A practical and positive guide from Gluten-Free Living Magazine (www.glutenfreeliving.com):
25 WAYS TO EAT WELL & STAY HEALTHY & HAPPY ON A GF DIET
1. Be Patient.
Give yourself time to adjust. Almost everyone is overwhelmed by the challenge of eating gluten-free. Initially it might seem like the diet eliminates all the food you love to eat. Or you might feel surrounded by gluten and unsure if it’s safe to eat anything. It could take up to six months to begin to feel comfortable with the diet and confident about your food choices. So don’t expect to get it all straight overnight.
You may experience some grief over having to give up foods you have eaten all your life! Don’t worry, it’s normal. You will almost certainly make mistakes at first and eat food that contains gluten. This is also normal. Time is on your side and the lifestyle will get easier as you learn more and gain more confidence in your choices.
2. Be Positive.
Don’t think about what you can’t eat: concentrate on what you CAN eat. Remember that there are many nutritious, tasty foods that are gluten free: plain meat, eggs, vegetables, fruits, rice, nuts, legumes, and beans are all gluten free and can be fancied up with gluten free adornments like plain spices and herbs. Plain fruit juices, milk, coffee, tea, wine and distilled alcoholic beverages are gluten free. Later, when the insecurity fades away, you can go beyond plain. On the other hand, just because something is gluten free, does not mean it’s good for you. Cool Whip, for example, is gluten free. Junk food is still junk food whether it’s gluten free or not.
3. Don’t Cheat.
Make a vow right now not to cheat. You WILL be tempted. At some point, you might start thinking the diet just isn’t worth it, especially if you weren’t very sick when you were diagnosed. You might decide there is simply too much gluten around to avoid, so you might as well go ahead and eat it. You might not want to stand out or make a fuss when you’re eating with others.
Let’s look closer at these excuses. The diet is most certainly worth it. Not only will it make you feel better than you ever have before, it will also protect you from the risks you face if you continue to eat gluten – osteoporosis, GI cancers, lymphoma, for example.
There IS a lot of gluten around. But once you develop some perspective on the diet and acquire knowledge about ingredients, you’ll discover that you can successfully avoid gluten and stay happy and healthy.
In terms of sticking out in a crowd, maybe the gluten-free diet is not quite as conspicuous to others as it is to you. While you’re consulting with the server or the host to make sure your meal is gluten free, your companions might be worrying about what they are going to eat. Maybe they want to lose weight. Maybe they don’t want to spend a lot of money. Maybe they are vegetarians or have diabetes or follow the current craze diet. Just maybe we celiacs and our demanding diet are not as special as we think!
4. Make connections.
Get in contact with a support group. There are over 100 local support groups across the country, all loosely connected. Most are wonderful sources of information, understanding, and practical details. If your doctor can’t put you in touch with a local support group, visit www.csaceliacs.org or email gfliving@aol.com and they’ll try to help you.
Once you’ve hooked up with a support group, go to meetings, get to know other celiacs and volunteer to help. Virtually all support groups need more help than they get. And virtually all offer a great deal more to individuals than each celiac can possibly put back in.
Some people feel they are not the support group “type.” That may be, but if there is a group near you, go to at least one meeting. You’ll find out where you can shop and eat out, and you’ll have a chance to speak to people who will understand exactly what you are going through. Most celiac support groups focus on sharing information, not personal details.
Others have found support groups to be overly scary because they concentrate on all the downsides of the diet and the ominous implications of making mistakes. If this happens and it upsets you, collect all the practical help you can and move on to whatever support helps you feel comfortable and confident. This might even mean starting your own support group.
5. Gather information.
Learn everything you can about the diet. This will involve time and effort, and eventually it will mean sifting through conflicting information to try to separate the accurate from inaccurate or unfounded information. The information here and in our Basic Diet guide has been approved by the Gluten-Free Living Editorial Board.
Your doctor may give you some literature or sources of information. Follow up. There are now several books about celiac disease and a number of newsletters. Naturally, we recommend GF Living Magazine! It is a reliable source of information and if you subscribe, don't find that to be true, we will refund your money ($32/1 yr, $54/2).
6. Buy a Cookbook.
Buy at least one gf cookbook. A cookbook is important because it will also provide some basic information about the diet and about the peculiarities of gf cooking and baking. There are several to choose from, and you will find them informative and helpful if you have no plans to become a gf Julia Child. For starters, Bette Hagman, Carol Fenster (savorypalate.com) and Connie Sarros have authored multiple gf cookbooks, and there are more.
