Gluten sensitivity can be on a sliding scale




Like Rodney Dangerfield, gluten-free diets “don’t get no respect.” Utter “gluten-free” and watch the eye-rolling, the snarky smirks, the “Oh, get over yourself” attitudes.

While doing research for two months to gather information for this article, I shopped, cooked and pretty much lived the gluten-free life. It’s hard.

To many people, gluten-free is just one more diet fad, one more bandwagon in the endless parade of diets so beloved by Americans. The gluten-free diet and the industry it has spawned, detractors say, will go the way of Atkins, South Beach diets and the many that came before and that will come after them.

But maybe not.

Odds are, you know someone who is trying to eat gluten-free or gluten-limited meals. They often say, “I feel better when I don’t eat gluten.” But the odds are also that you don’t know anyone who actually has celiac disease. There’s a huge difference.

Less than 1 percent of the U.S. population has celiac disease, an autoimmune condition that can destroy the small intestine. That’s about one out of every 133 people in the United States. The treatment for celiac disease is a strict, lifelong gluten-free diet. The people afflicted with celiac must never eat gluten, a protein found in wheat, barley and rye. And no, they can’t just “take a little taste” of those foods. A blood test can determine whether a person has the disease. Diagnoses of celiac have seen a big uptick in recent decades.

But an estimated 6 percent of the population, or 16 to 18 million people, are considered to have a very real, but lesser, condition called non-celiac gluten sensitivity (NCGS), a term originally described in the 1980s. Much of the current scientific work on celiac disease and NCGS has been led by Dr. Alessio Fasano, a pediatric gastroenterologist, now at MassGeneral Hospital for Children, and his colleagues.

Gluten-sensitive people will not suffer small-intestinal damage, but they will complain of bloating, gas, cramps and diarrhea when they eat gluten-containing foods. It’s real, it’s embarrassing, it’s painful. That’s reason enough to shun the stuff.

Here’s where things get sticky. While the 6-percenters are in fact gluten-sensitive, and there are lots of people for whom eating foods without gluten is the only gut-comfortable way to go, others may be riding the gluten tide for a variety of often uninformed reasons.

New terminology already has come into use to describe this preference. People will say, “I prefer to eat foods made without gluten,” rather than “I eat foods that are gluten-free.”

One theory says that because gluten is a relative newcomer to the human diet, we have not yet adapted to digesting the substance. Another says that avoiding gluten helps people to avoid highly processed grain. Some people agree, other people debunk those theories. There is plenty of information and misinformation to be found online.

What is gluten good for, anyway? Can’t we “just leave it out?” I wish. Think of all the wheat, as well as barley or rye, that you encounter in a day. The gluten protein is what gives stretchiness to doughs and structure to breads. It is the elastic stuff that keeps a pizza in one piece when it’s tossed into the air. It also makes your pie crust tough when you over-roll the dough.

You think it’s easy to avoid bread, pasta, pancakes, pies and cookies? And beer, soy sauce, malt, flour-thickened sauces and pre-made items coated with bread crumbs? At best, avoiding gluten is a mind-boggling, label-reading pain in the you-know-what.

The Food and Drug Administration has taken note of the gluten-free (GF) tsunami and passed new labeling laws for gluten-free products. The compliance date for the final rule was Aug. 5, 2014. Not surprisingly, manufacturers are on the case big time. It’s predicted that the market for manufactured foods made without gluten will reach $15 billion in annual sales by 2016. Gluten-free sells.

Go gluten less, not gluten free

“Is gluten the sole issue, or is it the quantity of gluten eaten?” asks Leslie Bonci, director of the nutrition program for the University of Pittsburgh Physicians. “Gluten sensitivity is on a spectrum, which means a scale that has two extreme and opposite points: highly sensitive and not at all sensitive. Everyone is different. It is not all or nothing.”

