Gluten Free Mom

Celiac Disease and Nutrition

This is a little bit different of a post than normal, but Lori wrote the following article for my website and I thought it might be helpful for some of you-all as well. 

I know that as soon as I initially figured out what to eat, the next question for me was how to have a healthy gluten free diet. 

CELIAC DISEASE AND NUTRITION

By Lori S. Brizee MS, RD, LD, CSP

Central Oregon Nutrition Consultants

This article is about eating healthfully while following the gluten free diet. Working with a registered dietitian, who has experience with CD and use of web sites such as this one can make following the diet and being well nourished much easier.

When first diagnosed with CD a person is often anemic, under weight and deficient in many vitamins and minerals due to long term malabsorption of nutrients. For a person who has had long-standing, undiagnosed CD, thinning or weak bones is a major and debilitating problem. In the worst case scenario, adults will have osteoporosis and a child will have rickets as well as poor growth in height. Problems with bones and anemia effect people with ‘silent’ CD (CD without diarrhea) as well. Following the gluten free diet while meeting nutrient needs can reverse most if not all of these problems. (1, 2, 3, 4) 

An issue for children can be the association of eating with the pain, bloating and diarrhea that they experience before starting the diet.  This can cause a dislike or fear of eating, resulting in poor or very ‘picky’ eating; it may take several months of being on the diet and feeling good before a child is willing to eat enough to meet his needs and to accept new foods.  Working with an RD and/or therapist who is skilled in ‘feeding problems’ can help parents to promote healthy eating and prevent future eating disorders.  Children required to follow special diets are at higher than normal risk for developing eating disorders (e.g. anorexia and/or bulemia) as they enter adolescence (5).

Re-nourishing After Diagnosis of CD:

• Calcium and Vitamin D:

Needs for calcium and vitamin D are high if bone problems have developed before diagnosis of CD.  It is very important that everyone with CD meet at least the Dietary Reference Intake (DRI) for Calcium, and two to three times the DRI for Vitamin D.  (See table 1 for recommended intake.)

Several, recent research studies have shown that current DRI’s for vitamin D are much too low; it is quite reasonable to increase vitamin D intake  to a higher, but safe level to ensure healthy bone development and prevention of many other chronic diseases.  However, excess vitamin D is toxic; staying within the DRI’s safe and tolerable upper limit for the vitamin is essential.

Table 1: Current United States vitamin D recommendations

(Often, Hellwig and Meyers (editors); Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. National Academies Press, Washington DC, 2006 pp220-231)

Age	Adequate Intake (AI)	Reasonable intake (this author’s recommendation based on ref 7 and,8)	Tolerable upper limit
0-12 months	200 IU (breast fed infants need a supplement)	200-400 IU	1000 IU
1 year through 3 years	200 IU mcg`	400-600 IU	2000IU
4 years through 8 years	200 IU	400-800	2000 IU
9 years through 13 years	200 IU	600-1000	2000 IU
14 years through 50 years and pregnant/lactating women	200 IU	800-1000	2000 IU
51-70 years	400 IU/10mcg	800-1000	2000IU
>70 years	600 IU/15mcg	800-1000	2000IU

• Iron/Anemia:

Iron intake may need to be increased, as iron deficiency anemia is common in people with untreated CD.  Anemia is present even in people who have ‘silent CD’.  In addition to iron deficiency, the inflammation present with CD may be a cause of anemia. To eliminate this anemia, one needs to strictly follow the gluten free diet. (4)

• Other vitamins and minerals

Other vitamins and minerals are all likely to be deficient if diarrhea has persisted for a long time. It is suggested that a newly diagnosed CD patient take a gluten free multi-vitamin and mineral supplement until he has been symptom free for several months.  After that, it is quite possible to meet needs with food.

Nourishing a Person With CD Over the Long Term:

Once on the gluten free diet for several weeks, people who had diarrhea prior to diagnosis usually gain weight well, and children “catch up” in growth in both weight and height.  Some people actually become overweight—for the first time in many years they can eat without having pain, AND they are absorbing the nutrients that they eat.  Others, especially those with ‘silent’ CD (no gut symptoms or diarrhea) may have a hard time keeping there weight up, due to removing such a huge body of foods from their diets.  Just like the rest of the world, a person with CD needs to avoid over OR under-eating.  Children can do a good job of self regulating if offered foods in 5 to 6 regular meals and snacks each day. Coaxing children to eat or restricting them because we think they are over-eating can lead to many parent-child battles over food, and even eating disorders. 

The gluten free diet must be strictly followed; eating wheat (even with no symptoms) can cause lesions to begin forming in the small intestine and significantly increase the risks of osteoporosis and anemia. (6) This can be a big problem in adolescents who want to fit in with their friends—if they can eat a little wheat here and there without pain or diarrhea, it will be difficult to convince them to stop.  They have a hard time believing that problems associated with CD will truly impact them. (5)

What does a Healthy Diet Look Like?

