Sunday, August 31, 2008

Can Oats Be Included On a Gluten Free Diet?

Whether to include oats on a gluten free diet is controversial. Many oats are not gluten free because of crop rotation – the same soil is used to grow wheat one season and oats the next. There are oats which are specially grown to be gluten free, but according to Wikipedia even the gluten free oats contain avenin (a protein very similar in molecular structure to gluten) that is "toxic to the intestinal submucosa and can trigger a reaction in some celiacs."

Studies regarding people with celiac and their ability to tolerate oats are mixed. Some studies show celiac sufferers can tolerate oats which are free from contamination, but a possible reason for this conclusion is that those who can’t tolerate oats end up dropping out (biasing the sample) midway through the study.

There is also new research indicating a molecular basis for oat intolerance in patients with celiac disease. People with celiac who have the DQ8 gene seem to tolerate oats better than those with the DQ2 gene. I have the DQ2 gene so I don't include any oats in my gluten free diet. The Celiac Sprue Association tends to have zero tolerance risk profile and "recommends that excluding oats is the only risk free choice for those on a gluten-free diet."

It is recommended that EVERYONE exclude oats from a gluten free diet for the first six months so that they can completely heal before trying to incorporate oats. If you do want to try to include oats, use a certified gluten free oats and monitor your symptoms closely. Remember, double blind studies are one thing but reality is another. If you react to oats, they should not be part of your diet.

WHAT TO DO: I like to use Gluten Free Mighty Tasty Hot Cereal Mix by Bob's Red Mill with Coconut Milk, Peanuts and Raisins and Maple Syrup. Ancient Harvest Quinoa is a nutritios grain that can be used as a hot cereal. This recipe is from I only use Ancient Harvest Brand Quinoa because it is washed and dried already which gets rid of the bitter taste.

Quinoa Hot Breakfast Cereal Bring 2 cups water to a boil, add 1 cup quinoa, reduce heat, simmer 5 minutes. Add 1/2 cup thinly sliced apples, 1/3 cup raisins, 1/2 tsp cinnamon and simmer until water is absorbed. Serve with milk or cream or coconut milk and sweeten to taste with honey or brown sugar or maple syrup.

Sunday, August 24, 2008

Iron & Anemia in Infant Development

Iron deficiency (a severe lack of iron in the blood) is the most common nutrient deficiency in the world. This post explores both a common and potentially dangerous nutritional deficiency (low iron) as well as a bigger conundrum: What if you know what you are deficient in, you try and supplement the nutrient, but, the real problem is that your body can’t actually absorb the nutrient, even if you have identified it exactly and supplement it perfectly? Iron deficiency, unfortunately, all too often illustrates this nutritional enigma.

While it sounds like a relatively minor condition, it can actually interfere with development of the brain for infants and little children. Researchers have found that severe, chronic iron-deficiency in infancy can lead to motor delays, cognitive delays and behavioral problems later. Sometimes supplementing with iron will work, to bring iron levels back to normal. In addition, eating foods rich in iron such as red meat, liver, raisins, spinach, brocoli and egg yolks could also help increase iron levels in the blood, paving the way for normal development. Other times, supplementation doesn't raise blood levels of iron, When this happens, it becomes necessary to address why the body isn’t absorbing the iron supplements, on top of the essentially symptomatic deficiency.

One possibility is that the damaged gut is unable to absorb nutrients due to gluten intolerance. If you have celiac or gluten intolerance, then only removing gluten will allow the gut to heal so that vitamins can be absorbed.

Another possibility is that bad bacteria has overtaken the gut and the bad bacteria is using the iron as a food source.

In the past we had a lot of beneficial bacteria in our food to keep the bad bacteria in check, but antibiotics as well as food processing has killed the good bacteria as well as the bad bacteria, leaving many people vulnerable to an overgrowth of bad bacteria in their gut.

Getting to the bottom of unexplained anemia should be a priority since it will probably determine your best cause of action to alleviate it and put development back on track (as well as make yourself feel better).

WHAT TO DO: Try to get to the bottom of malabsorption syndromes instead of just treating the symptom. Ask your doctor for an explanation of why you aren't absorbing the iron. If supplementation by itself isn't effective consider eliminating gluten or introducing probiotics, which could help you create more good bacteria to help you get rid of the bad bacteria which is stealing your iron.