7. Eat GF Bread.
Bread should remain a staple in your daily diet. You can purchase a variety of ready-made gf breads. Usually you'll find them in health food or specialty shops or you can use mail order or go through the internet. The available selection gets better and more nutritious every year. Initially the taste and consistency might seem odd, but don't make any snap decisions. Try all gf food at least twice. You will be amazed how quickly you adapt.
The best loaf of gf bread might be the one you bake yourself. To make this job easier, consider buying a bread machine. With a bread machine and some ready-made bread mixes or gf baking supplies, you will always be able to eat your daily bread. Although bread machines may seem expensive, they can be especially helpful in the gf kitchen. Just as there is nothing like a freshly baked loaf of wheat bread, there is nothing like a freshly baked loaf of gf bread!
8. Shop Around.
Visit all the health food stores; get to know the owners. Give them information about CD and put them in touch with gluten-free food processing companies. Tell them about the growing numbers of celiacs being diagnosed in the U.S. A prevalence study conducted by Alessio Fasano, MD, and other celiac experts, published in the Annals of Internal Medicine (2003), suggests one out of every 133 people has CD. Dr. Fasano has pointed out that this makes CD more common than Crohn's disease, ulcerative colitis and cystic fibrosis combined.
There are now several shops across the country that are completely gf, and they are prospering! Others have sections of gf food. The days of searching endlessly for ready-made gf products are just about gone. In fact, you may even find some in your local supermarket.
9. Develop Supermarket Savvy.
Learn to navigate the supermarket. At first, you will probably spend double or triple the time you used to spend on each shopping trip. That's because you will have to read every label, every time you shop, and at first, you won't be familiar with many of the ingredients. (see next tip).
Don't try to figure out everything at once. Select one or two items you would like to be able to eat and check them out. Almost all food processors have 800 numbers and if you bring your cell phone to the supermarket, you can make the call on the spot. Then, next time you shop, you can select one or two more items to check up on.
Be practical. Plan on doing a lot of shopping in the produce and meat departments. Concentrate on plain rice and potatoes, which are naturally gf, rather than on pasta, which is mostly likely made from wheat. (You will find rice- and corn-based pasta in some grocery stores, at the health food store or by special order.) Look through the frozen food cases for gf items, including desserts. Avoid aisles like those that contain bread, cake, cereal and cookies. You can be pretty sure that just about everything in these areas contain gluten.
Be smart. Try not to start with junk foods. Yes, there are still plenty of junk foods that are gf. But that's really not the best place to start coping with the diet, especially if you've been very sick. One hidden advantage to following the gf diet is that it forces you to adopt healthy eating habits.
10. Become a Label Expert.
Rise to the challenge of reading labels to determine if a food is safe for you. Start with ones that list only a few ingredients and work your way up to those that rival a legal document in terms of complexity. Like anything else, reading labels gets easier each time you do it. It would be impossible to go through an extensive list of ingredients here. These are the ones you will most likely question at first:
CARAMEL COLOR:
FDA regulations indicate caramel color can be made from malt syrup. But processors in North America say they use corn because it makes a better product.
CITRIC ACID:
FDA regulations indicate citric acid can be fermented from wheat. But processors in the US say they use corn. Scientists say even if wheat is used, the ingredient is so highly purified, no harmful proteins would remain.
DEXTRIN:
Can be made from wheat. To find out, you would need to call the food processor.
MALT:
Almost always made from barley. You can call the processor to check, but odds are very good that the source is barley.
MALTODEXTRIN:
Gluten free unless a gluten-containing ingredient appears right before or after the word in parenthesis, for example, "maltodextrin (wheat)" or "wheat maltodextrin." Don't confuse this with dextrin.
NATURAL AND ARTIFICIAL FLAVORINGS:
May or may not be gluten free, and it may be impossible to find out for sure. You can call the processor, but even then, you might not find out. We will probably never know what is in all flavorings. But according to the Flavor Extract Manufacturers Association, they are highly likely to be gluten free unless they are found in a meat product or a product that contains meat.
SPICES & SEASONINGS:
Pure spices are gluten free. Bottled spices may contain silicon dioxide, which is gluten free, to keep the spice free flowing. If a pure spice container does not have a list of ingredients on the label, the only thing it contains is the spice indicated. Seasonings have not been defined by the FDA and therefore could contain anything. Sometimes the contents of a seasoning are included on the label in parenthesis.
STARCH:
On a food label, "starch" always indicates cornstarch. Modified food starch, however, could be made from wheat, although most processors use cornstarch. In pharmaceuticals, starch and modified food starch could be made from wheat, although cornstarch is a more likely choice.
