Should You Be Gluten-Free?

I LOVE when patients ask me if they should be GLUTEN-FREE. Why? Because the gluten-free diet is inherently healthy (if you do it without searching out the elusive gluten-free twinkies) and because I have been following a GF diet for about seven years, so I have far more personal opinions and advice about this diet than your average non-GF doc.

Who NEEDS to be Gluten-Free? People with Celiac Disease. Anyone with this autoimmune disorder needs to COMPLETELY avoid gluten, which is a protein found in wheat, barley and rye. If they do eat gluten, their body basically overreacts and the inflammatory response in their gut damages the gut lining, which blocks absorption of important minerals and vitamins. Untreated celiac disease can lead to multiple complications, including anemia, a skin disorder called dermatitis herpetiformis, autoimmune disorders, neurological problems and some cancers.

Who MIGHT be helped from a gluten-free diet? People with autoimmune disorders. Gluten is pro-inflammatory, which means that it can stir up an overactive immune system by irritating the gut lining and triggering a whole body response, sort of poking the giant. With autoimmune diseases, the problem comes from too much immune response (too much inflammation) creating swollen joints, rashes, etc. The general concept is that if you remove gluten, that is one less thing to provoke your overactive system.

My most important advice about the GF diet: emphasize the natural foods that are gluten free- fruits, vegetables and protein sources (nuts, meats, fish, eggs, etc). If all you do is substitute the GF version of every bread, pasta, pizza, cookie, cake and twinkie for those things in your diet now, then yes, you will be GF but not necessarily healthy. And from the mental/emotional aspect, sometimes that's the easiest way to start GF without feeling deprived. But why not have those GF alternatives in moderation, while emphasizing the healthy wonder that is the colorful world of veggies and fruits? Your body will thank you for it.

Do I still seek out the best GF treats like pizza, calamari and brownies? You bet! Am I excited to find Udi's newest delicious GF multigrain bread? Of course! But my dietary GOAL remains focusing on more vegetables and fruits, always paired with a protein source.

BOTTOM LINE: Gluten-free diets are necessary for people with celiac disease, probably good for those with autoimmune disorders, and healthy for all of us as long as we "go natural". 

Gluten-Free Calamari: April Fools?

One of my biggest challenges of eating gluten-free (GF) can be dining out, especially at my favorite seafood or Italian restaurant. (What's Gluten? Click here.) My stomach moans and mouth waters when the waiter presents the loaded basket of heavenly scented fresh bread or crispy rings of fried calamari, and I inwardly pout (okay, perhaps I outwardly whine) as I am left to sip my water, which is often the only GF item at my place setting. This week, however, while in Boston, I had a delightful surprise on the waterfront at the famous Legal Sea Foods.

A large group had dashed over for lunch during our full conference day. I asked if they had GF labels on their dishes, and the waiter immediately swapped out my menu for one that highlighted the GF choices. To be honest, I was skeptical when I saw fried fish as part of the choices, but happily, the waiter clearly was educated about special diets, and I had my pick of numerous dishes. He took our orders, then came back with drinks and the infamous bread basket. As he set it down, however, he smiled at me and said- unsolicited- "no worries, your gluten-free rolls are in the oven and I'll be back with them in a few minutes"! I squealed with delight, much to the amusement of my new friends and colleagues, I might add...

Ultimately, I ended up eating at Legal's not once or twice but literally four times in three days (a definite first for me for ANY restaurant) and the icing on the proverbial GF cake was that last night I discovered FRIED CALAMARI on the list! This was the best calamari I have ever had, GF or "regular". Yum!

BOTTOM LINE: More and more restaurants are offering GF options- be sure to ask your waiter! AND...if you're in Boston (or anywhere there is a Legal Sea Food), you've gotta go to Legal's and have the GF Calamari!

PS. First of the month, so change those AIR FILTERS (especially here in Austin- the oak is out of control!)

What a Chef! Sicola's in Austin

I need to take time today to have a "commercial" for Sicola's: A Culinary Experience in Austin, TX. Last night I was at a Journal Club meeting there, and the before our talk, the waitstaff was circulating with luscious looking appetizers. Since I am still GF (Gluten Free), I will admit to feeling a bit deprived as I politely passed them up. Not wanting to appear rude for turning down multiple choices, I told one of the waitresses that if I were not gluten-free, I'd grab them in a moment.

Within a few minutes, the same lovely waitress returned, letting me know that indeed, the rest of the evening's menu was completely GF. I was pleased she would go to that trouble, and happily sipped my wine. However, that was not all. A little bit later, another waitress came over and told me that the chef was excited to CREATE a GF appetizer just for me! Can you believe that? In the throws of preparing a gourmet meal for fifty people, he stopped and literally experimented simply to allow someone with a special diet to enjoy an appetizer. Amazing!

I wish I could tell you exactly what the appetizer was, but I CAN tell you that it involved goat cheese and a non-wheat crumb coating, and it was DELICIOUS! I have never felt so pampered. Apparently, Stephen Sicola (the amazing chef) is creating specialized dishes to cater for all kinds of special diets, including youth with diabetes. Very cool!

BOTTOM LINE: If you live in Austin and have a private dining party to plan, call Sicola's and book it now!
PS. If you follow a special diet, it never hurts to ASK for something a bit off the menu when you dine out, so give it a try!

Gluten-Free Decadence

After talking about gluten-free diets and celiac disease this week, I want to be sure no one is left with the impression that you need to feel completely deprived if you must be gluten-free (GF). Can you ever eat at a restaurant? Is every GF food expensive?
No worries, there are plenty of delicious and reasonably priced choices out there!

