Autism: Gluten Free?

For a success story involving autism and the GFCF diet, read Jake’s Story.

By Dr. Selena Eon, ND

The prevalence of autistic spectrum disorders appears to be increasing, either through increased incidence or through better diagnosis.

Currently, there is no known cause, and no known cure.

Without a known cure, desperate families are turning to a variety of potential treatments discovered through the internet, television and other parents.

These new therapies may work, however, at this point in time there is no scientific evidence that ANY treatment works for autism.

Without known treatments, families are left with a choice: to either do nothing, or to try alternative treatments. Many families make the choice to try a variety of potential treatments rather than do nothing. These treatments can become expensive.

Frequently, parents need to do something to help even if there’s no scientific data to support the efficacy of the chosen treatment. If your child has autism now, waiting for scientific research validating any treatment could take years, or even decades—while your child goes untreated into adulthood. I certainly understand why a parent would choose to treat rather than to sit by and do nothing! Yet, it is extraordinarily important to ensure that all treatments are not harmful and in the long-term best interest of the affected child and their family.

The GFCF diet is the most popular treatment for autism. The GFCF diet is completely gluten-free and casein-free. Therefore, no wheat, spelt, kamut, triticale, rye, barley, semolina or dairy! As gluten and dairy are frequently found in prepared foods, this diet requires careful attention to detail and should only be implemented when appropriate and with adequate foresight.

Interest towards a GFCF diet as a treatment for autism grew after a study by Cade. 87% of the children in the study had high levels of IgG to gliadin, and that 30% of the children had high levels of antibodies to casein or gluten. An astonishing 81% of the children were considered improved by parent and teacher reports after 3 months on the diet. Unfortunately, this diet study lacked a control group of children who were not following the GFCF diet.

Therefore, the results have been widely discounted by scientists and physicians. I was particularly interested in how the number of children with antibodies to gluten was very similar to those who were considered improved at the end of the trial, leading me to believe that the children who demonstrated improvement on the GFCF diet were likely gluten intolerant or had celiac disease. More on this subject later!

It is incredibly important for scientists to continue investigating the effects of this diet systematically, in well-controlled trials. At the present time, there is no strong research that supports the use of a GFCF diet as a treatment for autism, despite the diet’s position as one of the most popular treatments for autism.

It is hypothesized that some autistic symptoms may be the result of opoid peptides formed in the intestine from incomplete digestion of foods containing gluten and casein. In a person with “leaky gut”—increased gut digestion and gut permeability, the gluten and casein that should be completely digested are not, and these larger molecules are able to pass directly into the bloodstream. In a healthy gut, proteins are digested fully and absorbed as individual peptides (the building blocks of proteins) rather than as complete proteins.

After the gluten/casein enter the bloodstream, they may be capable of crossing the blood-brain barrier—a protective group of cells that selectively allow molecules to enter the central nervous system. The gluten/casein proteins have a similar appearance and chemical makeup to opoids, and may be capable of affecting the internal opiate system and transmission between nerve cells.

Much of this process is not fully understood, but it is possible that opoidlike peptides affect the central nervous system in such a way that increases stereotypical behaviors, ritualistic behaviors, perseveration, hyperactivity, speech/language delays and other oddities frequently seen in autism.

The leaky-gut opoid theory above depends upon the presence of a leaky gut, and there is evidence that points towards this being the case in many causes of autism. It is common for autistic children to experience GI symptoms that could be a result of leaky gut, including diarrhea, constipation, abdominal pain and reflux. A number of studies have reported significant dysfunction of the gastrointestinal system in autistic children.

As a naturopathic physician, I firmly believe in treating the whole person rather than a “condition” or symptoms. I often spend time thinking about a patient and trying to elicit what is the root cause of their health concerns. The success of the GFCF diet in many cases of autism leads me to wonder if gluten and dairy intolerance are more common in autistic populations.

I don’t believe removing foods from a person’s diet forever is appropriate without good reason to back up the suspicion that the food is problematic. But, I am aware of the tremendous impact that removing problem foods can have on health! It is important to carefully consider each case as an individual before making the decision to remove foods from an autistic child’s diet, and also, to not neglect removing additional foods, as appropriate.

Overt celiac disease presents in at least 1:133 people and may be found in higher rates within the autistic population. It is advisable to test for celiac disease through bloodwork before beginning a gluten-free diet for any reason, including autism treatment. This is because once the person eliminates gluten from their diet, future blood tests are likely to be negative, even if the person does have celiac disease.

Recommended tests to include are: Anti-gliadin antibodies (AGA) both IgA and IgG, Anti-endomysial antibodies (EMA) – IgA, Anti-tissue transglutaminase antibodies (tTG) – IgA andTotal IgA levels.

Patients who test positive in a full celiac panel can then be monitored for compliance with the diet. If they follow the diet, subsequent results (titers) should be lower after a period of time; if they fall off the diet secretly or accidentally, the celiac panel can provide evidence of the lapse. This is particularly helpful if dealing with a child who may sneak unacceptable foods without the family being aware or in situations in which the family may not be following the diet accurately.

But if the patient goes gluten-free without the testing, there will be no pre-diet baseline test results, and no way to objectively assess compliance. Also, as celiac disease is hereditary, a positive test indicates a higher level of suspicion in other family members. Celiac can present with a wide variety of symptoms, some of which are not gastrointestinal, therefore being aware that celiac disease runs in a particular family can be very helpful.

It is important to know that even if a full celiac panel comes back negative, this does not mean the child is not gluten intolerant. Additional research is sorely needed in the topic of gluten intolerance, but gluten intolerance appears to present on a spectrum, much like autism. At one end are individuals who test positive for celiac—the most severe of gluten intolerance. The rest of the spectrum is made up of the many individuals who should not consume gluten who do not have celiac disease.

