Tis the season, and parties about.

I love this time of year, but it does not love my waistline. It happened to me last weekend. I was invited to a Christmas party around the time I normally eat dinner. I knew that hostess was a great cook and did not want to miss out on some of the food. Nonetheless, I still wanted to watch the calories, especially since I was quite hungry.  Hum, what to do?

Easy, I ate a big Honey Crisp apple before I left for the party. It was just enough to take the edge off my hunger. That way I was not so tempted to eat nuts, cheese or corn chips that preceded the buffet. By the way, nuts, cheese, chips, even if they are gluten free, are the highest fat (and most caloric) items at parties. Try to keep from eating them, if you can. If you aren’t hungry, it will be easier to skip the fattening snacks and choose the lower-calories options such as salmon, crudités, salads, and simple gluten-free cookies.

Also, make sure to have food ready to eat at home though. Many people eat too much junk at a party because they have nothing to eat at home (too many parties, so little time for cooking). Even if you have not cooked in a while, you can still make a healthy sandwich with high-fiber bread (such as Glutino’s Gluten Free Fiber Bread – with 2 grams of fiber per slice) low-fat cold cuts such as turkey or roast beef, some lettuce and tomatoes. Top that with a piece of Belgian chocolate and you wouldn’t feel deprived at all.

And, what about booze? I will give you the scoop on that in my next post. Stay tuned…….

And, bon apetit!!

As I mentioned in my last post, I used to love having whole grain cereal for breakfast because of the fiber (especially the fiber!) and great nutrition in whole oats, muesli, Kasha go-lean, etc.  After being diagnosed with celiac disease, it took me years to find a breakfast that was as good for me as the whole grain cereals.  I thought I was doomed to drink physllium powder for the rest of my life (not the best tasting drink) – until I ran into a friend in the gym.

She told me of all the health problems she had been having and that she had recently been diagnosed with celiac disease and allergies to soy, lactose, and whey. She raved about this fantastic shake that restored her back to health. – it was Metagenics Ultrameal Rice protein shake.  Curious, I tried the shake myself and have been in love with my breakfast ever since.

Metagenic’s Ultrameal (Rice) protein shakes are tasty, extremely portable, easy to mix shake and have been my breakfast for the past seven years in over 15 countries. Ultrameal shakes are either made with soy or rice protein.  For those allergic to soy, the Ultrameal Rice is an excellent alternative, and the one I depend on.

Here is why I love this nutritonally fortified meal replacement drink.

First of all, Ultrameal Rice shake is very nutritious, especially for those of us with celiac disease. It contains a unique, highly absorbable folic acid blend. Folic acid is a water-soluble vitamin that is necessary for the formation and growth of blood cells (especially good if you are anemic) and is instrumental in cell division. Since folic acid is best absorbed in the duodenum, people with celiac disease may suffer a deficiency. Its critical role in the repair of damaged intestinal cells is very important for newly diagnosed celiacs. All Ultrameal protein shakes contain 400 mcg of folic acid, which is 100% of your daily reference intake (your daily needs).

Ultrameal shakes also contain 15 grams of protein, 5 grams of fiber (more than my whole grain cereals-yeah!), a non-dairy source of calcium (600 milligrams per serving), and all that for just 190 calories. All you have to do is mix two scoops with 8 ounces of water, and voila – you have a quick breakfast of champions!!

By the way, the Ultrameal Rice comes in both chocolate or vanilla. I like to blend the two (1 scoop of each) to get a mocha flavor. The Ultrameal Soy comes in more flavors, for those of you who can tolerate soy.

I don’t remember when I started adding ground flax seeds to my shake, but, once I did, I became even more addicted to my breakfast. If you add just two ground tablespoons of ground flax seeds, it makes the shake a little thicker, adds an additional 8 grams of fiber and gives you a healthy dose of omega 3 fatty acids. Now, you can’t beat that with a stick.