• Fruits and Vegetables:

Including at least 5 servings of vegetables and 3 servings of fruit per day is important for everyone to meet needs for vitamins, fiber, and antioxidants. People who eat lots of fruits and vegetables have lower levels of heart disease, macular degeneration, and many cancers. Fortunately, fresh, frozen, canned and dried, plain fruits and vegetables contain NO gluten, so everyone with CD can eat loads of them. Eating additional starchy vegetables (potatoes, yams, sweet potatoes, winter squashes, parsnips, carrots, peas) helps make up for the removal of many wheat, rye or barley based foods.

• Whole Grains:

Whole corn, brown rice and quinoa are whole grains that can take the place of gluten containing grains and are a great source of vitamins, minerals and fiber.  Including these on a regular basis is a part of a healthy diet.  Using brown rice pastas is another way to add whole grains. Look for gluten free products that include at least some whole grains (e.g. brown rice).  Gluten free breads, baking mixes and cereals are great, but aim to get about half your grains from whole grains. Adding ground nuts, flax seed or sesame seed to baking mixes can increase the fiber and nutrient content if the main flour is refined.  (See table 2 for fiber recommendations)

• Dairy products: 

Milk, yogurt, and cheeses are some of the highest calcium foods around, and milk and some yogurts are fortified with vitamin D.  If a person cannot tolerate milk or dairy products, calcium and vitamin D can be obtained in fortified GF soy, rice or almond milks or fortified orange juice.  If not eating/drinking 3 to 4 servings of one or more of these every day, a calcium and vitamin D supplement will be necessary.

There are many GF calcium and vitamin D supplements found in pharmacies, talk to your pharmacist to find the best supplement for you.

Another way to obtain vitamin D is with sun exposure to your skin. You need 5 to 30 minutes of exposure to the arms and face, without sunscreen, twice a week, when the sun is high. The darker your skin is the more sunlight exposure you need.  Once you have had this amount of sun exposure, it is important to apply sunscreen to protect against skin cancer. If you live in the north (above 35 degrees latitude) the sun is too low to provide direct exposure between November and February. One can actually get vitamin D in the winter months by exposing the whole body, in a swimsuit to UVB rays via a tanning bed once per month; you need only ¾ the amount of time that it takes to actually tan. (7,8)

• Protein foods:

We get protein, many B vitamins, iron and zinc from meats, poultry, fish, and eggs. Unprocessed meats can be convenient for persons with CD, because they do not contain gluten (read the labels of any processed meat you purchase as gluten containing flours/starches may be included in fillers).  We can meet our protein needs with small amounts of meat and dairy products, or with vegetable proteins such as beans, split peas, lentils, nuts, peanuts.  Vegetable proteins are also a great source of fiber, but need to be mixed with grains to provide a “complete protein”; this can be difficult, but not impossible when on a gluten free diet. 

Conclusion:  Basically, a person with CD has the same nutrient needs as the rest of the human race, but meeting those needs while eliminating gluten can be a challenge.  This web site gives you all the information you need on following a gluten free diet; this article is a reminder that we all need to eat a variety of foods to be as healthy as possible.

References:

1) Sharrett m and Case S; Celiac Disease – More common than you were taught! Pediatric Nutrition—A Building Block for Life (a publication of the American Dietetic Association Pediatric Nutrition Practice Group) volume 27(2):1-4, 2004.

2) Usai P, et al; Effect of a gluten free diet and co-morbidity of irritable bowel type symptoms on health related quality of life in adult celiac patients. Digestive and Liver Disease. 39(9):824-828, 2007, Sept. 

3) Alaedini A, and Green PHR; Narrative Review: Celiac Disease: understanding a complex autoimmune disorder. Annals of Internal Medicine, 142:289-298, 2005

4) Harper JW et al: Anemia in celiac disease is multi factorial in etiology. American J of Hematology 82(11):996-1000, 2007, Nov

5) Kyngas HA, et al; Compliance in Adolescents with Chronic Diseases: A Review. Journal of Adolescent Health, 26:379-388, 2000

6) Matysiak-Budnik T, et al Longterm follow-up of 61 coeliac patients diagnosed in childhood: evolution toward latency is possible on a normal diet. Gut, 56(10):1379-1386, 2007, Oct

7) Holick MF; Medical progress: Vitamin D deficiency.  New England Journal of Medicine, 357(3):266-281, 2007, July 19

8) Bickle DD; What is new in vitamin DL 2006-2007. Current Opinion in Rheumatology 19(4):383-388, 2007, July

Find this article on my website at Gluten Free Mom.com.

The Silver Lining of Celiac Disease

As the new year begins and another one slips away, I do not have a recipe to share (I have been cooking my brains out for two weeks and just need a break),

I'd rather share some JOY . . ..