This condition is frequently termed “non-celiac gluten intolerance”. Gluten intolerance is linked to a variety of conditions including infertility, poor quality dental enamel, neurological disorders, skin conditions, diabetes and a variety of autoimmune disorders. A person need not have gastrointestinal symptoms to be gluten intolerant.

At present, testing for gluten intolerance is not scientifically validated, although Enterolab has a stool test that appears to be fairly accurate in detecting cases of non-celiac gluten intolerance. Other labs also offer similar tests that can be helpful. Genetic testing for celiac disease is also available. A positive genetic test only shows if a person has the most common genetic markers found in celiac disease/gluten intolerance.

It appears possible to test positive on a genetic test for celiac disease and never develop celiac or overt gluten intolerance. Many labs offer blood and stool testing for dairy intolerance as well, I recommend including this testing along with testing for gluten intolerance. The testing topic is very complex and much is still unknown about the gluten intolerance- celiac disease spectrum. Most families will be best served working with a knowledgeable physician like myself throughout the testing process to avoid harm from misinterpreted test results.

I suspect that the children who are helped the most by a GFCF diet are those children who have celiac disease or gluten intolerance and reactivity to dairy products. A GFCF diet may yet be proven to help a wider group the autistic population and I strongly support further research. For now, it seems reasonable to begin with a test for celiac disease.

If this test is negative, expand testing to either stool antigens to gluten and dairy, and consider genetic testing. Individuals who test positive on any of these lab tests are probably more likely to be helped by a GFCF diet and should consider it more strongly than those who do not test positive.
Before implementing the diet, it is incredibly important to consider several important factors. Adequate preparation before starting a gluten-free, casein-free diet can make the difference between success and failure!

1. Does the family have the resources to purchase foods in a gluten-free casein-free diet that are often more expensive, and are these foods readily available? If not, is a family member willing and ready to produce home-made GFCF foods and are adequate supplies available?

2. Is there a commitment by at least one family member to keep accurate daily records of food intake and behavioral change to assess the outcome of this treatment?

3. Are there clinicians such as naturopathic physicians, pediatricians and nutritionists in the family’s geographical area who might assist in systematically assessing the gluten-free casein-free diet to ensure nutritional adequacy?

4. Does the child have a limited food repertoire that, if further limited by the gluten-free casein-free diet, might result in a dangerously compromised nutrition status?

Many children with autism have restricted food repertoires and may not consume a nutritionally adequate when food choices are restricted further. I strongly recommend working with a physician like me– someone who has a strong background in nutrition, or with a nutritionist who understand the GFCF diet.

There are many support groups available for families in need. Gradual transition to the GFCF diet, and “revising” old favorites to follow the diet may helpful. It can be hard to implement the diet when there are family members who are not following the GFCF diet. Parents may need special locks for cabinets and refrigerators, carefully watch their autistic child to ensure that they are not sneaking unacceptable foods and working closely with school personnel to ensure compliance at school.

The preparation aspect is easier if the whole family is eating GFCF otherwise, the family may need to prepare two individual meals at each mealtime! Shopping takes a considerable extra effort at first, but as the main food shopper becomes adept at reading labels, will become less of an issue.

Overall, I am encouraged by the reports of autistic children who have reported improvement on the GFCF diet. It seems reasonable to continue researching this area to determine if those children who respond favorably indeed test positive for celiac, gluten intolerance and dairy intolerance. At the same time, we may find that the children who do not respond favorably are indeed not intolerant to gluten and dairy!

To avoid potential harm from unnecessary dietary restrictions, I strongly urge all parents considering the GFCF diet for their child to have laboratory testing for celiac disease and meet with a qualified health care professional before adopting the GFCF diet long-term.

Families need support to successfully implement the diet and I believe planning and education are key to long term success. This allows families to being the diet with the best possible circumstances, and will likely lead to best possible outcomes for their child.

Related reading:

Celiac Disease

Eating Gluten-Free On A Budget, Parts 1, 2 and 3

Autism: 10 Strategies for Implementing Diet Changes

If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

Gluten-Free Alcoholic Drinks

58555113905215721By Dr. Selena Eon

As a physician, I don’t encourage drinking alcoholic beverages in the early stages of the gluten-free diet—please give your gut time to heal before adding alcohol to your diet. However, consumption of alcoholic beverages can be part of a healthful gluten-free diet for many, so long as the beverages chosen are gluten-free and consumed in moderation.

There is no one definition of “moderation”, but generally the term is used to describe a lower risk pattern of drinking, as shown in various epidemiological studies.

According to the Dietary Guidelines for Americans, drinking in moderation is defined as having no more than 1 drink per day for women and no more than 2 drinks per day for men. This definition refers to the amount consumed on any single day and is not intended to be used as an average over several days.

It can be frustrating trying to find alcoholic beverages that are gluten-free, primarily because alcoholic beverages are not required to display an ingredient label. Because alcohol is not regulated by the FDA, the FDA ingredient labeling requirements do not apply. How do you know if your beverage is gluten-free when there is no label and no ingredient list? It can be tricky!

The Center for Science in the Public Interest is has been petitioning the Alcohol and Tobacco Tax Bureau since 2003 to require ingredients and nutrition facts on alcohol labels, but so far, there is no law requiring ingredient lists on alcoholic beverages. You can help your lawmakers understand how important the labeling issue is to people with food sensitivies, check out this petition for more information.

Finding appropriate alcoholic beverages can certainly be a challenge, but Kitchen Table Medicine is here to help! Luckily, there are many choices that ARE gluten-free!

Alright, enough already—WHAT CAN I DRINK?

Previously, persons on the gluten-free diet were advised to consume only pure wine, potato vodka, rum and tequila. This is still good advice, and the safest approach possible, but I believe this approach is overly cautious and unnecessarily limits your choices.