Primarily, I want to again encourage you to take advantage of EVERY SINGLE fruit and vegetable, all of which are completely and totally gluten-free! Have a banana smothered in ice cream and topped with whip cream for dessert- yummy! Gluten-free chocolates are a bit more challenging to find, but absolutely out there.

Dining out? Last night, I had a business dinner at a lovely French restaurant...where most dishes appeared to be topped with a white sauce (that usually has flour in it.) Yes, I had to pass up the fragrant loaves of French bread, but I simply enjoyed my glass of wine and ordered a salad by asking for lettuce, tomato and a vinagrette-no croutons- (which was delicious!) and trout grilled and topped only with butter and lemon. The waiter and chef didn't flinch a bit when I asked for these off-menu choices, and I think I was possibly the only one who left the table not stuffed to the gills! I also could have chosen the steak, and had a baked potato instead of the french-fried version. Admittedly, I passed up dessert, but could have asked for strawberries and whipped topping- but I was pleasantly full.

Craving pasta? This was challenging, but I found a spiral pasta that is a quinoa blend that I can truly say I PREFER to regular pasta. Pizza is still leaves a bit to be desired, but I have even found a delivery pizza service that has very passable GF dough for only $5 extra- well worth it for me, though I order regular dough for my family.

I have blogged earlier about some wonderful baking GF products and cookbooks, and without a doubt, you can find all sorts of GF bagels, donuts, cakes, cookies.

BOTTOM LINE: Never fear, you can consume deliciously decadent GF foods and drinks with a little thought and willingness to venture off the printed menu- ASK THE WAITER/CHEF!

PS. The chef in this picture, Michael Marchitelli, is ironically an ITALIAN chef in Crested Butte, CO- Eat at his Gourmet Noodle for some AMAZING food! I'm not promising GF pasta, but I can attest from my pre-GF days that every item on the menu is delicious, and there are definitely GF options!

Gluten-Free for Weight Loss?

Many people think going gluten-free is a great way to diet in order to lose weight. Not surprisingly, it can be a pleasant side effect if you are overweight and diagnosed with celiac disease. It makes complete sense that if you simply ELIMINATE breads, cakes, pastries, pastas, cookies and breaded or coated foods (think chicken nuggets, french fries, meatballs) your calories will shrink dramatically!

I would likely approve any diet that reduces processed foods and complex carbohydrates, but I am MORE excited about diets that not only decrease those items, but INCREASE fruits and vegetables. Here is the trick with not only a gluten-free diet, but a vegan or vegetarian diet. Keep it HEALTHY by upping the produce (veggies and fruit) and NOT merely replacing everything you are "giving up" with a manufactured version that is GF (or CF, or Veggie-free).

For example, there are many gluten-free breads, crackers, cookies and treats out there. Very few of them happen to be low calorie and/or "good" for you- BUT- saying gluten-free somehow implies healthy and nutritious, doesn't it? It's that health-food store seal of approval when we see labels proclaiming a food item is "free" of something "BAD".

Ultimately, however, in the battle of the bulge, it still comes down to calories IN vs. calories OUT, regardless of the quality of those calories. So, enjoy those GF pancakes and breads in moderation, but don't pursue the search for the GF Twinkie, okay? Push up the produce and reap the rewards.

BOTTOM LINE: Eating gluten-free CAN be an incredibly healthy diet, rich in nutrients from fresh vegetables and fruit plus a protein source and GF carbs in moderation, but gluten-free does NOT equal low calorie!

Gluten-Free Diet

This week I am talking about celiac disease, which requires a life-long commitment to a gluten-free diet. So, what the heck does that involve? Well, gluten is a protein found in all forms of wheat, as well as related grains such as barley and rye. What is made with wheat? At first glance, it feels like EVERYTHING has wheat.

Most cereals, breads, cookies, muffins, cakes, dough (think pizza), buns, and pastas, etc. ALL are classically made using wheat flours. Happily, though, there are more and more foods in these categories that are made with rice, corn and potato flours- all of which are gluten-free. In almost every grocery, there is a small (and ever-expanding) section of gluten-free "bread" products and mixes. Check out my "commercial" for delicious gluten-free pancakes, for example- yum! And rice-flour cereals such as Rice Chex are still on the menu, though ones like Rice Krispies that sound gluten-free (GF) may not be (because of additives like malt.)

More importantly, though, there are tons of delicious, healthy foods that are naturally gluten-free. Practically the whole perimeter of the grocery store: every fruit and vegetable (think MORE!), dairy, nuts, and meat are all GF. Our bodies don't NEED gluten nor any of the treats/sweets/doughs that our MOUTHS or minds may crave...

I think the biggest challenge of GF eating is baking. There does not seem to be a simple recipe substitute- at least not "replace one cup of wheat flour with one cup of brown rice flour" style. Because of the TEXTURE, you need to make blends involving rice flour, potato starch and tapioca flours, for example. I have found a great baking cookbook that I would recommend: Gluten-Free Baking Classics, by Annalise Roberts- try the delicious lemon pound cake!

If you are committed to a GF diet, make an appointment with a registered dietician to really learn all the nuances of this meal plan. Here in Austin, I recommend Daniela Knight, RD, to help you with this transition.

BOTTOM LINE: Gluten-free diets are rich in fruits, veggies and protein, and can be supplemented with carefully chosen gluten-free baked goods.