Looking back, every year since our initial diagnosis with celiac disease has been a better year -

adjusting more easily,

feeling better,

moving forward with life instead of battling undiagnosed symptoms.

Looking forward, knowing that there will be challenges but that every year will be better . . ..

Yes, celiac disease is and can be very hard, but today lets focus on the good of celiac disease,

on one of the

The Silver Linings … in Celiac Disease

My daughter and I share a mutual love of cooking that has been one of the greatest blessings… yes blessings… of celiac disease.  

On a quiet afternoon or evening when we have a few hours between soccer games and guitar lessons,  you can often find my daughter and me in the kitchen, the TV turned on to the Food Network,  hammering out the ingredients for our latest and greatest gluten free, casein free food concoction.  No matter what our mood when we start, at the end of it we both fall blissfully (yet somewhat exhausted from all the finger licking) onto the stools at the kitchen counter to sample our latest endeavor.   

Of course the end result is almost always a reward in and of itself.  Like the Better than the Original Gluten Free Casein Free Samoas.  But we have had a few flops as well, such as the tomato soup that tasted more like thick and hearty pasta sauce.  In fact, we ended up using it as pasta sauce.

Even more than the food, it’s the time we spend together doing something we both love that is the greatest reward.  This is when my daughter shares her feelings about her friends, her dream of visiting Venice, her struggles with how hard it is to eat gluten free when her friends are eating birthday cake, or even worse, Krispy Kreme donuts.  But this is also when she learns how long to sauté onions or whip up a gluten free treat that will please any picky eaters.  Skills that will last a lifetime.  Skills she will need for a lifetime. And this is the silver lining in celiac disease. 

We all know the common thread of the story of diagnosing celiac disease.   My oldest daughter, Alex, entered the world on Leap Day 1996, an almost ten pound thriving baby with a full head of beautiful hair.  Then the signs began to appear – the colicky baby, the projectile vomiting in the ER one Thanksgiving, the pot belly stomach.  By third grade she was addicted to Pepto Bismal and often suffered from flu-like symptoms.  The doctor’s answer each time - "it’s just the flu."  Then finally that unforgettable visit to the doctor’s office where you are determined not to leave until you have an answer. 

The answer of course was celiac disease.  The relief in knowing that it was treatable by diet, but oh what a diet!  The day we found out that Alex had celiac disease, my husband and I darted straight to Whole Foods.  We spent five hours strolling the aisles, spent hundreds of dollars and rushed home to prepare a smorgasbord of gluten free childhood delights we were sure our family would love - namely cheese pizza, macaroni and cheese, and cookies.  Sadly, the meal ended with all of us in tears.  I mean we were literally all crying – we could not imagine eating this food for the rest of our lives.

And yet, only a week after the entire family went gluten free, I began feeling better than I’d ever felt in my life!! What was going on?  Of course, I soon realized that not only did my daughter have celiac disease, but I did as well. Not to mention a dairy allergy.

Then my child changed into someone we had not known before.  One of the first changes I noticed was the color of Alex's skin.  She had always been so pale.  Yet in the middle of the rainy season in Seattle, my daughter had a tan!  Where had this come from?  Then the shock at realizing it was because she was healing.  Not long after came the spontaneous dancing, the little skip across the family room for no apparent reason.  Finally bigger changes, five inches of growth in a year! 

Two years later, the changes required to live gluten free (and I mean LIVE) have all been made.   Our life seems normal again, at least our version of normal.  While celiac disease causes a lasting life adjustment, living gluten free will not prevent you from living the life you choose, unless you let it.  My family has chosen not to live to eat, but we eat so that we can LIVE.  You can eat out, you can travel, you can visit friends and family for meals, you can do anything you want, because there’s always a way.

There have been many, many silver linings in dealing with celiac disease.  What a blessing that the running, laughing, exploring, fun-loving, beautiful soul of my child, for so long hidden beneath the illness, has emerged and thrived.  The growing closeness of our entire family as we regularly gather around the table for family meals.  What a blessing that I feel better than I have my entire life. The healthier lifestyle that we all live (we have not had fast food in almost three years).  And, one of the greatest blessings of all, the bond that my daughter and I have sealed in the kitchen. 

My daughter says she wants to grow up and study cooking in Paris and be a chef.  She is only eleven so there are many years for her life dreams to change.  But one thing is certain – I know she will never forget the hours we spend in the kitchen, flour flying, creating our latest and greatest gluten free meals.

Published in the Arico Newsletter, Winter 2008.  Arico Foods.com.  Sign up to receive this newsletter at Arico Foods Newsletter

Gluten Free School Lunches

It's that time of year when the same old school lunch is getting a little boring for my celiac child. 

If your school is like ours, the only hot lunch item my child can have is the milk.

So that leaves a sack lunch five days a week.

Who would not get tired of eating the same thing every day? 

