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July 10, 2009
Living without gluten
More and more products are becoming available.
ELIZABETH NIDER
Living with celiac disease or a gluten intolerance is like observing Passover without the matzah: you are surrounded by foods that are off limits. According to the Canadian Celiac Association, one in 133 Canadians is affected by celiac disease and there are some who say it is more common in the Jewish community, although there is no scientific evidence to support this claim.
Gluten is a sticky protein found in wheat, barley and rye that may be hard for some people to digest, causing symptoms such as bloating, gas and diarrhea. These symptoms occur because the gluten stays in the gastrointestinal tract and causes inflammation. Depending on the severity of the sensitivity, gluten can even cause damage to the tiny fingerlike projections (called villi) of the small intestine, which provide efficient absorption of nutrients.
Celiac disease is an autoimmune illness that usually affects genetically predisposed people of any age and the only known treatment is to eliminate all forms of gluten from the diet. A blood test can often determine if a person has celiac disease, but the gold standard is to have an intestinal biopsy.
Celiac disease is more serious than gluten intolerance because it can lead to a malabsorption of nutrients. People with a gluten intolerance have less severe symptoms and could hypothetically eat gluten once in a while without causing any serious damage. Also, gluten intolerance can be made worse by other factors, such as high levels of stress, but celiac disease remains the same, regardless of whether or not someone's work project deadline just got moved up a week.
Before deciding to go on a gluten-free diet, consider getting tested for celiac disease first.
According to Shelley Case, a Saskatchewan dietician specializing in celiac disease, the blood tests used to diagnose the disease are based on the presence of gluten in the diet, so someone could potentially have a false-negative if they haven't been eating gluten.
Once celiac disease or gluten intolerance is confirmed, the next step is to understand how to eat gluten-free. Gluten can be found in many unsuspecting ingredients, such as soy sauce or certain flavorings made from barley malt, which contains gluten. Oats are usually on the "do not eat" list for people with celiac disease, but that is only because there is a very high chance of contamination. Individuals with celiac disease can enjoy a warm bowl of oatmeal if they use pure oats, such as Bob's Red Mill Gluten Free Oats – after getting their doctor's approval. While on the topic of contamination: it's also a good idea to avoid bulk bins at stores, in case, for example, someone used the rice scoop for wheat germ.
Because wheat flour and most gluten products are enriched with vitamins and most gluten-free breads in Canada are not, it is important to ensure adequate vitamin intake from other sources. Eating an assortment of fruits and vegetables is helpful in getting a variety of vitamins every day. Gluten-free products are generally low in fibre and, since most people who don't even have celiac disease do not get their recommended daily amount of fibre (20-35 grams), people eating a gluten-free diet must be especially creative in finding sources of fibre. Rice is a great gluten-free staple, but try wild or brown rice for added fibre and texture. Add flax seeds to breakfast cereal or yogurt: don't forget to use ground seeds to get the benefit of the omega-3 fatty acids within the seeds. Buckwheat has loads of fibre and can make a wonderful side dish when sautéed onions and mushrooms are added. And quinoa is a high-protein, grain-like crop with a pleasant nutty flavor when roasted, and makes a delicious pilaf when boiled and mixed with a variety of fresh or roasted vegetables.
Living with celiac disease or gluten intolerance isn't as challenging as it used to be. Alisa Magnan, an elementary school teacher in Richmond, realized she was gluten intolerant about 10 years ago and has noticed that the food industry is catching on and more gluten-free foods (many of which are also kosher) are becoming more readily available.
"Save-on Foods is carrying products like frozen bread, pizza crusts, cookies and crackers, [plus] rice crackers have become more popular," she said.
While shopping has become easier, it is still important to plan ahead, especially when going out for a meal or when travelling. Magnan suggested bringing a snack, like a gluten-free cereal bar, when going out, just in case there aren't any other options. There are many gluten-free products available, but for people who prefer to make their own, there is also a large variety of gluten-free flours and cooking ingredients. To keep up with current research, check reliable websites, such as that of the Canadian Celiac Association, celiac.ca.
Elizabeth Nider is a freelance writer living in Richmond.
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