Authors: Carol Svec
Food Cures (67 page)
FAQS
I just found out I have celiac disease, and it seems as though I have to spend hours at the grocery store reading labels. Does it ever get any easier?
Yes, it does get easier. You have a lot of new information to assimilate, but it’s knowledge that will serve you forever. Most of my clients with celiac disease only need to see me two or three times—after that, they understand exactly what they need to do to live a gluten-free life. I highly recommend consulting with a dietitian who specializes in celiac disease to get a handle on the details. Also, check out your local Whole Foods market—they offer a variety of gluten-free foods that are conveniently labeled. And certainly shop online at some of the gluten-free specialty stores. You’ll find a helpful list of resources on Chapter 18.
If you’re struggling emotionally with the transition to a gluten-free lifestyle, you might find it helpful to talk with a psychologist or counselor. Some people need time to mourn the loss of favorite foods, or favorite family meals, or their vision of themselves as indestructible. One or two sessions with a professional can mean the difference between fighting the change and a journey of discovery. Read everything, join a celiac disease support group, befriend the health care professionals, and don’t be afraid to ask questions. In addition, there are many wonderful resources to help you and those you love with celiac disease, regardless of whether the disease was diagnosed last week or ten years ago. Two of the best online sources of information are:
- The Celiac Disease Center at Columbia University (www.CeliacDiseaseCenter.columbia.edu). Check out the online store and the specialized patient information provided by some of the country’s best specialists.
- www.Celiac.com. This celiac disease and gluten-free resource offers information, a message board for people to talk with each other, and links to additional resources and Websites.
- If you don’t know, it’s a no-go.
Foods that are sold from bins may contain gluten, no matter how they are marked. The problem is that you have no way of knowing what sort of food was in the bin before the food you are buying. You may think you’re buying dried beans and dried beans alone, but you may also be getting dust from the bulgur wheat that was in the bin last week. The safest choice is to buy only packaged goods labeled
gluten-free
or with no suspect ingredients on the label. In restaurants, avoid fried foods. Even if your food doesn’t contain gluten, the fry oil may have remnants of breading or other gluten-containing foods. Sauces, gravies, and many toppings also contain gluten. You are safest if you eat pure, fresh, whole foods from sources you can trust.- Beware of contamination in your own home.
In nearly every jar of jam or tub of margarine are bread crumbs left behind by the last person to dip a knife or spoon in them. You have two choices—either stock your own private pantry that other family members know is for your consumption alone, or make sure that everyone in the household uses only fresh, clean utensils to spoon out the products.
Foods that are generally considered safe for people with celiac disease are listed in the grocery list beginning on Chapter 18.
BONUS POINTS
- Get regular screenings.
Experts recommend that all adults with celiac disease get annual blood screenings for ferritin (a measure of the amount of iron stored in the body), folate, vitamin B
12
, and thyroid-stimulating hormone (TSH, a measure of how well the thyroid is working). In addition, you will probably be tested for calcium absorption, which is measured by a test called a
24-hour urine catch
. This test is exactly what it sounds like—you urinate into a special container every time you use the bathroom during a 24-hour test period. These tests will allow you and your doctor to track how well your intestines have healed.- Ask your doctor if you should have a bone density scan.
Long-term malabsorption of calcium can lead to osteoporosis, thinning and weakening of bones. But osteoporosis often goes unnoticed. If a scan shows your bones are strong, it will be one less thing for you to worry about, and you’ll have a good baseline measure for future reference. If your bones show signs of thinning, you and your doctor can begin a treatment plan.- Urge family members get tested.
Celiac disease is genetic, so first-and second-degree relatives should all be tested. People with autoimmune disorders, such as type 1 diabetes or Hashimoto’s disease, also have an increased risk of celiac disease and should be tested.- If you are pregnant, or recently had a baby:
Remember that your child may have inherited celiac disease along with your soulful eyes. If it’s still an option, consider breastfeeding, which seems to offer some protection from celiac disease. When it’s time to start on solid food, the best time to introduce gluten-containing foods is when the child is between four and six months old. Research has shown that children who are at high risk of celiac disease have a greater risk of developing the disease if they are introduced to foods containing gluten
before
the fourth month, or
after
the seventh month.- Take advantage of the Clan Thompson Company.