Here is how we try to keep things fresh

Our lunch ingredients are broken down into six main categories: main entrée, fruit, vegetable, something cold, snack item, dessert. 

This may seem compulsive, but sticking to these makes it easier for me (I don't have to think too much before my coffee kicks in) and for my daughter, to make her lunch in the morning.  She can put in whatever she wants, as long as there is one thing from each category.

MAIN ENTREE:

If there is a microwave and it is clean enough for your child to use (I pack an extra paper towel in my daughter’s lunch so she can lay it down in the microwave then put her food on top of it.  She just leaves the paper towel in the microwave when she is done):

o    Lundberg Rice Express Microwaves in 60 seconds.

o    Thai Kitchen Instant Rice Noodle Soup Just add water and microwave for 3 minutes.

o    Leftover GF Mac –n- Cheese

If a microwave is not available:

o    Corn thins with peanut butter

o    GF bread with butter and cheese

o    GF bread with Hormel Natural lunch meat and cheese

o    GF bread with Nutella Hazelnut Spread 

o    Glutino Gluten Free Bagels with Cream Cheese Blue Diamond Almond Nut Thins

o    Edward & Sons Brown Rice Snaps, Ener G Gourmet Crackers  or Glutino Gluten Free Crackers with slices of cheddar cheese.

FRUIT:

Okay pretty obvious, but something different to try:

o    Satsumas

o    Bowl of raspberries, strawberries and blueberries mixed together

o    Cantaloupe

o    Dole cups of mandarin oranges

VEGETABLES:

o    Bags of carrots 

o    Pickles 

o    Celery sticks 

o    Cherry tomatoes 

o    Avocado (the first time she tried an avocado my daughter was hooked on them. Slice in half, remove the pit, and fill the bowl with GF balsamic vinegar) 

o    Can of  V-8

SOMETHING COLD:

o    This usually means yogurt for us.  Yoplait is GF.

o    Bowl of Organic Valley Cottage Cheese

o    Sliced cheddar cheese

o    Frigo cheese sticks

SNACK ITEM OR BAR:

o    Cracker Jacks

o    Eden Organic Pumpkin Seeds

o    Ener-g Pretzels

o    Frito Lay Sunflower Seeds

o    Jo-Sef - Graham Crackers

o    Fruit Gushers, Fruit by the Foot, Fruit Roll ups by General Mills

o    Lara bar Apple Pie these are not necessarily a favorite

o    Potato Chips:  We love Frito Lays not only for the list of gluten free items they provide on their web site, but also for Cheetos!!  Frito Lay Gluten Free List   

o    Purfit Nutrition Bar, Almond Crunch these are my favorite bars.  They are high in protein, travel well and taste great.  You can order them on their own website, but I add them to my Amazon.com order.  My Amazon.com Gluten Free Shopping List

o    Organic Food Bar Belgium Chocolate ChipThese are my daughter’s favorite bars.  We find them at Whole Foods. 

o    Eden Organic Tamari Almonds

DESSERT:

• Whatever gluten free treat I made that week such as 123 Gluten Free Sweet Goodness Pan Bars, 123 Gluten Free Devilishly Decadent Brownie, The Cravings Place Chocolate Chunk Cookie Mix  or Namaste Foods Spice Cake  muffins.
• Cherries by Ferrara Candy Company.  These are a favorite.  Candy Tree Organic Vines This great gluten free licorice is such a special treat and a favorite snack. 
• Glutino Cookies - Lemon Wafers, Vanilla Dreams and Wafer Cookies 
• Hershey’s Chocolate Kisses
• Kozy Shack Chocolate Pudding
• WOW Wheat and Gluten Free Cookies and Brownies  These are the best of the best.  Large, soft and delicious.  Much like you would find at the local bakery.   
• Yogos

Some other tips:

Buy a Fun and Different Lunchbox

This may sound silly, but buy your child a fun lunchbox that is not like everyone else’s. 

o    Fun; because they will carry this lunch box everywhere (school, sleepovers, parties).  We bought one at the M&M store in NYC that looks like a bag of Peanut M&M’s and my daughter loves it.

o    More importantly, you do not want her lunch box to look like anyone else’s.  Last year we had the standard issue Target lunchbox that several students had.   One day I had to bring an emergency lunch to school because someone else had grabbed her lunchbox by mistake.

Pack More Food than your Child Needs

The extra food is not necessarily for your child to eat during lunch:

o    Even though most schools do not permit it, all kids trade food.  A celiac child cannot take anyone else’s food  Having extra lunch in her bag to share, lets her be a part of this lunch time social exchange.  It does not have to be your pricely special GF  treats – we often pack a bag of sunflower seeds to pass around on the playground).

o    Secondly, you never know when a situation could arise where your celiac needs extra food.  A spontaneous invite after school for a play date is okay because she will have extra food left over from lunch for snack.   

o    You never know when an emergency may arise.  Yes, I’m probably overly protective and prepared, but in the event of an emergency I will feel better knowing my daughter has a little extra food (this is in addition to the emergency stash of food in her classroom).