How to tell approximately where you are on the gluten spectrum? The best way is an exclusion protocol. And you figure that out by keeping a food diary. Write down everything you eat and drink every day for, say, three days to a week. Also note how you feel. Then analyze the notes, noticing any problem-related patterns. Bellyache after beer? Cramps after two sandwiches? After a cookie binge? You can eliminate items for a period of time, introducing them back into the diet gradually and taking notice of any discomforts. You may find that you have a problem with gluten, with just too-much gluten, or something else entirely.

Could that something else be the way big-ag genetically-modified wheat is handled at harvest? Some online sources say that certain weed killers are sprayed on the grain just before harvesting. Whoa, might that point to a bellyache? And gluten would have nothing to do with it. The jury is still out on that one, but if you’d like to eat wheat, but are fearful of a possibility of pesticides, choose only organic wheat products, and use organic flour in your home baking. When eating out, reject anything made with conventionally produced and processed wheat. You won’t miss the restaurant pasta, bread and croutons and processed desserts. That’s certainly worth a try. Better yet, know your conscionable restaurants and patronize them.

Ms. Bonci continues, “Anyone can see how portion sizes have changed over the years. Bagels used to be the size of a hockey puck; they are now almost the size of a hubcap. Dinner plates are wider, bowls are broader. A serving of pasta used to be about one cup and served on the side; now it’s closing in on six cups; not just center of the plate but all of the plate. Go to some Italian restaurants and have a meal of pasta and garlic bread, and you are almost guaranteed to have gluten-bloat.

“For many people the quantity of gluten eaten is more at issue today than the wheat itself. As a first step, instead of removing gluten completely from meals, try cutting down,” she advises. “Eat half a bagel, one piece of toast instead of two, a smaller portion of pasta. A bonus is that with smaller portions, you’ll be eating half the calories along with half the gluten. And many gluten-free foods are loaded with calories from fat and sugar, with considerably less nutrition. Whole wheat has many benefits, and gluten-free items don’t often stack up nutritionally as well. At the same time, you can add more naturally non-gluten containing foods, such as rice and corn, to your meals; and certainly, more fruits and vegetables.”

There are more negative consequences when gluten is dropped entirely, according to Ms. Bonci. “Most people have some sort of salary cap on what they can spend on food,” she says. “Prices of gluten-free foods are through-the-roof expensive. How many people are literally ’buying in’ to this trend?”

Her wrap: “No gluten at all? If you don’t have to, why would you? Put gluten control into the equation. Cut back, not cut out. Try gluten less, not gluten free.”

Discriminate, not eliminate.

In the supermarket

You cannot escape the growing number of GF products on supermarket shelves. If labels could scream, you’d hear the cacophony: Here a GF, there a GF, everywhere a GF. There are even GF claims on foods that are inherently gluten-free, such as peanut butter, applesauce and fruit juice. In front of a store near Trader Joe’s, my husband saw a sign that said, “We Sell Gluten Free Mattresses Here.” Has it come to that?

A few weeks ago, I spied a poster at the Settler’s Ridge Market District supermarket: “Free! In-aisle excursion with a dietitian to identify gluten free products.” I just had to go.

The following Saturday morning, eight of us, all women, showed up. We were given a press kit of information identifying brands to look for and where to find them. Our leader, Jessica Tones, a registered dietitian, led us first through the “safe aisles” — produce, meat and fish. No gluten issues there, except for a few prepared foods that included bread crumbs. Then we walked and talked for an hour. It’s a big store.

The Iggle has dedicated sections, aisles and cold cases for GF products. Some of the brands are excellent; I can vouch for Barilla pasta, Nabisco Rice Thins and Udi’s bread. GF Bisquick works just fine. Amy’s products are consistently good. So are flours in the Bob’s Red Mill line, all packaged in small quantities. But note: some products are just plain awful and gag-worthy: gritty, pasty, bitter and nasty flavored. You’ll have to figure out what you can stand or not, and decide for yourself.