Clan Thompson LLC maintains numerous resources at www.ClanThompson.com, including a free email newsletter, lists of gluten-free foods and drugs, recipes, celiac news stories, travel information, and medical replies to more than 100 celiac disease-related questions. Free demos of their Celiac SmartList software (available for Windows, Mac, Palm handhelds, and Pocket PCs) are available for download. The SmartLists are a series of software programs which make it easy to find gluten information on thousands of items, including foods, prescription drugs, and over-the-counter products. Information is verified directly with each manufacturer, and a comments field provides additional details on issues like cross contamination. The SmartLists are updated quarterly, and the company will also research products at a subscriber’s request. When they learn that product information has changed and an item is no longer gluten-free, the information is posted on their Gluten Alerts page and an email also goes out to each subscriber. This is a fabulous resource for anyone with celiac disease.
FAQS
I understand that it is important to read food labels so I know what foods to buy in the grocery store, but how do I make sure that foods I order in a restaurant don’t contain gluten?
Most of the finer restaurants can prepare meals that are gluten-free—all you have to do is talk with the waiter about your options. This is the one time it is okay to use the word
allergy
. My clients with celiac disease find that most waiters don’t understand the wide range of ingredients that could potentially contain
gluten
and may misguide you even if they don’t mean to. If you tell the waiter that you have a severe allergy to even the smallest amounts of wheat, barley, and rye, you can usually count on respect for your food wishes. It can be helpful to become a “regular” at a favorite restaurant—if you develop a relationship with the chef and staff, you will be treated like family (or at least like a valued customer) and they will be more likely to cater to your needs. But it really is difficult to eat out with celiac disease. Most restaurants are a minefield of hidden gluten. You don’t want to become a hermit, but you don’t want to sacrifice your health for the sake of a fast food meal. Go for meals that are prepared simply, with no breading, no frying, and few added gravies or sauces. Choose from among fresh ingredients listed as safe on Chapter 18.
SUPPLEMENTS
People with celiac disease should seriously consider taking supplements to help them get the nutrients they need but won’t get in a gluten-free diet. I recommend:
- Multivitamin.
Because wheat products contain so many important nutrients, I like to recommend a good general multivitamin that provides plenty of the B vitamins, especially thiamin, riboflavin, vitamin B
6
, and vitamin B
12
. One of my favorites is Centrum Performance, which provides 300% DV of all those vitamins, plus 100% DV of folate.- Calcium, plus vitamin D.
Because so many people with celiac disease have osteoporosis, or have experienced malabsorption of calcium over the years, I always recommend women with celiac disease take a calcium supplement with vitamin D. Calcium can’t be absorbed and used by the body without vitamin D, the most potent form. Because too much calcium may increase the risk of prostate cancer, if you’re male and have celiac, speak with your physician before taking calcium supplements.- For women:
Take 500 to 600 milligrams of calcium twice a day—once in the morning and once in the evening—for a total of 1,000 to 1,200 milligrams per day. Choose a brand that also contains vitamin D
3
(also called
cholecalciferol
) at a dosage that will give you a total of 400 to 800 IU of vitamin D per day (the exact amount will depend on the dosage of vitamin D included in each calcium tablet—the daily total is the number to focus on).- Others, as directed by a physician.
People with celiac disease can have multiple nutrient deficiencies before their disease gets under control. Once the disease is diagnosed, blood work will indicate which extra supplements you might need. All additional supplements should only be taken if recommended by a doctor, and only for as long as the doctor recommends—too much of a good thing can be harmful. For example, even though many people with newly diagnosed celiac disease have anemia, too much iron can be toxic. Also, folate supplements can mask a deficiency in vitamin B
12
, so you might overlook a different problem if you start popping supplements on your own.
FAQS
What are your specific recommendations for staying gluten-free while dining out?
Appetizers:
Vegetable salad with olive oil and balsamic vinegar requested on the side, or sliced tomatoes and mozzarella (again, request olive oil and balsamic vinegar on the side, and avoid prepared vinaigrette dressings).
