It isn’t always easy to adjust to the gluten-free life. But there are commonsense ways to make it much simpler. These tips will help you love gluten-free living.
1. Be patient.
Almost everyone is overwhelmed by the challenge of eating gluten free. Initially it might seem like the diet eliminates all the food you love to eat. Or you might feel surrounded by gluten and unsure if it’s safe to eat anything. It could take up to six months to begin to feel comfortable with the diet and confident about your food choices. So don’t expect to get it all straight overnight.
You may experience grief over having to give up foods you have eaten all your life. Don’t worry, it’s normal. You will almost certainly make mistakes at first and eat food that contains gluten. This is also normal. And a few mistakes won’t kill you. Time is on your side and the lifestyle will get easier as you learn more and gain confidence in your choices.
2. Be positive.
Concentrate on what you can eat, not on what you can’t eat. Remember that most of the nutritious foods you are supposed to eat to stay healthy are gluten free. This includes plain meat, fish, poultry, beans, eggs, vegetables, fruits, rice, nuts and legumes, not to mention rice, corn and soy. Plain spices and herbs are also gluten free as are plain fruit juices, milk, coffee, tea, wine and distilled alcoholic beverages. Later, when the insecurity fades away, you can go beyond plain. On the other hand, just because something is gluten free, does not mean it is good for you. Cool Whip, for example, is gluten free. Junk food is still junk food whether it’s gluten free or not.
3. Don’t cheat.
Now is the time to decide you are not going to cheat. You will be tempted. At some point you might start thinking the diet just isn’t worth it, especially if you weren’t very sick when you were diagnosed. You might decide there is simply too much gluten around to avoid, so you might as well go ahead and eat it. You might not want to stand out or make a fuss when you are eating with others.
Let’s look at these excuses.
The diet is most certainly worth it. Now only will it make you feel better than you ever have before, it will also protect you from the risks you face if you continue to eat gluten – osteoporosis, for example.
There is a lot of gluten around. But once you develop some perspective on the diet and acquire knowledge about ingredients, you’ll discover that you can successfully avoid gluten and stay happy and healthy.
In terms of sticking out in a crowd, maybe the gluten-free diet is not quite as conspicuous to others as it is to you. These days people follow all kinds of diets – vegetarian or dairy-free, to take just two examples. Maybe they have diabetes and need to keep track of their carbohydrates. Or they are trying to lose weight or save money. In a climate of raised food consciousness, those who follow a gluten-free diet may not be as special as they think.
Beyond a few moments of guilty pleasure, you have nothing to gain by cheating, and you have a lot to lose, including your good health. Stick to your vow not to cheat. Treat yourself to a favorite gluten-free comfort food when the going gets rough.
4. Make connections.
Get in touch with a support group. There are local support groups all over the country, all loosely connected. Most are wonderful sources of information, understanding and practical details. If your doctor or dietitian can’t put you in touch with a local group, you can check celiac.com.
Once you’ve found a support group, go to meetings, get to know others who follow the gluten-free diet and volunteer to help. Most support groups need more help than they get. And most offer a great deal more to individuals than each person can possibly put back in.
If you’re not the support group “type,” you will still find it helpful to go to at least one meeting. You’ll find out where to shop and eat out. You’ll be able to talk to people who will understand exactly what you are going through.
5. Gather information.
Learn everything you can about the gluten-free diet. This will involve time and effort and eventually it will mean sifting through conflicting information to try to separate the accurate information from material that is inaccurate or unfounded. Naturally we recommend Gluten-Free Living. It is the best source of reliable information currently available. If you don’t find that to be true, we will gladly refund your subscription price. You can subscribe to our magazine here.
Be especially cautious online. Anyone who has a computer can become an instant expert. This is true in any area and you just need to be skeptical. That said, the Internet can be an excellent starting point for your information search. Our website is reliable and informative.
You might also want to purchase a basic book on celiac disease and gluten sensitivity. We recommend Celiac Disease: A Hidden Epidemic by Peter HR Green, MD and Rory Jones. This book clearly and comprehensively covers all the basic medical and other information you need to know to live a happy, healthy gluten-free life.
6. Buy a cookbook.
Buy at least one specifically gluten-free cookbook. It will offer recipes that are exclusively gluten free. But it will also provide basic details about the peculiarities of gluten-free cooking and baking. There are no many to choose from. Anything by Carol Fenster, Bette Hagman or Connie Sarros is sure to be good. But there are plenty of other authors to choose from.
