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Practical, delicious ways to manage a gluten-free diet If you have a wheat allergy, gluten intolerance, celiac disease, or you just want to enjoy the benefits of a diet free of wheat, barley, and rye, then this guide is for you. Trusted author Danna Korn explains the medical problems associated with gluten and shows you step by step how to make the transition to a gluten-free lifestyle - and love it! With 25% new and revised content, this easy-to-understand reference includes coverage of the most recent testing methods, an updated section on the link between a gluten-free diet and improving behaviors in the autistic, new information about the genetics of celiac disease, expanded coverage on the gluten-free certification process, increased nutritional information, and updated recipes and resources. * 65 delicious recipes plus tips on eating out * Guidance on how to shop and decipher food labels Advice on how to raise happy gluten-free kids Covering the practical, medical, and emotional aspects of the lifestyle, Living Gluten-Free For Dummies, 2nd Edition offers hope and inspiration as you make the switch to a life free of gluten.
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Table of Contents
by Danna Korn
Foreword by Alessio Fasano, MD
Living Gluten-Free For Dummies®, 2nd Edition
Published byWiley Publishing, Inc.111 River St.Hoboken, NJ 07030-5774www.wiley.com
Copyright © 2010 by Wiley Publishing, Inc., Indianapolis, Indiana
Published by Wiley Publishing, Inc., Indianapolis, Indiana
Published simultaneously in Canada
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About the Author
Danna Korn is also the author of Gluten-Free Cooking For Dummies, Wheat-Free, Worry-Free: The Art of Happy, Healthy, Gluten-Free Living and Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy Gluten-Free Children. Respected as one of the leading authorities on the gluten-free diet and the medical conditions that benefit from it, she speaks frequently to health care professionals, celiacs, parents of celiacs, parents of autistic kids involved in a gluten-free/casein-free dietary intervention program, and others on or considering a gluten-free diet. She has been invited twice to be a presenter at the International Symposium on Celiac Disease.
Danna has been researching celiac disease since her son, Tyler, was diagnosed with the condition in 1991. That same year, she founded R.O.C.K. (Raising Our Celiac Kids), a support group for families of children on a gluten-free diet. Today Danna leads more than 100 chapters of R.O.C.K. worldwide. She is a consultant to retailers, manufacturers, testing companies, dietitians, nutritionists, and people newly diagnosed with gluten intolerance and celiac disease. She also coordinates the International Walk/Run for Celiac Disease each May in San Diego.
Dedication
This book is dedicated to the people who have patiently supported my sometimes overzealous and usually over-the-top efforts as The Glutenator, singing the praises of a gluten-free lifestyle throughout the land. Most importantly, to my family and friends — especially Tyler, Kelsie, and Bryan — who encourage, inspire, and energize me. Your support means more to me than you could ever know, and I couldn’t have written a word without you. And to those of you who embrace or are planning to embrace the gluten-free lifestyle, I hope I can make a difference, if even only a small one, in your lives by inspiring you to love the gluten-free way of life.
Author’s Acknowledgments
A huge thank you to the hard-working team at Wiley Publishing. First, thank you to Mikal Belicove, the original acquisitions editor who came up with and promoted the idea of doing a For Dummies book about the gluten-free lifestyle, and then held my hand as I learned the ropes of writing in the For Dummies format. To Mike Lewis and Natalie Harris, thank you for your patience as I took liberties with the table of contents on the second edition. To Tim Gallan, Natalie Harris, Danielle Voirol, and Krista Hansing, thank you for tolerating my sometimes quirky sense of humor and my many made-up words. It must have driven your spell-checker crazy. I’d like to thank Emily Nolan for testing all of the recipes, and for her tactful and humorous comments when the dishes I had invented were outrageous flops (don’t worry, we fixed ’em!). And thank you to Patty Santelli for nutritional analysis of the recipes.
I’m extremely grateful to my friends and colleagues, Michelle Pietzak, MD; Ron Hoggan, PhD.; and Cynthia Kupper, RD; for their careful technical review of the book. All of you go far and above the “call of duty” in helping the gluten-free community each and every day. Ron, writing the second edition of this book knowing that you were reviewing it was beyond intimidating. You are one of my all-time gluten-free heroes.
A huge thank you to my friend and another hero, Alessio Fasano, MD, who is one of the biggest fish in the celiac sea. I’m honored that you wrote the foreword for this book and am grateful for your phenomenal work in the celiac world.