11. Don't Believe Everything.
REGARDLESS OF WHAT YOU MAY READ ELSEWHERE, VINEGAR IS GF. The only vinegar celiacs need to avoid is malt vinegar (send a stamped, self-addressed envelope to GF Living, PO Box 105, Hastings on Hudson, NY 10706 for our detailed explanation of why vinegar is gf.) Regardless of what you read on the package, spelt and kamut are forms of wheat so they contain gluten. On the other hand, canola oil, pure vanilla extract and oat gum are gf.
12. Customize Your Kitchen.
Develop a plan for your kitchen that will protect "your" food from contamination. Although celiac disease does tend to run in families (see tip 21), most celiacs live with gluten-eating relatives.
If you can, buy two containers of spreadable staples like butter, mayo, peanut butter, jellies, and cream cheese and designate one of them for gf use. This will prevent gluten-containing crumbs from getting mixed in and then spread on gf bread. Another way to prevent contamination is by using a spoon to remove spreads from a container, and then spreading with a knife.
Some families buy bright neon stickers or tape (readily available and inexpensive) and stick them on everything that is or should remain gf. You might also want to keep all the gf foods in one place in the refrigerator or cupboard and even designate a portion of the kitchen counter for preparing gf foods.
Buy a personal toaster and make sure no one else uses it to toast gluten bread. You might even want to treat yourself to a deluxe model. Most gf bread tastes better toasted, so it will get a lot of use.
There are many solutions to this challenge as there are families coping with the needs of a gf family member. Whatever works for you is the right way to go.
13. Plan Appropriately.
Modify the way you plant menus. When purchasing, storing and cooking food, think in terms of making the job as easy, adaptable and comfortable for everyone as possible. Keep a stock of gf food on hand. Store carefully. Cook in large quantities and freeze leftovers.
Some meals are naturally gf. For example, broiled fish or meat, plain vegetables, and plain potatoes or rice are all gf. If you want to serve pasta, use separate pots, or boil the gf pasta first and make sure the sauce is save (it almost always is, but you should still be in the habit of checking). Then be careful with utensils.
14. Vary Your Diet.
It's very tempting, especially when first diagnosed, to start eating the same things over and over. This usually happens when early paranoia sets in and gluten begins to seem like it's everywhere. Some celiacs never lose their fears and it's at least open to debate as to whether this kind of paranoia is helpful or not. While new restrictions are a normal part of adjusting to gf living, you still need to consume a variety of foods in order to get all the nutrients you need to stay healthy. You have to think gf. But you also need to think in terms of packing as many nutrients as possible into your nutrient-starved body.
15. Emphasize Calcium.
Be sure to eat plenty of calcium-rich food, especially when you are newly diagnosed and making the transition to the gf diet. The rigors of learning the diet might make you forget how important this mineral is, especially to celiacs. Calcium is one of the main nutrients robbed from the body by undetected gluten sensitivity, and inadequate calcium can lead to long-term problems, such as osteoporosis.
Dairy foods are the best sources of calcium (see next tip). In addition, the following foods are among the best non-dairy sources of calcium and they are all naturally gf (but be sure to read all labels): canned sardines and salmon with bones, canned shrimp, bok choy, collard greens, turnip greens, and broccoli.
Celiacs should consider taking a calcium supplement daily. Calcium carbonate is usually recommended as the best, most bioavailable (meaning it dissolves so the body can absorb it) form to take. The suggested general dose is 1,000mg a day. According to the National Osteoporosis Foundation, women over 51 should take 1200mg of calcium.*
Health care professional suggest not taking your recommended dose all at once, but spreading it out over two or three doses throughout the day, with each partial dose taken at or near mealtimes.
(*I've read otherwise: that calcium citrate is more bioavailable. My doc recommended Posture D, which has a balanced ratio of magnesium and Vit D for max absorption. My Vit D levels were checked and I also needed an Rx for Vit D. Ask your doc to check your fat soluble vitamin levels. Do your research and talk with your doc.)
16. Don't Skip Dairy Foods.
Dairy foods are important even if you are lactose intolerant. But they can be a problem (sometimes it's a temporary problem) for newly diagnosed celiacs who are often lactose intolerant. That's because untreated gluten sensitivity tends to destroy the tips of the villi where lactase is produced. Lactase is the enzyme which helps digest lactose.
Some celiacs find lactose intolerance goes away as their small intestine heals. Others discover it doesn't go away because they are genetically predisposed to be intolerant of lactose. These celiacs will have to continue to cope with the problem, but they still need to eat dairy products.