Meanwhile, do not throw out the cookbooks you now have. As you become more and more informed, you’ll be better able to tell if a given recipe is safe and even to know what substitutions you will need to make to convert a recipe to gluten free.
7. Shop around.
Check out all your local supermarkets, health food stores or other shops that sell food. Gluten-free foods are getting more shelf space in supermarkets every day. You’ll probably go through some trial and error before you figure out the best places to shop locally. At the same time, continue surfing the Internet to discover new sources of gluten-free products. At this point, you will probably be amazed by how many gluten-free products there are. These days you can find a gluten-free version of almost anything.
You’ll find many individual companies that sell a wide variety of gluten-free food or order though giants like Amazon.com. Amazon can be very economical when you buy in bulk. So if you have storage space at home, check what’s available there.
8. Develop supermarket savvy.
Learn to navigate the supermarket. At first you’ll probably spend double or triple the time you used to spend on each shopping trip. That’s because you have to read every label every time you shop and at first, you won’t be familiar with many of the ingredients.
Don’t try to figure out everything at once. Select one or two items you would like to be able to eat and check them out. Almost all food processors have 800 numbers listed on their food labels. Bring your cell phone to the supermarket and gather detailed information on the spot. The next time you shop, you can select one or two more items to check up on. If you have a smart phone, there are a number of apps that enable you to check the gluten-free status of a product right on your screen while you are at the supermarket.
Don’t forget to shop the perimeter of the supermarket. That’s where you usually find the produce departments, where just about everything will be gluten free, or the meat and dairy departments, where most of the items will be gluten free. Look through the frozen food cases for gluten-free items.
Although aisles that contain bread, cake or cookies used to be barren of gluten-free items, you might find a few gluten-free choices depending on how your store stocks gluten-free foods. Some, like Wegmans, put all the gluten-free products together. Others, put gluten-free cookies in the general cookie section and gluten-free bread in the bakery department. Cereal, too, usually contains gluten. But recently a few companies have reformulated some popular products to be gluten free. You can find gluten-free Chex products as well as gluten-free Rice Krispies and Fruity and Coco Pebbles. Check the label carefully to make sure you pick up the right ones.
9. Become a label expert.
Labels are the key to finding safe gluten-free food. First, look for a gluten-free label. It tells you a product is made with gluten-free ingredients and can be a short cut for finding foods that fit in your gluten-free diet. Be aware that current U.S. labeling laws don’t require gluten-free ingredients to be tested for cross contamination. The Food and Drug Administration (FDA) is working on a definition for use of the gluten-free label on foods. Once approved, the FDA-approved label will set specific standards for foods labeled gluten free and take cross contamination into account.
Meanwhile, if you want more exacting standards for items labeled gluten-free, look for a certification seal from the Gluten Intolerance Group or the Celiac Sprue Association. (See next tip for more details)
When a food has neither a gluten-free label nor a certification seal, you have to rely on the ingredients list to determine if it has gluten-containing ingredients. Look for any wheat, rye, barley, malt or oats.
Under the Food Allergen Labeling and Consumer Protection Act, wheat always has to appear on a label when it is used in any form in a food regulated by the FDA. So if an ingredient, modified food starch for example, is made with wheat it will clearly say so on the label. The word wheat can be in the ingredients list or in a Contains statement that follows the ingredient list. Foods that contain wheat are not gluten free unless the wheat is found in a highly processed ingredient from which the harmful protein has been removed. This includes maltodextrin, glucose syrup and citric acid.
Barley, rye and oats are not covered by the allergen labeling law. Rye is mainly used in rye bread, where it is clearly labeled. Barley is also usually included in the ingredients list when used, though it may be called malt, malt flavoring or malt extract and should be avoided. Oats that are not specifically labeled as gluten-free are highly likely to be cross-contaminated and are not gluten free.
Some foods also have advisory statements, like “May contain wheat,” “Made in a facility that also processes wheat,” “Made on equipment that also processes wheat.” These statements are voluntary and have no official definition. Some companies use them broadly for legal protection and others use them to warn allergic consumers about a real risk in the processing of a food. On the flip side, you may see statements like “Made in a dedicated gluten-free facility,” or “Made on dedicated gluten-free equipment.” At first labeling reading can seem overwhelming, but you will learn the ins and outs faster than you might think.
