The Morning After (diagnosis, that is)

My story- the short and sweet version?

After a history of medical mysteries and six different doctors telling me (over a ten-year period) I suffered from- take your pick- depression, hormonal migraines, stress, too much coffee or not enough fiber, I was told, It's what we call IBS. Just relax. Give up coffee. Eat more wheat germ. Take up meditation.

Yeah that worked. After losing twenty pounds (and chugging Pepto Bismol daily) I was finally (thanks to info I found on the Internet) diagnosed with malabsorption caused by gluten intolerance.

A gene test confirmed I carried one of the two prime HLA DQ genes for celiac disease, a genetic autoimmune response to the grain protein called gluten- you know, that sticky elastic thing that makes pizza dough stretchy and tossable and birthday cupcakes so heavenly tender.

In a heartbeat it was good-bye chocolate croissants; hello rice cakes and peanut butter. That was December 2001. I've been gluten-free ever since.

The down side? Keeping wheat, rye, barley and spelt out of my diet. The up side? Food is my medicine. And lucky for me, olive oil and garlic, wine, green chiles, cherries and dark chocolate are all gluten-free.

I ditched my bottle of Pepto and picked a new mantra-
Life is short. Make today delicious.
That's why I blog.

Where do I begin? And what can I eat?

In the beginning, as I embarked upon my new sans-gluten adventure, I found it easiest to focus on whole, naturally gluten-free foods. A good place to start? Say yes to produce– and if you’re a vegetarian, you're in luck. You already love fresh veggies of all kinds, so go for it. Do your bunny food thing. Love meat and potatoes? You're in luck, too. Plain fresh meat, chicken and fish are gluten-free. Potatoes (white, gold, red, sweet, purple) are a gluten-free starch. And don't forget fresh fruit (Eve must have been gluten-free!).

Say yes to rice (whole grain brown rice is especially good for touchy digestion) and legumes, quinoa, and rolls of plain polenta. Include free-range organic eggs with omegas. And if dairy is fine for you, try cultured plain organic yogurt with a dab of honey or agave nectar. Aged block cheeses are safe; start with a wedge of good Parmesan, and aged cheddar; both are high in calcium and have zero lactose. When you are ready to branch out, fresh goat cheese is delicious; and there are many varieties of real cheese that are safe (check labels for additives or flavorings).

If your digestion cannot tolerate lactose, casein or whey (the sugar and proteins in dairy food) there are several vegan alternatives on the market usually crafted from rice, almonds, or soy (note that soy can be problematic for many). And always check labels- luckily many non-dairy milks now say Gluten-Free right on the package. Call the company when in doubt.

For sandwiches think: corn and brown rice tortillas, lettuce wraps, rice paper wraps, and even toasted gluten-free waffles (they make fabulous grilled panini). There are several gluten-free breads available with a wide variety of quality and taste. Some are sawdust awful. Some aren’t half bad (Whole Foods makes some delicious breads). To be honest, however, I wouldn’t jump into gluten-free bread right away. Give your taste buds time to adjust to the newness of gluten-free flours. They are, indeed, different.

Oats have been a controversial topic in the celiac community. Here’s why. Although the protein in oats is not the exact same problematic protein found in wheat, rye, barley and spelt, oats have been found to contain gluten, possibly due to cross contamination in the harvesting, storing and milling process. When it comes to oats, proceed with caution.

Most doctors recommend avoiding oats until you have healed your gut inflammation. When you are ready to try some, make sure they are certified gluten-free. There are a few small farms now growing and harvesting gluten-free oats. And if you decide to include some oats in you diet, start slowly. Oats are high in fiber. They can be gassy. Try them in small amounts, once or twice a week; give your digestion a chance to adjust.

Aside from the obvious forbidden foods (bread, breadcrumbs, rolls, muffins, bagels, donuts, croissants, cereal, pizza, fried food, pasta, beer, crackers, pretzels, cookies, cake, brownies, pie crust) I advise saying no to processed foods and mixes, fast food, junk food, snack food dusted with flavors, packaged seasonings, soups and dressings- in other words, anything with ingredients you can barely pronounce.

When food is the cure for what ails you, choosing whole natural foods makes the most sense, after all.

Experience taught me to avoid high fructose corn syrup as much as possible. HFCS is a relatively new super-refined, super-sweet cornstarch based sweetener (added to so many products now, it's ubiquitous). HFCS can cause digestive troubles in an already sensitive system (and you should know it also raises your set point for "sweet" taste, and is suspected to contribute to insulin resistance, linked to developing Type 2 Diabetes- now endangering our children and teens).