Friday, August 22, 2008

What is Gluten?

"What is gluten?" is a question people ask me when I tell them our family is gluten free. Gluten is the protein found in wheat, barley and rye. It is composed of the proteins gliadin and glutenin. Most mainstream cereals, bread and packaged snacks contain gluten unless they are labeled "gluten free" or made of rice or potatoes. Gluten makes kneaded bread elastic and is responsible for the chewy texture of bagels. The tricky part about being gluten free is avoiding the hidden gluten in most processed food and in some very surprising foods. Soy sauce, twizzlers, rice crispies and Rice Dream rice milk (labeled "gluten free") all contain gluten. And most "wheat free" products are made with spelt, durum, semolina, kamut, couscous and triticale which all contain gluten. Some grains that don't have gluten are: rice, corn, buckwheat, quinoa, sorghum, amaranth and tapioca. Oats that are not labeled "gluten free" can be contaminated with gluten because of crop rotation. Other foods that may contain hidden gluten are: MSG, textured vegetable protein and modified food starch.

Celiac disease is an autoimmune disease (like lupus, arthritis and diabetes) triggered by gluten which interferes with the absorption of nutrients. The National Foundation for Celiac Awareness says "Failure to thrive during childhood development is a common indicator of celiac." A gluten free diet is the treatment for celiac disease. But there are many reports of people who don't test positive for celiac recovering from chronic conditions such as autism, psoriasis, schizophrenia, Crohn's disease, sensory integration disorder, iron deficient anemia, depression and arthritis. And there are also reports of people who don't test positive for celiac, who later turn out to have celiac. So, many people with chronic conditions can benefit from a gluten free diet.

Thursday, August 21, 2008

Gluten Free Turkey Burgers

This is a turkey burger recipe from my sister who does a great job cooking for her family--she makes this gluten free version for our family. My kids don't like my turkey burgers but they love these when she makes them. These tasty burgers are a great thing to grill in the summer.

Serves 6
1 lb. ground organic turkey
1/2 cup gluten free breadcrumbs
1 large egg lightly beaten
1 medium onion
1-2 cloves garlic
1/4 cup gluten free barbeque sauce
2 tablespoons mustard
2 Tbl. herbs like basil, parsley or cilantro

Combine all ingredients well, form into patties, cook until well done on grill or saute in olive oil over medium heat.

Serve with avocado slices, tomato slices, and mayonnaise!

Saturday, August 16, 2008

Gluten Free Travel: Road Food

We have been on the road the entire summer and I am sure some of the friends and family we have visited have been surprised by the road food that Our Gluten Free Family has eaten. McDonald's fries and a hamburger patty hold the bun, ketchup and pickle. JUST THE HAMBURGER PATTY...IN A BOX...NO BUN. And way too many Applewood Farms Organic Grass fed Beef Hotdogs. And Applewood Farms Uncured Nitrate Free Pepperoni. I am all about rotating food at home. But when we are traveling I am just trying to get through the day. Usually I am super prepared with gluten free alternatives when we go somewhere, but at my cousin's wedding, I tried to wing it and ended up driving to a gas station in the middle of the vineyards in upstate New York. I have never been so happy to see a bag of Lay's Potato Chips. Potato chips are, by the way, one of the most unhealthy foods on the planet and always make the top 10 worst foods you can eat list but when you are gluten free they are, somehow, an necessary option. I try to buy ones that only have three ingredients on them: potatoes, oil and salt. Then I let my kids eat the entire bag. Well, only that once at the wedding because we weren't sitting at the same table. But, really, I don't restrict their eating whenever I can, because being gluten free 80% of the food they see is off limits completely which protects them
from all sorts of processed food that is unhealthy.

