Chapter 1
In This Chapter
Getting a grip on gluten
Uncovering the advantages of the gluten-free lifestyle
Making the most of meals
Going from gluten-gobbler to gluten-free forager — and loving it
Hitting the ground running in your first two weeks
M argaret found herself at last in the dim recesses of the Menzies Library at the Australian National University. ‘My condition, vividly described, was on page 448 of a huge, dusty medical reference book. Lethargy, tiredness, chronic diarrhoea, painful mouth ulcers, weight loss. There was even a photograph of a child that reminded me sharply of one of my childhood photos. Me as a pale, skinny three-year-old, with stick arms and legs and a huge pot belly, at the beach in my first swimming costume.’
‘I’d gone to the library, desperate for answers in the interminably long nine-week wait to see a gastroenterologist — nine weeks when I began to think I was losing the plot. I existed on weak black tea, dry toast with Vegemite and the occasional soft-boiled egg. I secured my clothes with big safety pins and worried that one day my undies would slip right down and land in a crumpled, mortifying heap around my ankles. I didn’t allow myself to go back into the bedroom after I was up and dressed, because the mere sight of my bed made me want to sink into the soft covers “just for a little rest”, with dire consequences for the day’s work. I knew something was seriously wrong with me, but my GP clearly thought otherwise, only reluctantly referring me to a specialist. Maybe he was right and I was just another hypochondriac?’
‘Several weeks later, prodded and probed, blood tested and biopsied, I had my answer. I had the strange condition called coeliac disease, but I would get better if I stopped eating bread and other things that contained gluten.’
‘But what on earth was gluten? Now this was last century, way back in 1980 and, although I’d heard of gluten, I knew as much about it as I know about the mysterious workings of my lovely laptop: Less than zilch. Forget Google — the internet didn’t exist. I had to search for information out there in the real world, wherever I could. And in my search, I discovered a tiny cluster of other searchers, eager to share their knowledge.’
‘Little did I know how that search would grow; how more than 30 years later many thousands of Australians would also be asking the same questions, facing the same dilemmas and searching for the same gluten-free alternatives. To make the search easier for others I’ve gathered the sum total of my knowledge and experience, added a vast amount of information from The Experts and put my head together with Danna Korn, author of the US version of Living Gluten-Free For Dummies.’
‘So I start at the beginning. This chapter gives you a basic rundown of what living gluten-free is all about.’
Gluten has a couple of definitions; one is technically correct but not commonly used and the other is commonly used but not technically correct. You get more details on both definitions in Chapter 4, but to get you started and for the purposes of most of this book, here’s the common definition: Gluten is the elastic material of dough that has been made from wheat flour.
You can find a lot of information about what you can and can’t eat in Chapter 4 and dietitians can provide lists of gluten-free foods. The most extensive list around is the Ingredient List published by Coeliac Australia, an organisation run by coeliacs, for coeliacs (you can find information about Coeliac Australia and how to join in Chapter 5). But you need to have a general idea of what kinds of foods have gluten in them so you know what to avoid. Things with wheat flour in them are the most common culprits when you’re avoiding gluten. The following are obvious gluten-loaded foods:
But not-so-obvious suspects are around, too, like breakfast cereals, sauces, soups, licorice, confectionery, some potato chips and beer. When you’re gluten-free, you get used to reading labels and digging a little deeper to know for sure what you can and can’t eat (more on that in Chapter 4). You have to do without those foods, but you really don’t have to do without. Food manufacturers make delicious gluten-free versions of just about every food imaginable these days. We talk more about those and where to buy them in Chapter 8.
You may see lots of labels proudly declaring a product to be wheat-free (some of which, like spelt and kamut, aren’t really wheat-free at all). That doesn’t mean the food is gluten-free.
Being gluten-free involves much more than just cutting gluten out of your diet. It affects other aspects of your life, from how you handle ordering at restaurants to attending social functions and dealing with emotional challenges.
We believe it’s important to take control of the diet or, if it’s your kids who are gluten-free, help them gain control. Going gluten-free also gives you an opportunity to reach out and help others who may need to embark on the wonderful world of gluten-freedom, as well as a chance to discover more about nutrition and what you’re actually putting in your body on a daily basis. If that sounds like a lot of work, relax. We’ll guide you through it. And not only can you feel better, but you can also feel better about yourself!