We'd love to hear how you make it through lunch.  Email me with your suggestions at liveglutenfree@gmail.com.

For more tips on Raising a Celiac Kid go to www.glutenfreemom.com.

Raising a Celiac Kid: Something to be Thankful for on Thanksgiving

If you have a child with celiac disease you know how hard it can be at times. 

My daughter is eleven years old.

It is hard enough just to be a 6^th grade girl. 

Add to that something that makes you “different” (the one thing middle school girls don’t want is to be different) and life can be challenging at times.

A good day can suddenly turn into a bad day when the Volleyball coach decides to reward the team with frosted cookies and drinks my daughter cannot have.  Or worse yet, when someone brings in Krispy Crème donuts for their birthday celebration at school. 

We try to prepare for the challenging situations. 

We are as positive as possible about celiac disease and the changes it requires.  For every difficulty faced our motto has been “There is Always a Way.” 

I encouraged her to start a website (www.glutenfreekid.net) as a way to express her feelings and connect with other celiac kids. 

Extra effort is put into showing my daughter there is more to life than just food.  We don’t live to eat; we eat so we can live. 

I try to make her enough treats and good food that she does not feel deprived.  When she got home from the impromptu volleyball party we melted away the tears with a root beer float.

But no matter how hard we try, there just are bad days.  Even I have days when I just want to throw the towel in and order a pizza for goodness sakes!  Days when I just know that my daughter is sad about having celiac disease.

That is why I was brought to tears last night when my daughter slipped a note under my door.  Ever since Alex learned to write, we have this fun game of leaving notes on each other’s beds at night time.  If she is having a bad day, this is how I find out.  If she was extra nice to her brother or sister during the day, this is how I tell her how much I appreciated it.

Last night, I was in my bed reading and heard the note come under the door .  This is what it said:

Dear Mom,

Wow.  I have finally realized why I am allergic to gluten. 

It was God. 

Through God I am going to help others around the world that have celiac.  It is like I feel him talking to me and telling me these things. 

Through my website I am going to make a difference.  I can feel God’s power in me as I write these words.  He is moving my hand across the paper

I got an email from an 11 year old girl in Arkansas about my website.

I feel wonderful! God used me to save my life, my Mom’s life and hopefully more people to come. 

I have always hated celiac and people have told me it is gonna be okay and I have helped my family eat healthier, but I realized that God has a reason for this.  And I promise I am going to make a difference through the power of God.

                                                                                    Love,

                                                                                                Alex

After wiping the tears from my eyes, I slipped my response under her door.  It is not fair to Alex if I don’t share it as well:

Dear Alex,

I was so sad when you were sick and then diagnosed with celiac.  Not that having celiac is a bad thing, but because I wanted your life to be “normal.”  Because I did not want your life to be hard.

Then I started seeing God work in you~us~our family.  I started recognizing his foot prints in the gluten free flour spilled on our kitchen floor.

While God wants to share the blessings of this world with you and he is happy when you experience joy, he is more concerned about your character, your everlasting character, than he is with your comfort in this world.  A life without opportunity and growth is hardly a life at all.

I am glad that God is working in your life and that you feel wonderful!

Just remember to be patient, God works slowly. 

To follow your heart, because God is love.

To not be too discouraged by the hardships (unfortunately, there will probably be more).

It is one of the greatest joys in my life to see God working through you, in you, besides you.

                                                                                    All my Love,

                                                                                    Your Gluten Free Mom

Starting a Gluten Free Diet

You just found out you have to go Gluten Free.

What do you eat now?

This will seem counter to all of your intuitions, but the first thing you should NOT do is go out and buy every gluten free thing you can find.  You will want to and it is exactly what I did:

The day we found out that Alex had celiac disease, my husband and I headed straight to Whole Foods.  We spent FIVE hours strolling the aisles, hundreds of dollars and rushed home to prepare a smorgasbord of gluten free childhood delights we were sure our family would love - namely cheese pizza, macaroni and cheese and cookies.  Sadly, the meal ended with ALL iof us in tears.  We were literally all crying - it tasted horrid and we could not imagine eating this food for the rest of our lives.

Almost three years later, some of the foods that we ate that first night are our favorites that we eat regularly and I can make it through Whole Foods (one of our favorite shopping venues) in under thirty minutes with my cart overflowing with gluten free food that we love. 

The point being, you will probably not like the gluten free food the first time you eat it.

• First, if your celiac child is like my daughter, they feel awful from being sick for a long time.  My daughter remembers not wanting to eat in general because her stomach hurt so much.  So no food tastes really good at this point. 
• Second, gluten free food is different.  It really does take time for your taste buds to change.  I still remember the first time I baked a loaf of gluten free bread.  I did not like the taste of it, but I also could not stand the smell of it baking.