Thursday, August 14, 2008

Our Favorite Gluten Free Foods

When we first went gluten free we tried so many different gluten free products. Many were terrible and were thrown out after one bite. One out of ten gluten free products were delicious and have become staples in our house. Here are our favorites:

Pasta: Tinkyada Organic Brown Rice Pasta
Ancient Harvest Quinoa
Bread: Food for Life Raisin Pecan Bread (toasted)
Donuts: Kinnikinnick Gluten Free Dairy Free Soy Free Cinnamon Sugar Donuts(hard to find--I found them in Burlington, Vermont at Healthy Living, but I am going to ask
my local health food store to order these.)
Licorice: Organic Strawberry Vines
Oreo Cookies: Kinnikkinnick K-Toos
Chocolate Chip Cookies: Everybody Eats or homemade
Enjoy Life Chocolate Chips
Dr. Schar Italian Bread sticks
Cereal: Bakery on Main Granola
Gorrilla Munch
Nature's Path Organic Crispy Rice Cereal
Enjoy Life Cookies (allergy free brand): Snickerdoodles are healthy tasting cookies--not too sweet good for little kids who have never had cookies.
Animal Crackers by Orgran
Bagels-Enjoy Life (allergy free heavy not like regular bagels, but my son likes them!)
Foods by George-Pound Cake, Blueberry Muffins, Brownies
Kinnickkinnick Pizza Crust, Amy's Pizza (has dairy)

we use a mix of equal parts
Authentic Foods Brown Rice Flour
EnerG Tapioca Flour
Sorghum Flour

Whole Grains and Calcium

While doing research on the benefits of a Paleo Diet, I stumbled upon a site which explains how cereal grains causes calcium depletion and people who are eating high fiber grains can be at risk. Dogs fed oatmeal in the 30's got rickets and it was discovered that oatmeal and other whole grains contain phytic acid which binds to minerals like calcium, iron, zinc and magnesium and form phytates. According to "phytate was the dietary factor responsible for inhibition of calcium absorption by oatmeal as well as the induction of rickets in dogs." The public has been encouraged to eat whole grains because it is healthier, but for certain people who are low in minerals this recommendation might have to be reconsidered. A diet high in fiber from fruits and vegetables seems not to have this problem so loading up on fiber from these paleo sources wouldn't deplete minerals. Interestingly, soaking and fermenting seem to reduce phytic acid so if you do plan on eating oatmeal or other grains everyday for breakfast and are worried about calcium absorption, you could try soaking them to reduce the phytic acid.

Tuesday, August 12, 2008

Gluten Free Question: Why Grain Free is Healing For the Gut (SCD)

Q: I find I feel better when I eat "grain free." Sometimes when I eat something GF, like a GF bagel, I feel just as bad as if I had a a regular bagel. I realize that it could be something else in the bagel (most "added" oils and fats make me pretty sick)...but it seems strange to me. Do you think that means I should stay away from all grains, including GF?

A: When your intestines are so damaged you can't digest any grains. The specific carbohydrate diet (SCD) is a grain free, lactose free, sucrose free diet that is used to treat Celiac Disease, Crohn's Disease, IBS, Chronic Diarrhea, candidiasis, and autism. I also stumbled upon it being helpful for some kids with Down Syndrome. It is a paleo diet which consists of food which early man ate before the introduction of agriculture: meat, eggs, fish, vegetables and low sugar fruits. The idea is to starve the bad bacteria of their source of energy: grains, sugar and preservatives. But like the GF diet, you need to be 100% on the SCD to benefit from this healing regimen. The Specific Carboydrate Diet was created by Elaine Gottshall to cure her daughter's Ulcerative Colitis. According to Elaine Gottschall's book Breaking the Vicious Cycle: "Many cases of celiac disease, spastic colon and diverticulitis appear to be cured by the end of the year." For other conditions it can take longer. The SCD diet starves the intestines of sugars allowing only sugars that are easily digestible allowing the gut to heal. Perhaps you are a person who who would benefit from an SCD diet. Or perhaps you have already stumbled upon it.

Monday, August 11, 2008

Q: Is there any benefit to being partially gluten free?

I love being gluten free and I won't ever go back to eating gluten, but I sort of fell into being gluten free after watching my kids be sick for years on gluten and then recover off gluten. Then genetic testing and a gluten challenge revealed that gluten was a big problem for me. When I loaded up on gluten for a test (after being gluten free) my arms and legs got numb and tingly, I took to my bed with exhaustion in the afternoon and I was moody and depressed. Other people might not have such a dramatic wake up call which makes them rethink a lifetime of eating gluten, which is in wheat, rye, barley and most oats. People whose symptoms are suggestive of some type of allergy and who suspect gluten might be an issue might wonder if being partially gluten free is at all beneficial.

