Wednesday, January 16, 2008

Every time she eats in a restaurant, Shauna James Ahern could be taking a risk. Eating the most ordinary foods could result in searing abdominal cramps, stomach pain and overwhelming exhaustion.

Miss Ahern is one of tens of thousands of people in the United States diagnosed with celiac disease, an autoimmune disease that makes gluten, a protein found in wheat, the body’s enemy. Along with celiac disease, some people have an allergy to wheat, which is one of the eight most common food allergies in the United States, and still more Americans are gluten intolerant.

For Miss Ahern and others with similar health concerns, many foods or beverages others take for granted — such as bread, pasta, many breakfast cereals and beer — can be dangerous.

At one time, people with celiac disease or a wheat avoidance condition would have had a limited diet. That’s changing.

Because more Americans may have celiac disease than previously thought, more is known about managing a gluten-free life. People with celiac disease share their culinary triumphs. Nutrition and culinary experts are helping, as well, by offering advice on using alternative ingredients.



Taking a positive approach to food makes a big difference, says Miss Ahern, who lives in Seattle.

“Instead of longing for the food I had as a child, I’m looking for foods that are naturally gluten-free,” says Miss Ahern, author of “Gluten-Free Girl” (Wiley) and creator of the popular blog by the same name (www.glutenfreegirl.com).

Her culinary high points have included risotto with black truffles in Umbria during her Italian honeymoon. “It was better than any pasta,” she says. She has learned to love red quinoa and makes sorghum bread she “adores.”

“I still love carbs; I eat better carbs,” she says.

Miss Ahern educated herself on nutritious alternatives to wheat. However, eating a healthy wheat-free diet may be challenging for many.

People with celiac disease are advised to omit wheat, barley, rye, spelt, kamut and triticale from their diets. Some experts say to avoid oats because of contamination with wheat (for a more complete discussion of celiac disease and diet, visit the Web site of the Gluten Intolerance Group of North America at www.gluten.net or the government’s Web site at www.celiac.nih.gov).

When you substitute other foods for wheat you may be consuming less dietary fiber and more calories, says Cynthia Kupper, a registered dietitian and executive director of the Gluten Intolerance Group of North America in Auburn, Wash.

“If you take a look at the history of the gluten-free diet, the grains that were used instead were potato starch and rice; very refined,” says Miss Kupper.

As a result, people with celiac disease could be short zinc, calcium, iron and some B vitamins as well as fiber, she says.

That doesn’t have to be the case, however. You’ll find a wide variety of healthful gluten-free grains and flours made from legumes in your supermarket or natural food store.

“We’re looking at more nutritious bean flours, soy flour and more exotic grains such as buckwheat, quinoa and teff. These tend to have more fiber and more iron,” says Miss Kupper, who is a fan of teff, with the texture and taste of a whole grain.

Eating whole grains instead of pasta and bread opens you up to new culinary adventures, say Miss Kupper and Miss Ahern.

What do you do if you really miss the taste and feel of freshly baked bread?

Explore alternate ingredients and different preparation techniques, says Carol Fenster, an expert on gluten-free cooking. She uses sorghum flour instead of wheat flour as the base for baking.

“I like sorghum because it’s mild,” says Miss Fenster, of Centennial, Colo.

Like an alchemist, she blends various ingredients for specific results: nut flours for protein, potato starch for lighter texture, and tapioca starch for body and resistance. “Tapioca gives more body. You want a little resistance to your tooth, which you expect, especially in bread,” says Miss Fenster, author of “Gluten-Free Quick and Easy” (Avery).

Xanthan gum (or the substitute guar gum) is also in her bag of baking tricks. “It replaces gluten in a recipe. If you don’t use xanthan gum, your bread won’t rise. It will be flat and will crumble,” says Miss Fenster, who is wheat sensitive.

Cooking gluten-free foods is a positive experience for her, as it is for Miss Ahern.

“Look on the bright side. If you control your food, you eat better,” says Miss Fenster.

MEDICAL STUDY

Until recently the medical community thought celiac disease was very rare or misdiagnosed it as a food allergy, according to Dr. Alessio Fasano, professor of pediatrics, medicine and physiology at the University of Maryland School of Medicine.

Now the estimate is that more than more than 2 million Americans suffer from celiac disease, according to Dr. Fasano, the principal investigator in a study of the disease’s prevalence.

Unfortunately, celiac disease is difficult to diagnose. Symptoms may vary.

“It can present itself in so many ways. It’s a moving target of a disease,” says Dr. Fasano, who is also director of the University of Maryland Center for Celiac Research in Baltimore.

Where people used to wait 10 to 12 years for a diagnosis or would diagnose themselves, those with suspected celiac disease are being identified earlier by physicians, thanks to the increased awareness of the disease.

However, don’t assume you have celiac disease, or try treatments, without consulting a medical expert.

Here are two recipes for delicious gluten-free baking.

French bread

From “Gluten-Free Quick & Easy”

1 tablespoon active dry yeast

1 cup warm water (110 degrees)

3 large egg whites (½ cup), at room temperature, divided

3 cups Carol’s yeast bread mix (recipe follows)

1/4 cup canola oil

2 teaspoons cider vinegar

1 teaspoon sesame seeds for sprinkling on loaves

Dissolve the yeast in water; set aside for 5 minutes. Grease a French bread pan (8 inches by 16 inches, with two indentations) or line with parchment paper if perforated.

In the bowl of a heavy-duty stand mixer combine the yeast mixture with the egg whites (reserving 1 tablespoon egg white for brushing on the bread), bread mix, oil and vinegar.

