Gluten Free Tips

Coeliac disease is caused by an intolerance to gluten, a protein found in wheat and rye (and something similar in barley and possibly oats). This immune reaction to antigenic factors damages the mucosal lining of the small intestine, flattening the villi and reducing its ability to absorb nutrients.

The resulting symptoms of malabsorption which occur in varying degrees, may be acute
– steathorrhea, diarrhoea and abdominal discomfort, or more chronic
– tiredness, irritability and unexplained weight loss or failure to thrive in children.
The intolerance requires complete, life-long exclusion of gluten from the diet.

The peak age of onset of coeliac disease is now between 40 and 50 years, with increasing numbers of people being diagnosed in later life. The disease is more common in women than men by almost 3:1 in middle aged adults

Much remains to be learnt about how or why gluten harms the intestine. Gluten intolerance can also result in a skin disorder, dermatitis herpetiformis, which may or may not be associated with intestinal damage but is less likely to result in gastrointestinal symptoms.

A gluten-free diet is a major undertaking and always requires expert dietetic advice

It can take several months of gluten avoidance before the gut mucosa and villi return to normal and a year before previously impaired blood biochemistry improves

Complete and permanent avoidance of gluten is essential to reduce the risk of bowel malignancy and other long terms consequences of the disease.

Not to be confused with coeliac disease, wheat may provoke allergic reactions (delayed type IV) or chronic gastrointestinal symptoms of intolerance with no obvious immunological basis. Wheat allergy or intolerance will require total wheat exclusion though partial exclusion may suffice for those with a non-immunologically mediated form of intolerance for whom there seems to be a threshold of sensitivity. Commercially wheat free (and gluten-free) products are not prescribable for wheat allergy/intolerance per se.

The treatment of coeliac disease is exclusively dietary and requires the complete exclusion of gluten. This means avoidance of all sources of wheat, rye and barley. Oats are controversial and may be tolerated in moderate amounts.

The aim of medical advisors is to give first line dietary advice on a gluten-free diet for patients with confirmed coeliac disease or dermatitis herpetiformis. People who are allergic/intolerant to wheat will require different dietary advice.

Practical dietary advice is often given such as: -

The exclusion of gluten means avoiding a wide range of manufactured and processed foods, which imposes considerable constraints on food choice and variety. Food labeling is not always helpful because although ingredient lists on food products can confirm the presence of gluten, they cannot confirm that they are gluten-free.

Gluten may be present via constituents which do not have to be declared or through cross-contamination during processing. Any food in a can, packet or jar or food that has been coated or modified in any way has therefore to be suspected of containing gluten.

Many manufacturers and supermarkets are voluntarily identifying gluten-free products by providing information or a logo on the label. In the UK, the Coeliac Society maintains a continually up-dated database of manufactured foods free from gluten.

Proprietary gluten-free foods such as breads, crackers, biscuits, pasta, flour and flour mixes are prescribabled for people medically diagnosed with coeliac disease or dermatitis herpetiformis. Their use should be encouraged to reduce the risk of dietary imbalance or non-compliance. Luxury items such as gluten-free cakes, chocolate and fancy biscuits are also available but not prescribable to reduce the costs on the NHS.

1 in 100 people in the UK has coeliac disease.  However, research has showed that only 12.5% of
those have been diagnosed equating to over half a million people currently undiagnosed in the
UK. 

For people with coeliac disease, eating gluten  damages the lining of the gut, which prevents
normal digestion and absorption of food. If a gluten-free diet is not followed, the disease can
ultimately lead to malnutrition, osteoporosis, bowel cancer and also cause infertility problems.

Gluten is a protein found in wheat, rye and barley; beer; obvious sources of
gluten include breads, pastas, flours, cereals, cakes and biscuits. It is also often used as an
ingredient in many favourite foods such as fish  fingers, sausages, gravies, sauces and soy sauce.
People with coeliac disease can also be sensitive to oats.

The symptoms of coeliac disease range from mild to severe and can vary between individuals. Not
everyone with coeliac disease experiences gut-related symptoms; any area of the body can be
affected.

Symptoms of coeliac disease can include diarrhea, but occasionally constipation, tiredness,
anemia, mouth ulcers, recurrent miscarriages, weight loss (but not in all cases), skin problems,
depression, joint or bone pain, and nerve problems. Sometimes the symptoms can mimic irritable
bowel syndrome that is bloating, abdominal pain and constipation. The only treatment is the life-
long avoidance of ingestion of gluten.

Due to the wide variety of the symptoms of the disease, not only do patients suffer from a
reduced quality of life during the years prior to diagnosis, but also they can be unnecessarily
hospitalised and quite often completely misdiagnosed, and treated with costly drugs.