You need to give yourselves a little time to forget what bread and cookies made out of wheat tastes like.  Start with the simple changes outlined below and give yourself time to feel better and for your taste buds to adjust.

Breakfast Ideas

• Yogurt, Smoothies,
• Enviro Kids Koala Crisp (my very picky eaters never turned those noises up at this cereal)
• Nature's Path Honey'd Corn Flakes
• Fried eggs
• Pocono Cream of Buckwheat - This might be pushing it a little for the newly diagnosed, but we absolutely love this!  Buckwheat is good for you and naturally sweet so it is a winner all of the way around.  We make a double serving, and refrigerate half for the next morning.  Top with milk, sugar and cinnamon!  Delicious!

Lunch and Dinner ideas

• Steamed rice - Lundberg Farms is GF
• Lunchmeat - Hormel Natural Choice lunchmeats are GF.  We make ham roll ups.  Just roll some lunch meat and cheese and stick a fancy toothpick in it.  We still eat these.
• Hot dogs - Boars Head are  GF. Most kids don't eat their hot dogs on buns anyway.  Heinz Ketchup and French's Mustard are GF. 
• Thai Noodles instant rice noodles - just add water and microwave for three minutes.  Leave off the seasonings or go light on them.
• Baked Potatoes, Mashed Potatoes, Potatoes of all kinds
• Any kind of meat, just be careful how you prepare it.  Gluten is in everything.
• Nachos - Tostitos chips with melted cheese on top.  (If you are using shredded cheese, make sure it is gluten free.  Some manufacturers coat shredded cheese with flour to keep it from sticking.  In the beginning I shredded all of the cheese myself.  I now use Tillamook cheese). 
• Peanut Butter - Jif while not the healthiest is GF. 
• Corn Thins - These served as our initial replacement for bread and sometimes still do.  They hold up well in a sack lunch and are good spread with peanut butter, butter and cheese, ham and cheese . . ..  They are made by Real Foods and sold just about everywhere.

Snacks

• Smoothies saved us:  Yogurt is good for your digestion (assuming you do not have a dairy allergy), it is cold and tastes good.  Yoplait yogurt says gluten free on the label.  Go to www.glutenfreemom.com to the Recipe section for some our favorite smoothies.  We even have a chocolate/strawberry smoothie that is also casein free. 
• Don't forget  fruit and vegies:  Do not underestimate the value of fruit and vegies.  We eat more of these than anything else.  Bananas and apples can be very filling.  In fact, recent research shows that people who eat an apple before lunch actually consume less calories during lunch.  That is how filling an apple can be.  We love trying all of the fruits as they come out with the seasons, blueberries and raspberries in summer, apples and pears in the fall.  I often just leave a bowl of carrots on my kitchen bar - they seem to disappear amazingly fast.
• Cheese:   Again, assuming dairy is okay, cheese will probably also become a big part of your diet.  Frigo cheese chicks, blocks of cheese . . ..  As things progress try different flavors - my kids love gouda and sharp cheddar.
• Chips - Cheetos, Plain Lays, Tostitos.  Go to Frito Lay Gluten Free List
• Air popped popcorn:  Some of the microwave popcorn is gluten free but I get tired of having to check on it all of the time so we bought our own popper and we make our own popcorn.  Of course this is how we grew up.  You'd be surprised what a treat this is for kids of the microwave popcorn generation. 

• Hard boiled eggs
• Pudding:  Kozy Shack.   My kids like the chocolate but not the tapioca.

Drinks

• Nestle Hot Chocolate
• Juices that are 100 percent fruit juice

Desserts:

• Haagen-Dazs ice cream -Ice cream itself is gluten free but may contain products which are made from gluten so avoid ice cream sandwiches, cone products, cookie and ice cream flavours such as Oreo, and flavours which contain brownie pieces, cookie dough and cheese cake etc. 

GET EDUCATED

Now that you have at least a few things you can eat, you need to get educated.  Thankfully there are many gluten free resources.  The following are my favorites: 

Websites:

• www.csaceliacs.org
• www.celiac.com
• www.celiac.org

Books About Celiac Disease

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

  

• Celiac Disease: A Hidden Epidemic by Peter H.R. Green, M.D.

There are several great glulten free cook books, but I have found that most of my old favorite recipes are very easy to convert.  Additionally, there are so many great recipe sources on the internet that you could almost go without buying a gluten free cookbook.  When I am looking for a new recipe, I just do a search such as "Gluten free recipe for  -----"   

• Cooking Gluten-Free by Karen Robertson  Great section on desserts and good general tips on cooking gluten free. 

Magazines

• Living Without is a magazine for "people with allergies and food sensitivities. It discusses a variety of health-related issues, and provides support, encouragement, guidance and resources."  I read it for the first year, but have not since then.