Beat on low speed until blended. Increase speed to high and beat until the dough thickens slightly, stirring down the sides of the bowl with a spatula, if necessary. Dough will be soft.

Place half the dough in each indentation of the pan. Using a wet spatula, smooth each half to a 9-inch loaf, taking care to make each loaf the same length and equal thickness with blunt rather than tapered ends.

Whisk the reserved 1 tablespoon egg white with 1 tablespoon water until foamy and brush the loaves for glossier crusts. Make 3 diagonal slashes, 1/8-inch deep in each loaf so the steam can escape during baking. Sprinkle with sesame seeds.

Place the pan immediately on the middle rack of a cold oven. Set the oven to 425 degrees and bake 30 to 35 minutes, or until the loaves are nicely browned. Cover the loaves with aluminum foil after 15 minutes of baking to prevent overbrowning. Remove the loaves from the pan. Cool completely on a wire rack before slicing with an electric or serrated knife. Makes 2 loaves.

CAROL’S YEAST BREAD MIX

8 cups potato starch

4 cups Carol’s flour blend (recipe follows)

8 tablespoons cane sugar

8 teaspoons xanthan gum

6 teaspoons salt

4 teaspoons guar gum

Sift the ingredients into a large storage container or stir to mix well. Cover and store in a dark, dry place. Makes about 123/4 cups mix; enough for 4 to 5 recipes.

CAROL’S FLOUR BLEND

1½ cups sorghum flour

1½ cups potato starch or cornstarch

1 cup tapioca flour

Stir all ingredients together with a whisk in a large bowl. Store, covered in a container. Makes 4 cups.

Note: You’ll find the ingredients for Carol’s bread in many natural food stores and some supermarkets.

Brown bottom cheesecake

From Enjoy Life; www.enjoylifefoods.com

CRUST:

1 box Enjoy Life Double Chocolate Brownie cookies, processed into crumbs

½ cup brown rice flour

1/4 cup cocoa powder

2 tablespoons tapioca flour/starch

1/4 cup plus 1 tablespoon butter or dairy-free alternative (see tip 1)

CHEESECAKE:

Vanilla filling:

1 8-ounce package cream cheese or dairy-free alternative (see tip 2)

½ cup sugar

1 egg or egg substitute (see tip 3)

2 teaspoons vanilla extract

Chocolate filling:

1 8-ounce package cream cheese or dairy-free alternative (see tip 2)

½ cup sugar

1 egg or egg substitute (see tip 3)

1/4 cup cocoa powder

1 teaspoons vanilla extract

1/4 cup Enjoy Life semisweet chocolate chips (optional)

Preheat oven to 350 degrees. Lightly spray a 9-inch tart pan with removable bottom.

To prepare crust, mix cookie crumbs with brown rice flour, cocoa powder and tapioca flour. With a fork, cut in butter until mixed well. Press crumbs into bottom and on the sides of tart pan. Bake for 6 minutes to set the crust.

To prepare cheesecake, make the vanilla and chocolate fillings. First, make vanilla filling: beat cream cheese, sugar, egg and vanilla until smooth.

Next, make the chocolate filling: Beat cream cheese, sugar, egg, cocoa powder and vanilla until smooth. Add chocolate chips.

Spoon dollops of chocolate and vanilla filling over the baked crust. With a knife, gently swirl the dollops for a marbled appearance. Bake at 350 degrees for 45 to 50 minutes or until knife inserted comes out clean. Let cool. Cover and refrigerate 6 hours or overnight. Makes 6 to 8 servings.

Tips:

1. Dairy-free option: Use 1/4 cup plus 1 tablespoon Earth Balance margarine (contains soy) or Spectrum shortening in place of butter.

2. Dairy-free option: Use one 8-ounce package of Tofutti Better Than Cream Cheese (plain nonhydrogenated) (contains soy) in place of cream cheese.

3. Egg-free option: For best results, use Ener-G Egg Replacer in place of eggs. We found that flax/water egg substitute does not work well in this recipe.

Gluten-free products to eat safely

Becoming a proficient cook is one way to consume a varied diet if you can’t eat gluten-containing products. However, you might not have the time or inclination to cook every time you want a cracker or cookie.

Fortunately, it’s becoming easier to find gluten-free products, especially in natural food stores.

Some of the leading manufacturers of gluten-free foods have personal experiences with limited diets, which inspired them.

Mary Waldner, who started Mary’s Gone Crackers, discovered she had celiac disease more than 10 years. “I converted the recipes I’d been making, such as pancakes, muffins and cakes, to gluten-free versions I liked and my friends liked. If there was a party, I’d bring the cake,” says Miss Waldner, of Gridley, Calif.

Her crackers grew out of her cooking experiments. “I wanted to have a cracker for parties or to bring to restaurants where people were having crackers before dinner.

As a self-described health nut, she developed crackers using flaxseed and quinoa. “I’d been reading everything and knew about healthy ingredients,” says Miss Waldner. At first she made her whole-grain crackers at home, but as demand from her friends and family grew, she moved to a factory and set up her business making organic, gluten-free crackers.

Enjoy Life, a Chicago-area company manufacturing allergen- and gluten-free ingredients and snack foods, began as a business school class project when Scott Mandell, company founder, realized that people with dietary restrictions often sacrifice good taste for safe, gluten-free foods.

“There is a lot of improvement in the taste and texture of gluten-free (foods) in the last 10 to 15 years,” says Nancy Curby, director of marketing for Enjoy Life. “The company name says it all: Enjoy Life. We really like to celebrate what people on special diets can eat, not what they can’t eat,” she says.

Bev Bennett is the author of “30-Minute Meals for Dummies” (John Wiley & Sons).

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