We have often stated that Coeliac disease is a life-long autoimmune disease, which is triggered
by eating gluten, a type of protein found in wheat, rye and barley.
Untreated it can lead to serious ill health and be life-threatening.
There is currently no cure for the condition; the only treatment is
life-long adherence to a strict gluten-free diet.

Coeliac UK, the national charity for people with coeliac disease, is being proactive and hosting a conference on Wednesday 3rd Decemberin central London announcing the latest findings in coeliac disease research including progress on the development of a possible vaccine for the condition.
 
 
Research at The Walter and Eliza Hall Institute in Australia has identified the toxic elements of gluten creating the potential for a vaccine therapy to suppress or prevent gluten toxicity.  The research indicates that there are only a few dominant peptides in the gluten protein that trigger the autoimmune response in people with coeliac disease which makes the creation of a vaccine easier.
 
The lead researcher stated “We have developed a peptide-based therapeutic vaccine based on the dominant problem T-cell epitopes of gluten.  The “vaccine” has the potential to treat about 80% of people with the disease. In common with traditional desensitization therapy for allergy,  peptide-based therapeutic vaccines administered in many small doses over a course of injections could induce immune tolerance not only to the selected gluten fragments but also suppress the toxicity of other toxic gluten components,”.
 
Further research findings will be provided at the conference identifying a new genetic risk factor for coeliac disease and, following continued research, discovered an additional seven gene regions implicated in causing the condition. Of the nine coeliac gene regions now known, four of these are  also predisposing factors for type 1 diabetes. Their research sheds light not only on the nature of coeliac disease, but on the common origins of both diseases.
 
Other speakers at the conference will be highlighting  advancements in testing of gluten in food, the nutritional content of a gluten-free diet and the need for point of care testing in order to help increase the number of people diagnosed.

For some people, food allergies can be very serious. One bite of a cookie with ground peanuts can cause a life-threatening emergency in someone with a peanut allergy, while just the smell of fish can make a highly sensitive person feel ill.

Although these are extreme reactions, it’s no wonder many people worry about food allergies. Unfortunately, because of a lack of good information about severe food allergies, many people are restricting their diet unnecessarily. One allergist found that, out of 23 people who thought they had a food allergy, approximately 4 actually did. Some of those who didn’t have allergies were avoiding so many foods they had become sick and malnourished. Don’t guess. If you suspect you have a food allergy, have it properly diagnosed by a doctor, then obtain nutritional advice from a registered dietitian.

What is a Food Allergy?

People with food allergies have an unusually sensitive immune system. For some reason, swallowing a protein from a particular food causes the person’s own antibodies to rush into action to attack the foreign substance. This starts a chain reaction of chemical changes which cause swelling and irritation in certain parts of the body.

Food allergies are most common in young children. Many infants become sensitive to foods, such as cow’s milk, soy and eggs during their first year of life. Fortunately, most infants outgrow these sensitivities in a year or two.

However, a child with an allergy to peanut or shellfish will not outgrow it. In fact, the symptoms may become more severe each time the child is exposed.

What is a Food Intolerance?

Food can cause problems for people in ways that do not involve the immune system. For example, people with lactose intolerance don’t have enough of the enzyme lactase to digest the sugar or lactose in milk. People with celiac disease cannot digest wheat protein. Other people have trouble with caffeine, chili peppers, horseradish or hot sauce. These food- related problems are called “food intolerances” not food allergies.

It is important to know the difference between food intolerances and food allergies. A person with a milk allergy must avoid all milk protein, even the small amount found in a slice of bread, whereas a person with a lactose intolerance may be able to eat some cheese and drink certain modified milk.

Facts About Food Intolerances

· Milk, eggs, peanuts, nuts, soy, wheat, and fish are responsible for 95% of all actual food allergies. It is rare for people to have two or more food allergies.

· It is usually not necessary to avoid an entire food family. For example, people who are allergic to lobster can often tolerate shrimp and crab. Even children with a life-threatening peanut allergy are rarely sensitive to other legumes, such as soybeans and lentils.

Just read about a restaurant in Kingston-upon-Thamess which caters for gluten intolerances. Apparently they produce gluten-free pizza and pastas along with “normal” ones. The kitchen staff are trained to ensure no cross-contamination happens. It is called  Brushetta Restaurant and it’s located on 141 London Road, not too far from the main shopping precinct at Kingston.

The restaurant also serves non-gluten free food.  The manager, Guilia Zardetto, is originally from Italy, and has worked in the catering business  for over 10 years.  The chefs at Bruschetta have been trained at reputable Italian Cookery Schools.  They are trained in all aspects of handling gluten-free foods and making their own gluten-free pizza bases for the restaurant.

Guilia hopes to open more restaurants throughout the UK in the future.  I hope she does.

For now, we stick with the one in Kingston-up-Thames.

The address is 141 London Road, Kingston-upon-Thames, Surrey KT2 6NH.  Tel : 0208 546 9328.

