Chelsea Clinton, Keith Olbermann, Miley Cyrus and 3-year-old Manuel Oliva, of Homestead, have something in common.
They don’t eat gluten.
Over the years, more and more people have been switching to gluten-free diets for everything from weight loss to autism.
“There’s been a lot of hype about eating gluten-free diets. It’s become a buzz word,” says registered dietitian Susan Nowrouzi of Baptist Hospital in Miami. She’s watched the trend crest in the last decade.
However there are really only three diagnoses for which doctors regularly recommend a gluten-free regimen to their patients: celiac disease, wheat allergies and gluten sensitivity.
Gluten is a protein found in wheat, barley and rye. It carries many of the calories and nutrients found in these grains. Bakers like it because it expands and gives bread structure as it rises in the oven. But people whose bodies react badly to it need to avoid it.
A gluten-free diet is not easy to follow — especially because it means avoiding wheat-based pasta and bread. And that’s difficult for many people. It also can be difficult to determine which foods actually contain gluten
Glicelia Oliva, whose son was diagnosed with celiac disease in June, is relieved to have found pasta made from rice that he finds acceptable. She also has discovered a gluten-free bread to replace the Cuban bread on which Manuel was raised. At Whole Foods, she can even buy chicken nuggets breaded with rice to replace his favorite fast food.
But for some of his other favorite foods, it hasn’t been so easy to find satisfactory substitutes.
Take Oreos. Oliva bought sandwich cookies that look like Oreos but they didn’t fool her son. “He knew the difference just by looking at the packaging,” she says.
Don’t make the mistake of going out and buying a lot of gluten-free copycat products as soon as you are diagnosed, says Mirta Rios, a pediatric dietitian at Miami Children’s Hospital. They can be expensive and may not satisfy. Then you’ll end up throwing them out.
Better to stick with naturally gluten-free foods such as lean meats, fresh fruits and veggies that are readily available at supermarkets. “When my patients say ‘We can’t afford special foods; we aren’t rich,’ I tell them they don’t need to,” Rios says.
To replace the bread and pasta that provide starch in meals, try serving potatoes, rice, quinoa, corn or amaranth. South Floridians are lucky to have such gluten-free choices as yuca, plantains, malanga and pumpkin, as well as beans, Rios says.
In fact one of Manuel’s favorite dishes is the red beans and rice his Cuban grandmother serves with a chicken breast.
It’s easier to stick to unprocessed foods because you may find gluten lurking as an ingredient in manufactured products such as soy sauce, ketchup, candy, self-basting turkeys, processed meats, soup bases, croutons and imitation seafood. It’s even in some medications.
To keep your diet gluten-free, you have to carefully consider the ingredients listed on the food label.
But it can be a puzzle, says Pamela Garjian, a gastroenterologist and the sub-section chief of endoscopy at Baptist Hospital. For example, if the ingredient list includes “barley malt” you must recognize that it is made from barley and therefore contains gluten.
“I never used to read labels. I never cared,” Oliva says. “But now I read them every day.”
The job of buying gluten-free foods may become easier if the FDA adopts a final regulation defining what “gluten-free” used on a food packages means. Currently there is no legal definition. Rios is hopeful the final regulation will be in effect later this year but it has been in the writing stage since 2007.
“It will mean that a food labeled gluten-free really is gluten-free,” she says.
And it will mean that foods manufactured with other foods won’t be cross-contaminated. This is a big problem both with manufactured foods and foods served in restaurants.
Gluten can be transferred from one food to another by as simply turning a chicken breast with a spatula that was used to flip a breaded chicken breast. Even a toaster used to toast wheat bread can transfer gluten to a slice of gluten-free bread, Rios says.
“And what’s safe today may not be safe tomorrow,” she adds. After all, companies can change the formulation of a product at any time.
Clearly, eating gluten-free takes vigilance.
At school, parents must work with teachers to be sure their child isn’t given a cupcake or cookie at snack time. (All-purpose flour generally comes from wheat).
Manuel’s mother gets around this by packing his lunch as well as his snacks. She fills his Spiderman and Lightning McQueen insulated boxes with his favorite gluten-free macaroni and cheese. She adds a bit of gluten-free dry cereal to munch and slices of his special bread.
“I always have to think ahead about where we’ll be when so there’s plenty for Manuel to eat and we won’t have to rush home,” Oliva says.
At birthday parties, she provides him a meal plus a treat such as lollipops. When other celebrants are digging into the pizza and cake, she tries to distract him by heading him for the bounce house.
Although Oliva finds all the planning and packing gluten-free meals requires time, she is happy to do it.
“I was devastated when we were told Manuel had celiac disease,” she says. “But now I know that if he follows his gluten-free diet, he’ll thrive. He’ll grow up, go off to college and be just fine.”