False information about gluten and alcoholic beverages is rife on the internet, so it is easy to become confused. I agree that being cautious is incredibly important when following a strict gluten-free diet, but I also believe that causing unnecessary lifelong restriction of any food is unacceptable!

Newer wisdom on the subject dictates that all distilled liquors are gluten-free, even those derived from a gluten containing grain. Distilled liquors are gluten-free no matter what the original source ingredients are because the distillation process ensures that none of the gluten from the original ingredients can remain in the finished product.

It is reasonable to assume that all pure distilled liquors must therefore be gluten-free. For more information, check out this article on gluten and distillationThe only exceptions to the blanket statement that distilled liquors are all gluten-free are situations in which gluten-containing ingredients are added in after distillation.

I researched rumors about gluten-containing whiskey mash being added in after distillation of whiskey, but found no major manufacturers in the US who report adding gluten-containing mash to the distilled whiskey.

Another potential problem could be liquors in which caramel coloring is added. Caramel coloring may contain gluten, primarily if the ingredient is produced outside the USA, but not always. Thus, many on gluten-free diets may choose to avoid dark colored liquors because caramel coloring may be in the liquor and represent a potential source of gluten.

It is safest to avoid dark colored liquors because without food labels it is difficult, if not impossible, to know if caramel color is used in the liquor, and if so, if the caramel color is gluten-free. Individual consumers may be able to request this information from manufacturers, but most manufacturers are unlikely to promise the product gluten-free because manufacturers in mass-production environments are typically unaware of the source of an ingredient like caramel color.

If gluten-containing caramel color is present in a particular liquor, it is usually found in very small amounts, and people typically consume small amounts of liquor, so the amount of gluten in the alcohol may be negligible. Even so, I still recommend avoiding these suspect beverages as the safest long-term choice of action because there is no way to know how much gluten is in the drink.

I also recommend avoiding most prepared cocktails (strawberry daiquiris, margaritas, mojitos) when out, as the mixes commonly used contain lots of sugar, usually in the form of disgusting high-fructose corn syrup- a non-food best avoided by everyone.

If you want to order one of these cocktails, it is best to ask your bar or restaurant if you can see the ingredients on their mixer before you order. I found that many of my favorite restaurants carry a high-quality mixer made from real juices and pure cane sugar—but you can only get it if you order the “top shelf” drink with more expensive liquor.

If you mix your alcoholic beverage with another beverage, such as soda, tonic water, root beer, orange juice, be sure to check that your mixer is also gluten free. I have listed some popular mixers below, but did not mention sodas or juices. Most sodas and juices are gluten-free, but check the label to be sure.

Gluten-free alcoholic beverage choices- the list below is in alphabetic order.

  • Armagnac – made from grapes.
  • Beer: most beers contain gluten. However, there are now gluten-free beers on the market!
               Redbridge- easiest to find nationally, produced by Anheiser-Busch.
               Bard’s Tale brand (several varieties, most common is Dragon’s Gold)
               Green’s (several varieties)
  • Bourbon – Makers Mark is definitely GF.
  • Brandy
  • Champagne
  • Cider – fermented from apples or other fruits. Some are safe, however, many add barley for enzymes and flavor. Be sure to read labels or contact manufacturer. Spire Ciders are GF.
  • Cognac – made from grapes.
  • Gin
  • Grappa
  • Kahlua
  • Kirschwasser (cherry liqueur)
  • Margarita Mix:
            Jose Cuervo.
            Mr. & Mrs. T.
  • Martini: traditional martinis are generally GF. Common mixes:
           Club Extra Dry Martini (corn & grape).
           Club Vodka Martini (corn & grape).
  • Mead – distilled from honey.
  • Mistico:
           Jose Cuervo Mistico (agave and cane).
  • Mixes & Cooking Alcohol:
           Club Tom Collins (corn).
           Dimond Jims Bloody Mary Mystery.
           Holland House – all EXCEPT Teriyaki Marinade and Smooth & Spicy Bloody Mary Mixes.
           Mr. & Mrs. T – all Except Bloody Mary Mix.
           Spice Islands – Cooking Wines – Burgundy, Sherry and White. However, I suggest cooking with REAL wine as cooking wines are poor quality.
           Stirrings- they make a variety of cocktail mixes, higher quality that most mixes.
  • Ouzo – made from grapes and anise.
  • Rum
  • Sake – fermented with rice and Koji enzymes. The Koji enzymes are grown on Miso, which is usually made with barley. The two-product separation from barley, and the manufacturing process should make it gluten-free.
  • Scotch Whiskey.
  • SherrySparkling Wine
  • Tequila
  • Vermouth
  • Vodka
  • Wine – all wines, including port wines and sherry, are gluten-free.
    Wine Coolers: Despite the name, most wine coolers are malt based and contain gluten.
           Bartle & James – wine-based beverages only.
           Boones – wine-based beverages only
  • Whiskey- Jack Daniels’ Black Label Whiskey is GF. Maker’s Mark Whiskey is GF. Seagram’s Crown Whiskey is also GF. Other whiskeys likely are, as per previous discussion, however are not confirmed by the manufacturer.

If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Related reading:

Celiac Disease

Eating Gluten-Free on a Budget

Wheat and Gluten-Free Recipes

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

Food Allergy Elimination Diet

PhotobucketIf you or your physician suspect that you might have a food allergy you can follow these basic guidelines to best determine the food that is the culprit.

Symptoms of food allergies can be insidious or immediate and include symptoms such as: skin rashes, dermatitis, eczema, psoriasis, seborrheic dermatitis, irritable bowel syndrome, fatigue, suppressed immune system, autoimmunity, rheumatoid arthritis, depression, brain fog, neurological symptoms and much more.