Entrée:
Grilled or broiled skinless chicken breast or fish (request seasoned with olive oil, salt, pepper, and lemon)
Unlimited Vegetables:
Anything goes, steamed or sautéed in olive oil and garlic.
Starch:
Plain baked white or sweet potato, plain brown or wild rice. Take advantage if a restaurant offers amaranth, millet, or quinoa on the menu.
Dessert:
Fresh fruit
Follow this program if you have celiac disease.
STEP 1…
START WITH THE BASICS
These are the first things you should do to take control of celiac disease.
- Make sure you thoroughly understand what foods and additives to avoid. If you have any questions or problems following a gluten-free diet, make an appointment with a dietitian who
specializes
in celiac disease. He or she will answer every question in as much detail as you need.- Review all the products in your kitchen pantry, refrigerator, freezer, and bathroom medicine cabinet—including medications, toothpaste, and mouth rinses. Read the ingredients on all food labels. Find ways to separate safe products from those that contain gluten.
- Don’t cheat!
- Talk with your doctor about the value of regular screenings for bone density, nutrient malnutrition, and celiac disease markers.
- Consider taking a multivitamin. If you’re a woman, also consider a calcium supplement containing vitamin D
3
.
STEP 2…
YOUR ULTIMATE GROCERY LIST
Controlling celiac disease is not so much about foods you should eat as foods you shouldn’t eat. The foods on this list are considered to be generally safe for people with celiac disease. You’ll need to carefully check labels on all foods marked with an
asterisk (*)
—that’s because ingredients can vary from brand to brand (for some categories, I provide gluten-free brands worth considering).
Because most of the popular grains contain gluten, it is important to try new, safe grains. You’ll also need to eat a variety of fresh fruits and vegetables to make sure that you get a wide variety of naturally occurring vitamins, minerals, fiber, antioxidants, and other nutrients. Toward the end of the grocery list, I’ve listed additives and ingredients that are also thought to be safe. And to make your life even easier, I’ve provided a resource listing of companies (and their Web sites) that offer a variety of gluten-free food items. Take advantage and shop online!
FRUIT
ALL fresh fruits
Frozen whole fruits, with no additives
*
Fruit juice
VEGETABLES
ALL fresh vegetables
ALL frozen vegetables with no additives, breading, or sauces
Alfalfa
Artichokes
Avocado
Beans, adzuki
*
Beans, canned (no gluten additives)
Beans, mung
Beans and peas, dried
Chickpeas (garbanzo beans)
Lentils
Olives
Potatoes (all varieties)
*
Pumpkin, canned, 100% pure puree
Seaweed
SEAFOOD
ALL fresh seafood
All frozen raw seafood with no additives or sauces
LEAN MEATS/EGGS/SOY FOODS
ALL fresh meats and poultry with no breading or additives
All frozen raw meats and poultry with no breading or additives
Eggs
Soybeans (including edamame)
Tofu
NUTS AND SEEDS (PREFERABLY UNSALTED)
ALL nuts
ALL seeds except rye and barley
Peanut butter and other nut butters
GRAINS, CEREALS, PASTA, AND MORE
Amaranth
Arrowroot starch
Buckwheat
*
Cereals, cold: puffed and flake varieties made with amaranth, buckwheat, corn, millet, rice, or soy; good choices are Nature’s Path Crispy Rice, Barbara’s Bakery Brown Rice Crisps and Honey Rice Puffins, Health Valley’s Organic Blue Corn Flakes
*
Cereals, hot: cream and flake varieties made with amaranth, cornmeal, buckwheat, hominy grits, rice, quinoa, or soy
Corn bran
Corn chips, plain (preferably baked)
Corn flour/corn meal products
Crackers, rice
