Tuesday, March 25, 2008

Cool Yiddishe Maidel

I want to dedicate this post to my daughter, "cool yiddishe maidel". [To keep her identity private, I use this as her "nom de web".] CYM is six years old in kindergarten at a local Jewish day school (but not the one I work at). CYM is also the inspiration for our exploration into "special diets".

Unlike other young families, we have not followed the SAD (Standard American Diet) for a long time. For as long as I can remember, we have used whole grain products. (I even increased my consumption after my father died of colon cancer. In researching gluten intolerance, I have since learned the possibility that my father may have had gluten issues that were left untreated.) Three years ago, my husband returned from a physical with higher than normal cholesterol numbers (he was 29 at the time). His doctor suggested making some dietary changes and a re-test in six months or he would need medication. (Did I mention that he was 29 and unlike me, a bit on the thin side?)

Taking what I know about "alternative" treatments (as opposed to "pharmaceutical" cures), we increased our omega-3 consumption (fatty fish, walnuts, and flax seeds are all good sources) and cut out trans fats (this was 3 years ago around the start of the "trans fat" buzz). At first, he was resistant, claiming that eggs were doing it. After all, conventional wisdom says that since egg yolks are mostly cholesterol, they were the cause. We kept the eggs (but gave up the packaged treats made with hydrogenated vegetable shortening) and added more fish to the menu. Needless to say, at his six month follow-up, his numbers were "normal". My only concession has been to buy him Joe's-Joe's Sandwich Cookies at Trader Joe's at a "treat" in his lunch.

[Side note: Two years ago, my 6 year old niece was diagnosed with type 1 diabetes and as a result, my sister has made her entire house diabetic-friendly, realizing that my niece gets more bang for her carb buck by eating brown rice instead of white.]

Meanwhile, CYM has just about always had a problem with incontinence (both daytime and nighttime). We would have short spans of dryness but that was only when my husband and I (as well as teachers at school) stood over her like a hawk and monitored her bathroom habits, something that could not continue forever. (She also had negative reactions to sugar such as mood swings, decreased impulse control, and increased difficulty staying dry.)

In October when the wetting accidents had increased to several times a day, the doctor found a blockage of stool in her colon and put her on a stool softener. Adding this to watered-down cranberry juice sweetened with stevia (my own mixture, not available in stores) to alleviate any possible bladder infections started to make a difference.

With no desire to allow my daughter to remain dependent on stool softener, I started to research other causes for the problem. My search for a solution led me to a book about using diet to achieve nighttime dryness. [To be honest, nighttime dryness has not been, and is still not, a concern of mine as research has proven bedwetting to be a physiological problem and in most cases, it will correct itself without intervention.]

The diet (found in the book Try for Dry) suggests eliminating all refined sugar, citrus (a medical industry friend later told me how citrus can aggravate bladder issues), caffeine, artificial colors and flavors, and dairy. The book said to cut dairy after noon to help with nighttime dryness, but I decided to cut out all dairy milk and still allow yogurt, kefir, and cheese (as these are lactose-free but not casein-free). The school was resistant, even though they went nut-free after several parents complained, to accommodating my child without a doctor's note. I offered that I would provide enriched rice milk for her to drink but apparently, the state inspectors want to ensure that milk is served to all children everyday (unless there is a proven allergy). I outlined the diet to the doctor and asked her to sign off, explaining what I was doing, and she did it.

It would interest parents who are paying top dollar for drugs to "fix" their "ADD" children that within a couple weeks, what I had thought were just "personality quirks" in CYM were reduced (her mood swings, irritability, etc) to almost non-existent. We set out to take care of the wetting (which we considered a social impediment as children can be very cruel to each other) and ended up fixing another problem. I would also like to add that putting her on the "special" diet also empowered us to seek the OT help she needed for her sensory integration issues. [After three months, she has more than caught up to her developmental age in that area as well.]

