On Gluten Free

A Primer

On Gluten Free

TEN YEARS AGO, many people, including savvy foodies, had never heard of the word gluten, much less the implications it could have on health. Few, if any, restaurants posted gluten-free dishes on their menus, and gluten-free bakeries were nonexistent.

Now firmly established in the culinary vocabulary, gluten-free is tossed around almost as freely as low-fat. Restaurants throughout the Hudson Valley tout their gluten-free choices; mainstream supermarkets as well as health food stores have expanded their gluten-free sections, and a whole new sector of bakeries has emerged sans gluten. To separate the wheat from the chaff, so to speak, this primer presents some essential facts about gluten and how those affected by this ubiquitous substance can eat without it—and still enjoy mealtime.

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What is gluten?

Gluten is a protein (actually, it’s a combination of two proteins—gliadin and glutelin) found in many grains. In its natural state it helps nourish the embryonic seed and bind the grain’s components together. It is insoluble in water—it’s what is left after grain has been milled and the starch washed away. Incorporated into flour, gluten’s sticky nature helps give dough elasticity.

What foods contain gluten?

Gluten is present in all wheat (durum, emmer, spelt, farina, faro and einkorn), rye, barley and triticale (a new grain developed as a wheat substitute), and thus it’s present in any food that uses these grains or flour made from them. This includes bread, pastries, pasta, noodles (including ramen and egg noodle), cereal, crackers (including pretzels and graham crackers), breakfast foods like pancakes and waffles, and any sauce or gravy that uses wheat flour as a thickener. Brewer’s yeast also contains gluten, as do most beers, ales, malt beverages (including malted milk and milkshakes) and malt vinegar. Pope Francis has yet to address the sad fact that Catholic communion wafers, too, contain gluten. In short, unless the labeling of a prepared product clearly states it is gluten-free, it likely contains some main ingredient, thickener, seasoning or enzyme derived from gluten.

Who needs to avoid gluten?

According to estimates from the Mayo Clinic, about 1 percent of the population suffers from celiac disease—a genetically linked autoimmune disease. Triggered by the presence of gluten, the body reacts against itself, in this case causing painful inflammation of the small intestines, resulting in malabsorption of essential nutrients that ultimately can lead to anemia, osteoporosis, thyroid disorders and even infertility. There is no cure and no medication for celiac disease—the only way to manage the condition is with a strict gluten-free diet.

Less well understood, but not necessarily less painful, is non-celiac gluten sensitivity (NCGS), whose symptoms can mimic those of celiac disease. Anecdotal evidence suggests as many as 20 percent of Americans may suffer from NCGS, experiencing uncomfortable abdominal cramps, belching and water retention after eating gluten products. “Gluten is a potent protein that stimulates an immune response and makes some people feel crummy,” notes Dr. Louis Aurisicchio, a gastroenterologist with Putnam Hospital Center and Mount Kisco Medical Group, who adds, “Any patient who comes in with abdominal pain, weight loss and bloating—celiac disease is thought of at the first encounter.” Blood tests and a biopsy of the small intestine can confirm the diagnosis.

What foods are off limits on a gluten-free diet?

If you’ve been diagnosed with celiac disease or NCGS, identifying triggers and reading labels becomes a necessary obsession. The nomenclature on processed food labels can be dizzying. Wheat or wheat-derived product in any form, of course, is the primary red flag; packaged products containing wheat are required to be labeled with that information because wheat is classified as a major food allergen. “Natural flavors” can be tricky—it is a big umbrella under which many gluten-containing additives can fall—thus anything with added flavorings and not certified as gluten-free should be avoided. “Hydrolyzed vegetable protein,” found in many packaged products, is another flag (it usually is made from wheat protein). Uncertified soy sauce and other soy products also are off limits, which is somewhat surprising since soybeans are naturally gluten-free. However, because soybeans (and oats) are handled and processed in such close conjunction with wheat or other grains, it is often seriously cross-contaminated. (A safer choice for soy-sauce lovers is tamari.)