Most homemade GF pie doughs are a disaster. With no gluten structure to hold them together, they rip, tear, fall apart and are gritty on the tongue. However, there is an excellent product in the dairy case: Pillsbury’s Gluten Free Pie Dough. It’s close, very close. But if that won’t fly at your house, better to forget pies and make crumbles or cobblers that need no structure.

In the kitchen

This is not as hard as you might think. No worries about meat, eggs, nuts, oils, fruits and vegetables; they are naturally free of gluten. But you will want a GF cookbook, and be sure to page through it before you buy. Some of the quick-to-publish-to-get-in-on-the-cash cookbooks take up most of their recipe space for things such as chicken and potatoes, salads and soups, all naturally GF. Choose a book that pays strong attention to baked goods because that’s the hardest category of all to duplicate without gluten.

Then cook. Experiment, tweak and don’t be afraid to pitch out a dish if it is unacceptable. Come to terms with the facts that GF cooking and baking will present unfamiliar textures and consistencies. Not that there’s anything wrong with that; it’s just different. Hey, when you choose one path and not the other, the destinations are bound to differ.

The diabetics who watch sugar, the lactose-intolerant folks who pass by dairy and the weight-watchers who count points get through the day by selective eating. No big deal. So don’t be uppity or brag about cutting back on or taking gluten out of your meals.

In my own kitchen, the effects of going GF for a couple of months are lasting. I cook more cornmeal, rice, quinoa, and legume dishes, and mealtime is the better for it. I thicken sauces with cornstarch. I’ve switched from regular soy sauce to tamari, a soy sauce made without wheat. Fruits and vegetables are way up on my preferences. I make Chex mix with only rice and corn chips. I drink wine, not beer, and often snack on popcorn and nachos. I’ve found many ways to naturally cut back.

But what’s for dessert? I have an insatiable sweet tooth. I have a GF cookbook, but more often than not, I page through my tried and true traditional cookbooks to find a load of GF options. Here are some very family- and guest-worthy ones. I think you’ll like them.

* Skillet Apple Crisp. A one-utensil, stovetop dessert that comes together in minutes. It will please the whole family.

• Coconut Kisses. Naturally GF, these are kiss-the-cook good.

• Silver Dollar Blini. Quick, inexpensive and delicious. Serve these instead of bruschetta with all kinds of toppings and spreads. Even caviar and sour cream.

• Autumn Mushroom Pie. I made this with Pillsbury’s Gluten Free Pie and pastry refrigerated dough. And nobody knew.

• Flourless Chocolate Cake with Eggnog Creme Anglaise. A classic cake with a surprisingly easy one-ingredient sauce. Everyone needs a go-to chocolate cake.

Making and eating foods without gluten or even cutting back is a journey. Challenging, interesting, accepting of what is and what is not. Perhaps you need or want to make that journey. Perhaps you don’t.

As for me, I will discriminate, not eliminate.

For more information:

Call 1-877-289-2588 or go to Gianteagle.com/dietitian

Skillet Apple Crisp

PG tested

This recipe can be made with any fruit you like, including berries, mangoes and pears. Adjust cooking time based on the firmness of the fruit. The topping can get as crunchy as brittle, clumpy as granola, and you may have to break it up into small pieces with a fork. The recipe is from Mark Bittman’s latest book.

6 tablespoons (3/4 stick) butter, divided

1/2 cup chopped walnuts or pecans

1 teaspoon grated lemon zest

1/2 cup GF rolled oats

1/4 cup shredded unsweetened coconut

1/3 cup packed brown sugar

1/2 teaspoon cinnamon

Pinch salt

2 pounds apples (about 4 large) unpeeled, but trimmed, cored and chopped

Put 5 tablespoons butter in large skillet over low heat. When butter is melted, add nuts, lemon zest, oats, coconut, brown sugar, cinnamon and a pinch of salt; toss to coat. Cook, stirring frequently, until topping is golden and crisp, 6 to 8 minutes. Remove from the pan; no need to wipe it out. The topping can be made ahead and stored in an airtight container up to a day or so in advance.