What is our "proof" that this diet works? We can tell when there has been a "relapse". While her dietary needs are clearly posted in her classroom at school (and I have provided a stash of acceptable food), she has a teacher who has expressed to outside parties that I am a "nut" and has "forgotten" the restrictions a few times. This has been followed by her having accidents and moodiness for two or three days afterwards. We know that there can be slip-ups in a child’s life when it is filled with birthday parties (in school and out), well-intending teachers who wish to reward their students with candy, and “candy men” strategically planted throughout a Shabbat (Jewish Sabbath) morning worship service.

We still have unintentional saboteurs who do not seem to understand the “harm” a “little” bit of sugar can do to someone. They have pled to allow CYM to eat these sweets when she has been “so good”. Although my daughter will not get very sick from eating too much sugar (unlike my diabetic niece or what could happen when a nut allergic child inadvertently eats an almond), it still causes harm (especially when all those “quirks” return).

The best advice I ever got on how to navigate the minefield of this “legalized cocaine” came from my sister raising the diabetic child. Desperate to make my niece’s life as “normal” as possible after the diagnosis, she raced out to buy anything and everything with a “sugar-free” label. After a while, she calmed down and chose to consider these alternatives as “treats” just as one should when giving sweets to their children.

Product Review: S'Better Gluten-Gree Corn Dogs

S'Better Beef Corn Dogs

Last week, I was at my local Wild Oats (currently transforming into Whole Foods), in search of my favorite gluten-free crust by Sans Gluten. However, they were out and I had to settle for the "other" one which is more expensive and not as good.

I took my 6 year old with me, as we were at the store after school. She is a beautiful, bright, extremely friendly little girl. [Next post will be about cool yiddishe maidel.] After we put her "special" ice cream (needed for her restricted refined sugar/dairy/citrus diet) into the cart, she struck up a conversation with an older man looking at the gluten-free products. While I was searching for that GF pizza crust, she immediately started to explain how she needs her "special" ice cream (fruit-sweetened Soy Delicious) because she's on a "special" diet. His interest was piqued and she continued to describe how her "eema" (Hebrew for "Mom") can't eat gluten because "it hurts her tummy".

The man showed me the large assortment of GF products, and I explained that I really have to label search since we also keep kosher. Right before he walked away, he pointed to a section of the freezer containing this company's entire line. Now, you have to understand that I was skeptical when I saw the hechsher (kosher symbol) as I have all but given up on finding too many kosher-certified GF products outside of Passover (when made with potato starch). I didn't want to risk paying the $8.59 for a box of corn dogs and find out that they were not kosher.

Yesterday, I had a friend contact the Orthodox Union (who certifies the product) who vouched that this company is indeed kosher-certified. Immediately after work, I drove straight to that Whole Foods and purchased the (last) package of corn dogs. [S'Better also makes Chicken Fingers, Chicken Siciliano, and a couple frozen dinners.] I realize that the point of this blog is to explore eating gluten-free without going broke but as a working mom, sometimes I have to go for the convenience.

You have to understand...most people who know me happen to know me as a scratch cook all the way. Puttering away in the kitchen and creating has always served as a wonderful de-stresser, but, unfortunately, has gone (somewhat) by the wayside with my going to work full-time. It also happened to be this school year (I work as a teacher's assistant) that I discovered my gluten issues.

Product Review: I was disappointed at seeing how small the five corn dogs were, especially after paying $8.59. Luckily, I had also stopped at the local grocery store and purchased a package of "regular" kosher beef dogs (Aaron's Best is also GF) to stretch the meal between the family. For a frozen corn dog, it tasted alright (although the corn bread coating took my children by surprise as they have rarely eaten these since they are generally unavailable in kosher establishments). Would I purchase it again? I see these products as a convenience, but they have earned a space in my freezer for "emergency" meals. Perhaps to save a little money, I will continue to buy "regular" products for the rest of the family and eat a portion of my GF "look alike". For those of you who are Muslim, in a true sign of religious harmony, they are also certified halal.