This book is the resource you need — wade your way through it and dog-ear the pages you want to come back to when you need some practical or emotional reminders on how to deal with difficult issues. If you have an optimistic but realistic approach, you’ll encounter fewer obstacles along the way.
You have a lot of company. Coeliac disease is now being diagnosed at a faster rate than any other disease and the number of people diagnosed with gluten intolerance is also on the rise. Changing both your diet and lifestyle is neither quick nor easy, but the benefits of going gluten-free can be fantastic — no surgery or medication required!
Food is supposed to give you energy and make you feel good, not make you hurt. But when you eat things that your body doesn’t like for one reason or another, your body has a sometimes not-so-subtle way of telling you to knock it off. Food that your body objects to can cause gas, bloating, diarrhoea, constipation and nausea — and even things that don’t seem to be associated with the gastrointestinal tract, like headaches, fatigue, depression, joint pain and respiratory distress.
The great thing about all this is that when you find out, through medical tests, that your body can’t tolerate gluten, you can stop eating it and then your body stops being so ‘precious’. In fact, feed it right and it can make you feel great in many different ways.
The 12th-century physician Maimonides said, ‘Man should strive to have his intestines relaxed all the days of his life’. No doubt! When your intestines aren’t relaxed — or when they’re downright edgy or uptight — they affect all your other parts, too. It’s like when you’re in a really good mood and your best friend is grumpy — the situation can make you grumpy, too. One cantankerous intestine can be a party-pooper for the entire body.
In a way, the body’s reaction to gluten doesn’t compute. In some people, eating gluten can cause headaches, fatigue, joint pain, depression or infertility; at first those types of symptoms may seem unrelated to something going on in your gut, much less something you eat — much less something as common as wheat in your diet.
But those — and about 250 others — can be symptoms of coeliac disease and gluten intolerance. People with coeliac disease or gluten intolerance often have gastrointestinal symptoms, but sometimes the symptoms are extraintestinal, meaning they take place outside the intestinal tract.
If you’re diagnosed with coeliac disease, a gluten-free diet should relieve many symptoms, such as:
It may also help with some other conditions, such as:
The list’s impressive, isn’t it? The idea that eliminating one thing from your diet — gluten — could improve a range of seemingly unconnected conditions is hard to believe. Yet it’s true — and it really makes sense when you realise that if the food you’re eating is toxic to your body, your body’s going to scream. Obviously gluten isn’t the answer to all medical problems. Some of the symptoms on the list are due to other conditions and gluten won’t help with those.
For people with gluten intolerance, eating gluten may make the symptoms of some psychiatric conditions worse. (We talk more about that in Chapter 2.) Some researchers think removing gluten from the diet can improve the behaviours of some people with:
Some people find that eliminating wheat not only relieves their main symptoms but also has other benefits as well, such as reducing PMT or menopausal symptoms.
Of course you did. Anyone who’s spent more than a day on planet Earth has been barraged with messages hailing the virtues of wheat — especially in its whole form! It and other grains hog much of the food pyramid(s), suggesting you should eat loads of it, and it’s touted as a good source of fibre and nutrients. Wheat does provide some health benefits, but you can find them in other food sources, too. So how can wheat be at the root of so many health problems? This section covers some of the reasons wheat may not be good for everyone.
Wheat wasn’t introduced until the Agricultural Revolution, about 10,000 years ago. Before that, people ate lean meats, fish, seafood, non-starchy vegetables and fruits.
When wheat came on the scene, it was completely foreign. Human bodies had to adapt in order to tolerate it and some researchers believe that many people don’t tolerate it well at all.
If you’ve just been diagnosed as a coeliac and you’re afraid you’ll have to wake up at 4.00 am to bake gluten-free bread and make pasta from scratch, turn off the alarm and go back to sleep. Plenty of ready-made gluten-free foods are available to take the place of all your old favourites.
And if you’re as happy as a red-back in a gumboot when you’re surrounded by recipe books, wooden spoons and culinary challenges, go right ahead. We’ll be waiting outside for you to create the perfect gluten-free Anzac biscuit.
Whether you’re a kitchenphobe or a foodie, you’ll find a steadily increasing selection of gluten-free foods and ingredients to choose from.
Putting together healthy and delicious gluten-free meals is a lot easier if you plan ahead. Wandering through a supermarket, perusing restaurant menus, or (gasp!) sitting in a bakery with a growling tummy isn’t exactly conducive to making good food choices.
