t eat potato or corn, and my sweetheart can’t have rice. So, we were both headed abroad knowing that food choices could be tough. We had the good fortune of staying with family, so for most of the journey we had a kitchen and fridge to stock with staples we could rely on. For me – mostly eggs, rice cakes, delicious olive paste, incredible fresh green olives. For my sweetheart – she had the bonus of finding gluten free bread, plus corn cakes, jam, and yogurt. Then we  shared fruit, veggies and local cheeses. She brought her own corn pasta, and I had no trouble finding rice pasta as needed in the local “Veritas” (organic) market for family dinners. We even found quinoa! Local markets and/or supermarkets also had lovely fresh meats, fish and produce for family dinners. We both brought some snack bars (Kits Organics for her and Luna Protein for me) as well as trail mixes. Of course, there were also lots of delicious treats we could both have. Europe has an impressive array of yogurts, puddings, and other cold delights in small jars. (Less ice cream though, in the freezer sections.)

Overall, food turned out to be less of a problem than we feared. When going out, my sweetheart was invariably able to get “patatas bravas,” a local dish of fried potato with a yummy spicy mayonnaise. Tapas (or pinxtos as they are called in San Sebastian) were harder for me to navigate, so often I just didn’t. Dinners out were easier – I could almost always find some delicious fish or chicken and vegetable options in the Menu del Dia – a 10-15 Euro daily menu with 3 courses and wine and coffee included. As my sweetheart is more sensitive to gluten and cant get away with any exposure, she usually stuck to Ensalada Mixta (salad, tuna, olives, and hardboiled eggs) with a potato side dish. All in all, it worked out well. We weren’t able to sample the breadth of Spanish gourmet cuisine, but we still had some flavorful dishes and local delicacies.

As a Naturopathic Doctor, I was constantly assessing the Mediterranean Diet and to see how the classic reputation of the region matched the real fare. As I suspected, there was plenty of bread, cheese, sugar, and packaged foods available as in the Standard American Diet (SAD.) There were a few noticeable differences though that may account for some of Europe’s lower body weights and improved life expectancy. First, there was no bacon. Yes, “bacin” was on some menus, but it was peameal-style bacon, pan-fried and not the true “bacon” of North American fame. Second, beef was rare to see on a menu or in the supermarkets, and was quite expensive. This made sense as we drove across the country, as there were very few cows. European terrain is not made for grazing the way Texas is.

Finally, and perhaps most impressive to me was the rest stops for food along highways. Each one was set up like a classy buffet restaurant, complete with chefs behind the food casing presenting grilled vegetables, roasted chicken, and a wide arrays of sandwiches, jambon, fruit and cheese choices. There were mini bottles of wine and cans of beer at every register, as if instead of being on a roadtrip one was intentionally stopping at that location for a meal. And stop everyone did, even for coffee. The American in me was shocked that people were literally getting perfect little iced espressos and walking to sit down and drink it before they got back on the road. We are such a to go culture! The contrast was very strong, and was I think the best illustration of the differences between our SAD diet culture and that of the Mediterranean. They sit down and savor a meal, a coffee, and a moment in time. It’s a lifestyle, a way of thinking, and a paradigm. We eat on the go, “para llavales”. We Rush, wolfing down food, eating mindlessly as we multitask and gulping down our beverages while we push on ahead. And we pack on the pounds and generate chronic disease as we go along, coercing our nervous systems into simultaneously digesting and running at the same time.

I am still filtering through layers of impressions, photos and reflecting on the whole experience of world travel. I highly recommend Spain to anyone – Barcelona is the second most popular tourist destination in the world, and well worth the hype. Traveling gluten free was not a problem; we were able to find great local resources and food options, especially for a food adventurist. For those who can eat gluten, there is an incredible world of tapas out there just waiting your arrival! But do yourself a favor – eat like you have all the time in the world.

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