For those of you who are too busy to eat breakfast, keep your Ultrameal powder at your desk and mix it when you are at work.  It requires little stirring and dissolves pretty. I have even used the handle of a tooth brush to mix the shake and it still dissolved quickly – hey, when you are in the bush, you have to adapt! Ultameal is also a GREAT afternoon snack.

This drink is so portable that I take it with me no matter where I go. I was just in Rhode Island and I put enough powder in a plastic freezer bag for the three nights that I was away.  In August, I am planning to travel to Africa for a couple of weeks, and you can be sure that I wll bring my Ultrameal Rice with me – along with my ground flax seeds, of course.

The reason I started this post was to provide nutritious alternatives to the celiac community. Celiacs have unique nutritional needs, which low-fiber, unfortified gluten-free products can not provide. Hope you will give the Metagenics shake a try. Let me know what you think.

Nobody wants to talk about it, but everyone experiences it more “regularly” than they would like.

Irregularity (aka constipation)

Okay, now that I have labeled the elephant in the room, let’s talk about it because this is a real issue for people on gluten-free diets.

During the first half of my life (even before I was diagnosed with celiac disease) I suffered from slow digestion and constipation.  Fortunately, I am not a trend setter as about 15% of Americans report chronic constipation.  I never knew why this was a problem until I became a vegetarian and started eating more grains and vegetables.

Once I learned about the role of fiber in moving things along in a comfortable way, I made fiber a main stay of my diet.  As a vegetarian, I thrived on muesli and other high-fiber cereals, tabbouleh (a Middle Eastern salad made with bulgur wheat), high-fiber wheat and whole grain bread and crackers, and, of course, wheat and oat bran.

Life was good (and comfortable) until I was diagnosed with Celiac disease (see my profile).

The reason I was slow to change my diet to gluten-free was because I did not know how to replace all the fiber I was getting from grains.  But, as the intestinal pain increased, I had to go totally gluten-free and suffer the consequences of a slow digestion again.

At first I tried adding physillum powder to juice. I don’t know about you, but that was disgusting!

We need 25 to 30 grams of fiber a day.  That is pretty hard to get if you are relying on gluten-free breads and cereals made from the common low fiber, gluten-free grains.  So, here are some tips for improving your exit strategy.

Start your day with fiber.  If you can eat gluten-free oats (4 grams of fiber), that is a great beginning.  If not, try a bowl of berries (4 grams), or two slices of Glutino’s Fiber Bread.  Or, you can also drink a Metagenics UltraMeal (Rice or Soy) protein shake(4 grams).  I love this shake so much that I take it with me everywhere (yes, even to Ghana, Laos, Holland and Rhode Island).  More about this shake in my next post.

If you are organized, make some gluten-free chili on the weekend and bring it for lunch (tons of fiber).  A sandwich with two slices of Glutino’s Fiber Bread gives you 4 grams of fiber.  Always have fruit with you – peaches, blackberries, apples and pears have the most fiber (4 grams).

And, then there are beans.

Beans and legumes, such as green peas, are your prime movers.  Add them to almost everything, especially salads.  This will increase your fiber intake tremendously.  A half cup of beans and green peas gives you 6 to 8 grams of fiber for only 12 grams a carbs.  Not only are beans and legumes gluten-free, they are inexpensive, fat free and low in carbohydrates.  They are a celiac’s (and dieter’s) best friend!!  Yes, I know, beans make you toot, so add more of them slowly in your diet.

Finally, I want to put a plug in here for flax seeds.  They are one of the best ways to improve your “exit strategy.”  One tablespoon of ground flax seeds gives you 3 grams of fiber and lots of beneficial omega 3 fatty acids.  I actually add three tablespoons of flax seeds to my Metagenics protein shake.  You can sprinkle a tablespoon of ground flax seeds on your cereal, soup, chili, salad dressing, or – well you get the picture.