10. Look for a GF certification seal.
When you are looking for gluten-free products, a seal of approval from one of the groups that certify gluten-free foods can give you an increased level of confidence in their safety.
The Gluten Intolerance Group and the Celiac Sprue Association both offer certification for products that meet their standards. To use the GIG seal, a product must be tested and found to contain less than 10 parts per million of gluten. In addition, GIG auditors review ingredients and do an on-site inspection. CSA puts its recognition seal on products that test to less than 5 ppm of gluten. CSA also reviews the process, equipment and ingredients a company uses.
For the gluten-free consumer, these seals guarantee that gluten cross-contamination from all sources, including growing, harvesting, transportation and processing, is measured and limited.
11. Solve the bread challenge.
Bread should remain a staple in your daily diet. You can buy a variety of ready-made gluten-free breads. Some supermarkets and most health food stores carry them, as do chains like Whole Foods or Trader Joe’s. Or you can order on the Internet.
If you like to bake, you can bake your own bread. To make the job easier, consider buying a bread machine. With a bread machine and a ready-made bread mix or gluten-free baking supplies, you will always have fresh gluten-free bread available. The delightful aroma of baking bread will instantly make you feel better about going gluten free. Although bread machines may seem expensive, they can be especially helpful in the gluten-free kitchen and may save you money in the long run.
Initially the taste and consistence of gluten-free bread might seem odd, but don’t make any snap decisions. Try all gluten-free food at least twice. Or if you don’t like the initial taste, try toasting the bread. You’ll be amazed at how quickly you adapt.
12. Base your GF decisions on facts.
It’s easy to worry needlessly about a few gluten-free topics because of all the misinformation floating around about them. We include chewing gum, stamps and envelopes and toothpaste in this category. Research into each of these topics has shown that finding gluten in any of them would be difficult if not outright impossible.
Likewise worry about gluten in lipstick, medications and cold cuts is out of proportion to the danger it poses for those who follow the gluten-free diet. While you might occasionally find a brand of one of these products that is made with gluten, the vast majority are gluten free. It’s wise to verify the gluten-free status of each, but silly to spend a lot of time worrying about the risk they pose.
Overall, your gluten-free decisions should be based on facts, not broad generalizations that spring from a nugget of misinformation that keeps getting passed around.
13. Customize your kitchen.
Develop a plan for your kitchen that will protect gluten-free food from contamination. Although celiac disease does tend to run in families (see 23) most of those who follow a gluten-free diet live with gluten-eating relatives.
If you can, buy two containers of spreadable staples like butter, mayonnaise, peanut butter, jellies and cream cheese, and designate one of the two for gluten-free use. This will prevent gluten-containing crumbs from getting mixed in and then spread on gluten-free bread. Another way to prevent contamination is by using a clean spoon to remove spreads from a container and then spreading with a knife.
Some families buy bright tape or neon stickers and stick them on everything that is or should remain gluten free. You might also want to keep all the gluten-free foods in one place in the refrigerator or cupboard and even designate a portion of the kitchen counter for preparing gluten-free foods.
Buy a personal toaster and make sure on one else uses it to toast bread that contains gluten. You might even want to treat yourself to a deluxe model. Many gluten-free breads taste better toasted so it will get a lot of use.
You can also toast gluten-free bread in a toaster oven, but protect it with foil or one of the special bags that are available for just this purpose. Several brands are available at Amazon.com.
There are as many simple and practical ways to prevent cross contamination as there are families coping with the needs of gluten-free family members. Whatever works for you is the right way to go.
14. Plan appropriately.
Modify the way you plan menus. When purchasing, storing and cooking food, think in terms of making the job as easy, adaptable and comfortable for everyone as possible. Keep a stock of gluten-free food on hand, including gluten-free snacks. You may need them for times when you are away from home and unsure of what you will be able to eat or where you might buy something. Store carefully. Cook in quantities. Freeze leftovers. You can also freeze many gluten-free baking items so you have them on hand.
In planning meals, don’t forget that some meals are naturally gluten free. For example, broiled fish or meat, plain vegetables and plain potatoes and rice are all gluten free. Keep a supply of gluten-free pasta on hand. Many of the pasta dishes you have been cooking are probably gluten free as long as you use gluten-free pasta. When cooking for your family, use separate pots to boil the pastas. Make sure your pasta sauce is gluten free (it usually is), but be careful with your utensils. Be sure to use clean ones to serve the gluten-free pasta.