The answer is a little complicated. You won't be able to tell if gluten is a problem for you unless you give up gluten 100% for 3 months. This is because it takes a while for gluten to get out of your system. By incorporating some gluten free food into your diet-- cereals, pasta, breads, snacks--you might realize being gluten free is not only do-able it is is fun. Being partially gluten free would allow you to change your eating habits gradually and to learn about living gluten free. But you wouldn't get the huge benefit of feeling better and having chronic problems potentially disappear.

Dr. Nancy O'Hara, who is an integrated doctor says if you can't be 100% off gluten (or dairy) then she would rather see you on a different type of healing diet (The Body Ecology Diet, Gut and Psychology Syndrome Diet, Specific Carbohydrate Diet or a low oxalate diet.) People often go on a 85% gluten free diet and don't get better and so they decide the GF diet doesn't work for them, when they might get completely better by removing gluten completely. A gluten free diet is tricky because so much food contains hidden gluten. Oats, for instant, are not gluten free unless specially labelled because they rotate crops and often grow oats in the old wheat fields. And soy sauce, rice crispies and Twizzlers all contain gluten. So unless you are reading every label and researching how to do a gluten free diet, you might think you are doing a gluten free diet but you really aren't.

I would caution anyone to not judge the effectiveness of being GF until they are 100% on it for a few months. Also, typical celiac tests, which aren't terribly reliable anyway, don't work on a gluten free or gluten restricted diet, so it is a good idea to get testing done before you decrease the amount of gluten in your diet if the information is important for you to have.

WHAT TO DO: I recommend rotating some gluten free foods into your diet if you aren't ready to be 100% gluten free, because rotating foods is healthier than eating the same foods day after day. Adding one gluten free meal or day a week might be of some benefit for someone who is interested in being gluten free. Then, when convenient, try eliminating gluten completely for a few months.

Sunday, August 10, 2008

EASY "homemade" FRESH pickles RECIPE

kids eating homemade pickles
I went to Haverhill, Massachusetts as part of our two month road trip. Of course, we brought some Bubbies Pickles--we don't travel without them. I realize that is a little quirky, but my daughter loves pickles and Bubbies are naturally fermented and cured and made without vinegar, which I like because vinegar can feed yeast overgrowth. But, Bubbies pickles aren't cheap and hard to find when you are on the road in the middle of nowhere. My Uncle John, who we were visiting, peeled a fresh cucumber leaving a little dark green rind and cut the cucumber into wedges and put them in the leftover pickle juice. Everyone loved the "fresh" pickles. I loved having one more vegetable to feed everyone. Also, it is important to spear the pickle with a clean fork so you don't contaminate the pickle juice. Here is a picture of everyone enjoying our fresh pickles in Vermont, our next stop.

Related posts:
Snack Trays
Fresh, Raw Food--An Important Source of Glutathione
Food Rotating for Picky Eaters

Thursday, August 7, 2008

Gluten Free Cuban Chicken Recipe

My friend Amy made this delicious chicken and rice dish when I took Our Gluten Free Family on the road while our kitchen was being renovated. The brown rice cooks in a stock with onions and peppers and tomato so it ends up being creamy like risotto but having the yummy flavors of a burrito. I was so impressed by her gluten free dish I had to post it, even though I haven't actually made it yet.

olive oil
2# chicken-cubed
1 tsp cumin
1 tsp chili powder
2-3 cloves garlic
1 large onion, diced small
1 yellow or red pepper, diced small
3 cups brown rice
7 cups chicken stock
1can diced tomatoes with green chilies
1 can black beans (optional)
1 tsp salt
1/2 tsp pepper

Put olive oil in bottom of large pan. Sprinkle cumin and chili powder and salt on chicken. Saute in olive oil until chicken is brown. Set aside chicken. Saute garlic, onion and pepper until onion is translucent. Add 2 cups of brown rice and saute for a few more minutes. Follow directions of whatever rice you are using. Add 4 cups chicken stock or amount of water on package. Add a can of diced tomatoes w/ green chilies, black beans and chopped cilantro. Cover and simmer until rice is absorbed 10 minutes before it is done throw chicken back in. Add fresh cilantro, salt and pepper to taste.