Because 70% of our immune system surrounds our gut in the form of GALT (Gut Associated Lymphatic Tissue) it only makes sense that food allergies and intolerances easily place a burden on our immune system.

Blood testing for food allergies may be helpful for children or patients that are unable to follow this regimented of a diet such as those with a history of eating disorders. However, blood testing for allergies is truly only 60-70% accurate.

The immune system creates either IgA or IgE responses to food. IgE reactions are immediate and typically result in anaphylactic shock whereas IgA allergies are insidious and most patients only notice improvement once the food has been eliminated for at least four days. Food allergy testing only identifies foods that create these IgA or IgE immunological responses; and not those that an individual is intolerant to. Lactose intolerance for instance is a classic example of a food like milk causing a problem such as diarrhea without the presence of allergy.

The gold standard for determining food allergies/intolerances is therefore the Elimination Diet. Be sure to follow the specific diet prescribed to you by your physician.

As with any health care suggestions given here be sure to check with your physician before attempting a food allergy elimination diet. Those with history of eating disorders whether active or dormant for instance are not candidates for this regimented of a diet. If you are suffering from any chronic health complaints you absolutely should not attempt this on your own and should be under the supervision of a licensed health care provider.

To identify foods that may be causing some or all of your symptoms. During the elimination period, foods that commonly cause symptoms are completely eliminated from the diet for one to two weeks. After your symptoms improve, foods are added back one at a time to determine which foods provoke symptoms. The following is a basic template used by many health care providers and may need to be modified to suit your specific needs.

FOODS YOU MAY EAT:

Cereals:Hot: cream of rice, quinoa cereal (Quinoa Flakes).
Dry: puffed rice, puffed millet

Grains: Rice: no wild rice but all kinds of other rice including rice products such as pasta (Brands: Pastariso, Lundberg), plain rice cakes, rice bread without yeast (Brand:Energy), mochi (found frozen or fresh in Asian stores), buckwheat (kasha), millet, quinoa (a quick cooking grain), amaranth, and teff

Flours: Rice, millet, quinoa, amaranth, teff, bean flours, and tapioca

Fruit: All fruits except citrus fruits (oranges, lemons, limes and grapefruit)

Protein: Meat: lamb and wild game meats such as venison
Beans/legumes: all beans and legumes, except soy and peanuts. Check labels of canned beans, dips and soups for sweeteners, spices and additives (Brand: Taste Adventure dried refried beans and split pea soup). Do not eat canned beans with chemical additives (EDTA)

Vegetables: All vegetables except tomatoes, eggplant, peppers, potatoes, and corn

Nuts/Seeds: All nuts and seeds except peanuts

Oils/fats: All oils except peanut oil, corn oil and soybean oil

Sweeteners: Maple syrup (pure) and brown rice syrup

Beverages: Water (plain, mineral or sparkling), rice milk (plain or vanilla – check labels for ingredients, gums are allowed but barley malt or corn syrup are not allowed), all fruit juices except citrus juices are allowed and all herbal teas are allowed

Condiments: All condiments are allowed except for chocolate, tomato products (catsup), pepper products (Tabasco, hot peppers), and vinegars that contain malt or other ingredients requiring elimination. Black pepper is allowed. Check all condiments to make sure that the ingredients are allowed.

Elimination Diet Guidelines

1. Do not eat any food that you suspect is causing symptoms even if it is on the list of acceptable foods.

2. Use only those foods allowed unless you check with your health practitioner. READ LABELS! “Flour” usually means wheat flour, “vegetable oil” may mean corn oil or soybean oil, casein and whey are dairy products, and potato and soy flour is in some gluten free foods.

3. Withdrawal symptoms may occur during the first few days or week on the diet. Some or all of your symptoms may increase temporarily. You also may experience symptoms that you do not usually experience. The symptoms usually subside within 10 days. The following may help you feel better: drinking at least 8 glasses of water a day, buffered vitamin C, baths with Epsom salts or baking soda, naps and mild exercise such as walking.

4. The elimination diet may be followed for up to 4 weeks. When you have had 5 days in a row, without symptoms or your symptoms have decreased you are ready to challenge.

5. If no improvement occurs in 4 weeks, then the food substances were probably not the cause of your problem and you can gradually return to a normal diet.

HOW TO CHALLENGE

Start: Begin challenging when you have been on the elimination diet for at least 2 weeks and when you have had at least 5 days in a row without symptoms or at least your symptoms have decreased.

Challenge: Challenge one food or food group at a time, eating the recommended amount of food for 3 days in a row. For instance if you are challenging dairy you should have a glass of milk three times a day for three days. Try to use the purest form of the food possible. Cream of wheat is a better choice than bread when testing wheat for instance in order to ensure that the problem is the wheat in the bread and not the yeast or any other additives.

Stop: If symptoms occur, stop the challenge. Do not start the next challenge until you have had 1 full day free of symptoms.

When you challenge, keep a record of both your physical and behavioral symptoms.

Be patient, reactions can take up to 48 hours to begin. If you hurry your challenges, you are likely to end up getting confused and having to start again. If a reaction is doubtful, wait until the end of the challenge period and repeat the challenge to confirm a reaction.

Food Challenges: When challenging individual foods, eat one serving three times a day along with the elimination diet foods. Challenge for at least three days.

Occasionally some patients will have severe “anaphylactic” reactions to a food they are challenging. If you experience extreme symtpoms such as shortness of breath, sensation of your airway closing, swollen tongue or lips, redness or swelling of your entire body, or any other symptoms of an urgent nature do not hesitate to call 911. These symptoms can come on quite suddenly and it is better to be safe than sorry.

