Gluten-Free Makeovers (3 page)

As mixes became the foundation of Gluten-Free Pantry, my new flour blends became the basis for
Gluten-Free Makeovers
, a book that not only offers delicious recipes, but also techniques that can become your foundation, your ticket to great
gluten-free baking and cooking in your own kitchen. So put on your apron, plug in your mixer, and get ready to embark on a yummy gluten-free adventure, a Gluten-Free Makeover.

Gluten is the protein in wheat (including durum, semolina, spelt, kamut, einkorn, triticale, and faro), rye, and barley. In addition to the obvious items to avoid such as bread, pasta, desserts, crackers, and pizza, there are many not so obvious, including breading, croutons, cereal products, imitation seafood, imitation bacon, marinades, sauces, gravies, cold cuts, soup bases, soy sauce, communion wafers, supplements, Play-Doh, and over-the-counter and prescription medications.

People diagnosed with celiac disease, gluten sensitivity, or gluten or wheat allergies need a gluten-free diet. (See page 5 for more on wheat allergies.)

Celiac Disease (CD), sometimes called celiac sprue or gluten sensitive enteropathy, is a lifelong digestive disorder found in children and adults. Damage to the small intestine is caused by an autoimmune response to eating gluten and prevents the proper absorption of food.

Celiac disease potentially affects 1 in 133 people in the United States or about 3 million people. It is a chronic, inherited disease, and if untreated can lead to malnutrition, infertility, osteoporosis, anemia, and neurological disorders, to name a few. Symptoms of celiac disease vary widely, which is why it is difficult to diagnose. Symptoms can include diarrhea, short stature, lactose intolerance, bloating, constipation, and indigestion, or no symptoms at all. Patients are sometimes diagnosed through secondary disorders or other autoimmune diseases such as thyroid disease or type 1 diabetes.

Approximately 1 in 10 first-degree relatives could have celiac disease and should undergo testing once a relative has tested positive for the disease.

Patients who remain on the gluten-free diet will begin to feel better almost immediately as the small intestine begins to heal. Complete recovery may take several months or years.

If a product is gluten-free, it is, by definition, wheat-free. However, the reverse is not true as products labeled “Wheat-Free” can still contain rye or barley-based ingredients that are not GF. Although spelt is a form of wheat, products containing spelt are sometimes erroneously labeled wheat-free. According to the FDA, the Food Allergen Labeling and Consumer Protection Act (FALCPA) requires foods containing spelt to list “wheat” in the ingredient statement. Products containing spelt that do not list wheat as an ingredient may be subject to recall by the FDA.

Celiac disease, wheat allergy, and gluten intolerance/sensitivity are treated similarly, in that wheat is removed from the diet. But there are important differences between the three medical problems.

Celiac disease is an autoimmune condition, where the body’s immune system starts attacking normal tissue, such as intestinal tissue, in response to eating gluten. Because of this, people with celiac disease are at risk for malabsorption of food in the GI tract, causing nutritional deficiencies.

Celiac disease also involves the activation of a particular type of white blood cell, the T lymphocyte, as well as other parts of the immune system. Because of this, patients with celiac disease are at increased risk for developing some forms of cancers, particularly lymphomas. Since wheat allergy and gluten sensitivity are not autoimmune conditions, people who have food allergies and intolerances are not at increased risk for these cancers.

While celiac disease, wheat allergy, and gluten intolerance/sensitivity may be treated with similar diets, they are not the same conditions. It is very important
for a person to know which condition they have, as the person with celiac disease needs to monitor himself or herself for nutritional deficiencies, other autoimmune diseases, and GI cancers.

Wheat allergy is one of the top eight food allergies in the United States. Allergic reactions after eating wheat may include reactions in the skin, mouth, lungs, and even the GI tract. Symptoms of wheat allergy can include rash, wheezing, lip swelling, abdominal pain, and diarrhea. The branch of the immune system activated in allergic reactions is different from the branch thought to be responsible for the autoimmune reactions of celiac disease.

Testing for a wheat allergy usually involves skin tests or eliminating wheat from the diet.

People can also experience “intolerance/sensitivity” to gluten even in the absence of celiac disease. Such form of intolerance is not thought to be immune mediated, and currently there are no tests available to diagnose it. GI symptoms with wheat or gluten sensitivity may include gassiness, abdominal pain, abdominal distension, and diarrhea. These symptoms are usually transient, and are thought not to cause permanent damage.

Sometimes people decide they have celiac disease and start a gluten-free diet on their own. This is not a good idea as the gluten-free diet is a lifelong commitment. In addition, starting the diet before testing can make it difficult to diagnose the disease as antibodies to gluten must be present to obtain an accurate diagnosis. The body can only make these antibodies when gluten is ingested.

A panel of blood tests can be used to screen for celiac disease. However, a physician will often confirm the diagnosis with a small intestinal biopsy, the gold standard for determining celiac disease. For more information on testing, visit one of these resources:

Celiac Disease Foundation,
www.celiac.org

Gluten Intolerance Group,
www.gluten.net

National Digestive Diseases Information Clearinghouse,
http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

University of Chicago Celiac Disease Center,
http://celiacdisease.net

The answer is a resounding, “No.” When it comes to celiac disease and the gluten-free diet, cross-contamination can be as big a problem as ingesting the actual ingredient. If a person is celiac, they must be as close to 100 percent gluten free as humanly possible. People with gluten or wheat sensitivities without the presence of celiac disease may be able to ingest tiny amounts of the offending grains without having a reaction.