Tuesday, March 18, 2008

Day 3 of a Possible Reaction

Sunday night, hubby and I went to a benefit for my school. I ate a lot of "safe" food with reckless abandon: corn tortilla chips, seven layer dip, veggies, and then the buffet. I did not realize until this morning that the chicken breast I naively enjoyed may have been dredged with flour! THIS would explain the cramping/bloating feeling I've had since Sunday. Today, I was in bed with a great deal of abdominal pain until 10AM! Tonight, the rash is coming back. It may not look like much (especially with my bedroom's bad lighting) but it's itchy as anything (and had been essentially gone until tonight). If there are any fellow sufferers out there actually reading, let me know if this is the start of DH or if I am a hypocondriac!

I have also taken the step of locating a gastro doctor in the area who may actually know something. It has been suggested that I may have to glutenize in order to prove the problem. If I have been off gluten long enough, the tests will come up negative.

Monday, March 17, 2008

What Will It Take?

I went to the doctor last month for a scheduled physical. While there, I shared with her my concerns about gluten intolerance. Immediately, she discounted the issue by telling me that I can't be celiac because I am overweight. I countered with research consisting of the tests I have done on my own body. Wheat seems to trigger my appetite for more food, resulting in bloating, gastric distress, and fatigue. I also observed that when I would eat rice, potatoes, and corn, I did not feel the same way.

Five years ago, while on a low-carb diet, I attributed the increase in energy to my leaving bread and pasta behind. As soon as I was off the diet (because of becoming pregnant with child number two), my fatigue came back due to a combination of the growing baby and the return to starchy delights. The "baby" is now three and despite (mostly) obedient calorie-counting and diligent dieting, the weight has stuck.

My decision to go gluten-free was a combination of wanting my energy to return as well as the realization that the only two times I have lost weight on diets were due to eliminating gluten ("blood-type diet" for type A and low-carb).

Before approaching my GP, I repeatedly tested myself by not eating wheat for several days and then having it again. Each time, it would trigger me to eat more (of whatever it was), feel bloated, followed by horrible gas pains that mimicked menstrual cramps. Then, the rash came...

At first, I thought it was an allergic reaction to some new body wash (I am perfume-sensitive and am limited to certain soaps). However, it was mostly on my arms and horribly itchy. After an ENTIRE MONTH of putting up with this, I came across some information connecting a rash to gluten intolerance. While I had been toying with the idea of going gluten-free, I kept myself from doing it because of my unwillingness to put my husband and children out. Sure enough, I stopped eating gluten, and after a week... THE RASH WAS GONE!

The last straw was the Subway brought into work for the staff. [I work at a Jewish day school and they thoughtfully provided us with kosher-certified Subway for a working lunch.] I purposely ate a portion of a sub (as well as a cookie) before departing (as my work was done for the day). Within a HALF HOUR, I was feeling tired, itchy, and spent the evening with cramps. (The sandwich was definitely NOT WORTH all that pain!) Oh, and the rash? It came back for a few days.

I don't know why my doctor can not be convinced of my having gluten intolerance. I mean, since the treatment is essentially my never touching gluten again, it's not like I will have to pay insurance premiums for a cure. The more I read about gluten intolerance, the more frustrated I have become. For starters, I have been "slightly" anemic for a long time (during all my pregnancies and now) despite my "healthy, well-balanced diet". My father (who died of colon cancer at the relatively young age of 59) has a Scottish ancestry. [For those of you who have not done much research, untreated celiac CAN lead to gastro-intestinal cancer and people with a Celtic background are generally more prone to the disease.] He died six years ago.

My plan now is to simply take myself off of gluten as a blood test will not diagnose me unless I am celiac. Why wait for the testing when I know the results based on my body?

Thursday, March 6, 2008

Recipe: Potato Crusted Chicken

Unfortunately, I did not get a picture of this before my family gobbled it up as the idea for my starting this blog happened during dinner last night. My husband has always loved my cooking (one of the reasons he married me, he says) and is usually impressed with my ability to make "diet" food that everyone can enjoy.

If you like schnitzel (breaded cutlets) or "Shake and Bake Chicken", this one is for you:

* 2 pounds chicken drumsticks (what I used last night, but you can use any cut of chicken). Drumsticks are my children's favorite due to their portability.