Meal Planning
Breakfast Ideas
• Mochi with cashew butter, peeled pear or apple
• Rice toast with cashew butter, pear
• Rice cereal and rice milk
• Rice pudding with soy milk

Lunch and Dinner Ideas
• Lamb, rice and green beans
• Lentil soup and rice crackers
• Cabbage soup and rice bread toast
• Beans and rice, lettuce salad
• Rice cakes with cashew butter, celery sticks
• Lamb, cabbage and rice soup
• Lettuce salad with cashews, celery, shallots and mung bean sprouts
• Rice pasta with parsley and green beans
• Bean soup and rice cakes
• Split pea soup and rice bread toast

Helpful Hints:
Eat as much as you want.
Add cold pressed oil to vegetables and rice for flavor and calories.
Read a good book (not a cookbook!)

RECIPES

Combination Cereals

Hearty Morning Cereal
1/2 cup amaranth
1/2 cup millet
1/2 cup teff
1/4 cup cashews

Sweet Rice Cereal
1 cup brown rice
1 cup sweet brown rice

Cashew Millet Cereal
1 cup millet
1 cup brown rice
1 cup cashews

Millet and Quinoa Cereal
1 1/2 cup millet
1 cup amaranth or quinoa

Place all grains and nuts in a fine strainer; rinse and drain. Toast grains in one of two ways:

Oven toasting:
Preheat oven to 350? F. Spread grains on a cookie sheet and toast in oven until they give off a nutty aroma (12-15 minutes).

Skillet toasting:
Place washed grains in a large skillet on burner and toast on medium heat, stirring constantly, until grains give off a nutty aroma (5 – 8 minutes).

Let toasted grains cool and store in sealed container. You can toast a big batch of several different grains at one time and store them in separate jars.
For the best nutrition, grind grains just prior to using in a small electric grinder or food processor. Once a grain is ground it begins to lose nutritional value within 24 to 48 hours. Store the whole toasted grains in labeled, sealed containers and grind the amount you need before cooking.

To cook ground grains into cereal use 1/3-cup ground cereal and 1 cup water per person. Combine cereal and water in a pot; bring to a boil. Reduce heat to low and simmer, covered, for 10-12 minutes. Using a flame-tamer or heat deflector on the burner while simmering the cereal helps prevent scorching or sticking.

Top plain cooked cereal with a little fruit sauce topping.

Amaranth Breakfast Cereal
1 cup amaranth
2 cups water
1 pear, peeled and chopped

In a small saucepan, bring the amaranth, water and pear to a boil. Lower heat to simmer, and cook for 20-30 minutes, or until all water has been absorbed. Garnish cereal with maple syrup, vanilla or rice milk.

Rice Waffles
2 cups rice flour
4 tsp. baking powder
2 cups rice milk
3 tbsp. safflower oil

Sift the dry ingredients together. Add the milk and oil gradually, stirring the mixture constantly until smooth. Bake in a hot oiled waffle iron. Serves 4

Rice Pancakes
1/2 cup ground cashews
1 1/2-Cup amaranth, quinoa or rice flours 1 1/4-cup water
1 tsp. baking powder 2 tbsp. oil

Combine dry ingredients, mix well. Combine liquid ingredients in small bowl, mix well. Stir into dry ingredients. Cook pancakes on preheated, un-greased, non-stick griddle or fry pan. When bubbly and brown, turn. As batter thickens, add water, a tablespoon at a time to keep cakes thin.

Minestra
1 head cabbage, chopped
3-4 cloves garlic
2 tbsp. sunflower oil
16 oz can white beans, drained

In a large pot, steam cabbage with a small amount of water. Cook until soft. Remove cooked cabbage from pot and add oil and garlic. Sauté garlic for 2-3 minutes. Add the cabbage back to the pot with enough water to cover the cabbage by 1 inch. Add bean to cabbage and let cook for 30 minutes on low heat. Add salt to taste.

Nutty Drizzle (serve over grain, vegetables or pasta)
1/4 cup cashew butter
1/3 cup water

Place all ingredients in a small saucepan on low heat. Stir with a whisk until mixture is smooth and warm. Serve over your favorite grain, vegetables or pasta.

Quinoa Pilaf
1 cup quinoa
1/2 cup red lentils
1/4 cup chopped parsley
3 cups water

Combine all ingredients in a medium saucepan on high heat. When quinoa comes to a boil, lower heat to simmer and cook for 20 minutes. Fluff with a fork. Option: This mixture can be eaten warm as is or cold as a salad with added chopped vegetables.

Lentil Stew (6 servings)
1 lamb leg bone or 4 oz lamb blade steak, trimmed of fat and chopped (optional)
2 tsp. canola oil
1/2 green cabbage, chopped
6 cloves garlic, coarsely chopped
2 cups green lentils, washed and checked for stones
chopped parsley

Heat canola oil in large saucepan over medium-high heat. Add lamb bone or steak (optional). Sauté until brown on all sides. Add cabbage and garlic. Sauté until soft and just beginning to brown. Add lentils and water. Bring to a boil. Turn heat to low and simmer with a lid on until lentils and lamb are very tender, 1-2 hours. After cooking, add parsley to taste.

Falafel
3-4 cups cooked garbanzo beans
5 cloves minced garlic
1 cup parsley
2-3 tbsp. safflower oil
3-4 tbsp. water
1 tsp. cashew butter
garbanzo bean flour

Mix all ingredients in food processor except the flour. When smooth, add flour until a thick batter/thin dough consistency is reached. Fry in oil in skillet until browned/crisp on both sides. Top with tofu dressing.

Black Bean Garlic Stir Fry
4 cloves garlic, minced
chopped vegetables (cabbage, scallions, leeks, celery, green beans)
chives and parsley, to taste
2 cups cooked black beans
4 cups cooked rice

Sauté garlic in a wok or large skillet. Add chopped vegetables and sauté until soft. Add chives and parsley and black beans and cook until heated thoroughly. Serve over rice.

