A helpful guide for those who don’t normally eat gluten free
My friends don’t invite me over for dinner anymore.
It’s not because I don’t enjoy having people cook for me. Who doesn’t love being the guest at the table?
But after I was diagnosed with celiac disease in 2012, the dinner party invitations more or less stopped. That was partly because I put up huge barriers whenever I got invited to a friend’s house: I can’t eat this, I can’t eat THAT, dear God no, I can’t even look at that.
And it was partly because my friends had no idea how or what to cook for me — and they were deathly afraid they were going to kill me.
Dietitian Sarah Campbell Bligh can relate. “I was diagnosed with celiac five years ago this November, and I have two other dietitians in the family – my mother and my mother-in-law – and even they were terrified to feed me at first.”
So let’s begin by putting that notion to bed: Even if you feed me a whole plateful of gluten, you are not going to kill me. Well, not immediately.
Why do people with celiac get so freaked out about gluten?
Celiac disease is an autoimmune disorder that interferes with the body’s ability to absorb vitamins and nutrients from food.
It’s not an allergy. It’s especially not an allergy that causes an anaphylactic reaction, the way peanuts or shellfish can for those who are allergic to them. In my case, if you feed me a bunch of gluten, the most immediate reaction I will have will be to become extremely … well, uncomfortable.
It’s the long-term implications of eating gluten that cause people like me to get so freaked out.
According to the Mayo Clinic, people with celiac are more prone than non-celiacs to certain cancers, including cancers of the small intestine and lymphomas, because of the damage gluten does to their small intestine.
The Canadian Celiac Association also notes that there is an association between celiac disease and type 1 diabetes, and an association with liver disease. And celiac disease is also recognized as a common cause of osteoporosis.
Contamination is measured in parts per million
This is a key point: I don’t have to eat a whole slice of bread to be put at risk from gluten.
Gluten contamination is measured in parts per million. Food is considered gluten free by Health Canada when it contains fewer than 20 ppm.
Which is why a crumb of bread on my plate freaks me out. Why a dollop of soy sauce in a salad dressing renders it inedible. Why “gluten free” pizza crust cooked in the same wood-fired oven as regular pizza crust just doesn’t cut it.
So, given that I spend all day, every day, depriving myself of delicious gluteny treats — only to have the healthy intestines I’ve earned through years of deprivation taken back to square one in a single meal — can you blame me for being a little touchy about it?
Still, I do want you to invite me over for dinner. So here’s what you have to know, on a practical level, to make it safe for me.
1. Unexpected sources of gluten
The primary sources of gluten in food originate from wheat, rye and barley.
But gluten is found in more things than bread and beer. I’m going to assume you know that ordinary crackers, cakes, pies and things like that are forbidden.
“People forget that there are things other than wheat that contain gluten,” says Campbell Bligh. “Barley malt extract is an ingredient that I find trips a lot of people up. They look for the wheat and they see barley and they kind of forget sometimes.”
Essentially, any food that has been packaged or processed in any way is suspect.
“Most people don’t realize that condiments might contain gluten because they don’t look like a grain,” says Campbell Bligh. In fact, salad dressings, dips and sauces are quite likely to contain gluten. They may have wheat-based thickeners, malt vinegar or flavourings that make them unsafe. There are gluten free versions of most condiments; it’s best to look for brands that specify on the label that they are gluten free.
The following foods are not safe for people with celiac — unless the foods are labelled gluten free:
- most soup stocks
- most soya sauces
- oats (because, unless specially processed, they are contaminated in the processing)
- wheat pastas
- french fries (if they are cooked in the same oil as gluten-containing foods or if they have a coating)
- bulk nuts
- most cereals
- some corn breads
- most barbecue sauces
- Worcestershire sauce
- some hot pepper sauces*
- Dijon mustard
- some ketchups, relishes, mustards
- most gravies
- most canned soups
- most bacon, cold cuts, hot dogs, salami, sausages
- some ice creams
- some potato chips
- food additives, such as malt flavouring and modified food starch
- some alcohol based extracts
- some canned tuna (if packed in broth)
- some cheese spreads
- some colorings.