Flour: buckwheat, carob, chickpea, lentil, potato, rice, sago, sorghum, soy
Grits (corn or soy)
Kasha (
not
the same as Kashi)
Masa
Millet
Pasta made from beans, rice, corn, peas, potato, quinoa, rice, or soy
Polenta
*
Popcorn, gluten-free microwave varieties; good choices are Healthy Choice, Jolly Time Light, Newman’s Light
Potato chips, plain (preferably baked)
Quinoa
Ragi
Rice (preferably brown or wild)
Rice cakes, plain
*
Soba, 100% buckwheat
Sorghum and sorghum flour
Tacos shells made with corn, hard and soft
Teff
Tortillas made with corn, soy, or brown rice
DAIRY
*
Cheese (preferably reduced-fat),
not
bleu cheese
Cheese, cottage, fat-free or 1% reduced-fat; good choices are from Cabot, Albertson’s, Kemps, Axelrod, Friendship, Hood, Winn Dixie, Price Chopper
*
Cheese, shredded fat-free Cheddar (for meal plan)
*
Cream cheese (preferably reduced-fat)
*
Ice cream (check labels, ingredients will vary from flavor to flavor)
Milk (preferably fat-free, 1% reduced-fat, or enriched/fortified soy)
*
Sour cream (preferably fat-free or reduced-fat), plain flavors
only
; good choices are from Cabot, Kemp, Albertson’s, Winn Dixie, Hood, Friendship, Axelrod
*
Yogurt, plain, unflavored (preferably fat-free or low-fat); good choices are from Stoneyfield Farms and Yoplait
MISCELLANEOUS
ALL pure herbs (
*
if herb mixes, check ingredients)
ALL pure spices (
*
if spice mixes, check ingredients)
*
Alcohol: all distilled alcohols are gluten-free, but always check with manufacturer, or at www.celiac.com, to be sure that there are no gluten-containing additives
Apple cider vinegar
Baking chocolate
Baking powder
Baking soda
*
Beverages, some soy and rice beverages (check ingredients)
MISCELLANEOUS
Cocoa powder
Coffee, instant and ground; check ingredients of
*
flavored coffee
Corn syrup
Cornstarch
Cream of tartar
Garlic
Gelatin
Herbs and spices (for meal plans): basil (dried), black pepper, Cajun spice, cinnamon, dill, garlic powder, nutmeg, parsley (fresh), rosemary, thyme (fresh)
Honey
*
Hummus (check lablels; ingredients will vary from flavor to flavor); good choices are Trader Joe’s garlic, original, kalamata, organic, roasted garlic, and roasted red pepper; all flavors from Wildwood Harvest Foods except roasted red pepper; all flavors from Athenos
Jam and jelly
*
Ketchup; good choices are Heinz, Del Monte, Price Chopper
Maple syrup
*
Margarine spread, soft tub, trans fat-free; good choices are I Can’t Believe It’s Not Butter regular, light, and fat-free spray; Benecol regular and light; Promise soft tub, regular and light
*
Mayonnaise (preferably reduced-fat); good choices are Hellman’s and Best Foods’ regular and reduced-fat, Cain’s regular, light, and fat-free
Molasses
*
Mustard; good choices are French’s Dijon, Laura Lynn, 365 Organic Every Day Dijon
Nonstick cooking spray; good choices are Pam Original and Butter flavor, however Pam Baking is NOT gluten-free)
Oil, canola
Oil, olive
Pickles
Relish
*
Salad dressings; good choices are Newman’s Own olive oil and vinegar, balsamic vinaigrette, light balsamic vinaigrette, light red wine and vinegar, light raspberry and walnut, light Italian, light Caesar
*
Salsa; good choices are Amy’s Kitchen, Albertson’s, Newman’s Own
*
Snack bars; always check ingredients to be sure; good choice is Enjoy Life brand, Cocoa Loco or Caramel Apple flavors
*
Soup, lentil or black bean (any gluten-free brand
*
Soy crisps; good choice is Genisoy
*
Soy sauce; good choices are La Choy, Hy-Vee soy sauce, Sav-A-Lot Jade Dragon, Bragg Liquid Aminos, Price Chopper
Sugar
Tapioca (
not
pudding)
Tea
Vanilla
Vinegar, balsamic, or red wine
Vinegar, white
Wine, red and white
SAFE (GLUTEN-FREE) ADDITIVES
Acacia gum
Adipic acid
Agar