To the entire gluten-free community, thank you for your steadfast encouragement. You motivate me to be passionate.
And last, but by no means least, I’m incredibly grateful to my family and friends. After I finished the books before this one, I asked you to slip cyanide in my coffee if I ever thought about writing another book. Thanks for not doing that. Seriously, without your patience, encouragement, support, optimism, love, and inspiration, I couldn’t have written a word. Bryan, you are the love of my life. Thank you for your patience as I squeezed this book between you, the kids, and Sonic Boom.
Living Gluten-Free
FORDUMmIES‰
2ND EDITION
Publisher’s Acknowledgments
We’re proud of this book; please send us your comments at http://dummies.custhelp.com. For other comments, please contact our Customer Care Department within the U.S. at 877-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002.
Some of the people who helped bring this book to market include the following:
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Foreword
Anybody out there ever experienced stomach aches, bloating, headaches, mood swings, short memory loss, difficulty concentrating, fatigue, constipation, diarrhea, short temper, hair loss, tingling of the arms or legs, joint pain, or anemia for unknown reasons? If not, go ahead and eat as much pasta and pizza you like. If, on the other end, you have experienced any of these symptoms (and I’ll bet all of us have, at some point), chance are, you and gluten do not agree. These symptoms are a few examples of how these chameleonic conditions called celiac disease and gluten sensitivity can present clinically. But what really are celiac disease and gluten sensitivity?
You can read lots of details about celiac disease and gluten sensitivity in this book. But let’s take a quick look at these conditions and why they’re so often misdiagnosed.
Celiac disease is an autoimmune disease that targets the intestines and renders them unable to properly handle foodstuff. The condition leads to a wide range of clinical manifestations of variable severity. Besides the typical malabsorption symptoms (chronic diarrhea, weight loss, and abdominal distension), celiac disease can manifest itself in a previously unappreciated spectrum of symptoms that potentially can affect any organ system. What’s more, because many people who have celiac disease don’t even exhibit the typical gastrointestinal symptoms. More common are patients with non-intestinal symptoms, such as anemia, joint pain, chronic fatigue, short stature, skin lesions, and neurological and behavioral problems (including peripheral neuropathy, epilepsy, dementia, schizophrenia, and seizure with intracranial calcifications).
Because celiac disease often presents in an atypical or even “silent” manner, many cases remain undiagnosed. Such cases carry the risk of long-term complications in adolescence and adulthood, including osteoporosis, infertility, miscarriages, cancer, and the onset of other autoimmune diseases.
Until recently, celiac disease was mostly restricted to Europe. New epidemiological studies suggest that celiac disease is going more global, with no continent on the planet spared by the disease. An estimated 3 millions Americans are affected by celiac disease, with only about 120,000 diagnosed so far.
Celiac disease is unique among autoimmune diseases, in that its trigger has something to do with nutrition. Like other autoimmune diseases, celiac disease results from the interplay of a genetic predisposition and an environmental trigger. Conversely, gluten sensitivity, the new kid on the block of the gluten village, does not involve an autoimmune process and, therefore, does not damage the intestine. Nevertheless, its clinical presentations can mimic celiac disease, so distinguishing gluten sensitivity from celiac disease is difficult based merely on the symptoms experienced.
Nevertheless, it is becoming apparent that gluten sensitivity is much more frequent than celiac disease: For each celiac patient, five to seven patients are affected by gluten sensitivity. Despite some similarities, substantial differences exist between these two diseases:
✓ Celiac disease is with you for life, whereas gluten sensitivity is not necessarily a lifelong condition.
✓ Celiac disease requires 100% compliance with a gluten-free diet, since even traces of gluten can be harmful. This is not necessarily true for gluten sensitivity.
✓ Not complying with the recommended diet causes immediate and cumulative, long-term consequences for celiac sufferers, whereas people with gluten sensitivity pay only the price of immediate symptoms.
The trigger for celiac disease and gluten sensitivity involves grains like wheat, rye, and barley. These grains contain a protein called gluten that is toxic to certain individuals. Thus, the cornerstone of their treatment is adhering to a strict gluten-free diet devoid of proteins from wheat, rye, barley, and related cereals. Unfortunately, gluten is a common — and, in many countries, unlabeled — ingredient in the human diet, presenting a big challenge for celiac patients. Gluten-free products are now becoming more widely available, but they’re still difficult to find and certainly more expensive than their gluten-containing counterparts.