If you are lactose intolerant, use one of the products currently available that helps people digest lactose, but remember to call the manufacturer to check the gluten status. The Calcium Information Center suggests that lactose intolerant people consume food at the same time as lactose containing beverages to help delay gastric emptying and decrease symptoms.
17. Deal with DH.
Pay attention to all these tips if you have dermatitis herpetiformis (DH). DH has been called CD of the skin. It is an extremely itchy, red rash that tends to appear on the elbows, knees, buttocks, scalp and back. The rash is caused by IgA deposits just under the skin that result because the individual is sensitive to gluten.
Dermatologists often treat DH with dapsone, a drug that relieves the itch and slowly clears the rash. Affected individuals also should follow a gf diet or the rash returns as soon as the dapsone is discontinued.
A gluten-free diet will gradually decrease the need for continued dapsone use. Approximately 70% of DH patients will be able to discontinue dapsone therapy completely after 18 months on the diet, but they, too, must continue the diet for life.
Unfortunately not all dermatologists recognize the gluten connection to DH. Some simply prescribe dapsone, which can have very serious side effects including damage to the red blood cells (and liver), and don't mention the importance of the gf diet. So the educaton component suggested in tip 22 is particularly important where dermatologists are concerned.
18. Don't Stay Home.
You can travel and eat out, but be cautious. When you travel, plan ahead. Try to bring as many food items as you can without making yourself uncomfortable during the trip. If you're traveling in this country, you can contact a local support group at your destination. The members should be able to give you tips on eating out safely in their locale.
(Think ahead in terms of emergency preparedness as well. I live in tornado country now - our shelter is stocked with water and gf food. I'm moving to hurricane country and will learn how to prepare for that. ~Dots.)
If you're traveling abroad, make sure to bring a translation that explains your dietary needs. We have translations in Spanish, French, Hungarian, and Koren. For copies, send a stamped, self-addressed envelope to GF Living, PO Box 105, Hastings on Hudson, NY 10706.*
Eating out takes on a new twist when you lead a gf lifestyle. Think in terms of small, ethnic (since many ethnic cuisines are corn- or rice-based) or standard American, which can be good choices. If you develop a relationship with a restaurant (tipping well doesn't hurt), your confidence level will rise. When dining out, patiently and clearly explain your needs to the staff (sometimes the manager or chef is a better contact than the server). Then relax and enjoy yourself.
*restaurant/travel card links or search online for more:
www.celiactravel.com/restaurant-cards.html
(free/asks for donation),
www.glutenfreepassport.com/traveling/trans
lations.html, (free)
www.triumphdining.com/ (when I bought them, $10. Laminated and good quality.)
19. Don't Complain.
Try not to think of the added expense of gf food as a burden. Remember it is the only "medicine" that will assure your good health. Compared to the cost of prescription drugs and minus the negative side effects they often cause, you can even convince yourself that gf food is quite a bargain.
Don't get mad at companies that specialize in gf food. Their products are more expensive because of the limited numbers of customers, the necessity for carefully investigating all ingredients, some difficulties reaching the gf market and the rigorous processing requirements. Vendors of gf foods are knowledgeable and well informed. They are working for YOU.
Another reason not to blame vendors for the cost of gf food is their overall graciousness toward the gf community. You'll find dealing with gf specialty companies a pleasure. Most companies now have 800 numbers and all are knowledgeable, sometimes more knowledgeable than their customers. These companies are in business because they understand your problems (an amazing number were started by people who were diagnosed themselves). They know what you can eat and what you can't eat. They are well aware of the contamination problem and have adopted processing standards that make their products safe for you to eat.
Most importantly, think about the monetary and lifestyle costs of the long-term problems a strict gf diet could save you from - osteoporosis and lymphoma to name two of the most important. If you look at the gf diet as a critical preventive health measure, then it will seem cheap, indeed.
20. Stock Up.
During the spring Passover season, Jewish law forbids eating any food that contains "chametz," which refers to wheat, rye, barley, oats or spelt, the exact grains forbidden on the gf diet. So it's a good time to stock up on foods labeled "Kosher for Passover," which are certified to be gf with one very important exception. The exception is any Passover food that contains any form of matzo. Matzo is a special unleavened bread made with wheat flour and water. It is eaten as is in the large square crackers that substitute for bread during Passover. It is also ground into matzo meal or processed further into matzo flour.