Cross-contamination lurks anyplace where gluten meets gluten-free. Pitfalls include: sharing the same peanut butter jar, jam jar, or butter; using the same toaster; sharing pasta water; eating foods fried in a deep fryer that’s been used to fry breaded products; sharing flour sifters; and using utensils that are not clean. Airborne wheat flour can also present a problem. And anything that has come in contact with gluten, such as frosting on a cake and burgers on buns, is just like eating gluten.

FALCPA covers dietary supplements and vitamins. It does not, however, cover prescription drugs or over-the-counter medications. Individuals need to verify the ingredients on these medications by contacting the drug manufacturer, or through the pharmacist.

Distilled alcoholic beverages and vinegars are gluten-free. Research indicates that the gluten peptide is too large to carry over in the distillation process. This leaves the resultant liquid gluten-free. Wines are gluten-free. Beers, ales, lagers,
and malt vinegar are made from gluten-containing grains and are
not
distilled, therefore they are
not
gluten-free. In the past few years, several gluten-free beers have come onto the market. These are great with pizza and a joy for those of us who like to cook with beer occasionally. The Bureau of Alcohol and Tobacco Tax and Trade Bureau will begin labeling wines, distilled spirits, and malt beverages in 2011.

Unfortunately, the only treatment for celiac disease is lifelong adherence to a gluten-free diet. Trials studying medical treatments to supplement or even replace the diet are being conducted at medical centers around the country, and research into the triggers for this autoimmune response to gluten are underway. However, the availability for any of these treatments is several years away. Until then, it’s very important to stick to the diet.

Take a deep breath and smile. It’s the best medicine. Being proactive about a special diet is important, and a glass-half-full attitude is the best defense. Learn everything you can about your diet, and make a list of ingredients you can tolerate. When you see a recipe that contains offending foods, examine the ways in which you can change it to meet your needs. When presented with a problem, imagine how many ways it can be solved. Make substitution your ally. We’ll do a lot of that within the pages of this book.

Not all flour blends are created equal. I look for a balance of starch, fiber, and protein when I create a blend. And then I look for the balance that is best for creating crumb and texture in a recipe—breads and piecrusts need the most protein for structure. Cookies need the least. Too much of any one flour can result in a gritty mouth feel, a pronounced aftertaste, or a pastry or bread that rises beautifully and collapses as soon as it comes out of the oven.

The blends I’ve created work well with the recipes here and should work in all your baking. If you are avoiding a specific kind of flour that is listed in my blends, replace it with one that you can have that appears in the same column on the Flour Power Chart on page 14. It will perform nearly the same function in your baking.

To help replace gluten properties in baking, it’s important to use xanthan or guar gum. These are thickening agents that provide the “glue” that minimizes the crumble factor and adds the necessary structure to allow the final product to rise. Potato flour can also be used to improve structure.

These blends create texture and taste that is very close to wheat flour according to my non-celiac tasters. I rely on nutritionally rich, high-protein ingredients like amaranth flour and sorghum flour. I think we can all stand a little more fiber and nutrition in our carbohydrate-laden gluten-free baking.

However, many cooks grumble at the prospect of creating yet another blend for baking. I hear you and I don’t want that to be the deterrent in trying my recipes. With the flour blends in the Flour Power section, I’ve provided shortcuts: ways to turn basic, commercial blends into self-rising, bread, or pastry flour (see pages 15–17). I would rather you try my recipes using these than miss out.

Better yet, mix up double or triple batches of my flour blends on page 15 and store them in the refrigerator so they’ll be ready when you are. I provide quantities in weights as well as in cups to make it easy to make these blends.

• Avoid buying flours that are displayed in bins. Besides the unknown source of these flours, the commingling of scoops can be a hazard.

• Be careful of contamination. Some companies produce both wheat and non-wheat products and often mill and process them in the same location. Particles can linger in the air and on equipment surfaces. Most companies clean the equipment between the processing of different flours but that doesn’t guarantee against contamination.

• If possible, purchase prepackaged flour from a manufacturer that uses a dedicated wheat-free, gluten-free facility (see Pantry, page 271).

• Store flours in airtight plastic or glass containers with a wide mouth so you can measure over the container.

• Refrigerate all gluten-free flours for a longer shelf life. Flours with more fat and protein, such as almond, brown rice, sorghum, or amaranth flours, can spoil quickly at room temperature.

• Allow refrigerated flours to come to room temperature before you use them.

• Use a wire whisk to get rid of flour clumps before you measure.

So often people give me a list of foods they cannot eat. I sense their frustration, but a simple exercise will help to bring success back to your baking.

Create a table of the prohibited foods. Under each, list similar foods you can have. For instance, if you can’t have peanuts or tree nuts, maybe you can eat sunflower or pumpkin seeds. If you are allergic to potato, perhaps you can eat rice or tapioca. Add to this list as you discover other substitutions that work for you. You will find many more possibilities looking at your diet through this lens.

I once thought that being gluten-free was a challenge all its own. But lately questions about multiple food allergies are more prevalent than even those about gluten. “I can’t have corn. What can I use instead?” “My doctor told me to avoid rice but everything that’s gluten-free contains rice. What can I eat?”

I can hear the hopelessness in people’s voices, even on e-mails, when they are hit with a laundry list of foods they must avoid. And because each individual has his or her own set of allergies, it is difficult to create a recipe that meets everyone’s needs.