Some people find the gluten-free diet just too challenging to follow. That, indisputably, is the main reason people with celiac disease and gluten sensitivity don’t comply with the diet sometimes. But the reason they find it so challenging is because there’s a lack of information, poor awareness among health care professionals, and major confusion in what foods are safe and what are not. After people are diagnosed, it is not unusual for doctors to advise them to go on a gluten-free diet and “good luck with that.”
Even with an idea of what to look for, shopping for gluten-free products can be a daunting proposition, with hours of shopping to get two to three items in your cart. The idea of a lifelong gluten-free diet can quickly morph into a sense of deprivation and a powerless feeling against what will be a tangible change in lifestyle. Every single event suddenly needs to be carefully planned in advance to attend to one of the most natural activities of humankind: eating. Shopping, cooking, avoiding cross-contamination, having a balanced and palatable diet — all become overwhelming enterprises, unless you have in your hand Danna’s second edition of Living Gluten-Free For Dummies.
As someone who has “been there, done that,” Danna masterfully navigates the challenges of implementing a new lifestyle that celiac disease and gluten sensitivity impose. This book alleviates the stress of learning the new rules of the game, using a direct and friendly approach to offer practical suggestions for eating healthy, eating well, and staying safe. This is truly a “must” for both beginners and veterans on the celiac and gluten sensitivity circuit. It’s a book you want to have handy in your kitchen take with you when you travel, and give to friends and loved ones – it’s a resource to help you get back to eating with a smile on your face. Enjoy!
Alessio Fasano, MDProfessor of Pediatrics, Medicine, and PhysiologyDirector, Mucosal Biology Research CenterUniversity of Maryland School of Medicine
Introduction
Not so many years ago, the gluten-free lifestyle was reserved for an obscure cluster of people who were forced to settle for wannabe foods that resembled sawdust but didn’t taste as good.
Today, the gluten-free lifestyle is sweeping the world with the force of a really big blowtorch, and the ramifications are enormous. Gluten-free products abound (and are a far cry from the foods we used to choke down), labels are far less ambiguous, and people no longer look at you like you have four heads when you ask for a burger without the bun.
Being gluten-free isn’t about being on a diet. It’s about living a lifestyle. Whether you’ve been gluten-free for decades or are only considering the idea of giving up gluten, this book is loaded with information that can affect every aspect of your life, from the obvious — your health and how you shop, cook, and eat — to more subtle facets, like minimizing expenses, socializing, dealing with friends and family, and managing various emotional ups and downs.
I live a gluten-free lifestyle, and I have for years. I have no ulterior motives, other than some quirky desire to don a cape, call myself the Glutenator, and travel far and wide to extol the virtues of a gluten-free diet. Whether you go gluten-free really doesn’t matter to me. I have no supplements to sell you, no gluten-free food products that I endorse — I don’t even get paid for running the world’s largest support organization for gluten-free kids!
What does matter to me is that I do my best to tell you everything you need to know about living a gluten-free lifestyle so you can make healthy decisions. This book is the reference guide you need to help you with all those aspects. It’s your reference for living — and loving — a gluten-free lifestyle.
About This Book
Living Gluten-Free For Dummies, 2nd Edition, like all For Dummies books, is divided up so you don’t have to read it all at once, or even front to back, if you don’t want to. You can skip from B to R to A and even reread B if you want. You can read it sideways and standing on your head, if you’d like; all you have to do is find a section you’re interested in and dig in (how’s that for liberating?).
I recommend you peruse the table of contents and see whether any particular chapter or subject really floats your boat, and start there. Or you can flip through the book and see whether any of the headings catch your interest.
If you’re new to the gluten-free lifestyle and have tons of questions, you’re probably best off starting at Chapter 1 and working your way through most of the book in order.
If you’ve been gluten-free for years, do yourself a favor and take a look at Chapter 5. You may be surprised by some of the foods allowed on the gluten-free diet that used to be considered no-nos. You may find that this chapter opens a lot of cupboard doors you once thought were closed!
Conventions Used in This Book
To keep things consistent and easy to follow, this book uses some basic ground rules and conventions:
I make words up, but they’re pretty easy to figure out. For instance, glutenated means a product has been contaminated with gluten. Glutenous means it has gluten in it, a glutenivore is something that eats gluten, a Glutenator is one who battles the evils of gluten, and so on. It’s fun! Before you know it, I’ll bet you’ll be making up your own glutenologisms.