Bean Dip
2 shallots
1/2 cup chopped leeks
2 cloves garlic, minced
16 oz cooked beans (Garbanzo, black, kidney or white)
1 tbsp. cashew butter
3 tbsp. chopped fresh parsley
1 tbsp. oil

In a small skillet, heat oil on medium heat. Add leeks, shallots and garlic. Sauté for 5-10 minutes or until leeks are soft. While vegetables cook, add remaining ingredients to a food processor. When vegetables are cooked, add to bean mixture in food processor. Process until all ingredients are well mixed and texture is creamy. Allow to cool before eating.

Split Peas and Rice (serves 4)
3 tbsp. oil 2 cups brown rice
1 leek chopped 6 cups water
1 clove garlic minced 1 cup yellow split peas
2 tsp. chopped chives
2 tsp. chopped parsley

In a large heavy pot, heat 3 tbs. oil and sauté leeks, garlic, chives and parsley until leeks are tender. Stir in rice and cook for 5 minutes or until rice begins to turn white. Add water and bring to a boil. Reduce heat and cook covered for 20 minutes. Add split peas to the cooking rice and cook 30 minutes more.

Split Pea Delight
1/4 cup dried green split peas
1/4 carrot, sliced
1 1/4 cups water

Wash peas and scrub carrot. Put peas, carrot, and water in a small pan; bring to a boil. Reduce heat and simmer, covered, for 20-30 minutes. Puree in a blender.

Bean Salad
2 cups cooked beans (lentils, black, kidney, chick peas)
1/2 cup celery, chopped
1/2 cup parsley, chopped
2 shallots chopped
2 cloves garlic, minced
1-2 tbsp. oil

Combine the beans and chopped vegetables in a large bowl and toss until well mixed. Add oil and salt to taste and mix until beans and vegetables are evenly coated.

Rice Pasta and Vegetables
1 package rice pasta cooked according to package directions
2 leeks, chopped
3 shallots, chopped
2-3 cloves of garlic, minced
2 tbsp. fresh parsley, chopped
2 tbsp. fresh chives, chopped or 2 tsp. dried
2 tbsp. safflower oil

Heat oil in a skillet over medium heat. Add leeks, shallots and garlic and sauté for 5-7 minutes until leeks are soft. Add fresh parsley and chives and cook 1 minute longer. Remove vegetables from heat. Add rice pasta to vegetables, mix well. Add salt to taste.

Rice Salad
4 cups cooked brown rice
1 cup celery
2 tbsp. fresh chives
1 cup chopped red cabbage
1 cup chopped parsley
1/3 cup cashews
2 tbsp. oil

Toss brown rice with chopped vegetables and cashew nuts until evenly mixed. Add oil and salt to taste. Optional: add 1/2 cup to 1 cup canned beans or lentils.

Rice Pudding
* this recipe can be made with cooked leftover rice or uncooked rice
1 cup cooked rice
1 cup rice milk
1 tsp. vanilla

Place cooked rice in a pan with the rice milk. Heat on medium heat until most or all of the rice milk has been absorbed. Remove pan from heat. Add vanilla. If consistency is too hard, add more rice milk and return to stove.

To make this recipe with uncooked rice, add I cup uncooked rice with 2 cups rice milk and 1 cup water. Cook like ordinary rice. When rice is cooked, add vanilla.

Millet and Pears
1 cup millet
2 cup water or rice milk
1 pear, peeled and chopped

In a pan, bring millet, water and pear to a boil over high heat. Lower heat to simmer and cook for 30 minutes. remove from stove top. Mix well. If desired, add some rice milk for a creamier texture.

Fruit Sauce
Use 1 cup water per 1/4 cup cut-up pear or apple. Peel and slice the fruit. Place cut-up fruit and water in a pot; bring to a boil. Reduce heat and simmer until the fruit is tender and water has cooked off (about 15 minutes). Puree in a blender.

If you are in need of support while on a food elimination diet feel free to leave your questions or challenges in the comments section. If you have a favorite tip or recipe for those on this diet please attach it as well for all to enjoy!

Just a note: Next month we’ll be focusing on food allergies – so stay tuned!

~Dr. Nicole Sundene

Read more articles on allergies

References: Food Allergies and Food Intolerances

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

The Sensitive Chef Cookbook

PhotobucketBy Bobbie Laing

Living with food allergies can be a frustrating way of life for many people.

In our world of instant everything, from Hamburger Helper to that pre-seasoned chicken that looks so tempting in the frozen isle of the grocery store, it is harder than ever to make healthy choices for our families.

Much less having to factor in what allergens may be lurking inside these foods.

The author’s own experience with severe food allergies and sensitivities, as well as having a daughter with Celiac Disease, led her on this quest to find food that was not just safe for herself and her family, but also delicious.

In the book are everyday recipes, as well as ideas for food on the go when traveling or dining out. She also gives valuable tips on how you may be able to continue to dine at some of your favorite restaurants.

In the introduction to the book, author Sharon D. Morse tells of her sudden and nearly fatal experience with a severe allergic reaction to a tree nut:

A few years ago, I nearly died from anaphylactic shock after ingesting a small piece of a tree nut. That reaction triggered many underlying sensitivities and allergies. I became sensitive to many foods and anaphylactic to peanuts, tree nuts, and other common allergens. Needless to say, I had a long road ahead of me in just trying to figure out what I could and couldn’t eat. After several accidental anaphylactic reactions, I had to be very careful and not take ANY chances with my choice of sustenance.

I have literally spent countless hours in the kitchen, pondering over recipes, creating new recipes, and doing research on food allergies and sensitivities. After hundreds of hours of testing and retesting to make delightfully tasty recipes, it is really a delight to me to make available The Sensitive Chef cookbook.