Also problematic for many are the artificial sugar alcohol based sweeteners (sorbitol, mannitol, xylitol). They can cause digestive symptoms remarkably similar to a gluten reaction. Limiting refined sugar, saturated fats, and simple (starchy) carbs will go a long way toward healing a stressed digestive system. To read a post and discussion on sugar and alternative sweeteners go here.

Many celiac folks need to avoid coffee, too, especially if heartburn is a symptom. Try, instead, drinking plain green or black tea, unsmoked yerba mate, and chai (original and organic Oregon Chai is gluten-free). Be careful with blended teas and herbal teas; many contain barley, malt, or flavors derived from gluten grains.

As for alcoholic drinks, there is good news. Many are safe. In general, avoid flavorings, mixes, and malt. Potato vodkas and unflavored rums and tequilas are naturally gluten-free. Distilled whiskey is as well. Cognac and good brandy are fine. Red and white wines are safe (avoid wine coolers). And the best news of all is: there are gluten-free lagers on the market now. Redbridge beer, made from sorghum, is excellent.

Okay. Cocktails are solved. What about snacks?

In the beginning, Dear Reader, I kept it really simple. I snacked on rice cakes smeared with natural organic peanut or cashew butter and honey. I ate roasted almonds, applesauce and bananas. I sliced cheddar cheese and ate it with grapes. I kept bags of carrot sticks handy to dip in hummus. I made my own flavored yogurts with organic plain yogurt and natural fruit preserves.

I got a Stir-Crazy popcorn maker (so that I could choose my cooking oil and seasoning). And I always kept some organic dark chocolate on hand for a real treat. I still do (it’s those nifty antioxidants, I’m after- really it is).

After I got more comfortable with knowing what brands were- and were not- gluten-free, I branched out to corn and blue corn tortilla chips. They’re fab and easy to serve with salsa and guacamole. And there are even more safe gluten-free snacks available now– Pirate’s Booty, Blue Diamond Nut Thins, and Lundberg Rice Chips, to name a few.

Great! So, what's for dinner?

Here’s what I did the first year. As I mentioned, I like to keep things simple. I roasted lots of cut-up vegetables tossed in sea salt and extra virgin olive oil. I based meals around baked potatoes, both white and sweet [split baked potatoes, sweet potatoes and yams make a wonderful base for all kinds of toppings: chili, stew, roasted veggies, lentils, baked beans, and even a fresh baby greens salad with chick peas].

And, as you might guess, I ate a lot of rice- long and short grain brown, arborio and white basmati rice. (I love both short and long grain brown rice because it loves me; it just feels so good to my body; and its whole grain fiber status makes it beneficial for touchy digestion. It also happens to be satisfyingly nutty, versatile, and delicious.)

On an average day I like to cook up a batch of rice in a rice cooker and lightly stir-fry it in a skillet with a little olive oil, herbs and spices. I add cut-up fresh vegetables and protein- try anything from meat to fish to beans or slivered almonds. To conjure my art school days I might do a simple brown rice stir-fry with matchstick carrots, golden raisins and chickpeas. Sometimes I add chopped green chiles, cumin, black beans and a squeeze of fresh lime juice. I stir-fry rice Thai-style with a splash of coconut milk, basil leaves and mild curry, and add whatever veggies we happen to have on hand.

On nights we crave Italian, I might make a marinara sauce with tomatoes, sweet peppers and mushrooms, with a splash of balsamic vinegar and toss in some white Northern beans and chopped fresh herbs.

For breakfast try hot rice or buckwheat cereal; or even short grain brown rice cooked in real apple juice with a chopped apple and cinnamon. Brown rice is an excellent overall replacement for gluten-filled starches. It remains a favorite staple, even now after we've discovered a terrific brown rice pasta called Tinkyada (more on that later).

Healing Soups & Stews & Smoothies

I'm a big believer in the power of fresh vegetables. All those vitamins and antioxidants! Make lots of them. Too busy to make soup? Dust off your slow cooker – it’s perfect for making soups, stews and comfort food.

Spike your soups with the healing properties of fresh minced garlic, ginger, fennel, a squeeze of lemon or lime juice or apple cider vinegar, shredded cabbage, parsley and cilantro, and you have some serious medicine! In our house it’s called Jewish Penicillin.