Put 1 tablespoon butter in the skillet over medium heat. When it’s melted, add fruit and cook, stirring occasionally until apples are soft but not mushy, 5 to 6 minutes.

Scatter the topping over the warm fruit and serve. Makes 4 to 6 servings.

-- “How to Cook Everything Fast” by Mark Bittman (Houghton Mifflin Harcourt, Oct. 2014, $35)

Coconut Kisses 

PG tested

1 cup sweetened condensed milk

2⅔ cups (7 ounces) shredded coconut

3/4 teaspoon rum extract

Pinch of salt

Preheat the oven to 350 degrees. Combine milk, coconut and rum extract in medium bowl. Add a pinch of salt, and stir. Mixture will be sticky.

Drop mixture by level tablespoons on cookie sheet lined with parchment paper. Bake for 10 to 12 minutes, until lightly browned. Remove from pan while hot. Put on wire rack and let cool completely. Store in airtight container. Makes about 3 dozen cookies.

-- “Entertaining 1-2-3” by Rozanne Gold (Little Brown, 1999) 

Socca Silver-Dollar Blini with “Caviar”

PG tested

Socca, an omnipresent snack food of Nice, is a thin, flat pancake made from chickpea (garbanzo) flour, olive oil, salt and water traditionally prepared in a wood-fired oven. In this recipe, use the batter to form a kind of mini-crepe, quickly cooked in a skillet on top of the stove. Serve as an appetizer with cocktails, and top with 1/2 tablespoon of tapanade, pesto or eggplant caviar. I’ve served these blini with real caviar and Champagne.

1 cup chickpea flour

5 tablespoons extra-virgin olive oil

Coarse salt

Black pepper

3/4 cup of a topping, such as those noted above

Sift flour into mixing bowl. Make a well. Whisk in 1/2 cup water to form a smooth, thick paste. Add another 1/2 cup water and 2 tablespoons olive oil,1/4 teaspoon coarse salt and a grinding of black pepper. Stir until very smooth.

In a large nonstick skillet, heat remaining 3 tablespoons oil. When it is hot, add tablespoonfuls of batter to make little pancakes. (Make 1 or 2 “testers” to check if oil is hot enough.) When batter has set, turn over an cook for 30 seconds, or until golden. Remove to platter and continue until all pancakes are made. Serve warm or at room temperature. Makes about 24 blini.

-- “Entertaining 1-2-3” by Rozanne Gold (Little Brown, 1999)

Autumn Mushroom Pie with Pillsbury’s GF Pie/Pastry Dough

PG tested

Most homemade GF pie doughs are a disaster. With no structure to hold them together, they rip, tear, fall apart and are gritty on the tongue. There is an excellent product in the dairy case, however: Pillsbury’s Gluten Free Pie Dough. Here’s how to work with it.

Follow the directions exactly. Don’t try to second-guess the product. Roll the dough out on parchment paper. Not wax paper or parchment paper. When transferring the rolled dough to the pie plate, it might, and likely will, tear. And why would that happen? Because there is no gluten to give it structure. Duh. No worries, press the dough together. And if you flute the crust high, either cover the rim with aluminum foil (not easy to do) or accept a nice brown rim.

Filling-wise, the first time you work with a GF crust, you don’t have to worry about a juicy berry filling or anything fussy. Concentrate on the crust. This mushroom filling is precooked, and it can be made in advance. Use a combination of richly-flavored mushrooms such as cremini, porcini, chanterelles and portobellos. Brush the mushrooms to clean them, but don’t rinse in water. Make the filling up to a day ahead. Serve wedges of pie for a lunch or light supper along with a tartly dressed green salad.