What about vegetables, you ask?  Well, vegetables have fiber, of course, but not a lot.  Broccoli, lima beans, green peas, sweet potatoes have about 3 to 4 grams per serving.  But, you would have to eat 6 heads of lettuce to get the same amount of fiber as 1/2 cup beans.  Your leafy greens mostly contain water.  But, they have tons of vitamins, so don’t skip on the veggies.

Do remember to drink lots of water when adding more fiber to your diet.  The fiber absorbs the water and makes your trip to the bathroom a much quicker one.

Life is too short to spend hours in the bathroom. So, eat fiber and I’ll see you around.

Hello,

It has been a long time since I last posted something. Sorry for the absence. I was asked to lead an international health project and have been too busy to get back to my blog.  Fortunately, I am getting the hang of things now and am eager to get back to giving you information that keeps you healthy on your gluten-free lifestyle.

A lot of people have been asking where to get gluten-free crab cakes, so let me turn you on to the best ones on the East Coast. Chris’s crab cakes are delicious and guaranteed to be gluten-free. I wrote a post about Chris last September 2008, so check it out. You can reach Chris at the following Farmer’s markets: Saturday – Falls Church, Sundays – Dupont circle (9 am to 1 pm),  and Thursdays – Penn Quarter. Don’t live in DC? No problem, give him a call, he will send you the crab cakes. His phone number is 301-565-1681.

Don’t forget to ask for the lump crab cakes and the mini crab cakes that are great for appetizers. Bon apetit, and save some for me.

the gluten-free nutritionist

Okay, I am not going to the Kremlin, but I am on my way to Charleston, South Carolina for a meeting. It is a short trip, but my planning is the same as if I were going to Africa.

Traveling is one of the biggest challenges for people on gluten-free diets. It is nearly impossible to find gluten-free food at the airport or in hotels. Over the last 10 years of being gluten-free, I have traveled extensively all over the world. And, I have finally perfected a system that works for me.

Breakfast is always the hardest meal to cope with and one of the biggest challenges in hotels. So, I carry my own breakfast with me. For this trip, I am packing six scoops of my wonderful protein powder (gluten, soy, and lactose free) into a plastic snack bag – enough for three days worth of breakfast. I also pack 6 scoops of ground flax seeds, which I will add to the protein shake. In the mornings I will just mix up my healthy, fiber and vitamin packed protein shake and drink it while I am getting dressed. It is as easy as 1, 2, 3. I am also packing some gluten-free bread in case there is a group breakfast. All I have to do is add a couple of eggs and no one knows the difference. 

Since it is a short trip, I also bring a couple of apples, Jocalat bars (by Larabars) and some rice crackers to munch on if I get hungry between meals. Sometimes, conferences run late, and if I am not prepared, I end up eating a Snickers candy bar, which I would prefer not to do. My gluten-free snacks are also handy if I get stuck at the airport because of delayed flights.

It took me a while to learn to be proactive and talk to the organizers about my diet. Sometimes it works and sometimes it doesn’t. Since most conferences have buffets, I just get the meat and vegetables. If I crave carbs, I use my gluten-free bread to fill in the starch gap. When there is a sit-down dinner, I will be very proactive in asking for a gluten free meal. However, if the meal sucks, I always have my protein shake in the hotel room to fill the gap.  

This is what I am packing for my short trip to South Carolina. What are your gluten-free travel tips? I would love to hear your comments.

 It’s the fall in the United States and a fantastic time for fresh apples. This delicious fruit is everyone’s best friend, but especially for those of us who are gluten free. There is a reason why they say, “An apple a day, keeps the doctor away.”

First of all, apples are rich in natural fiber. As you know, getting enough fiber in the diet is a real challenge for anyone on a gluten-free diet. A medium sized apple has about 4 grams of fiber – a heck of a lot more fiber than most cereals and breads have.