You can find an extensive list of unsafe foods here.
When you’re preparing food at home for a person with celiac, you need to know that if a bread board, knife, or other utensil has been in contact with anything that contains gluten before being thoroughly cleaned, it is a potential source of cross-contamination.
Cathy Doyle is a clinical dietitian at the QEII Health Sciences Centre in Halifax. “Don’t use equipment or utensils that are too porous,” she advises. “Don’t use a wooden spoon that you’ve had in the kitchen for a long time; maybe use stainless steel.”
If your butter knife has touched toast, if you’ve dipped your bread knife into your mayonnaise, if you’ve peanut buttered your sandwich, I can’t eat anything made from those jars because they are contaminated with crumbs.
If you’re serving gluten free bread, please don’t put it in the same basket as regular bread. If you’re thinking of toasting that gluten free bread — don’t. Gluten free bread requires a dedicated toaster.
If you’re cooking/barbecuing/baking foods that have gluten at the same time you’re preparing foods that don’t, make sure you use separate tongs, spatulas and serving spoons for the gluten free foods.
“And make sure you clean the rack on the barbecue really well, or clean a section of it so that the person who has a gluten free steak or hamburger can go in that area,” says Doyle.
“The best thing for people to do is to treat celiac like an allergy,” adds Sarah Campbell Bligh. “You would never prepare a sandwich for someone with a peanut allergy on a cutting board you had just made a peanut butter sandwich on, but people don’t think about doing that for people with celiac. So my advice would be to treat it the same way and have things as clean as possible.”
3. The safe zone
Up to this point, there have been a whole lot of “don’ts.” But there are plenty of foods that are perfectly safe.
You’ve probably heard that you should “shop the perimeter” to get the healthiest foods at the grocery store. That rule applies to gluten, too, because it puts the emphasis on whole, unprocessed foods.
It may also be wise to avoid substitutions — don’t try to prepare gluten free breads, pastas, cookies or cakes. “It takes skill and experience to do substitutions,” says dietitian Cathy Doyle. “Someone with celiac may know how to do it, but this may be the time to go to a gluten free bakery and buy from them.”
Also — and no offence to anyone — but gluten free substitutes are generally not as good as the foods they are meant to replace, in terms of flavour, texture or nutritional value.
Foods that are safe
So, to get you started, here are some things I can safely eat:
- Unprocessed meats, vegetables and fruits (but be cautious about the accompaniments like salad dressings and barbecue and other sauces)
- quinoa (but check packaging; some types have come in contact with gluten sources)
- cheese and most dairy products
- gluten free pastas (but note that they cook differently than regular pastas and cannot be cooked in the same water that regular pasta was cooked in)
- salt and pepper
- butter, vegetable oil and olive oil
- distilled alcoholic beverages.
Here’s a good list of what’s allowed on a gluten free diet.
Some suggested dishes
Now that you’ve got the basics down, I have a few suggestions for gluten free dishes that you could prepare:
- Straight-up meat-and-potatoes (as an aside, roasted veggies are safe, and barbecued meat is always a winner)
- rice and vegetable casserole (as long as no canned soups or thickeners are used)
- rice and beans
- risotto, as long as gluten free stock is used in the preparation
- veggie stir-fry
- fish tacos (check that your tacos are corn-only)
- soup, if made with gluten free stock
- salads of all varieties (again, mind the dressing).
Now you know
Okay, I’ll admit the whole thing is a little complicated, but now that you have the basics, you’re good, right?
I’ll be happy to accept your dinner invitation now that we can both relax. Oh, and that glass of wine you’ll pour me when I arrive?
Yes, it’s gluten free.
(*Note: The line above, which previously read “Tabasco sauce”, was revised on May 12, 2015.)