The healthiest way to enjoy a gluten-free lifestyle is to eat things you can find at any supermarket or even a farmer’s market: meat, fish, seafood, fruits and vegetables (see Chapter 6). If you want to add canned, processed and even junk foods to your shopping list, you can still do most of your shopping at a supermarket.
If you hope to enjoy the delicious gluten-free commercial products that are available these days, you can find them in health food aisles, in the supermarket freezers or at health food shops. Or you can shop in your PJs on one of the internet sites specialising in gluten-free products (if you’re using your library’s internet or an internet cafe to shop online, you may want to change out of the PJs).
Some people worry about the cost of gluten-free food, but less-expensive ways of doing it are possible. We talk about eating gluten-free more affordably in Chapter 8.
For the most part, a gluten-free kitchen looks the same as any other kitchen — without the gluten, of course. You don’t need to go out and buy special gadgets and tools. If you’re sharing a kitchen with gluten, you need to be aware of some contamination issues so you don’t inadvertently contaminate a perfectly good gluten-free meal with gluten. Getting people to keep their crumbs to themselves isn’t just a matter of hygiene, but can mean the difference between a meal you can eat and one you can’t.
You’ll discover that you can make most things gluten-free. All you need is a little creativity and some basic guidelines for using gluten-free substitutions, which you can find in Chapter 9.
If you’re a die-hard recipe fan, never fear — we include loads of recipes in Chapters 10 to 15. Most of them are easy to follow but leave your family or guests with the impression that you spent all day in the kitchen (and being thus indebted, may volunteer to do the dishes).
Most people who embark on a gluten-free diet are doing so because of health issues — and that means they have no choice in the matter. When people are forced to make changes in their routine, especially changes that affect what they can and can’t eat, they’re not always so quick to see the joy in the adjustments.
If you’re a little gloomy about going from gluten-gobbler to gluten-freebie, we understand. But prepare yourself to read about all the good reasons to be positive about the gluten-free lifestyle (impatient types, feel free to skip to Chapters 19 and 20 for a jump-start on all the pluses).
If you’ve been eating gluten for a long time — say, for most of your life — giving up foods as you know them may seem like a tough transition at first. Besides the obvious practical challenges of learning to ferret out gluten, you have to deal with emotional, physical, social and even financial challenges.
You have to do only one thing in order to love the gluten-free lifestyle and that’s to adjust your perspective on food just a tinge. You really don’t have to give up anything; you just have to make some modifications. The foods that used to be your favourites can still be your favourites if you want them to be, just in a slightly different form. And be prepared for the delights of discovering new favourites, for you certainly will. Your palate is pretty agreeable, if you let it, to enjoying new tastes and textures.
Or you may want to consider what may be a new and extra-healthy approach for you: making lean meats, fresh fruits and non-starchy vegetables the main components of your diet. We talk more about creating a really healthy, balanced gluten-free diet in Chapter 6.
People who are new to the concept of being gluten-free sometimes comment that the diet is boring. If you ask what they’re eating, they’ve usually found a few meals that are gluten-free and they stick to those, day in and day out. Instead of seeking out gluten-free breads that they like, they chomp through a daily ration of rice cakes. Who wouldn’t grow bored with that? That type of a diet is downright depressing.
A nutritious, gluten-free diet doesn’t have to be boring or restrictive. You don’t need to limit your diet to a few absolutely safe foods. If you do prefer bland foods, terrific. But if you have always enjoyed a rich variety of tasty foods, you can keep right on enjoying. No way does gluten-free have to be flavour-free.
You don’t have to let your gluten-free diet hold you back from doing anything you want to do. Well, okay, you can’t do some things — like eat a pizza from every pizza place, or devour a plate of gluten-laden Tim Tams. But as far as your activities and lifestyle are concerned, you can — and should — get out and about as you always have.
For the most part, ordering out isn’t as easy as walking into a restaurant and asking for a gluten-free menu (dream on). But eating at restaurants is definitely do-able; you just need to discover how to order and be aware of contamination issues. Travelling is a bit more challenging and requires a little more flexibility about what you eat and when in the day you eat it. But finding suitable meals adds spice to the travel adventure as you grapple with gluten-free in another language. Thousands who try it agree that it’s much easier than they expected. Going to social events often requires a little advance planning, and holidays may barely faze you — after you get the hang of getting out and about gluten-free style. Chapter 16 gives you more information on this.