If you are trying to manage your waistline, a recent study showed that a group of women who ate apple wedges before a meal, lost more weight than the group that did not. This is because the fiber in the apple was filling and caused them to eat slightly less then their counterparts. The fiber in apples is also known to help lower cholesterol.
This fantastic little fruit does not stop there! Apple peels are high in quercetin, a compound with antioxidant properties that is more powerful than vitamin C. High intake of quercetin may reduce the risk of asthma, respiratory conditions and even Alzheimer’s disease.

But wait, there is more!! The peel of the apple also has cancer-fighting compounds. The Red Delicious apple is shown to contain triterpenoids, powerful compounds that have shown strong anticancer potential against breast, liver and colon cancers.

The moral of this story is to eat an apple or two a day. Instead of skipping breakfast, at least eat an apple. Have the munchies around 11 am or 5 pm? Grab an apple and a cup of tea. The fiber and water will fill you up. Hey, don’t blame me if you have to buy smaller clothes.

Allergic to corn? Buy organic apples that do not have that artificial waxy substance on them. Food companies add the waxy substance to apples to keep them fresher for a longer time (it prevents the apple from breathing). The waxy substance contains a corn derivative. So, select your apples carefully.

Living in Washington, DC, close to the Chesapeake Bay and home of the Maryland crab, crab cakes are bountiful from May until October. As much as I love these things, I rarely get to eat them. You see must cooks mix the crab with breadcrumbs. It is the gluten in bread that helps bind the crab mixture together and keeps it from falling apart. Not good if you are allergic to gluten like me and 1% of the world’s population.

That is until, drum roll please, Chris’s marketplace. Yes, that is Chris in the picture making his famous crab cakes. Oh, and did I mention he makes gluten-free crab cakes as well? I see Chris every Sunday at the Dupont Circle farmer’s market. I often stop by to get some of his gluten-free crab cakes. But, you have to get there early or he sells out. Unless, you call ahead and ask him to make a batch for you, in which case he saves them until you get to the market.

Chris has regular crab cakes and ones with lump crab meat – luscious large chunks of crab that melt in your mouth. He also has mini crab cakes that make great hor’d oeuvres. The crab cakes freeze well and can be brought out in the dead of winter for a quick meal.

You can catch Chris at the Dupont Circle Farmer’s market on Sundays (9 am to 1pm), Annapolis on Sundays (check times), Penn Quarter market on Thursdays (3 pm to 7 pm) and in Falls Church on Saturday. If you want to order your crab cakes, call him at 301-565-1681. But, save some for me!!

The biggest challenge of going gluten-free is knowing which packaged food products you can eat. What seems logical to eat may very well contain gluten. For example, corn flakes are made from corn, and thus have no gluten, that is until manufactures throw in some malt flavoring. Yogurt, which is made from milk – also gluten-free, may have gluten-containing thickeners in it. Other products such as soups, sauces, salad dressings, prepared meats, candy and flavored teas can contain gluten-containing ingredients. Heck, even some chocolate covered espresso beans can contain gluten. Is there no justice?

Well, actually, there is some justice for those of us with food allergies. In first update to their guidelines since 1983, the Codex Alimentarius Commission, which was formed by the World Health Organization (WHO) and the Food and Agriculture Organization (FAO), approved an accepted threshold for gluten in “gluten-free products. In July 2008 the limit was hugely cut from 5 g per kilogram (500ppm) to 20 mg per kilogram (20ppm) –a level that is considered to pose no risk to allergy suffers. Yahoo! Finally a more precise and useful definition.