Egg Wash:
* 1-2 eggs beaten with 1/4 cup water

Coating Mix:
In a bowl or in a plastic bag, mix together:
* 1 cup instant mashed potato flakes (I use Potato Buds from Betty Crocker since it is the only one available at the local grocery store that is pareve, neither "meaty" or "milky", therefore can be used at any meal)
* 1/4 cup rice flour (optional)
* paprika, garlic powder, pepper (1-1 1/2 teaspoons each, according to taste)
* salt (optional)

Preheat oven to 450F. Dip pieces of chicken into egg wash. Either roll the chicken over the coating mix or put into a plastic bag for shaking. [I have noticed that the "crust" is better if done in the bowl as one can press the coating into the meat.] Place in a oil-coated baking dish and put into the oven. Immediately, turn the oven down to 425F and bake for 20-25 minutes, turning pieces halfway through the baking process until golden brown. [Boneless pieces will take less time, so adjust accordingly.]

Passover adjustment: Use Kosher for Passover certified instant mashed potatoes.

Serve with rice or oven-baked French fries (yes, it's redundant, but I was cooking quick last night), and vegetables.

Laws of Bread for the Celiac Observant Jew

According to halakhah (Jewish law), bread needs to have been made from any of five grains (wheat, barley, oats, rye, and spelt) and a majority proportion of water to any other "liquid" (classified as oil, sugar, honey, and eggs). Yeast added to the mixture is not taken into consideration as shown with matzah during Pesach (Passover). Therefore if one encounters a "bread" product made with apple juice (rather than water), it is technically mezonot (a baked good) rather than motzi. [In frumspeak (lingo used by frum Jews, those who are ritually observant), foods are often categorized by the blessing one recites before eating it. Therefore, hamotzi is anything that is actual bread, and requires the ritual washing and full Birkat ha-Mazon (Grace after Meals). Mezonot is the last word of the blessing on any other flour-based product that is not bread, such as cookies, crackers, cake, and pasta.]

Called the "staff of life", bread is the basis of a meal. During Shabbat, Jews sit down to several meals, all containing challah, a "fancy" braided loaf. This can be problematic for the person who is gluten-sensitive. Solutions for some have included not eating the bread at all or eating a small bite (depending on the sensitivity level). No rabbi worth following would suggest that one with a food allergy should feel forced to eat bread, as pikuach nefesh (saving one's life) takes precedence over the observance of mitzvot (commandments).

There are several gluten-free "breads" on the market made from rice flour. The best-tasting one I have found is made by
Food for Life (see picture at beginning of post). They make an entire line of whole grain (for the non-celiac) as well as gluten-free/wheat-free bread products. They are rice flour-based and are considered she-hakol (the "catch-all" blessing for food that is no longer in its original recognizable form). All their products are certified by the kaf-K as pareve. Food for Life is also sold at Trader Joe's and Whole Foods. Some have the custom of regarding this as "bread" and will treat it as motzi since it is "bread" to them. However, it is not motzi.

Since I am gluten-sensitive and not a celiac, I have started to bake loaves of oat bread for exclusive consumption on Shabbat (I'Y'H, I will post recipe and pictures soon) while eating the rice flour bread during the week. I like this custom I have taken for myself since it reminds me of the specialness that Chazal (Rabbis from the Talmudic era) placed upon bread in the first place. Historically, it was common for poor people to make "bread" from "inferior" flours by grinding lesser grains (as well as legumes and nuts). Wheat was more expensive and it therefore makes sense that it would have been reserved for "special occasions" such as Shabbat. Today, wheat flour is VERY available and eaten, sometimes to excess.

Please check for my post Pesach for the Gluten Sensitive where I will go into detail about handling Pesach.

[Note: I advocate a high consumption of whole grains in any eating plan rather than enriched. All whole grains have the fiber and vitamins that are stripped in the refining process, but added in a synthetic form as "enrichment". Non-gluten sensitive people should continue to select whole grains at least half the time over the white stuff. To illustrate my point to people, I have taken white flour and water, mixed it together and made paste. (This does not work with whole wheat flour.) In my case, as well as the millions of people worldwide who are gluten sensitive, eating wheat adds more problems than it is worth. It is recommended for gluten sensitive people to choose brown rice over white and other non-gluten grains as a part of a balanced varied diet.]

