6 simple trick for living gluten free

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A DIAGNOSIS of celiac disease or gluten intolerance doesn't mean you have to GIVE UP YOUR FAVORITE FOODS AND TREATS. Replacing problem ingredients and following a GLUTEN-FREE DIET are easier than you think

It used to be an unfamiliar affliction, seemingly affecting only a handful of people. Now, some estimates say that up to 3 million Americans — about 1 in 133 people — have some form of gluten intolerance. If you suffer from sensitivity to gluten, you may feel doomed to a life of scrutinizing labels, interrogating waiters, and sneaking your own dishes to dinner parties. But with a few tips for developing diet-friendly habits, you can lead a nearly normal life.

Gluten intolerance is the inability to digest or break down gluten, a protein that's found in wheat, barley, rye, and spelt. The condition can range from a mild sensitivity to gluten to full blown celiac disease, says Alessio Fasano, MD, director of the University of Maryland Center for Celiac Research. In celiac disease, the body produces antibodies to attack the gluten; those antibodies also attack and damage the lining of the small intestine, resulting in immediate gastrointestinal symptoms, such as bloating, gas, pain, and diarrhea. In people with gluten intolerance — rather than true celiac disease — symptoms are often less immediate and harder to diagnose.

"You may feel symptoms three hours after eating gluten, or it might take five days," says Jules E. D. Shepard, author of Nearly Normal Cooking for Gluten-Free Eating. "And because gluten intolerance may manifest as headaches, sinus pain, joint aches, irritability, fatigue, and other broad symptoms, it may be years before some people are diagnosed."

Left untreated, celiac disease and gluten intolerance can lead to serious, long-term problems. "Both are associated with nutrient loss and related deficiency diseases, such as osteoporosis," says Walter Gaman, MD, author of Executive Medicine: Optimizing Your Chances for a Longer Life. "People with gluten intolerance or celiac [disease] also appear to be predisposed to developing lymphoma, which is a cancer of the lymph nodes — a risk that goes down with a diet avoiding gluten."

A simple blood test can identify antibodies that are produced by the body in response to gluten. "The catch is you can test negative for celiac, but still have gluten intolerance," says Shepard. "At that point, the best test is to go off gluten and see if you feel better. For most people, it will take several weeks before you notice a difference."

If you do have celiac disease or gluten intolerance, the only real treatment is following a gluten-free diet — a tricky proposition at best. It's easy to avoid the obvious things, like wheat bread. But gluten is also found in many other grains. It's in some condiments, such as soy sauce and vinegar. It may be used in gravies, sour cream, and other products that include thickeners or binders. It's even found in many prescription medications, over the-counter drugs, and dietary supplements.

A diagnosis of celiac disease, or even gluten intolerance, may require significant changes in your daily routine, but you can still live your life. Try these six tips to be nearly normal in your gluten-free eating — and living.

REVAMP YOUR KITCHEN. First, get rid of everything that contains gluten. That includes wheat, barley, rye, triticale, kamut, spelt, couscous, oats (unless they're certified gluten free); anything with modified food starch, malt and malt flavorings; and many kinds of soy sauce. Bag it all up and drive it down to your local homeless shelter. Then stock up on some readymade alternatives, like gluten-free bread, crackers, pasta, and cereals. And make reading labels a part of your life.
GET FAMILIAR WITH FLOUR. Good gluten-free substitutes for baking include buckwheat, corn, rice, sorghum, millet, and quinoa. These usually work best in combination. "Some provide bulk, some add lightness, some are finer in texture so you don't end up with a gritty bread," says Shepard. "You'll also need xanthan gum or guar gum as a substitute for the binding properties of gluten." One or two teaspoons per recipe is usually required. Tapioca flour also works as a binder, as do egg whites. Glutinous rice flour, which does not contain gluten but gets sticky, can be added (1-2tsp. per cup of flour). Experiment with several different flours in baked goods; when you find a combination that works, make up a big batch and store in glass jars. Shepard's book includes a recipe for Nearly Normal Gluten-Free Flour Mix.
KEEP IT SIMPLE. Stick to whole, fresh, unprocessed foods, and you'll make your diet naturally gluten free by default. Stock your kitchen with dark leafy greens; cruciferous vegetables, such as broccoli and cauliflower; deep red-orange vegetables like sweet potatoes, carrots, and red peppers; fresh fruit, especially berries; lean, organic meats and wild caught fish; and nuts, seeds, and beans Season your foods with olive oil, sea salt, fresh herbs, and spices. The high content of antioxidants will also help heal existing damage to your intestinal tract.
EAT OUT NORMALLY. You really can if you follow a few simple tips. First, stick to grilled fish, meat, or vegetables. Avoid fried foods; even if the food you're ordering doesn't contain gluten, it could have been fried in the same pan or oil used to cook battered foods. Steamed vegetables are a safe bet; order them without sauces, or get sauces on the side. Of course, it's hard to feel normal when you're spewing forth a list of dietary requirements to the waiter. "Also, many chefs may not know what 'gluten free' really means, and instructions get lost in translation between the server and the chef," says Shepard. "One solution is to a bring a small card with you that explains your dietary restrictions, and just hand it to the server. He or she doesn't have to write it all down, or translate it for the chef." You can make your own, or download one at NearlyNormalCooking.com.
RUN SCREAMING — or at least avoid — certain restaurants at all costs. Forget about most buffets and salad bars, where cross-contamination is an issue. Also avoid restaurants that don't make their own food — that usually means chains, fast-food restaurants, and bakeries. "That sounds like a no-brainer, but say a bakery makes gluten-free bread," says Shepard. "It sounds tempting, but if they're also making regular baked goods, there are too many opportunities for cross-contamination." Stick to baked goods from a gluten-free commercial kitchen or bakery.
BYOB — bread, that is — to holiday gatherings, potlucks, and dinner parties. Or make a gluten-free lasagna, stir-fry, or casserole. You can even bring gluten-free chips, crackers, cookies, or brownies. If it's a dinner party, and you know your hosts, make them aware of your dietary needs, and offer to bring a dish. Other gluten-intolerant guests will thank you for it.
"The catch is you can test negative for celiac, but still have gluten intolerance.

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By Lisa Turner

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