The news that your child will have to be gluten-free for the rest of his life often unleashes a flood of emotions, many of them not pleasant. At first, you feel burdened and overcome with grief and frustration and long for the perfectly healthy little baby or child you thought you were entitled to. It’s easy to focus on what you’ve lost and all that you have to change in your lives. But making adjustments doesn’t take long and soon you discover that life isn’t so different after all. The transformation in your child’s health and behaviour compensates for the realisation that you need to be a bit more organised, a bit more watchful and a little less spontaneous when you go out.
Most importantly, you want your child to be happy about the adjustments. After all, it’s their diet, their life, their future that is most affected. Thankfully, almost all kids take dietary changes in their stride and just get on with enjoying life as they did before.
A few issues are central in raising happy, healthy, gluten-free kids. Some of the highlights include
Promoting an optimistic outlook can instil a positive approach in kids. Chapter 17 deals in detail with raising kids to love the gluten-free lifestyle and for more practical advice, help is at hand through Coeliac Australia in your state. In Chapter 5, we also provide a list of books you may want to look out for.
Setting reasonable expectations for what things will be like when you adopt a gluten-free lifestyle is important, because you will encounter challenges, and you need to prepare to handle them well. Friends, family and loved ones may not understand. They may not accommodate your diet when you hope or expect they will. You may find social events to be overwhelming at first; or you may get confused or frustrated and feel like giving up on the diet. You can overcome these challenges and come out stronger for them.
The good news is that because so many people are now on a gluten-free diet a lot of information about it is floating around. The bad news is that not all of it’s accurate.
Be wary of what you hear and read and ensure it comes from a reputable source, like a government health site, Coeliac Australia or a dietitian. If you find conflicting information — and you will — dig deeper until you find out which source is right.
We list a few good sources of information in Chapter 5 and you can find more on your own. Just remember to keep a sceptical eye out for the good, the bad and the completely ludicrous.
If you’ve just been diagnosed as a coeliac, or told to go on a gluten-free diet for other reasons, you’ll want to start right now, but you may not have time to look through this whole book. You’re right — starting right now is important, not waiting until you know everything there is to know about living gluten-free. Your body has been taking a battering from gluten and you want that to stop quick smart so you can get on the road to recovery.
The following sections help you do just that — get started straightaway. If you like, you can come back and thumb through the rest of the book once you have made a start.
Many of the foods in your kitchen are naturally gluten-free. Meat, fish and seafood, eggs, poultry, most dairy products, rice and pulses like chickpeas and beans, and all fruits and vegetables are fine, unless they’ve been processed in some way. You can also eat nuts and seeds, dried fruits, butter, margarine, sugar, salt, spices, vinegar (but not malt vinegar), most tomato sauces, jam, honey, tea, coffee, cocoa, fruit and vegetable juices, most chocolate, most plain potato crisps, wine and spirits. You may already have maize cornflour in the pantry. The foods you’ll have to change are cereals, bread and baked products, pastas, flours and many processed and packaged foods like sauces, biscuits and snack foods. (We go into this in much more detail in Chapters 7 and 8.) In the following sections, we provide a basic shopping list to get you started and a suggested meal plan for the first two weeks.
If fast food is a major part of your diet, the change to gluten-free may hit extra hard. You’ll probably have to (gulp, yes!) dig out the old wooden spoon and chopping knife, buy yourself a pot and pan and have a go at some home cooking, because your gluten-free fast-food options simply won’t provide you with a healthy, varied diet. However, fast-food options are available to keep you fed for the first few days (see Chapter 16 for more on these options) while you make a transition to some home cooking.
Here are some starter tips:
www.coeliac.org.au
or call 1300 458 836.www.daa.asn.au
) to find an APD in your area. This will pay off in the long term as you discover lots more options and ensure your new diet is balanced and meets your particular needs.Diets — and tastes — very so widely it’s hard to create a shopping list to suit everyone. So this is more like a list of items for you to consider; you can add and delete to your heart’s content. If your budget won’t stretch to everything at once, run down the list and decide which sorts of items you really can’t do without, and buy those first. Keep in mind that you’re doing a once-only ‘getting started’ shop, so it may cost more than your usual weekly shop.