Other spicy recipes:
Another GFCF Taco Recipe
Summertime Chicken Tacos

Wednesday, August 6, 2008

EASY Gluten Free Pancakes Recipe

This is a recipe that serves 1-2 people. I like it because it has a whole egg in it, so if your kids eat a bunch of pancakes they are getting more egg than the typical pancakes. Even non gluten-free friends like these pancakes. I made them with Enjoy Life Chocolate Chips for Charlie, Gigi and Zoe and Charlie said "These are good!" which if you know Charlie is a HUGE compliment. If you are still eating gluten, you can make these nutritious pancakes with whatever flour you have on hand.

1/4 c. gluten free flour mix (see post Gluten Free Flour Mix)
1 egg
1/4 tsp baking soda
1 tsp. sugar/maple syrup or agave
1 T. rice milk or seltzer

This is an individual recipe. Multiply it by the number of people you are serving. Just mix all the ingredients together in a bowl. Heat oil in a pan. Drop spoonfuls of batter into pan. Cook until a few holes appear in batter. Flip to brown other sides. Enjoy with your favorite pancake toppings--Vermont maple syrup, powdered sugar or raspberry jam.


1/4 c. gluten free flour mix (see post Gluten Free Flour Mix)
1 egg
1/4 tsp baking soda
1 tsp. sugar/maple syrup or agave
1 T. rice milk or seltzer

1 teaspoon apple cider vinegar
2 pinches baking powder
1 pinch cream of tartar

WHAT TO FEED YOUR KIDS: A delicious homemade breakfast whenever possible. If you don't have time to make something a few nuts and a piece of fruit. Leftovers from the night before might sound strange, but it is often more nutritious than usual breakfast fare.

Tuesday, August 5, 2008

Apple Juice and Toddler Diarrhea

A new friend asked me if her three year old's never formed stool were the result of his apple juice consumption...

"Toddler Diarrhoea: more a nutritional disorder than a disease," an article in the journal Archives of Disease in Childhood, has some very good information for parents about how fruit juice and low fat diets sometimes play a part in diarrhea. Very low fat diets and clear apple juice can contribute to diarrhea. Here are excerpts from the article:

"In retrospective studies, toddler diarrhoea has been found in children consuming very low fat diets to prevent coronary artery disease, on very high fluid intake, and with high fluid osmolality.
In a randomised trial of children with a recent diagnosis of toddler diarrhoea who were free from symptoms after dietary advice, only reintroduction of normal clear apple juice resulted in the recurrence of diarrhoea; these children could tolerate cloudy apple juice. Cloudy juice is bottled immediately after pressing, whereas clear apple juice is industrially prepared by means of enzymatic treatment of the apple pulp to obtain a higher yield and an attractive clear product. The products therefore differ in the amount of dietary fibre and the amounts of indigestible monosaccharides and oligosaccharides.

In developed countries, the diet of children, especially of infants and toddlers, has changed dramatically over the past years. Paediatricians and other physicians are increasingly consulted not only for toddler diarrhoea but also for other health problems related to these changes. Ready-made products increasingly replace food prepared fully by parents. Here, new nutritional habits originate that go together with an increase in affluence. Drinking plain water is out of vogue. It has largely been replaced by fruit juice and squash. Drinks are consumed on a more or less constant basis, often by a drinking bottle. They provide a high number of calories and may diminish the appetite. Reports from the United States indicate that these mainly carbohydrate containing fluids contribute to unbalanced nutrition. In clinical practice we encounter young children having excess juice consumption as a contributing factor in non-organic failure to thrive. In a cross sectional sample of healthy young children, excess fruit juice consumption was associated with short stature and obesity.

Frequently, drinking fruit juice results in a high fluid intake with displacement of fat and fibre from the diet. More parents seem to be concerned with obesity and intend to offer low calorie drinks, not being aware of the fact that, because of its high carbohydrate content, fruit juice equals the caloric content of many popular dairy products.

Fat intake should be increased to at least 35%, even 40%, of total energy intake. Restoration of a pattern with well defined meals and snacks provides the opportunity for significant increases of fibre intake. Fruit juices, in particular clear apple juice, and other squashes should be limited to restore appetite at meal times. Drinks between meals are acceptable, but overconsumption should be discouraged. In almost all patients the efficacy of these dietary measures is such that it may even serve as a confirmation of the diagnosis.