If anyone gets to eat there before I do, let me know how the restaurant is and what your experience was like!

Long, long ago, man was a simple hunter/gatherer and he enjoyed this. His diet  consisted of fruits, nuts, perhaps tubers and the occasional feast of meat. But eventually, he learned to cultivate plants, and the agricultural revolution began. Soon, the hunter/gatherer way of life was replaced by domestication of crops and animals which had implications for our diet.

As habits changed, some unanticipated problems arose. The human gut had developed, over more than 2 million years, into a sophisticated organ that could tolerate food antigens that were staples of the human diet over hundreds of thousands of years. But how would it react to new antigens, suddenly appearing in the diet? He may like the food but would it like him? The agricultural revolution of the Neolithic period generated a whole battery of food antigens previously unknown to man, including  protein from cow, goat, and donkey milk, as well as birds’ eggs and cereals. Most individuals were able to adapt. Among those who could not, food intolerances appeared and celiac disease was born.

Some 8,000 years after its onset, celiac disease was identifed and named. This was the begining of better understanding.  A clever Greek physician named Aretaeus of Cappadocia, living in the frst century AD, wrote about The Coeliac Affection.” In fact, he named it “koiliakos” after the Greek word “koelia” (abdomen). His description: “If the stomach be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs.

During the 1980’s it became increasingly clear that Celiac Disease could be associated with other conditions, mostly autoimmune disorders such as type 1 diabetes, but also some syndromes such as Down. It was also apparent that Celiac Disease was changing patterns of presentation, becoming less an intestinal disorder, and more a variety of extra-intestinal symptoms and signs.

In the late 80’s, a large multicenter Italian study that I conducted demonstrated that by relying on strict clinical and laboratoristic criteria, a correct diagnosis of Celiac Disease could be reached in 95% of cases by limiting to the one initial biopsy, and new diagnostic guidelines were published in 1990 by ESPGHAN, guidelines that stand to this day. After 1990,Celiac Disease  was increasingly accepted as an example of an autoimmune disease, associated with a specifc gene (either DQ2 or DQ8) and the missing autoantigen was fnally identifed in the enzyme tissue transglutaminase. At long last, there was universal acceptance that celiac disease is an autoimmune condition whose trigger (gluten) and autoantigen (tissue transglutaminase) are known.

Last Christmas, my husband surprised me with a waffle maker. It’s a German-manufactured (Tchibo) one, with the ability to make 2 waffles at a time. Each waffle sub-divides into 5 heart-shaped waffles. I’ve experimented with many gluten and gluten free waffle recipe dishes over the past few months.

My first attempt with a gluten free waffle recipe was to take a recipe similar to the breakfast waffles made with wheat flour, only substituting the flour with a gluten-free flour or baking mix. I find buckwheat and rice flour works well for this. However, you do need to add baking powder and you need to ensure they are fluffy by beating the egg whites separately and folding them in as the last step. You will also need to adjust the amount of milk to add. Gluten-free flours tend to absorb milk more.

This gluten free waffle recipe takes 15 minutes to prepare, and if you have a double-waffle iron like mine, it will not take long to make a delicious, warm breakfast with this gluten free waffle recipe! .
The Ingredients are :

• 3 eggs, separated
• 400ml milk
• 225g gluten free flour
• 2 teaspoons baking powder
• 3 teaspoons sugar
• 1/2 teaspoon salt
• 4 teaspoons vegetable oil

A second gluten free waffle recipe I tried was one adapted from a gluten-free pancake recipe from Thailand. It was made with rice flour, coconut milk, an egg, some sugar, baking powder and a pinch of salt. Again you need to beat the egg whites separately so as to make the waffles lighter, and you do need to add baking powder to ensure a light, airy texture to the waffles.

A third recipe – again adapted from a gluten free pancake recipe is the following : Mix 1 cup rice flour, 1/2 cup soya flour and 1/2 cup corn meal, 1 tbsp baking powder. In a separate bowl, beat together 1 egg and 1.5 cups milk and 2tbsp vegetable oil. Mix the dry ingredients with the wet ingredients and cook immediately.

Another gluten-free waffle recipe is to take a gluten-free pancake or muffin mix – many supermarkets and health food shops stock these. Some are made with buckwheat flour or rice flour; and some have added ingredients such as apple and cinnamon, or maple syrup. You may need to experiment a bit with the mixes and vary the ingredients to your gluten free waffle recipe a bit, such as less liquid, more baking powder and fluffing up the whites into the batter.

As long as you persevere with the above gluten free waffle recipes, you will find the waffles that suit your tastes and lifestyle. I hope the above gluten free waffle recipe ideas entice your taste buds to start trying!

