This article first appeared in the St. Louis Beacon, March 4, 2009 - Claire Berman is a self-described "foodie." The 25-year-old constantly conjures up new recipes in the kitchen of her University City apartment. Berman's recipes span the exotic to the ordinary but they all have one thing in common: They are all gluten-free.
Celiac Facts
- One in 133 Americans have celiac disease.
- Seven percent of celiacs are undiagnosed or misdiagnosed with other conditions.
- Celiac disease can lead to infertility, neurological disorders and cancer.
- There is no pharmaceutical cure for celiac disease.
Berman has celiac disease; and eating food with gluten, a protein found in grains and wheat, makes her sick. Celiac disease is a hereditary digestive disorder that the National Institutes of Health estimates affects 2 million Americans.
People with celiac disease are intolerant to gluten, and a strict, gluten-free diet is the only treatment. Foods such as bread, salad dressing, sausage and even beer are off limits to people with celiac.
Experts say that most people with celiac disease experience symptoms but are never diagnosed. If left undiagnosed and untreated, celiac disease can lead to serious health problems such as malnutrition, osteoporosis, neurological disorders and even cancer.
Celiac disease affects people of all ages and races.
When people with celiac disease eat a food containing gluten, their immune systems mount a reaction that causes an inflammation of the small intestines.
The inflammation destroys the millions of tiny, finger-like villi that line the small intestines and over time damages the gastrointestinal tract, says Dr. Brent Tetri, a professor of internal medicine at Saint Louis University.
Diagnosing celiac disease is difficult because the symptoms can be mild and are often blamed on other disorders, such as irritable bowel syndrome, according to Dr. Leonard Weinstock, a gastroenterologist and associate professor at the Washington University School of Medicine. On the other hand, he said, "some people have virtually no symptoms."
The National Foundation for Celiac Awareness lists 18 common symptoms of celiac, including such things abdominal pain, rashes, depression, diarrhea and migraines.
Although there are reliable tests that check for celiac disease, the road to diagnosis can be long and frustrating, often lasting five to 10 years, according to Dr. Tetri.
Claire Berman's diagnosis story is typical of many people with celiac disease. She experienced intense migraines, fatigue and digestion problems for years before being diagnosed.
"I knew something was wrong with me," she said, "but the doctors never tried to put it all together." She even worried that her symptoms were just in her head.
Eventually Berman turned to the Internet, a notoriously poor source of medical information, but after researching her symptoms she became convinced that she had celiac. A series of test eventually confirmed Berman's self-diagnosis.
"When I got diagnosed, it was a huge relief," she said. "There were many worse things that could have been wrong with me. Celiac is something controllable."
Berman has been gluten-free since her diagnosis in May 2008, and she says she feels great. "It's been wonderful," she said. "I feel so much better as each month passes by." Other positive outcomes have included feeling more energized, having fewer migraines and improved digestion.
Going gluten-free has even led to more creativity in the kitchen. "It's been very cool to discover new ways to cook. It opened up a lot of new food experiences," Berman said.
Finding gluten-free food can be a challenge but one that is getting easier as awareness of celiac spreads. The NFCA estimates that the gluten-free food sector will be a $1.3 billion industry by 2010, which means people with celiac will have more and better tasting food options than ever before.
Linda King is a training representative for the NFCA's GREAT Program, which works to educate restaurant staff about gluten issues. "I like to describe it as continuing education for chefs, like physicians get after they graduate," King said.
Among the restaurants King has worked with in the St. Louis area are The Pasta House, Cafe Napoli and Fitz's. The NFCA expects to have a comprehensive list of St. Louis restaurants that serve gluten-free dishes on its website soon, King said. There are also two gluten-free bakeries in the area: Andrea's Fine Foods in Chesterfield and Free Range Cookies in Ferguson.
If a person thinks he or she might have celiac, Dr. Tetri said the first thing that should be done is get tested. The most common method is a series of blood tests that measure the presence of certain antibodies that correspond to celiac. This is often followed by a biopsy of the small intestine to determine the extent of damage to the villi.
Dr. Tetri said there are still many questions about celiac disease that remain to be answered. For instance, researchers are looking at ways to desensitize the immune system so it doesn't have a reaction when exposed to gluten. Unfortunately, Dr. Tetri said, any such discovery is likely 10 years or longer away, but "I anticipate we will get there eventually."
Gluten-free doesn't have to be flavor-free. Check out this recipe from Claire Berman's blog The Food Outcast, foodoutcast.blogspot.com.
Vegan Creamy Pasta con Broccoli
by Claire Berman
1 1/2 cups brown rice pasta shells
2 cups chopped broccoli florets
1 1/2 tbsp. Earth Balance Natural Buttery Spread
1 1/2 tsp. minced garlic
1 1/4 cups mushrooms, chopped
1/2 cup Tofutti "Better than Cream Cheese" (available at Trader Joe's or Whole Foods)
1/4 cup rice milk (or plain soy, almond or hemp milk)
1/2 - 1 cup gluten-free tomato sauce, to taste (I used Trader Joe's Organic Tomato Basil Marinara)
1 - 1 1/2 tbsp. Vegan Grated Topping (Parmesan flavor), to taste
1/4 - 3/4 tsp. garlic salt, to taste
Pepper to taste
Cook the pasta al dente as directed (I boiled mine for about 9 minutes). Drain, rinse with cold water, remove from heat, and cover.
While the pasta is cooking, boil another pot of water and add the broccoli florets to the pot. Bring to a boil again, and cook for 4 minutes until it is lightly crunchy. Drain, remove from heat, and cover to retain heat.
In a large saute pan, melt the Earth Balance Buttery Spread with the minced garlic, then add the chopped mushrooms. Saute the mushrooms for 4-7 minutes, then add the cooked broccoli to the pan and stir into the mushrooms. Continue to saute for about 2 minutes longer. Add the 1/2 cup Tofutti, rice milk, and 1/2 cup of tomato sauce, and let it all melt together.
The sauce will appear a little strange at this point and it might look like the Tofutti is separating into unappetizing chunks, but give it a few more minutes and it will melt into a beautiful cream sauce. At this point, taste the sauce and if desired, add more tomato sauce by the spoonful until you reach your desired balance of flavors.
Sprinkle the pepper and garlic salt into the sauce (or if you would prefer less sodium, garlic powder). Again, test to your own taste. Then add the 1 - 1 1/2 tbsp. of Vegan Parmesan Grated Topping. I fiddled around with the taste quite a bit until I found the right balance for me, so feel free to do the same. Let the sauce simmer and thicken for about 5 more minutes until you are happy with the consistency. Add the sauce to the pasta and mix together. Serve immediately, sprinkled with more Parmesan if desired. Makes 2-3 servings.
Resources
Bi-State Celiac Support Group is an organization that offers information and networking opportunities for people with celiac in the St. Louis area: www.bscsg.org
National Foundation for Celiac Awareness is a national organization dedicated to finding a cure for celiac disease: www.celiaccentral.org
Jim Reilly is a writer and editor specializing in health, science and environmental issues.