In The Sensitive Chef Cookbook, you will find delicious alternatives for many of your favorite dishes. This book is a great resource for people with food allergies and other disorders that require that they eliminate many common foods and ingredients from their diet.

The book contains over 100 recipes that are Wheat-Free, Gluten-Free, Nut-Free, and Shellfish-Free, that outshine the competitors with dishes that are even better than their original counterparts.

The recipes include delicious entrees such as Chicken Enchilada Pie, Beefy Stew, and Luscious Lasagna.

Just to name a few! In addition to these, there are some wonderful looking quick breads & muffins, yeast breads, desserts, cookies, & candies as well as Vegetarian recipes like Chow Down Chili Burgers, Hearty Chili Con Queso, Super Beans, and Fresh (Raw) Pasta Sauce.

No matter what allergic or sensitivity issues you face, eating healthy, safe, and delicious food is important to you and your family. Books like The Sensitive Chef Cookbook can make that challenge a little easier.

Contact us if you would like your book considered for our book club.

Also check out our Amazon bookstore for more fantastic healthy book recommendations!

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

Eat Gluten-Free Without Going Broke, Part 1

PhotobucketBy Dr. Selena Eon, ND

If you have been on a gluten-free diet for any length of time, you have likely noticed the explosion of ready-made gluten-free foods available. At my local Red Apple Market, I can now purchase ready-made pasta, cookies, crackers, bagels, macaroni box meals, English muffins, bread, doughnuts and brownies. The freezer cases contain a variety of gluten-free frozen meals, from pizza to macaroni & cheese. I can buy mixes for bread, cookies, brownies and cakes.

Garlic Jim’s now delivers gluten-free pizza to your home from most of their locations in the state.  PF Chang’s offers a gluten-free menu. Overall, I consider the increased availability of these foods a positive leap forward for those of us who must follow a gluten-free diet for health reasons.

It is wonderful to have the option to use these foods to create healthful meals when time is short. It is incredibly useful for relatives to be able to purchase foods like this when gluten-free family members come over for dinner. But, there are many reasons to limit consumption of these foods. Today I am going to focus on financial reasons for doing so.

Many gluten-free goods are specialty products that are produced in much smaller quantities than most mass produced prepared foods. Manufacturers should take steps ensure that all the ingredients are gluten free. The products need to be tested for gluten on a periodic basis to ensure that they are safe for individuals who must avoid gluten completely.

Creating these products in a gluten-free manner generally requires a dedicated facility—one that never houses gluten containing foods, although some manufacturers use carefully cleaned shared facilities with wheat products (these foods may not be acceptable for some individuals). The ingredients must be shipped to the manufacturing facility. The food must be produced, packaged and shipped to your grocer. The cost of these processes is ultimately passed on to you, the consumer.

I choose to purchase food that is produced locally whenever possible. One reason for this choice is financial. When you purchase food produced hundred or even thousands of miles away the cost of the food goes up because you are also paying for the additional packaging and transportation. Packaging needs are increased to keep the food intact during shipping with the extra costs passed on to you, the consumer.

Transportation costs include the cost of fuel, maintaining the vehicles, paying the shipping company employees and more. I’m not going to discuss in detail today, but must mention the environmental impact of producing the fuel for transportation and the materials for packaging as well as increased pollution from using the fuel for transportation of food. Because of these factors, it is a good idea to purchase local products with little or no packaging whenever it is reasonable to do so. Purchasing local saves both money and resources.

Most families purchase food on a budget and cannot afford to substantially increase spending on food. Following a gluten-free diet may become an intolerable financial burden if a person tries to follow a gluten-free version of the standard American diet.  Gluten intolerance frequently runs in families, so it may be necessary to purchase gluten-free foods for multiple family members, compounding the financial issue. A family where only some members are gluten-intolerant may find that feeding the whole family gluten-free is the best way to ensure a gluten-free diet for those members who need it.

An example, using prices found at a local supermarket:

  • A package of 5 gluten-free bagels costs $5.59 while you can purchase wheat bagels for about $3 for 6.Photobucket
  • A 5 oz box of crackers is $4.99 while a 14.5 oz box of Ritz crackers is only $4.11.
  • A 12oz package of gluten-free spaghetti noodles costs $3.79 while a 16 oz package of wheat spaghetti  noodles can cost as little as $.99.

You can see from that, a person accustomed to a bagel with breakfast, crackers with a snack & spaghetti for dinner runs into a substantial difference in cost over time. This is particularly noticeable when feeding multiple people.

Learning that gluten is not a good food for you or a loved one is an incredible & life changing event. The positives of assuring that your amazing body is fed properly so far outweigh the negatives that it is worth the effort to learn how to feed yourself gluten-free and well.

Adopting a gluten-free lifestyle is a challenge for many people, and reasonably so! It can be difficult to change, especially without adequate support. I believe that learning how to cook & bake healthfully in your own home is a critical step in adapting to healthful gluten-free living on a budget. Preparing your own food does take time. I know people are very busy today, however, preparing extra food takes little additional time and then you have leftovers in your fridge or freezer, ready for healthy, low cost meals on busy days.

Many home cooks choose to set aside a morning, afternoon or evening each week to prepare several dishes to set aside for eating later in the week or month. This is an excellent strategy that cuts down the amount of time you need to spend preparing food on a daily basis.

PhotobucketNext up by Dr. Selena Eon is Part 2 in this three part series, “How to Eat Gluten Free on a Budget.” If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

What is Celiac Disease?

Photobucket

By Dr. Selena Eon

What is Celiac Disease/Gluten Intolerance?

Celiac Disease is an autoimmune condition found in people of all ages who are genetically susceptible. To develop Celiac Disease, you must inherit genetics for it, consume gluten, and have the gene triggered. Celiac Disease causes gradual destruction of the inner lining to the small intestine, leading to poor absorption of a wide variety of nutrients, and consequently a wide variety of patient presentations.