15. Vary your diet.
It’s very tempting, especially when first diagnosed, to start eating the same things over and over. This usually happens when early paranoia sets in and gluten begins to seem like it’s everywhere. Some people who follow a gluten-free diet never lose their fears and it’s at least open to debate as to whether this kind of paranoia is harmful or not. While new restrictions are a normal part of adjusting to gluten-free living, you still need to consume a variety of foods in order to get all the nutrients you need to stay healthy. You have to think gluten free. But you also need to think in terms of packing as many nutrients as possible into your nutrient-starved body.
16. Choose whole grains.
If you want to have a healthy gluten-free diet, you have to include whole grains. This includes brown rice, sorghum, buckwheat, quinoa, amaranth, millet and specialty gluten-free oats. They are rich in fiber, antioxidants and minerals such as calcium, magnesium and selenium and vitamins B6, E and niacin.
Some make great breakfasts in their original whole grain form. Others are ground into nutritious flours. And some make great side dishes at dinner, particularly brown rice and quinoa. In addition, many gluten-free food companies are now using whole grains in products as diverse as energy bars, pasta, bread and muffins.
The U.S. Department of Agriculture recommends that you eat at least three servings of whole grains each day. It’s easy to do if you eat brown rice instead of white rice, trade rice noodles for quinoa pasta and make your sandwich with whole-grain gluten free bread instead of bread made with white rice flour and potato and tapioca starch.
17. Emphasize calcium.
Be sure to eat plenty of calcium-rich food, especially if you are newly diagnosed and making the transition to a gluten-free diet. The rigors of learning the diet might make you forget how important this mineral is, especially to those who have been diagnosed with celiac disease. Calcium is one of the main nutrients robbed from the body by undetected celiac disease and inadequate calcium can lead to long-term problems, such as osteoporosis.
Dairy foods are the best sources of calcium (see next tip). In addition, the following foods are among the best non-dairy sources of calcium and they are all naturally gluten free (but be sure to read all labels): canned sardines and salmon with bones, canned shrimp, bok choy, collard greens, turnip greens and broccoli. You can also take advantage of products that sometimes include added calcium, like orange juice.
Consider taking a calcium supplement every day. Calcium carbonate is usually recommended as the best, most bioavailable form (meaning it dissolves so the body can absorb it). Dose recommendations vary, depending on age and gender. Ask your doctor or dietitian how much you should take.
Health care professionals suggest spreading your daily calcium supplement over two or three doses each day, with a partial amount taken at or near mealtimes.
18. Don’t skip dairy foods.
Dairy foods are important even if you are lactose intolerant. But they can be a problem (sometimes it’s a temporary problem) for those newly diagnosed with celiac disease. That’s because untreated celiac disease tends to destroy the tips of the villi where lactase is produced. Lactase helps digest lactose. Without sufficient lactase, you can develop problems like gas, bloating and diarrhea after consuming food that contains lactose.
Some people diagnosed with celiac disease find their lactose intolerance goes away as their small intestine heals. Others discover it doesn’t go away because they are genetically predisposed to be intolerant of lactose. If that’s the case and you continue to be lactose intolerant, use one of the products currently available that help people digest lactose. But remember to check that it is gluten free. The Calcium Information Center suggests that lactose intolerant individuals consume food with lactose-containing beverages to help delay gastric emptying and decrease symptoms.
19. Deal with DH.
Pay attention to all these tips if you have dermatitis herpetiformis (DH). DH has been called celiac disease of the skin. It is an extremely itchy, red rash that tends to appear on the elbows, knees, buttocks, scalp and back. The rash is caused by IgA deposits just under the skin that result because the individual is sensitive to gluten
Dermatologists often treat DH with dapsone, a drug that relieves the itch and slowly clears the rash. Affected individuals also should follow a gluten-free diet or the rash returns. The gluten-free diet gradually decreases the need for dapsone to the point where it can be discontinued. But DH patients must continue the diet for life.
20. Stock your pantry well.
When you have little or no time to make dinner, it’s great to have a few ready-made meals in the pantry or freezer. It used to be impossible to find any that were gluten free. Now, a growing number of companies make gluten-free frozen meals from pizza to pasta to breaded chicken and fish. The gluten-free diet won’t seem like such a burden if you have a few meals you can count on for days when you or the kids have an evening activity or you just don’t feel like cooking. Everyone needs a break from the stove every once in a while.
