Gluten intolerance

Recently, when I boasted about the fact that a dessert I had baked was gluten-free, the Engineer asked me why that was important to me, since I’m not actually gluten intolerant. The answer is that some of the people I love are gluten intolerant, so I can’t help but think about which dishes they can/cannot eat. And I love finding something good I could serve them. I realize, though, that a lot of people don’t know much about this condition (including some people who suffer from it). I figured I would give you some pointers, like I did once for lactose intolerance.

Gluten is the elastic protein in certain grains that, when baked, causes the food to rise higher and hold together. Gluten intolerance is also called celiac disease. It is an under-diagnosed digestive disorder that causes damage to the small intestine when it is in contact with gluten, because it is treated as a foreign body. So really, it is an auto-immune disorder. The reason it is so under-diagnosed is because symptoms vary greatly from one person to the next, perhaps depending on how much of the small intestine is affected. The classic symptoms are bloating, chronic diarrhea and stomach upset, but some people never experience that. Other possible symptoms include weight loss, anaemia, fatigue, nausea or rashes. Luckily, gluten intolerance can be diagnosed with a simple blood test.

Left untreated, gluten intolerance can cause secondary lactose intolerance (i.e., the small intestine that is damaged by gluten can stop producing lactase and thereby cause lactose intolerance, but this condition is reversible if gluten is avoided for several months and the intestine heals), osteoporosis and even lymphoma (an immune system cancer).

Gluten intolerance is NOT a wheat allergy. And wheat-free does NOT mean gluten-free. Other grains can contain gluten, like barley, rye or spelt. This is why people who are allergic to wheat can eat spelt without a problem, but people who are gluten-intolerant can’t.

Shauna James Ahern, also known as the Gluten-Free Girl, wrote a great book where she explains the condition quite well. She also helpfully gives names under which gluten can hide on an ingredient list (such as modified food starch, caramel coloring and barley malt, just to name a few) and shares gluten-free recipes. I am very much looking forward to the gluten-free cookbook that she and her husband, Danny Ahern (a chef), wrote, due out September 28th, 2010.

There is no cure to gluten intolerance, but the treatment is this: avoid gluten. Period. If you think of all the things you are giving up, you’ll drive yourself crazy. Think of all the things you can still have and discover the substitutes. Based on my experience with lactose intolerance, I divide food into two categories: the substitutes, i.e. the foods that look like they should have the ingredient that makes me sick but don’t; and the other foods, the ones that naturally don’t contain the ingredient I don’t want. For example, a steak with mashed potatoes and a green salad are naturally gluten-free. You’ll definitely have to read labels more closely, though, and only buy products certified gluten-free if you have any doubt (commercial foods are often made with thickeners that contain gluten, and even if that’s not the case, cross-contamination is always an issue). There are cases of people who claim their products are gluten-free when that is a lie, but thankfully, those are isolated cases. And that’s where gluten test strips come in handy – along with better laws.

It’s true that when you go to restaurants, your choices will be limited: either pick ones that don’t serve gluten (like Zero8), or pick ones that can accommodate you (many Indian restaurants, for example, serve foods that are naturally gluten-free; other restaurants might have dishes that are fine for you as well, if you check with the staff). In any case, once you are diagnosed with a food allergy or intolerance, you’re better off if you start cooking for yourself from scratch more. This can be so much fun once you taste the delicious, safe food you can make. You can buy (or make) gluten-free pasta, for example, and have all the pasta dishes you want knowing that they won’t make you sick. There are more and more gluten-free options in stores, especially in ready-made food and mixes (even Betty Crocker’s got them, and there are instructions to make them without dairy if that’s what you need!). Specialized online stores also sell items geared towards those of use with allergies or intolerances, like Dairy-Free Market (which does have gluten-free items).

There are many magazines that cater to gluten intolerance, such as Living Without, as well as specialized cookbooks. If you are looking for blogs to help you, either for support or with recipes, there are hundreds out there. Here is a list of some of them. I’ll recommend Gluten-Free Girl and the Chef in particular: it is extremely well written and has great recipes. To give you hope, I’ll point out here some of those that I consider substitute recipes (even though they are good in their own right), in the sense that you should try them if you are looking to replace some of the gluten staples (as opposed to recipes that naturally wouldn’t have any gluten in them anyway): gravy, cinnamon rolls, gingerbread, graham crackers, pancakes, Irish soda bread, pie crust, sandwich bread, dinner rolls and a crusty boule. (Note that I haven’t tried all of these yet, but I’ve bookmarked a bunch of them and added them to the long list of recipes I must try.)

Finally, here’s a great article titled For the people who love people who cannot eat gluten. If you or someone you love suffers from this condition, please educate yourself about it. With a little practise, cooking gluten-free becomes much easier, so keep trying new things!