All Web addresses appear in monofont, which looks like this.
When this book was printed, some Web addresses may have needed to break across two lines of text. If that happened, rest assured that we haven’t put in any extra characters (such as hyphens) to indicate the break. So when using one of these Web addresses, just type in exactly what you see in this book, as though the line break doesn’t exist.
Feel free to tinker with the recipes. If you don’t have an ingredient a recipe calls for, don’t worry — make a substitution. You may find your swap is a huge improvement. And don’t worry if you don’t want to measure. I estimated the measurements anyway, because I’m not sure I even own measuring spoons and cups!
If you want a vegetarian recipe, just look for the tomato icons.
Here are some conventions for the ingredients themselves:
If an ingredient appears in a recipe, it’s assumed to be gluten-free. For instance, I don’t specify “gluten-free vanilla” because all vanilla is gluten-free. And soy sauce usually has gluten, but when I call for soy sauce in a recipe, I’m assuming you’ll use a gluten-free version.
Baking with gluten-free flours works best if you use a mixture of flours. Chapter 10 goes into detail about how to mix gluten-free flours to get the best results.
Milk substitutes can be used in place of milk in most recipes.
Eggs are large.
Butter and margarine are interchangeable.
All temperatures are in Fahrenheit.
What You’re Not to Read
You won’t get into trouble if you do read everything, but if you’re a skimmer, you can skip some stuff and not miss anything important. In other words, there won’t be a pop quiz on the following:
Anything that has a Technical Stuff icon: The Technical Stuff icon represents information that’s interesting (downright fascinating sometimes!) but not crucial to your understanding of the subject matter.
Sidebars: These stories and tidbits of information appear in shaded boxes scattered throughout the chapters. Just like the Technical Stuff, you may find the information interesting, but you won’t be missing critical information if you skip them.
Recipes: Unless you’re actually using them to cook or to decide what to make for dinner, recipes aren’t the best late-night reading material. Feel free to skip them until you’re ready to whip up some gluten-free goodies.
Foolish Assumptions
You spent your hard-earned cashola on this book, and that means either you want to find out more about the gluten-free lifestyle or you’re related to me. Because my family members already hear way more about this stuff than any human should have to endure, I’ve written this book with you in mind — and I’ve taken the liberty of making a few assumptions about you. One or more of the following should apply:
You’re considering going gluten-free and will use this book to determine whether to take the plunge.
You love someone who’s gluten-free, and you’re so cool that you want to find out more about the lifestyle so you can be supportive.
You’re new to the diet and are looking for the “manual” that can tell you how to live a gluten-free lifestyle.
You’ve been gluten-free for years and want the latest, greatest information about dietary guidelines and state-of-the-art research.
You’re a professional who has gluten-free clients, customers, or patients, and you want to know more about the gluten-free lifestyle and the medical conditions that benefit from it.
At the same time, you can make a few assumptions about me and what I tell you in this book:
I generally know what I’m talking about. I do live a gluten-free lifestyle and have been immersed in it since 1991. My experience is worth noting, because some people who write about gluten-free living aren’t gluten-free themselves. I assure you, I wasn’t brought onboard to write this book because I was bored and looking for a project: I really do live — and love — the gluten-free lifestyle (and I have way too many projects, thank you very much!).
To the best of my knowledge, the information in this book is correct. This book has been reviewed by experts who are extremely knowledgeable in their fields.
This book is not intended to provide medical advice, so you’re not allowed to sue me for anything. Please see your physician for further follow-up if you feel you need it; void where prohibited; all rights reserved; good only while offer valid; only while supplies last; till death do us part; and all other legal disclaimers heretofore. There, my hiney is covered!
How This Book Is Organized
Living Gluten-Free For Dummies, 2nd Edition, is organized so that all the “like” material goes together. So that I don’t repeat too much information, I sometimes include cross-references to related topics. This book has five parts. Each part has several chapters, and each chapter is divided into sections. In the following sections, I explain how the parts are divided up.
Part I: Going Gluten-Free: Who, What, Why, and How
As the name implies, this part dives into the big-picture basics of being gluten-free. Chapter 1 is an overview. If you read nothing else in this book, read Chapter 1, because then you’ll at least sound like you know what you’re talking about. The rest of this part talks about who may want to consider going gluten-free and why, what you can and can’t eat on the gluten-free diet, and how to dig a little deeper so you’re sure the foods you’re eating are really safe for you.