Salad Dressings

On to dressings. Salad dressing labels are very scary, not to mention, unappetizing (exactly what is partially hydrogenated monosodium glutamate hydrolyzed vegetable protein cottonseed oil, anyway?). Instead, I take five minutes and whisk together my own simple dressings with extra virgin olive oil and fresh squeezed lemon juice, or Spectrum Organic Balsamic Vinegar or Champagne vinegar (adding a spoonful of gluten-free honey mustard, yogurt, or mayonnaise thickens the dressing if you’d like more than a simple vinaigrette). I add dried or fresh herbs- a little dill, a dash of basil, thyme or oregano and ground pepper. For a touch of sweetness I add a dab of agave nectar. It's so simple. Taste test and experiment; you'll soon come up with your own favorites.


Smoothies

For a jump start in added nutrition, whip up smoothies with yogurt and a banana, a touch of sweetener, a splash of fresh fruit juice and chunks of more fruit (frozen fruit works well for this). Find a gluten-free rice protein powder to add extra aminos and protein. I like Nutribiotics powder; it comes in vanilla and chocolate.

Dairy a problem?

For those avoiding dairy (50% of celiacs react to milk proteins and lactose), use a gluten-free rice, nut or hemp milk (the chocolate flavors make a decent cocoa). Check labels carefully, as some non-dairy milks are not gluten-free due to barley used in processing the “natural flavor”. If you tolerate lactose-free milk- and the milk proteins casein and whey are not a problem- try, at least, to find organic brands.

And don't forget coconut milk! Coconut milk is terrific in soups, stir-fries, sauces, puddings, and baking. Note: before you choose soy based dairy substitutes, please do a little research on the side effects of soy on the thyroid gland. Celiacs are vulnerable to autoimmune diseases including thyroid disease.

I’ve got a sweet tooth. How about gluten-free goodies?

Good question. Here’s what I did. So that I wouldn't have to stress about perfecting the art of gluten-free baking right away, I selected a favorite gluten-free ice cream and sorbet for dessert. Fortunately, there are quite a few available. Baking came later and now is a pleasure.

But before you bake, you have to go shopping!

Shopping Strategies – How Not To Feel Overwhelmed

I admit it. The first trip to the supermarket post diagnosis was a total nightmare. I spent almost two hours reading the super-fine print on every label in every crowded grocery aisle. I was bumped and glared at for taking up space. I felt stupid and discouraged and totally overwhelmed. I realized quickly I needed a strategy. So I went home with a grocery bag of fresh vegetables, Lundberg brown rice and rice cakes, a bunch of bananas, and made a plan.

I looked over the various safe food lists for celiacs on the Internet, copied all the familiar products I was interested in, pasted them into a document file, and created my own personalized Gluten-Free Shopping List. This helped me focus on the brands and foods I preferred (rather than printing out the uber-long on-line lists cluttered with brands and products I would never need or want). I scoured the lists for favorites.

For instance, I looked for a brand and flavor of sorbet I liked. Then, peanut butter, jam, ketchup, mayo, green tea, canned tomatoes, olive oil and balsamic vinegar. You get the idea. All the basics.

I compiled. I saved the list and printed it out for convenience. Over time, I have edited The List and pared it down quite a bit. Shopping has become infinitely easier now that I have my own list of tried and true favorites. Periodically, I re-check labels to make sure my favorites are still gluten-free.

Check the blog's Knowledge is Power links page for on-line gluten-free product lists and resources to get you started.

Please note: Even though you may find a certain brand listed on-line as gluten-free, it’s always wise to double check. And even as you develop and maintain your own personal gluten-free list over time, it's a good idea to continue to read labels (to make sure the ingredient list has not changed).

When in doubt, call. Most companies have 1-800 customer service numbers listed on food, health and beauty items and many, if not most, actually know what gluten is!

Eliminating Gluten

The day after I went gluten-free, my husband Steve and I tackled the pantry and the fridge. We raked through labels and identified any foods that contained gluten. If they were unopened, they went into a box for the local food bank. If they were partially used, we dumped them out and recycled the containers. If I was unsure about a product, I set it aside and researched it. It was an enormous task. Which brings me to an important side issue. Support.

Support is invaluable in this endeavor we call living gluten-free--- especially in the first year. Don't underestimate your need for it. To stay healthy and gluten-free it takes a partner, family member, or friend willing to embrace change, willing to listen and learn.

I want to share an aside here. Steve told me that pantry-clearing day, “I’m in this with you, Babela. I’m going gluten free.” Yes, he’s quite a guy. A mensch, even. And now you know why I fell in love with him in the first place. Well, that, and he could juggle. And whistle a Crowded House tune perfectly. So here's a shout out to my dear husband. The guy behind the goddess. He's been there for me from day one. And honestly, it’s made all the difference.