• Living Gluten Free is my favorite magazine.  It is very informative and answers the questions that are currently on my mind.  Most recently were articles on how enriched gluten free food is, reading labels and whether the flavoring in yogurt contains gluten.

Organizations/Support Groups

• Celiac Disease Foundation - I also belong to this group which holds annual education conferences and sends out a very informative quarterly newsletter.
• R.O.C.K. - Raising Our Celiac Kids is a support group for families with celiac disease or gluten intolerance.  In the beginning, this group was a great a source of support, encouragement, love and advise.  It was also encouraging for my daugther to be around other kids that had the same diet restrictions.    Follow the link above to an article on the group with local state by state contacts.  If you cannot find the group through this link, just search for ROCK, celiac and the name of your state. 

Other Resources

• Celiac ListServ is an unmoderated discussion list for those with gluten-related intolerances.  The topics cover a range of issues from what to eat at Disney Land, recent scientifc research, recipes, where to find mail-order gluten free food.  I get it in the digest version so my email is not constantly overflowing.  I find it very helpful when there are changes to mainstream products.  Recently, Lays changed the ingredients on their BBQ chips which were a treat for us.  I found out about this change from the listserv.  This list is free to anyone with internet access.   
• Delphi Celiac Disease On-Line Support Group is another on-line support group for people with celiac disease.  This group also provides great information on the gluten free lifestyle as well as support. 
• Celiac Food SmartList  This was extremely invaluable to me when we first started out.  I was terribly nervous about reading labels and this list gave me the assurance I needed when shopping for  mainstream items.  The SmartList is software you download that contains verified gluten information on thousands of products.  I download the software to my computer at home and to my PDA that I take everywhere with me.   You can simply type in an item name like "ice cream" and it gives you a list of manufacturers and what they say about their products.  You can also search by individual manufacturers.  The list is not going to contain everything you need.  There are way too many products out their to expect that.  But it will give you a ton of information.

GET BACK IN THE KITCHEN

You have found enough food to eat that you will not starve for the moment and you have learned a lot of new information, now it is time to get back in the kitchen. 

Have you been wanting to reorganize your kitchen?

Get some new appliances? 

Now is the time.

Deciding How Far to Go

Eventually you are going to have to decide how far to go on the gluten free lifestyle change.  Most likely, similar to my family, only one or two of you are gluten free.  If you are reading this website, it may be just one child.  In our family, it is my oldest daughter who was initially diagnosed followed by my realization that I, at a minimum,  have a gluten intolerance.  If you have very small children, it may be easy to just cook gluten free for them.  I know some families with toddlers and preschool aged children who bake a gluten free pizza for the little ones and still order carry out for themselves. 

However, if you have older children (my daughter was nine when she was diagnosed) I recommend that the entire family try to eat gluten free, at least when the gluten intolerant child is around. 

First of all, no matter how good of a show the child puts on, it hurts when other people eat gluten around them!  My daughter's worst experiences have been when other students have brought donuts into the classroom and she has had to not only smell them but also watch her freinds eat them!!   It is hard enough for my celiac daughter to see her friends eat gluten, much less her own siblings.  IThey have to constantly eat different food out in the real world.  Their home should be a safe haven where they don't feel constantly deprived and where they can eat almost everything in the refrigerator and pantry. 

Second, it will be a bigger adjustment in the beginning for the entire family to go gluten free, but it will make things easier in the long run.  It will greatly diminish the cross-contamination issues in your kitchen.  Occasionally, my four and eight year olds who do not have celiac disease will eat gluten items.   Wheat products such as bread and cookies are just messy.  By the time I clean them up, then clean the crumbs up from the kitchen, it usually seems hardly worth that slice of bread.  Plus, I hardly have the energy to cook one meal every night, much less two.  That being said, we do have a designated gluten area and toaster in our house, and my non-celiacs take wheat bread sandwiches to school in their lunch boxes.   This is an easy compromise for me because the food is eaten out of the house and, most importantly, not in front of their celiac sibling.

Finally, even though my daughter was the only one diagnosed with celiac disease, I thought it was extremely important for me to experience what she was going through so I could be as supportive and helpful as possible.  I know this may seem extreme - but I can sympathize with her because I know what it is like to go to a party and not be able to eat everything.  I am also very motivated to cook great gluten free food because I know how it feels to see others eating pizza and to want some that is gluten free and just as good as my friends.   That same motivation keeps me constantly searching for new and better products.   As a side note, this is also how I figured out that I am gluten intolerant as well. 

I know that not everyone has the time and resources to go completely gluten free, but just try to go as far as you can.  Everyone will benefit from you efforts.   

Clean out the Cabinets

Sorting out Safe versus Unsafe Food

Now is the time to go  through the food items in your kitchen and sort out the gluten versus the gluten free items.  Arm yourself with as much information as you can and clean out your cabinets and refrigerator. Why not donate the gluten items to a local food shelter?