But what about US guidelines? Currently, there is no there is no specific definition for the term “gluten-free” or what ingredients cannot be used in products labeled gluten-free in the United States. In 2004 the U.S. Food and Drug Administration’s (FDA) Food Allergen Labeling and Consumer Protection Act (FALCPA) requires the eight major food allergens that are used as ingredients to be declared in plain English terms on the label of all prepackaged foods under the purview of the US Food and Drug Administration (FDA). A major food allergen is defined by FALCPA to be one of the following eight food/food groups or an ingredient that contains a protein derived from them: milk, egg, fish, crustacean shellfish, tree nuts, wheat, peanuts, and soybeans. For example, if a food item contained seasonings containing whey powder and wheat flour, the terms “milk” and “wheat” must be declared on the label. Although wheat must be declared, the FALCPA labeling does not apply to other gluten-containing grains (barley and rye)

But, the US is catching up to international standards. In 2006 the FDA issued a proposed rule to define the food-labeling term gluten-free. The final rule to establish a regulatory definition for the term gluten is not expected until the Fall of 2008. A clear definition of gluten and a revised labeling requirement would help those of us with celicac disease to identify foods with hidden sources of gluten, like those deceitful little chocolate covered espresso beans. Stay tuned……………

Food allergies are caused by an abnormal immunologic response to a dietary protein. There are 8 main food groups that contain certain proteins that cause more than 90% of all food allergies. They are: milk, eggs, peanuts, tree nuts, soy, fish, shellfish and wheat (gluten). These are considered true food allergies.

Gluten is a type of protein (prolamin) found in wheat, rye, barley and contaminated oats. Technically, the gluten found in wheat, rye and barley is called gliadin and glutenin. They are elastic types of protein that act like glue that binds flour together in baked goods. If you have ever seen someone make bread, it is these proteins that make the dough elastic. (This is why many gluten-free baked goods are more crumbly.) The umbrella name for these types of proteins is gluten.

Someone with an allergy to gluten is considered to have celiac disease, also known as celiac sprue, or dermatitis herptetiformis. When consumed, gluten causes an abnormal immune response in the small intestines. The antibodies to gluten inflame and flatten the small intestinal villi. Basically, the body starts to attack itself. Sounds, weird, but that is what bodies do.

Intestinal villi are critical for absorbing nutrients from the food you eat. When they are flat, there are fewer surfaces available to absorb nutrients from food. This causes nutritional deficiencies in people with celiac disease and dermatitis herpetiformis. Unexplained anemia, premature osteoporosis, and vitamin and mineral deficiencies are all signs of celiac disease.

The consequences of not eliminating gluten from your diet, if you are allergic to it, are bloating and gas, diarrhea or constipation, severe intestinal damage, nutritional deficiencies, chronic fatigue, illness, joint pain, migraines and, last but not least, a several fold higher risk of developing intestinal lymphomas (cancer). Yuk!

So, if you are allergic to gluten, stop eating it – now!

I wish it were as easy just eliminating wheat, barley and rye from the diet. But, there are many derivatives of these grains that you should avoid if you are allergic to gluten. For example, couscous, durum, farina, graham flour, kamut, semolina, spelt and triticale are all types of wheat and, thus contain gluten. This is why “Wheat Free” is not gluten free.

Malt (including malt extract, malt syrup, and malt flavoring), pearl barley, Brewer’s yeast, and barley hops are all derivatives from barley. That rules out malt beer and lager (sorry!!!) Unfortunately, malt flavoring is also added to almost everything from corn flakes to chicken broth, and makes going gluten-free so challenging. Case in point, one winter evening I made a lovely risotto using a cartoon of chicken broth I bought at Whole Foods. Two days later the intestinal pain was so intense I could not move. I had been doing so well on my diet and could not imagine what could have made me sick. A little investigating led me to read the cartoon of chicken broth, which had malt flavoring. I couldn’t believe it. How puts malt in chicken broth for Pete sake?! Lesson learned – read every label!!

Rye and most oats, including oatmeal, oat bran, and oat flour, also contain gluten. Well, technically, oats don’t contain gluten, however they are usually grown close to wheat fields and processed in plants that also process gluten-containing grains. So, oats is off limits for those of us with celiac disease. However….., thanks to some awesome health conscious millers (Bob’s Red Mill being one of them), there are uncontaminated oats on the market. They are grown under the strictest of environments that make the oats gluten free and tolerable for many people with celiac disease. Personally I cannot eat them, but many of my gluten-free friends can.