In this article I’m going to share with you a selection of gluten free pumpkin recipe ideas. Pumpkins are full of the antioxidant called beta-carotene. Current research indicates that a diet rich in foods containing beta-carotene may reduce the risk of developing certain types of cancer and offers protect against heart disease. Pumpkins are also a good source of Vitamins C, K, and E, and magnesium, potassium, and iron.

Pumpkins are by nature a gluten free food, and I hope that via the following gluten free pumpkin recipe examples you can incorporate this food into your starter, main course and dessert options.

Pumpkin Nutrition Facts (quoted for 1 cup cooked, boiled, drained, without salt)

• Calories 49
• Protein 2 grams
• Carbohydrate 12 grams
• Dietary Fiber 3 grams
• Calcium 37 mg
• Iron 1.4 mg
• Magnesium 22 mg
• Potassium 564 mg
• Zinc 1 mg
• Selenium .50 mg
• Vitamin C 12 mg
• Niacin 1 mg
• Folate 21 mcg
• Vitamin A 2650 IU
• Vitamin E 3 mg

Now for gluten free pumpkin recipe number 1. The (often-forgotten) pumpkin seeds! These can be roasted and kept in a container for up to a year. Pumpkin seeds are delicious as a snack food, or can be added to breads or sprinkled onto soups or other dishes. Pumpkin seeds are believed to have an anti-inflammatory effect, and help protect against prostate cancer and osteoporosis.

The second gluten free pumpkin recipe is for Pumpkin muffins

• 1 cup gluten-free flour
• 1/4 teaspoon xanthan gum
• 1/4 teaspoon salt
• 1 1/2 teaspoons baking powder
• 2 tablespoons sugar
• 2 eggs
• 2 tablespoons vegetable oil
• 1/2 cup mashed, cooked pumpkin

Preheat oven to 180 degrees C. In a bowl, whisk together the flour mix, xanthan gum, salt, baking powder and sugar. In a seperate bowl, beat the eggs with a fork; then stir in the oil and pumpkin. Pour this into the dry ingredients and stir until blended. Spoon the batter into the prepared muffin cases and bake for 20 minutes.

The third gluten free pumpkin recipe is for Pumpkin soup.

Children like it because of it’s sweet taste; but you can also present it at a dinner party and pass it off as a very sophisticated dish. The ingredients and preparation for this gluten free pumpkin recipe are the following :
Olive oil, potatoes, Leeks, carrots, onions, pumpkin, garlic, chicken stock, nutmeg, salt & pepper, and parsley.

Put oil in pot and glaze the garlic and onions until they are transparent. Then add chopped up potatoes, leeks, carrots and pumpkin. Then add the chicken or vegetable stock. Let it simmer until the vegetables are soft. Then season with salt, pepper and nutmeg. Purree the soup and serve garnished with chopped parsley.

As evidenced by the above 3 examples above of gluten free pumpkin recipes, you can see that you can incorporate pumpkin in many types of dishes – not just vegetable dishes. I suggest you look at some of the other dishes you normally make and see if you can substitute or mix pumpkin into them.

Good luck and Enjoy!

Gluten-free pasta can be used as a substitute for normal, gluten laden, pasta in most recipes and is virtually indistinguishable from the normal type of pasta. As such there is nothing to stop you from throwing a meal with your favourite Italian cuisine and including many pasta dishes made with gluten-free pasta if you or some of your friends happen to have coeliac condition.

The food manufacturers have been quite ingenious in developing gluten-free pasta and use many different approaches to producing the end product. Some examples of gluten-free pastas are: -

1. rice and corn pasta – this has good cooking qualities and resembles wheat pasta very closely
2. organic brown rice pasta – a similar texture and flavour to normal pasta with the enhanced nutrients of whole grain rice
3. white rice pasta – ground rice used to produce a realistic looking pasta
4. maize, potato, soya and rice pasta – the taste and texture of standard Pasta with a nutritional result

One main advantage of using these pastas is there very close resemblance to the typical gluten-based pasta you would buy in the supermarket or local store. Firstly, you can substitute these for normal pasta when throwing a meal form friends and no one will be the wiser allowing the meal to proceed without being diverted into a cul-de-sac in discussing the ingredients. Secondly, if you have a child or teenager who has recently been diagnosed with coeliac condition, you can very happily substitute the standard pasta they have been used to for these gluten-free pastas and again the gluten-free product will be inconspicuous in the meal.

With the growing awareness of coeliac condition and a more general requirement for gluten-free foods from larger sections of the community, gluten-free pastas are now becoming a regular items on the shelves of supermarkets. Indeed many supermarkets now carry extensive lines of gluten-free foods stretching from pastas to bread and cake mixes to name but a few.

Why don’t you try one with the next meal that you take. As a challenge do a blindfold taste test to those members of your family who are able to eat gluten. You will find that blindfolded n one is able to distinguish the taste or the texture of gluten containing pasta from the gluten-free pasta.