2½ cups chopped onions, about 3 or 4 medium

4 tablespoons butter

8 cups chopped mushrooms, assorted

1/4 cup marsala wine

1 teaspoon fresh thyme leaves

1/2 teaspoon salt

Freshly ground black pepper

1 tablespoon cornstarch

1 9-inch GF pie shell with top crust, unbaked

1 egg yolk mixed with 1 tablespoon water

To make the filling, saute the onions in the butter in a very large skillet over medium heat. When the onions are soft, but not brown, add the mushrooms and thyme. When the mushrooms release their juices and reduce in volume, add the marsala and continue cooking until the juices reduce by half. Add salt and plenty of pepper. Sprinkle with cornstarch, and stir a minute or so until the juices thicken slightly. Remove from heat. Cool filling before making the pie.

Preheat the oven to 400 degrees. Prepare pastry for a double crust pie. Fit dough into a 9-inch pie pan. Add the mushrooms, smoothing evenly. Dampen the edge of the crust with water. Add the top crust, pressing edges to seal. Trim and, instead of fluting the edge, press the dough with the tines of a fork.

In a small dish, break up the egg yolk with a fork and thin it with water. Gently brush this egg wash on the top crust.

Bake the pie 30 to 35 minutes or until the crust is golden brown. Serve warm or at room temperature.

-- Marlene Parrish XX

Flourless Chocolate Cake

PG tested

Like a little black dress, this flourless cake is a necessary classic. Dress it up with a shower of powdered sugar, whipped cream, red or black raspberries or creme anglaise, super easy when you use the 1-ingredient recipe below. The original recipe says to move the cake to a platter while warm. That sounds like a disaster waiting to happen. I kept the cake on the pan-bottom.

1/2 cup walnuts or whole, unblanched almonds

1/2 cup sugar

5 ounces semi-sweet (plain) chocolate, finely chopped

5 ounces bittersweet chocolate, finely chopped

1/2 cup (1 stick) unsalted butter

8 large eggs, separated, at room temperature

Powdered sugar for dusting

Whipped cream or creme anglaise, optional

Position a rack in the middle of the oven, and preheat it to 300 degrees. Spritz the bottom and sides of a 9-inch springform pan with baking spray. Line the bottom with a circle of parchment paper cut to fit, In a food processor or blender, process together the nuts and granulated sugar until powdery.

Place the chocolates and butter in the top of a double boiler placed over (not touching) barely simmering water. Heat, stirring often, until the butter and chocolate melt. Remove from over the water.

In a large bowl, beat the egg whites on medium-high speed until soft peaks form.

Whisk the egg yolks into the somewhat cooled chocolate. Using a rubber spatula, stir one-fourth of the whites into the chocolate mixture.Gently fold in the ground nut mixture. Add the remaining egg whites, folding gently and thoroughly. Pour the batter into the prepared pan, using the spatula to scrape all of it into the pan.

Bake the cake until it puffs up a little and joggles only very slightly when the pan is gently shaken, 30 to 35 minutes. If the center looks soupy, bake for another 5 minutes. Transfer to a wire rack and let cool in the pan for 3 minutes, then release and lift off the pan sides.

Using an icing spatula, gently slide the cake from the bottom of the pan onto a cardboard cake circle or serving plate. Be careful, as the cake is very fragile when warm. Place on a rack and let cool completely. over the cake with a clean, slightly damp kitchen towel so that the outside does not dry out as it cools.

Using a fine-mesh sieve, dust the top of the cooled cake with powdered sugar or add a topping of choice. Makes a 9-inch cake layer.

-- “Williams-Sonoma Essentials of Baking” (Oxmoor, 2008) 

1-ingredient Eggnog “Creme Anglaise”

PG tested

Pour 3 cups commercial eggnog into a medium saucepan. Bring just to a boil, then reduce the heat to medium and cook, stirring frequently, until reduced to 1 1/2 cups, about 40 minutes. Cover and refrigerate until cold. Makes 1½ cups.

-- “Entertaining 1-2-3” by Rozanne Gold (Little Brown, 1999)





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