To begin with, shopping will take you longer because you need to read product ingredient lists carefully until you’re familiar with them. You can’t always rely on the name of the product itself. For example, ‘rice crackers’ may also contain wheat flour, and soft rice noodles may contain wheaten cornflour.
Here are the gluten-free products you may like to include on your ‘getting started’ list:
See Chapter 8 for more information.
You may choose to simply convert your usual meals into gluten-free versions, or use this opportunity to acquire a whole new repertoire. Most people sit somewhere in the middle, which seems to work well.
The meal plan shown in Table 1-1 provides that mix, with some new recipes from later chapters in this book, as well as suggestions for converting your old favourites to make them gluten-free.
Table 1-1 Two-Week Gluten-Free Meal Plan
Week One |
|||
Day |
Breakfast |
Lunch |
Dinner |
1 |
GF cereal/muesli, low-fat milk or yoghurt GF bread toasted with honey, jam or favourite spread |
Ham and salad sandwich with GF bread Fruit |
Salmon Steaks with Basil (Chapter 13) or fish of your choice Mixed steamed vegetables Fruit and ice cream |
2 |
Fruit and low-fat yoghurt Soft boiled egg on GF toast |
Tomato soup with GF bread (toasted) or corn thins Fruit |
Spaghetti bolognaise with GF pasta or rice sticks Green salad |
3 |
GF cereal/muesli with low-fat milk and fruit GF toast with favourite spread |
Grilled tomato and cheese on GF toast |
Your favourite meat or chicken stir-fry using GF soy or oyster sauce Rice or rice noodles Blueberry Layers (Chapter 15) |
4 |
Blueberry amaranth porridge with yoghurt (Chapter 10) GF toast |
Tuna with salad vegetables and rice or corn thins Fruit |
Spiced Moroccan Chicken with Quinoa and steamed vegetables (Chapter 13) Boiled Chocolate Cake (Chapter 15) |
5 |
Fruit smoothie (banana strawberry, pear, yoghurt and low-fat milk) GF toast |
GF toasted sandwich with peanut butter, celery and raisins Boiled Chocolate Cake (Chapter 15) |
Chickpea Curry in a Hurry (Chapter 13) Green salad |
6 |
GF cereal with low fat milk or yogurt GF toast with favourite spread |
Zucchini and Haloumi Fritters (Chapter 11) with salad greens |
Grilled chicken with baked mixed vegetables Baked custard with ice cream |
7 |
Fried egg with lean GF bacon and grilled mushrooms, GF toast |
Baked vegetable salad with fetta and green leaves |
Lean beef or lamb barbecue, baked potato in foil with green salad |
Week Two |
|||
8 |
GF cereal or muesli with low-fat milk GF toast with favourite spread |
Rice salad (cooked rice, cucumber celery, capsicum apple, yoghurt) Berry Muffin (Chapter 10) |
Grilled fish with lemon sauce, potato mash and steamed vegetables |
9 |
GF baked beans on GF toast Fruit |
Zucchini Soup (Chapter 12) with cheese and tomato sandwich |
Lamb and Eggplant Tgine (Chapter 13) Rice, green salad |
10 |
Fruit smoothie with fruit in season, low-fat yoghurt and milk GF toast |
Tinned salmon or tuna with GF toast and green salad |
Quick Zucchini and Ricotta Pasta (Chapter 14) Green salad Ice-cream |
11 |
GF cereal with low-fat milk or yoghurt. GF toast with favourite spread |
Curried egg and celery GF sandwich Fruit |
Simple Salmon and Quinoa Loaf (Chapter 13) with mixed vegetables |
12 |
Scrambled eggs with parsley on GF toast |
Cold Salmon Quinoa Loaf (leftover from Day 11) with salad |
Vegetarian Lasagne (Chapter 13) with green salad |
13 |
GF cereal with low-fat milk or yoghurt GF toast with favourite spread |
Ham and salad sandwich on GF bread or large corn crackers |
Pork, bok choy and noodle stir-fry Apricot Fruit Loaf (Chapter 15) |
14 |
Herb omelette with chopped tomato and capsicum filling GF toast |
Quick Bread (Chapter 14) with cheese and favourite toppings |
Chicken Quinotto with Mushrooms (Chapter 13) Steamed vegetables |
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