Part II: Planning and Preparing: The Preludes to Cooking
Part II takes you to the next level: getting ready to eat. It starts with some guidance on choosing the most nutritious approach to the gluten-free lifestyle and then helps you with preparing your kitchen, planning menus, shopping, and developing the techniques unique to gluten-free cooking that you’ll want to know before you cook.
Part III: From Menus to Meals: Recipes for the Gluten-Free Gastronome
You’ll find many recipes in this part submitted by a not-a-cookbook author: me. Okay, I admit I made ’em up. And I admit I don’t measure, nor is any one recipe ever the same the second time around. But my publisher has a real-live tester on hand to make sure the recipes work — and, much to my surprise, they do! So stop snickering, and start stewing — or baking — or whatever it is you want to do in the kitchen. Whether you’re a culinary fledgling or a Martha Stewart protégé, you’ll find these recipes to be simple, delicious, sometimes impressive, and most definitely gluten-free.
Part IV: Living — and Loving — the Gluten-Free Lifestyle 24/7
For some people, the gluten-free lifestyle presents unique social, practical, and emotional challenges. In this part, I help you figure out ways to handle some of the practical issues like attending social events; eating at restaurants; traveling; talking with friends and loved ones about your lifestyle; and raising happy, healthy, gluten-free kids. I also help you deal with some of the emotional challenges that sometimes come up so you can truly learn to love the gluten-free lifestyle.
Part V: The Part of Tens
What would a For Dummies book be without a Part of Tens? Incomplete, that’s what, because nearly all For Dummies books have them, and this one’s no exception. The Part of Tens is a few short chapters, each with (cleverly enough) ten tips, questions and answers, factoids, and tidbits of information about the gluten-free lifestyle.
Icons Used in This Book
Some people are more visual than others. That’s why icons are cool. This book uses several icons, and each has a little tidbit of information associated with it. Here’s what each icon means:
Cleverly designated as Tips, these are, well, tips that can help you live (and love!) the gluten-free lifestyle. They include info to help you save time or cut down on frustration.
Everyone can use a friendly little reminder. The Remember icon is a quick and easy way to identify some of the more important points that you may want to make note of throughout the book.
Text flagged with the Warning icon can keep you out of trouble.
Sometimes I get really into juicy, technical, and scientific stuff. Some of you will love it; others will be bored to tears. That’s why I put it in its own area, marked by a Technical Stuff icon, so you can skip it (if you want to) without missing the gist of what’s going on in that chapter or section.
Where to Go from Here
What I suggest you do at this point is curl up in your comfiest chair and dive into the book. If you find the section you start with to be boring (puh-lease!), or for whatever reason it doesn’t pop your cork, then skip it and move on.
If you’re feeling a little down about going gluten-free, I hope my sincere passion for the gluten-free lifestyle and the healthy benefits that go along with it touch you by offering comfort, optimism, and inspiration.
Living Gluten-Free For Dummies, 2nd Edition
Introduction
Part I
Going Gluten-Free: Who, What, Why, and How
In this part . . .
I cover the basics to help get you off and running on the gluten-free lifestyle. I start by taking a look at the many medical and psychological conditions that improve on a gluten-free diet so you can decide whether this lifestyle can benefit you and can set realistic expectations for how your health may improve. I talk about eliminating casein, too, because many of you are going gluten-free and casein-free. Then I spell out the basics of the gluten-free diet and introduce you to foods you may have never even heard of, some of which are far more nutritious than gluten ever wished it could be. Finally, I tell you how to think outside the ingredients box so you know what hidden sources of gluten to look for and how to make sure products are, in fact, gluten-free. So what are you waiting for? Today may be the first day of the rest of your new lifestyle.
Chapter 1
Gluten-Free from A to Z: The Basics of Being Gluten-Free
In This Chapter
Getting a grip on gluten
Discovering the advantages of the gluten-free lifestyle
Making the most of meals
Going from gluten-gorger to gluten-free forager — and loving it
I figured the doctor had made a mistake. “You mean glucose,” I corrected him with a tinge of exasperation at his clumsy blunder. “You must mean my son can’t eat glucose.” Geesh. This was going to be tough. No more gummi bears.
“No, I mean gluten,” he insisted. “And to be honest, I really don’t know much about the gluten-free diet. You can see our hospital dietitian, but she won’t have much on the diet, either. You’re going to have to do some homework on your own.”
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!