E-News Exclusive

An Insider’s Perspective of Gluten-Free Eating
By Melissa Schisler, RD, CD, LMP

When I first entered dietetics, I gave my patients with celiac disease a list of ingredients to avoid, mentioned the Bob’s Red Mill catalog, and sent them on their way. I didn’t fully comprehend how lacking of an education that was until the day my significant other needed to switch to a gluten-free diet. Suddenly, I realized I had no idea what to buy for him at the market or what he could order when dining out. I knew what he shouldn’t eat, but what could he safely eat?

Uncertainty plagues many people when they’re diagnosed with celiac disease. Patients want to know more than which ingredients to avoid. They also need to learn new meal and snack ideas, which gluten-free products to purchase, and how to modify recipes at home.

After trial and error to better understand gluten-free eating, I’ve developed more specific tips that I share with my patients with celiac disease and gluten intolerance to better personalize my care.

Helpful Hints
One of the most important things a patient with celiac disease should know is which items to stock up on for making meals at home. Whole Foods Market and other health food stores have an assortment of necessary gluten-free items: gluten-free all-purpose flour, xanthan gum (to use as a thickener in baked goods), rice flour, soy flour, potato starch, tapioca starch, corn tortillas, buckwheat frozen waffles, rice cakes, quinoa, rice-based pastas, and gluten-free cereals. These purchases may represent a large financial outlay to start, but having safe ingredients on hand is worth the investment.

Alternatively, one may find a more affordable line of rice flour in the Hispanic section of some grocery stores. Decent brown rice bread is available at Trader Joe’s locations; also look for sorghum-based beer, an excellent substitute for the more common hops-brewed versions. I’ve found that reading the back of soy sauce labels will reveal at least one on the shelf made with ingredients other than wheat. Even if these items aren’t available at your local grocery store, the store manager may agree to carry them if he knows you will be buying them regularly.

Gluten-free cookbooks and bread-making machines for homemade baked goods are also good investments. Making these goods at home is much less costly than buying specialty baked items and mixes at a store. Any recipe can be modified by substituting either gluten-free all-purpose flour or a combination of 2 cups rice flour, 2/3 cup potato starch, and 1/3 cup tapioca starch for every 3 cups of regular flour. Individual gluten-free recipes may suggest other flour combinations that more closely resemble the original product.

Restaurants are starting to cater to those who follow a gluten-free diet now too, making it easier for people to dine out without worry. Risoterria serves gluten-free pizzas and beers in New York City; the Outback Steakhouse chain marks gluten-free items on its menu; and many restaurants offer at least one bread-free entrée, thanks to the low-carb diet craze of the past decade. Thai and Mexican restaurants are traditionally gluten free as well (assuming you choose the rice noodles, corn tortillas, and nothing battered). When in doubt, speak up and tell the waiter you are eating gluten free. Inquire whether sauces are made with flour or cornstarch, and ask whether you can make substitutions, such as swapping toast for a piece of fruit or a potato.

It’s important to note that those with gluten intolerance (not true celiac disease) are similar to those with lactose intolerance in that they will likely have a gluten tolerance threshold. For example, a person with gluten intolerance may be able to consume regular soy sauce or drink up to three light beers before experiencing intolerance symptoms. Since this tolerance threshold varies from person to person, individuals should experiment with testing their own personal gluten tolerance limit.

Ideally, patients with gluten intolerance or celiac disease will get their survival information from dietitians instead of through trial and error. I believe personalized recommendations, including items to buy and substitutions to make, will be the guidance patients are looking for to successfully alter their diet.

— Melissa Schisler, RD, CD, LMP, is a dietitian, a writer, and a massage practitioner in New York City.