FAQ #1 (6 March 2008)

What is a gluten-free (GF) diet?

Gluten is what gives bread dough its stretchy quality. It is an integral part of wheat, barley, rye, and spelt (as well as lesser known grains such as kamut and triticale). People who have sensitivities to gluten (found most significantly in wheat products) can range from having a wheat allergy to celiac disease. Eliminating gluten from the diet (an arduous task for those who have to do it since current labeling laws do not require mention of gluten) is a first line of defense in treating celiac disease.

Who else can benefit from a GF diet?

Not only those with a gluten sensitivity may need to follow a GF diet. Although the research is not completely documented, symptoms of autism spectrum disorders as well as ADD/ADHD have been found to lessen after eliminating gluten (and in some cases, casein, a key ingredient in dairy products). Dermatitis herpetiformis (classified as severe itching rash found on behind the elbows and knees) has been considered either a separate disorder (treated with a GF diet) or as a symptom of celiac disease (which can only be diagnosed with a blood test and an endoscopy).

You didn't mention oats. Don't they contain gluten?

Currently, oats are a controversial subject in celiac circles. Technically, oats lack the gluten protein and therefore should not be a problem for most people with the sensitivity. The key concern is that oats can be cross-contaminated with glutinous grains in their processing. There are a few sources for certified non-contaminated oats. However, these are quite expensive. Since I do not think I am celiac, I freely use oat flour (rolled oats ground in a food processor). [Please see the post about Laws of Bread for the Celiac Observant Jew for more information.]

So, no bread, no pasta, what's left for me?

Quite a bit actually. Conventional starches such as potatoes, rice, and corn are still available. Use this opportunity to open your eyes to an entire world of almost-forgotten grains, all of them have unique tastes that expand your repetoire: amaranth, millet (not just for bird seed anymore), and quinoa. The basis of comfort foods, like tapioca (pudding) and buckwheat (pancakes), are also permitted. The good news is that many of these foods can be made into an assortment of flours (along with legume and nut flours), which will provide you with hours of baking pleasure.

Low-carb diets were big several years ago. Isn't gluten-free just another "fad diet"?

Not for the 1 in 200 Americans who have gluten sensitivity in one form or another. (For every diagnosed case, there are approximately a dozen people suffering in silence, completing unaware of the long-term effects.) A "classic" celiac case is a person whose body does not completely absorb nutrients in food. This could cause a
person to be too thin, unable to gain weight no matter what, or heavy, from the need to overeat as an attempt to satisfy nutrition requirements. There is a lot of buzz currently about gluten-free as well as a surge of GF products storming the market. People may inevitably turn to it as a fad diet but it will just as soon fade for some of these people once it gets "too boring".

I may have the sensitivity, but don't want to put my whole family on the diet, what should I do?

For those who observe the Jewish dietary laws (kashrut), we are already familiar with the stringencies of separating meat and dairy products from each other. Being the only GF person in a family requires the same attention (for those with severe allergies). Reactions can occur from a "double-dipped" knife in mayonnaise or cream cheese. [GF people can keep separate containers of these products for themselves.] Cutting boards and cooking utensils have to be cleaned with hot soapy water in between use. Keep your GF products clearly marked and away from the other foods and you should not have too many problems with cross-contamination.

Since processed food may not be clearly labeled "gluten-free", what else do I need to know?

Obviously, you know to avoid the flours of those offending grains. However, wheat, barley, rye, and spelt have several aliases on ingredient lists. Steer clear of these "code words": modified food starch (may be derived from wheat), hydrolyzed vegetable protein (commonly found in canned tuna fish), and malt flavoring.

What about alcoholic beverages?

Wine is still safe as well as distilled liquor from non-glutinous sources (such as rum and potato vodka). There is currently on the market beer made from sorghum (another gluten-free "grain"). However, at $8.99 per 6 pack, it is better reserved for special occasions.