Also be aware that during the spring Passover season, Jewish law forbids eating any food that contains “chametz,” which refers to wheat, rye, barley, oats or spelt, the exact grains forbidden on the gluten-free diet. So it’s a good time to stock up on foods labeled “Kosher for Passover.” They are certified to be gluten free with one very important exception – matzo. This is a special form of unleavened bread made with wheat flour and water. It is eaten as is in the large square crackers that substitute for bread during Passover. It is also ground into matzo meal or processed further into flour.
To assess Passover foods, first make sure the label clearly identifies the product as “Kosher for Passover” (must include all three words). Then read the ingredient list. If you don’t see matzo or any form of matzo (matzo meal, matzo flour, matzo anything or cake flour), the item is guaranteed to be gluten free.
21. Don’t stay home.
You can travel and eat out while following a gluten-free diet, but you do have to be cautious. When you travel, plan ahead. Try to bring as many food items as you can without making your trip uncomfortable. If you are traveling in this country, use the Internet to find a local support group at your destination. The group may have a website listing sources of gluten-free food or a phone number you can call.
If you are traveling abroad, make sure to bring a translation that explains your dietary needs. Go to triumphdining.com or glutenfreepassport.com for translations and other travel aids.
Eating out takes on a new twist when you lead a gluten-free lifestyle. Think in terms of small, ethnic (many ethnic cuisines are corn-or rice-based), or standard American, which can be good choices. If you develop a relationship with a restaurant (tipping well doesn’t hurt), your confidence level will rise. When dining out, clearly explain your dietary needs. You can talk to the server, the manager, or, preferably, to the chef. When you are sure that you have been understood, relax and enjoy yourself. An increasing number of restaurants, both local and chains, now have gluten-free menus. While these are a great place to start, still make sure the chef understands your needs. A gluten-free menu is only as good as the staff that prepares and serves your food.
22. Don’t complain.
Try not to think of the added expense of gluten-free food as a burden. Remember it is the only “medicine” that will assure your good health. Compared to the cost of prescription drugs and their associated and sometimes negative side effects, you can even convince yourself that the gluten-free diet is quite a bargain. And try not to blame specialty food companies for the added expense. It comes from all the additional steps they have to take to make sure they are producing safe food.
Most importantly, consider how much it would cost you to deal with the health problems that can develop if you have undiagnosed celiac disease. If you look at the gluten-free diet as a critical preventive health measure, then it will seem cheap indeed.
23. Test the family.
Encourage your relatives to be tested, especially your first-degree relatives. The prevalence of celiac disease in first-degree relatives (parents, children and siblings) is much higher than it is in the general population. But be prepared for resistance from relatives, whether or not they have symptoms. Sometimes relatives refuse to be tested. Don’t feel guilty if they make that decision.
24. Teach your children well.
If you are the parent of a child who follows the gluten-free diet, you have a challenging and very important job. You are in charge of your child’s gluten-free diet now, but you are also in charge of helping your child achieve and maintain a positive attitude since the gluten-free diet is for life.
Yes, you have to make sure you child’s food is gluten free so he or she will feel well and grow properly. But making your child feel as normal as possible within the confines of the diet is just as important. Generally that means never letting the diet stop him from participating in an activity, going to a party or hanging around with friends.
Plan for food in advance. Bag and freeze gluten-free cupcakes and pizza so you are always ready for a birthday or school celebration. Send gluten-free snacks your child can have when an unexpected treat turns up in the classroom. Offer to bring food, which happens to be gluten free, to scout meetings, soccer games and other activities so your child can enjoy it along with everyone else. Many of the foods children typically like are now available in gluten-free versions that you can keep stocked for your child.
You can police every food to make sure it does not contain gluten. But your child still won’t grow normally if she is made to feel that celiac disease limits or defines who he or she is. Gluten-free kids adjust amazingly well with the right kind of support from family and friends and a “can do” outlook on their diet from you.
25. Get on with life.
In the beginning, having to follow a gluten-free diet may seem like the worst thing that ever happened to you. But you will soon discover that it may be the best thing that ever happened to you. The diet is manageable. It prevents more serious health problems.
Most of all, the diet is doable and the lifestyle is rewarding. You can (and you will) get to a point where you follow a strict, unwavering gluten-free diet as if it were the most normal thing in the world.
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