It is evident that toddler diarrhoea is worrisome for many parents. It is a condition related to modern affluent societies where new nutritional practices have emerged. Related to these changes clinicians see children with toddler diarrhoea, nutritional deficiencies, and even manifest failure to thrive with stunting. The long term health effects remain uncertain."

WHAT TO DO: If you think that apple juice is playing a large part in the diarrhea of your child, try eliminating it and see if it the unformed stool improves. If you can't eliminate apple juice SWITCH TO A CLOUDY, LESS PROCESSED VERSION and see if that helps. And increase the healthy fats in your child's diet--healthy natural fat is important for developing children and important for proper digestion. See my post on Chronic Diarrhea for more information.

Monday, August 4, 2008

Chronic Diarrhea and Unformed Stools in Toddlers and Young Children

Because diarrhea and unformed stools are relatively common conditions for everyone at one time or another, they are often overlooked as a symptom and not taken seriously and dismissed as "toddler diarrhea." But chronic diarrhea for a baby or toddler over the age of one (who is not being breastfed) should be looked into carefully and treated. Severe cases of prolonged diarrhea can be a sign of celiac disease or a milk allergy or an overgrowth of bad bacteria in the gut. But the most important reason to take chronic diarrhea seriously is that malabsorption of food often means the child is not absorbing nutrients from food. Not absorbing vitamins at critical times of development can lead to developmental problems. Pediatricians are reluctant to try to get to the bottom of unformed stools because so often with gut problems, testing does not reveal anything. Blood tests for celiac are unreliable for children under 3 because it can take years to develop antibodies and allergy tests are often negative. Elimination diets can help tease out if juice or fruit or dairy is a factor, but if the child is intolerant of several foods, removing one of them won't help. If removing suspected food for a few days doesn't help, then you might need to look at the diarrhea in the context of how the child is doing otherwise. A child who is not meeting milestones or has any other developmental problems should take the diarrhea more seriously. A child who has loose stools after too much juice is very different from a child who NEVER has formed stools.

WHAT TO DO: For mild diarrhea: Limit fruit juice--try to have kids learn to drink water. If you do buy apple juice buy the cloudy apple juice not the clear apple juice. For more chronic diarrhea: take probiotics like GI flora from Allergy Research Group which have bifidus strain of good bacteria to repopulate the gut with beneficial bacteria and think about allergies and intolerances playing a part. Remember a daily multivitamin with minerals (a gummy: Hero Yummi Bears Multi Vitamin & Mineral, Trace Minerals Complete chewable or powdered Rainbow Light) in case your children aren't absorbing enough nutrients. For any child with severe digestive issues who also has developmental problems: Find an integrated doctor, like Nancy O'Hara or Dr. Fred Pescatore, who understands the importance of nutrition and gut function for development.

Saturday, August 2, 2008

Gluten Free In Burlington, Vermont

I bought a gluten free peach pie and a fresh carrot, apple, kale juice from Healthy Living in Burlington, Vermont. For me, it doesn't get much better than this. After being on the road for a week, I felt like I was at a spa when I was wandering around Healthy Living. The gluten free peach pie was from freshmeadowfarmbakery and it was delicious and flaky--even my brother-in-law had a piece and he is not a big fan of gluten free anything. And my daughter's friend asked for a second piece--"even a crumb" she said when I told her mom said only one small piece. The pie has some butter in the crust, which sometimes I occasionally include in my GFCF diet, but other members of our family can't. I also bought some Blue Ledge Farm Farmstead Gouda raw goats milk cheese, because sometimes people who are intolerant of cow's milk can have some goat's milk. And I have read that sometimes people who can't tolerate milk can, for some reason, tolerate the raw milk. So, I thought while I was in Vermont I would try some raw cheese. I was told by the environmental allergist to try things I might be sensitive to first thing in the morning on an empty stomach to see if there is a reaction. So I will be having a piece of cheese first thing in the morning--which is at 6 am because my neice Ella is like a rooster. Anyway, if you are in Burlington or anywhere near Burlington head to Healthy Living for some local, organic food.