Gluten intolerance is a similar, less severe condition in which a person who does not have overt intestinal damage, but still experiences negative health effects from consuming gluten containing foods. Gluten is found in wheat, rye, barley and products derived from these grains. Gluten is also a frequent contaminant of oats and perhaps other grains.

What are the signs and symptoms of celiac disease?

There are many signs and symptoms of Celiac Disease and gluten intolerance. They range from none (silent Celiac Disease), to severe weight loss and malnutrition. A selection of signs and symptoms include: weight loss, weight gain, abdominal pain & cramping, diarrhea, constipation, osteopenia or osteoporosis, fatigue, bloating, iron deficiency anemia, megaloblastic anemia, nutritional deficiencies, mouth ulcers, inadequate tooth enamel, lactose intolerance, inadequate growth in children and infertility.

What are the risks to the patient if they are not compliant with their gluten free diet?

A person with Celiac Disease risks continued intestinal damage when knowingly (or accidentally!) consuming gluten, even if they do not have symptoms. As a result of intestinal damage from continued exposure to gluten, the person may experience a worsening of the signs and symptoms they experienced before diagnosis, or one of a host of other possible additional symptoms. Over time, damage can become severe enough to cause both adenocarcinoma and lymphoma of the small intestine, ulcerative jenunitis or small intestine strictures.

PhotobucketAs patient with Celiac, what are the biggest challenges with this disease?

Eating away from home was very difficult at first, but with practice, experience, and perseverance, I found eating out to be enjoyable again. Learning how to cook and bake gluten-free were huge, but very fun challenges

Can you share five of your favorite tips for coping with the challenge of this disease?

1) Learn how to cook and bake at home!
2) Keep a ready-mixed gluten-free flour substitute (home-made or purchased) on hand AT EVERY HOME YOU EAT FREQUENTLY for easy substitutions in favorite wheat-flour recipes.
3) Focus on eating nutrient-dense foods that are naturally gluten-free.
4) Always bring something you can eat to the potluck and keep GF snacks in your bag or car.
5) Avoid new restaurants during busy, peak times-you are more likely to end up with some unwanted gluten.

What do you typically eat for breakfast lunch and dinner?

Breakfast: Fresh fruit in season! We love gluten-free homemade waffles, Bob’s gluten-free oatmeal, cornmeal mush (polenta) and veggie frittatas.

Lunch: Leftovers to the rescue!

Dinner: We have a large rotation of recipes and strive to eat at least ½ plate of veggies along with the main dish. Household favorites include: turkey meatballs, chicken soup, lentil soup, tuna noodle veggie casserole, noodles with peanut sauce, vegetable soups, mixed salads, enchilada casserole, fish cakes, risottos, and a wide variety of creative homemade pizzas.

Care to share your favorite gluten free recipe?

Cheddar Dijon Waffles:
This is a wonderful recipe to start off an active day right, or a outside-the-box lunch or dinner. I like to serve these waffles topped with a gently fried egg (low temperature to avoid damaging the protein) and lots of chunky salsa. This recipe can be doubled or tripled and frozen for quick future meals.

Yield: 4-5 6” waffles

1.5 cup Pamela’s Pancake & Baking Mix (or substitute your favorite GF flour blend)
2 eggs, separated
¾ cup water
1-2T vegetable oil
1/3-1/2 cup shredded smoked or, less desirably, sharp cheddar cheese
1tsp-1tb Dijon mustard (to taste)
1 bunch thinly sliced green onions (white and light green parts only)

If necessary, spray waffle iron with nonstick spray or brush with oil. Preheat waffle iron.

Separate the eggs. Put the egg yolks into a small bowl or glass, and the whites into a medium bowl. Add the Dijon mustard and vegetable oil to the egg yolks, stir to combine and set aside. Whip the egg whites until stiff peaks form and set aside.

In a medium bowl, gently toss the green onions and cheese to coat with the Pamela’s Mix. Add the water, the egg yolk mixture and mix until no dry spots remain. The batter will be thick. Gently fold in the egg whites.

Cook on preheated waffle iron until golden brown. I use about ½ cup per waffle and spread the batter evenly before closing the lid, but use your judgment for your particular waffle iron. Repeat until remaining batter is used up.

Note: you can make these waffles using three whole eggs and skip the egg separating/whipping step. Just mix the whole eggs with the mustard and vegetable oil and skip folding in the egg white. The finished waffles will not be as light and fluffy.

Ps: If your waffle iron is from your “gluten days”, be sure to clean it very thoroughly to remove all gluten-containing crumbs before using for gluten-free waffles or replace the waffle iron with a new, dedicated gluten-free one.

What kind of resources and support groups are available for celiac disease?

ACK, the hyperlink thingy for The Gluten Intolerance Group is all messed up. It should be www.gluten.net
Celiac Disease Awareness Campaign from the National Institutes of Health
Celiac Disease Foundation
The Gluten Intolerance Group
Celiac Disease practice guideline from the World Gastroenterology Organisation (WGO)
Celiac Sprue Association
• Outcomes of 2004 consensus development conference, National Institutes of Health
National Foundation for Celiac Awareness
University of Maryland Center for Celiac Research

Books and Magazines (does NOT include cookbooks)
Celiac Disease: A Hidden Epidemic by Peter Green, M.D. and Rory Jones

Gluten-Free Diet A Comprehensive Resource Guide by Shelley Case, R.D.

Gluten-Free Friends: An Activity Book for Kids by Nancy Patin Falini, M.A., R.D., L.D.N.

Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy Gluten-Free Children by Danna Korn

Gluten-Free Living Magazine

Living Without MagazinePhotobucket

Next up by Dr. Selena Eon is a three part series of “How to Eat Gluten Free on a Budget.” If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™