Contamination Issues

And now for the thorny part. The tricky bump on the learning curve- invisible gluten. It is dead sneaky! Where does it come from?

First- consider the contents of your refrigerator. All shared condiments must be avoided; it's best to purchase your own peanut butter, jam, butter & margarine, mayo- and separate it. You can label it: My GF Stash. Or use a colored sticker system. It does seem extreme, I know. But, Dear Reader, crumbs and residue from gluten containing food can wreak havoc. Trust me.

You may not think so, at first [I didn't believe it!], but even the tiniest gluten crumble contains the offending gluten molecule. And we know how tiny molecules are. And how invisible. Think about those sticky fingers of family and co-workers blissfully eating orange oil pizza or lip smacking sub sandwiches and glazed donuts- fingers that can easily leave gluten residue on fridge handles, computer key boards, phones, etc.

Remember, gluten is a protein– and sticky proteins are next to impossible to eradicate. (There's a reason wheat is used in wallpaper paste, adhesives and drywall compound.) Yup. Even teeny tiny bits of gluten residue can trigger the immune system in sensitive individuals. I suggest using alcohol wipes. And on the road, or after shaking hands, alcohol “soap”. Alcohol “soap” (aka hand sanitizer) has been shown to dissolve the gluten protein, if used liberally.

Other considerations?

Aware of the protein residue problem, I set aside my old cutting boards and breadboards- including a lovely antique round carved breadboard I’d had for twenty years. I hated to part with it, but my health trumped sentiment. Off they went, with all my favorite old wooden spoons, and anything porous that might contain old gluten residue, including our non-stick skillet, and wooden salad bowl. I also gathered up my old vinyl and plastic spatulas, my bread machine [Ack!], and our blender with a rubber gasket (it needed replacing anyway, I told myself). We made quite a big donation pile. And what wasn’t donated we sold at a yard sale.

On to replacing! The fun part. That first gluten-free year I loved Martha Stewart. I shopped at K-Mart and replaced everything in my kitchen for a reasonable sum; including a slick new All Clad-style roasting pan of hers, which I continue (after five years) to use every other day. I even gave the kitchen a new coat of paint, just to brighten my spirits and enhance my fresh start- with color.

Next on the agenda? I looked at even more labels: vitamins, medications, and cosmetics (especially lipsticks), mouthwash, and toothpaste. I even checked shampoo, hand and body lotions. Why, you might ask? I didn’t want anything in my house that could possibly transfer those sticky gluten proteins to my hands- I love finger food too much!

It took me a good 5 to 6 months to truly eradicate all specks of gluten from my life. I made some mistakes early on (an herb tea with barley, a lipstick with wheat germ oil, a friend’s old wooden spoon used to stir my pot luck supper offering of pumpkin soup), but time and experience smoothed out the bumps of my mistakes and the gluten-free lifestyle soon became second nature. As it will, for you, too, Dear Reader.

The Holy Grail: Bread? Gluten-free pasta? Brownies?

When you’re ready to branch out a bit and your taste buds have adjusted to food without gluten, I am here to tell you there are fabulous breads, pasta, baked goodies and sweets in your future! When the flavor memory of wheat begins to fade (this takes time by the way, and is why I didn’t recommend rushing out to purchase gluten-free substitutes for pasta, brownies, bread, and cookies; they’ll taste funny- even odd to your wheat saturated taste buds) there are plenty of tasty pastas to twirl, breads to toast, and brownies to melt in your mouth.

But try to give yourself two weeks first. Gluten affects brain chemistry. Experts liken it to addiction. One mother told me her agitated son actually licked the kitchen table during the his first gluten-free week, trying to get a taste of gluten.

Adjustment to living gluten-free usually takes a minimum of two weeks; and it can, in some individuals, take up to a month or two- especially if hidden gluten is consumed, and the craving for it lingers. Think of it as a psychic adjustment period, where your focus is not on what you can no longer have, but on choosing fresh, healthful, whole foods that will jump-start your healing process. And when you’re ready, peruse my recipes for luscious dark chocolate brownies, cookie bars with coconut, and a truly sexy flourless chocolate cake.

Most of all - have fun with the adventure of living gluten-free. Why? What’s fun about it? Babycakes, you're going to feel more energetic, clear, focused, and free of symptoms than you have in a long, long time. And last but by no means, least, keep a dash of humor handy; it helps us to heal, too. Laughter is damn good medicine.

The author Karina Allrich copyrights this original article ©2005-2008.
All rights reserved.
No reposting or copying is permitted.

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