Read the labels:  Become familiar with safe and forbidden ingredients and then read all labels carefully.   If an unsafe item is clearly listed, then it is an easy decision.  If it is one of the items listed below as a possible hidden source of gluten, check with the manufacaturer.  I take my cell phone with me so I can call before I buy it.  This is also another reason that I love the Celiac Food SmartList mentioned above. 

By now you know that gluten is a protein found in wheat, rye and barley.  Oats are okay to eat, but can be contaminate with wheat gluten.    

Some, but not all, UNSAFE FOODS AND INGREDIENTS:

Here is a condensed list of some of the more common unsafe, gluten containing ingredients and food:

• bran
• couscous
• kamut
• malt
• matzo
• rye
• seitan
• semolina
• spelt
• wheat

Some, but not all,  SAFE FOODS:

• amaranth
• arrowroot
• beans
• buckwheat (make sure it is not combined with wheat flour)
• butter
• canola oil
• cheeses (except Roquefort)
• chickpeas
• corm
• flax
• maltodextrin (that is made in the USA - this does not apply to ingredients listed on medicines and vitamins)
• manioc
• meat (plain)
• polenta
• quinoa
• rice
• sesame
• tapioca
• vinegar (except malt)

Hidden sources of gluten:

In addition, if the ingredient label lists one of the following, you will want to call and double check.  They may or may not contain gluten:

• modified food starch
• hydrolyzed plant protein
• hydrolyzed vegetable protein
• mono- and diglycerides (probably okay in the US)
• artifical and natural flavorings
• fillers
• seasonings

For more complete lists, Scott Adams has a through list of unsafe food on his website.  List of Unsafe Food  Print this list and take it with you to the grocery store.   

For a similar list of SAFE gluten free items, go to List of Safe Food Print this list as well. 

All of the these lists of safe and unsafe items were somewhat overwhelming in the beginning which is why I adopted the philosophy that simpler is better.  Thus if something has more than five ingredients and is not clearly labeled, I will not buy it.  I would rather go without than spend all the time it is going to take to find out if it is gluten free.  I have also found that in most instances it is quicker and easier to make it myself and find reassurance in knowing what all of the ingredients are and where they came from. 

Initially,it is going to take a lot of time as you figure out what kind of ketchup, sryups, jellies etc. are okay.  The good news is that once you get your list of main ingredients your family eats regularly, things get much easier.  I can now go to the grocery store and know what is safe to buy.  Nevertheless, every time I buy something, I read the ingredients label and check the front of the package to make sure the item has not  been changed (i.e., "new and improved" is a signal to check the ingredients again with the manufacturer).  This is also why I like the Celiac Food Smart List.   Ingredients changes by mainstream manufacturers show up on these lists relatively quickly.

Whenever I want to cook something new, I do research at home to check for new ingredients I might need.  This always takes a little extra time but saves me from buying food that I cannot use.

To get started and for some more ideas on safe food, go to www.glutenfreemom.com to find our favorite GF pasta, pizza crusts, cookies and tips on where to shop and mail order food.

Sorting Out Your Kitchen

Because of contamination issues, clean anything out of your kitchen that could have the residue of gluten on it.  The main items you are going to have to clean out of your kitchen and replace with designated gluten free items are your cutting boards, strainers, wood spoons, toaster and any other porous items.  Don't cut your celiac's fruit on a cutting board that has been used to cut bread.  We also replaced the grill on our BBQ.  Alot of marinades contain soy sauce which is made with wheat.  I bought all new cookie sheets.  It may not have been necessary (a good scrubbing can probably get any former gluten residue off) but I was a little too paranoid to use my old cookie sheets for my now gluten free cookies.  Again whether you go all of the way and adopt the gluten free diet in its entirety is up to you.  But if you do not, you will want to clearly label not only all food but all gluten containing appliances. 

We have a dedicated gluten area in our pantry where we put our "wheat" toaster and bread.  You may not have this option, but I like to keep the crumbs out of the main kitchen area. We also have a dedicated shelf  in our pantry and refrigerator that are clearly labeled as the "gluten areas."  Someday you will get out of the house again.  You want these areas to be clearly labeled and for your babysitters to know that any food in these areas is off limits when you are gone.  Yes, I am paranoid but I have seen too many family members and babysitters confess that they understand the cross-contamination issue then dip a knife with wheat crumbs on it in our gluten free butter.  Eliminate the concern by elminating this option when you are not around to monitor. 

Other sources of gluten to be on the lookout for

Do not forget to check out other sources of gluten that you may be ingesting.  Anything that you can ingest through your mouth can be a source of gluten.  This applies to, but is not limited to, medicine, vitamins, chap stick, lip stick, Play Doh, toothpaste.  Even bug spray and sunscreen can have gluten in it.