Other places that gluten hides is in licorice, modified food starch, textured vegetable protein (veggie burgers and “vegetarian” chili, soy sauce (derived from wheat) and some vitamins (gluten-containing fillers) and prescriptions. The list is endless, actually. The most important thing is to keep learning (hence this blog) and don’t get caught with your pants down – read labels!

Ten years ago when I first gave up gluten, I thought it was the worse curse ever. As a vegetarian, it was hard to give up whole grain cereals, oatmeal, breads, crackers, and pasta that formed a large part of my diet. They were also my main sources of fiber. To add insult to misery, I also became allergic to soy and lactose – the main protein foods for my vegetarian lifestyle. Needless to say, the transition was a pain in the neck. I had to learn what to eat all over again.

In the beginning I started adding physillum husks to juice – which was disgusting. Then, I had to give up my vegetarian ways and eat meat. Learning to cook meat was a comedy of errors. I can’t tell you how many burned or foul tasting fish and chicken dishes I had to throw out. I lived on eggs, and beans for a long time. Getting a variety of satisfying food was also a challenge. My diet had become so boring that sometimes I just did not want to eat.

But, slowly, I learned how to cook, got the gluten-free foods down, and slugged through the ups and downs of living gluten-free. Yes, the transition was difficult and challenging – still is sometimes. But, when I see what most of my colleagues and friends eat, I feel glad to be eating foods that love me back. I don’t mind skipping the coffee house muffins and pastries, birthday cakes, cookies, waffles, pizza, and other fattening and heart-stopping staples of the American diet. I love eating well. Why?

Because I am never sick anymore and have more energy than people half my age.

I have also become much more in tune with my body. Just a slight feeling of bloating or pain in my stomach tells me that something slipped by that should not have. I investigate what it could have been and make sure I never eat it again. Personally, I am glad Mother Nature gave me a challenge that encourages me to be in tune with my body. We should all be so lucky. There are many people that find bloating, smelly gas, fatigue, and being sickly the norm? When I suggest they consider being tested for a food allergy, they swear up and down they could never give up their bread or pasta. They prefer to silently suffer and/or complain to their friends about how bad they feel. If they only knew what delicious gluten-free treats await them.

Going gluten-free has also given me an unexpected benefit. I have gotten to know a lot of chefs. I speak to them personally and ask what they suggest that is gluten-free and they have been most accommodating. Once in Philadelphia I was walking past Maggiano’s and struck up a conversation with someone whom I thought was a waiter standing outside the restaurant. He suggested I come in and I told him I could not eat pasta. To my surprise he said he was the chef and told me about al the gluten-free dishes he had on the menu. I went in for lunch and was treated like a VIP. In addition to fabulous gluten-free shrimp pasta, I was given gifts of corn pasta and other goodies from the kitchen to take home with me. I mean, how cool is that?

Thank goodness there is an ever-growing number of chefs that are conscious of food allergies and who will adjust their restaurant menus for us. I make them my friends. Just before writing this post, I had brunch with friends, skipped the bread and had a nice baked chocolate mousse for dessert – made just for us.

Since I travel all over the world I also have learned a lot of packing and traveling tip. It took a while to get the drill down, but now, I am in control of my diet, not the airlines or airport restaurants. Heck, I am glad I don’t have to eat all that crap.

There are still times I miss having a fresh morning pastry at the Farmer’s market or bakery. But, then I reach into my bag and pull out a delicious farm-fresh peach or apple. Made especially for me by the Universe. Yum! Besides, these days, there are more and more gluten free scones, muffins, biscotti, and cupcakes to choose from…. if the urge hits me.

I am glad I am gluten-free. The rewards of a healthier body, more energy, unique friends and not having to crappy food are worth it. Kinda of like going to the gym. You reluctantly drag yourself there only to emerge with stronger muscles and leaner bodies – definitely worth the extra work, don’t you think?