What’s left to eat on a gluten-free diet?

Many popular and common foods are naturally gluten-free, and many others can be created using gluten-free ingredients. Meat and fish are safe bets—as long as they’re fresh and unprepared (meat, fish or other products that have been marinated or contain flavorings or other additives are not safe—most of these preparations contain gluten). Gluten is not in buckwheat, rice, quinoa, corn or millet, nor is it in eggs or dairy products. Fresh fruits, vegetables and nuts are gluten-free, as are wines and distilled liquors. (Even though liquors such as scotch or bourbon are made using gluten-containing grains, the distillation process eliminates the gluten peptides). The Hudson Valley’s signature beverage—hard cider—also is naturally gluten-free.

A Field Guide to Alternative Flours

Different types of gluten-free flours have varying properties that make them more or less suitable for different kinds of baking. Most chefs recommend making a blend of several different kinds, taking advantage of each type's best qualities. Arrowhead Mills, Bob’s Red Mill, Glutino and King Arthur are among the companies that make pre-mixed, all-purpose gluten-free flour blends.

Buckwheat flour

Nutty flavor, substitute for whole-wheat flour.

Corn flour

Mellow, sweet flavor. Ranges from coarsely ground to fine, smooth grains.

Corn starch

Not to be confused with corn flour, this is widely used as a thickening agent and gives lift to baked goods.

Oat flour

Finely ground and light, this is excellent for baking. Make sure the flour is from certified gluten-free oats—oats are commonly cross-contaminated.

Potato flour

Dense and smooth, with a pronounced flavor.

Potato starch

Like corn starch, this lightens flour blends for baking.

Rice flour

Can be found in several versions: brown, white and sweet white. Moist and lightly flavored; good as a thickening agent, though too much can make foods gummy.

Sorghum

This cereal grain is grown in many developing countries; it is most often found on these shores in molasses. Flavor ranges from sweet to slightly bitter. Very close in taste and texture to “regular” all-purpose wheat flour.

Tapioca

A good thickening agent (similar to arrowroot). When finely ground, this lends a smooth, chewy quality.

Teff

This grain comes from grass. Its flour has a slightly gelatinous quality, which mimics gluten’s binding abilities in an array of dishes.

Does celiac disease or NGCS mean restaurants or café are off limits?

Dining out can be a challenge for anyone with special dietary needs, but the growing consciousness about gluten in food has caught the attention of many restaurateurs and chefs. So, although living with gluten intolerance requires extra diligence, it needn’t eliminate the enjoyment of a meal out. With the number of gluten-sensitive customers on the rise, more restaurants now offer gluten-free items on their menus. In fact, gluten-free cuisine is one of the hottest food trends identified by the National Restaurant Association. New regulations by the FDA set strict rules on restaurants labeling items as gluten-free. Queries to the wait staff, maître d’ or even the chef should answer questions about ingredients, preparation methods and cross-contamination risks.

There also is a growing trend toward totally gluten-free businesses. Ella’s Bella’s (Beacon), By the Way Bakery (Hastings) and Flour Buds (Nyack) are among the growing number of bakeries in the Hudson Valley proving gluten-free can be delicious.

Where can people with gluten-sensitivity turn for support?

Many local community centers, libraries, hospitals and clinics host support group meetings. There are a growing number of “virtual” celiac support groups that offer advice, menu suggestions and recipes. One of the most popular online sources in this region is Gluten-Free Hudson Valley, where Ann Byrne, a community blogger for The Poughkeepsie Journal, shares her experiences living gluten-free in the Hudson Valley.

Thanks to Abby Luby for contributing to this article. Other sources of information include The Celiac Disease Foundation; The Celiac Support Association; the Cleveland Clinic Center for Continuing Education; Gastroenterology; The Lancet; MayoClinic.org; and the National Foundation for Celiac Awareness.

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