- Why Gluten Free?
- You've been diagnosed, now what?
Celiac disease (also known as celiac sprue and non-tropical sprue) is a genetic disease that is most common among people of northern European descent. Recent studies have shown the incidence of this disease in the US to be 1 in 133 people. First and second degree family members of a person with celiac have a much higher chance of having the disease, more like a 1 in 20 chance. This percentage is high enough that first and second degree relatives of people with celiac should also be tested for the disease. (After all, if you had a 1 in 20 chance of winning the lottery, how many tickets would you buy?)
The symptoms of this disease are many and varied. They range from chronic diarhea to chronic constipation and include depression, irritability, unexplained anemia, failure to gain weight, and early onset osteoporosis. (This list is by no means all inclusive. For more complete information, please visit www.celiac.com or www.celiac.org.) No one person has all the symptoms of celiac. (Who could have constipation and diarhea at the same time?) Though the obvious symptoms vary, however, the problem behind the symptoms is the same for all sufferers. People with celiac are gluten intolerant: they cannot digest the protein found in wheat, barley, or rye. When the body detects gluten in the digestive tract, it attacks, trying to destroy the invader. Unfortunately, the result is that the intestines (especially the small intestines) are damaged in the fight.
The interior of the small intestines have small, finger-like projections called villi. The villi are used to absorb nutrients from the food that passes through the digestive tract. When a person with celiac disease ingests gluten, the villi become damaged when the body tries to destroy the gluten in the intestines. Through time, the villi become blunted and shorter, decreasing the surface area available for the absorption of nutrients. Some people's intestines are damaged badly enough that they cannot absorb any nutrients. They eat and eat and still look like they are starving to death. This is because they ARE starving to death. The food they eat cannot be absorbed by their bodies and basically goes right through them. Other people seem to have "selective" absorption problems . . . fat gets through all right, but iron (or calcium, or something else) doesn't seem to make it. Many doctors will refuse to believe that a person might have celiac if they do not appear to be on the verge of starvation. THIS IS A MISCONCEPTION ON THE PART OF THE DOCTORS. My mother was about 25 pounds overweight when her diagnosis came through. One need not be at death's door to be negatively affected by absorption problems.
So, what should you do if you suspect that you may have celiac? The first thing to do is to find out as much as you can about the disease. More research on celiac is being completed all the time. Again, www.celiac.com is a great site to visit if you are looking for recent information. The next thing to do is to visit your doctor. Talk to him or her about your concerns. Explain why you want to be tested for celiac, and ask them to order the blood work. (There are currently 3 blood tests that are commonly run to check for celiac: anti-gliadin antibody, anti-reticulin antibody, and anti-tissue-transglutaminase antibody. iNOVA had a new test pass through the FDA in January of 2006, but (as of June 2006) no one is really using it yet. Research has shown it to be more specific, sensitive, and accurate than the other tests, though, so hopefully labs will start using it soon.) If your doctor refuses to acknowledge your concerns, you are always free to change doctors. Your doctor should always be willing to listen to you.
Now, what should you do if you are tested for celiac and everything comes back negative, but you still feel awful? Discuss a gluten-free diet with your physician, and (if recommended) try it for a while. You should also continue working with a physician to determine if there are other possible roots to your problems. (Avoiding gluten would do you little good if your real problem was cancer, for example).
On the other hand, if you ARE diagnosed with celiac . . . read the next article!
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2. Make a list of all the things you can eat. This is an important step to take. Because a diagnosis of celiac or gluten-intolerance comes with a negatively-phrased prescription ("You may NOT eat wheat, barley, rye, or contaminated oats"), it is easy to fall into the habit of listing all the things we CAN'T eat. When you start listing all the things you CAN eat, your whole perspective changes. Many people with celiac have been instinctively avoiding wheat-based food anyway, so your list of "Allowed Foods" is almost certain to include some of the things you eat regularly. For example, when I was growing up, we ate tacos, Spanish rice, baked potatoes, chicken fried rice (with a soy sauce that just happens to be GF), bunless hamburgers with cottage fried potatoes, and chili with rice all the time (at least once or twice a month). My mom didn't realize that she "just liked them" because these meals were gluten free, but she subconsciously gravitated toward these foods that didn't make her sick. Evaluate your eating habits . . . we bet you've done something similar.
3. Decide to cook. We live in a time where fast food and eating out are almost considered a necessity. Being diagnosed as gluten-intolerant changes that but that's okay! Look at this as an opportunity to start feeding yourself (and your family) the healthier diet (full of fruits and vegetables) that you've always dreamed of! :) You can also look at it as a chance to learn a new skill - cooking is an art form that has fallen out of fashion in many circles, but when your 3 year old looks at you and says, "Mom, this is delicious! You're a great cook!" you'll feel a sense of accomplishment that driving through at Wendy's could never match.
4. Find a friend to bake with. When you are trying new recipes, it always helps to have a friend around and plenty of time for trial and error. There's nothing worse than making your own GF birthday cake, only to have it explode (or collapse) on you 30 minutes before party time. Ask my sister! On the other hand, when you're cooking with a buddy and your cupcakes come out of the oven looking like Mount St. Helens after it exploded, you've got someone to laugh with. You've also got someone to discuss possible solutions with. (WE decided to fill the middles with LOTS of frosting and stick to full-sized cakes with that recipe in the future.)
5. Choose a Gluten Free recipe and make it! If you've never cooked anything but microwave popcorn, we suggest you start with something very easy (like migas or taco soup). If you've got more experience, choose something you've been missing (like our soft batch cookies or chocolate cake). Or you could choose to make our true yeast bread recipe, which can fill many different food needs (bread, toast, pizza crust, stuffing, sandwiches, hamburger buns, French toast, etc.). Successfully completing a delicious gluten free recipe raises your spirits considerably . . . you realize that you can do this!
6. (Or perhaps this should have been #5 . . . I couldn't decide.) Buy some basic Gluten Free baking supplies. Because other (non-wheat) flour have differing amounts of carbs, proteins, fibers, etc. than wheat, a mixture of different GF flours and starches works best to replace wheat flour in recipes. You could use plain white rice flour, but you wouldn't be happy with the result! The two flour mixes we use most often were developed by Bette Hagman, who has written several wonderful recipe books. The recipes for these mixes are on our main "Recipes" page, so here we'll just list the main ingredients you'll need to get started.
White Rice flour *
Tapioca Starch / Flour
Potato Starch **
Potato Flour **
Xanthan gum ***
You should also probably buy some plastic containers (with lids) to keep your GF flours in. Don't forget to clearly label them, as many gluten free flours look a lot alike!
* In the long run, it's cheaper to buy a mill and grind your own rice flour from bulk-purchased white rice. Be sure it's a mill that hasn't been used for wheat.
** Potato Starch and Potato Flour are not the same thing, and cannot be used interchangeably. Tapioca starch and tapioca flour, on the other hand, ARE the same thing . . . so don't get confused!
*** Xanthan gum is probably the most expensive ingredient you'll need to buy, but you don't use very much of it (only 1 tsp. or so in most recipes). Don't try to skip it because of the price tag . . . xanthan gum is what makes GF baked goods stick together!
7. If at first you don't succeed, try, try again! Sometimes things don't work out right, and other times you just don't like the flavor of the final product. DON'T GIVE UP! Make some notes about what worked and what you didn't like, and then try the recipe again later. As you get more experience cooking gluten free foods, you'll begin to realize the things you can do to make your recipes turn out the way you want them to. And soon you'll be creating wonderful gluten free recipes of your own!
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