Celiac Blues

Now that we’re back to inviting people to dinner – in small batches – we’ve resumed the practice of including in the invite a question about food restrictions. On occasion we’ve been amused by the dueling requirements listed by the guests – gluten-free, vegan, vegetarian, kosher, lactose intolerant, soy intolerant, nut allergies – which sometimes rule out just about every recipe in our playbook. But it’s no joke for the people who bear these burdens. Violations could lead to reactions ranging from uncomfortable to life-threatening.

And now I have become one of the restriction listers. I apologize in advance for devoting yet another posting to my body and its afflictions. I’ll get back to the larger world soon enough, but when your body is sending distress signals, your world shrinks to the size of an ancient four-inch TV screen. Regular readers may remember that I went through a long period beginning more than a year ago when my weight began to drop. Appropriately concerned, my primary care doctor directed me through a series of tests, primarily trying to smoke out a possible underlying cancer.

Nothing panned out until I was reviewing this journey with a friend over dinner. She said it sounded very similar to the situation of another friend who ultimately turned out to have celiac disease, even though he showed none of the overtand uncomfortablesymptoms of that disease. I shared that anecdote with my doctor which opened yet another diagnostic pathway. That exploration ended last week with a definitive diagnosis of celiac disease.

I’m a novice in this particular area, as I suspect many of you are, so I’ll pause for a minute to tell you what little I know about Celiac Disease. Celiac affects a critical area of the small intestine which is covered by tiny hair-like vili (sp?) which extract the nutrients from the food you’ve ingested. A biopsy of that area showed that those vili in my gut were flattened, resulting in my case in a Vitamin B12 deficiency and a low- grade anemia. For some reason, I have none of the more overt symptoms which bedevil other victims of Celiac Disease. For some the body reacts violently to even the tiniest trace of gluten. That was not the case for me, which is why it was so difficult to diagnose. I’m sure you can find a much more scientifically accurate portrait of this disease by consulting Dr. Google directly, but this will suffice for now.

The good news is Celiac sufferers get off easy because the treatment involves no medications and no surgery. It’s purely a matter changing your diet to eliminate any traces of the offending gluten. The bad news is that it’s a matter of changing your diet to exclude many of my favorite foods, including bread, pasta, cakes and cookies. Instantly I have been transformed into a food detective, carefully studying the labels of every prepared food product currently in our pantry and on the shelves of Trader Joe’s and Jewel, our two main food suppliers.

First came the cereals. Anything containing wheat, barley or rye is automatically out because those three horsemen are the main sources of gluten in our diets, with wheat outpacing the others by a good margin. So, everything whose major component is corn, rice or oats should be permissible. That turns out to be the case for Corn Chex and Rice Chex, but not so for others you’d think were okay, like Corn Flakes, Rice Krispies and some forms of Cheerios. On many ingredient lists you’ll find something called malt extract which is usually made from barley (goodbye beer!) which rules out an otherwise unobjectionable list of ingredients.

The day after my doctor handed down the celiac diagnosis, Rosellen and I made a special pilgrimage to Trader Joe’s to scout out the available gluten-free products. Now, if you had the misfortune of suffering from this disease a couple of decades ago, your options would have been quite limited, but there has been an explosion of available gluten-free products in recent years, fueled by a health conscious population who may not have celiac disease but who report feeling better when they eliminate gluten from their diet.

The bread and baked goods section displayed g-f English muffins, bagels (plain and everything), sliced bread (plain, whole wheat and pumpkin!??) and cinnamon coffee cake muffins. I haven’t sampled the bread yet, but the bagels and muffins occupied the space of their original versions though they offered little of the satisfaction. The muffins are tasty and present a possible breakfast option. The other sections offered an additional g-f option in cereals called Almond Puffs (I’ll stick with the Corn Chex), a variety of g-f crackers, including the old dieter’s favorite rice cakes, and a surprising variety of g-f pasta which we haven’t tried yet, but which I’m expecting will fall short in the same way most of the baked goods did. These days you can even find g-f pasta in Italy, so I’m guessing you can make anything palatable if you bathe it in a good sauce.

The truth is that, even absent all these off-the- shelf products, no one afflicted with celiac disease is going to starve. Between rice, potatoes, meat, fish, chicken, fruits and vegetables one can put together a diet that is both nutritious and, arguably, healthier than my pre-diagnosis fare. I’m just at the beginning of my exploration of what’s available that doesn’t violate the limits of my diet. I’m sure my fellow g-f folks will provide me with other resources to aid my “transition.” My daughter Adina got the ball rolling with a suggestion that I try Cream of Buckwheat cereal. It turns out that despite the name, buckwheat groats, aka kasha, is not wheat and is therefore permissible. Try it. It’s really good.

 Bread and, especially, challah recipes would be particularly welcome. I feel like I’ve finally mastered the latter and will continue to provide it for others, but Sunday morning challah French toast is something I will sorely miss, at least until I find a g-f way to replicate it.

Always looking for an angle, I asked my doctor what happens if I just ignore the whole thing and go on eating as I always have. After all, I was mostly asymptomatic in any case. She explained that in addition to anemia and vitamin deficiencies, which might be addressable by other means, not changing my diet will increase my risk of developing lymphoma, as well as a variety of autoimmune diseases. I don’t pretend to understand the cause-and-effect relationship here. Perhaps one of my doctor friends can fill in the blank here. I’ve decided that cheating isn’t worth the risk. I’ll willingly trade a few bagels and baguettes for a little bit more time on the planet.

Rosellen and I have decided to view this changeover as an adventure, an opportunity to learn new things. Check with me in a month or two to see if I’ve been able to maintain that stance. Bon Appetit!