The assess Passover foods, first make sure the label clearly identifies the product as "Kosher for Passover" (must include all three words). Then read the ingredient list. If you don't see matzo or any form of matzo (matzo meal, matzo flour, matzo anything or cake flour), the item is guaranteed to be gf. While no individual entrepeneur can be guaranteed, kosher bakeries follow strict directives and are knowledgeable about their ingredients and mixing and baking processes.
Once you understand the bottom line, you're in for some treats, many of which can be frozen. During Passover you will find certifiably gf condiments, many prepared cakes and cookies as well as mixes (read labels carefully), and candies, including Passover chocolate - as pure and as good as it gets!
21. Test the Family.
Encourage your relatives to be tested, especially your first-degree relatives. The prevalence of celiac disease in first-degree relatives (parents, children and siblings) is much higher than it is in the general population. According to a prevalence study published in the Annals of Medicine in 2003, one in 22 first-degree relatives of biopsy-proven celiacs has CD. But be prepared for resistance from your relatives whether they have symptoms or not. Sometimes, family members refuse to be tested. Don't feel guilty if they make that decision.
22. Educate Doctors.
Give information about celiac disease and blood testing to your current doctor and all the doctors you consulted before you were diagnosed. While more and more doctors are becoming aware of CD and its many symptoms, far too many still do not know about the growing prevalence of the disease. Every effort you make to inform the medical community will help doctors cultivate a higher suspicion for CD, which in turn will help others get diagnosed more quickly than you did. Two labs that are experienced in testing for CD are Immco Diagnostics in Buffalo, NY (800-537-8378 or
www.immcodiagnostics.com) and Prometheus Labs in San Diego, CA (888-423-5227 or
www.prometheuslabs.com.
23. Stay Sane.
It's easy to lose perspective, especially when you are new at gf living. Keep your sanity by remembering that each and every gastrointestinal upset or twinge may not be because you have inadvertantly consumed some gluten you weren't aware of. Gluten-sensitive individuals are still human and they can get sick just like those who are not gluten sensitive. Some of the problems people can have that might be misinterpreted as a gluten "reaction" are: microscopic colitis, pancreatic insufficiency, refractory sprue, or lactose, fructose, maltose or sucrose intolerance.
Certain ingredients cause gastrointestinal problems in lots of people, not just those who are gluten sensitive. Sorbitol is a good example. Sorbitol, a chemical used to prevent caking, promote flow and sweeten food is found in a variety of products that are ingested by humans. It is on the FDA's GRAS list which includes those foods "generally accepted as safe" for human consumption. And it is gf. However, excessive consumption of sorbitol may have a laxative affect.
24. Teach Your Children Well.
If you are the parent of a celiac child, you have a challenging and very important job. You are in charge of your child's gf diet, but even more importantly, your positive attitude can steer him or her toward a happy, healthy gf life.
Yes, you have to make sure your child's food is as gf as possible so he/she will feel well and grow properly. But making your child feel as normal as possible within the confines of the diet is just as important. Generally, that means never letting the diet stop him from participating in an activity, going to a party, joining in with friends.
Plan for food in advance. Bake and freeze gf cupcakes and pizza so you are always ready for a b-day or school celebration. Send gf snacks your child can have when an unexpected treat turns up in the classroom. Offer to bring food, which happens to be gf to scout meetings, soccer games and other activities so your child can enjoy it along with everyone else. Many of the foods children typically like are now available in gf versions that you can keep in stock for your child. You can police every food to make sure it does not contain gluten, but your child still won't grow normally if he/she is made to feel that CD limits or defines who he/she is. Celiac kids adjust amazingly well with the right kinds of support from family and friends and a "can do" outlook on their diet from you.
25. Get on With Life!
CD may seem like the worst thing that ever happened to you. But you will soon see that it may be the best thing that ever happened to you! The diet is manageable. It prevents more serious health problems.
Most of all, the diet is doable and the lifestyle is rewarding. You can (and you will!) get to a point where you follow a strict, unwavering gf diet as if it were the most normal thing in the world.
Edited by: DOTSLADY at: 2/4/2008 (23:20)
KNOWLEDGE = POWER. BODY = TEMPLE. FOOD = MEDICINE. PREVENTION IS THE CURE. YOU ARE WHAT YOU ABSORB!
One person's food is another person's poison.
__________
Celiac Disease: An autoimmune reaction from eating gluten grains: wheat, rye, barley and contaminated oats=nutrient deficiency=cancer. Have 1 of 300 symptoms?
bit.ly/cdsymptoms CD stories:
bit.ly/cdstories Nutrition/Cancer:
bit.ly/Quillinnutrition
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