Gluten-Free in the 21st Century

(This excerpt is taken from a book on gluten-free living I've been working on recently. Check back for more follow-ups, including "How to Stock a Gluten-Free Pantry")

More than two million people in the U.S. have been diagnosed with Celiac Disease (Celiac Sprue) or Gluten Intolerance (gluten-sensitive enteropathy). Celiac Disease is a life-long, immune-mediated disease of the small intestine that is caused by eating gluten. Gluten is a composite of the proteins gliadin and glutenin. These exist, conjoined with starch, in the endosperms of some grass-related grains, notably wheat, rye and barley. Gliadin and glutenin comprise about 80% of the protein contained in the wheat seed.

When a person with Celiac ingests glutens the proteins found within them damage the tiny villi that line the small intestine, causing them to essentially lie flat along the intestinal wall. These villi perform the necessary function of picking up the various food molecules passing through the small intestine, but in order to do this they must be active and standing at attention, so to speak. Once damaged, these villi can no longer perform this function and only the most easily digestible molecules, glucose and fat, are absorbed. Often patients with Celiac Sprue are underweight and malnourished, but because their small intestines are still able to absorb glucose and fat molecules, it is not uncommon for a Celiac patient to be both overweight AND malnourished!

According to the University of Chicago Celiac Disease Center…”recent prevalence studies have shown that Celiac [Disease ]is much more common than previously believed, affecting one in 120 to 300 people in Europe and North America. A recent large epidemiologic study in the U.S. found that the overall prevalence of Celiac [Disease] is one in 133.” Though this number could be much higher since so many U.S. citizens are descended from European haplogroups in which the incidence is significantly higher. However, for every American diagnosed with Celiac Disease another four are currently undiagnosed or misdiagnosed.

Some symptoms of Celiac Disease are:

Abdominal cramping/bloating		Feet (Reduced fat padding)
Abdominal distention		Flatus (Passing gas)
Acidosis		Gluten ataxia
Appetite (Increased to the point of craving)		Mouth sores or cracks in the corners
Back pain (Such as a result of collapsed lumbar vertebrae)		Muscle cramping (Especially in the hands and legs)
Constipation		Night blindness
Decreased ability to clot blood		Skin (Very dry)
Dehydration		Stools (anything inconsistent could be a symptom)
Diarrhea (See Stools below)		Tongue (Smooth or geographic - looks like different continents)
Edema		Tooth enamel defects
Electrolyte depletion		Weakness/ Fatigue
Energy loss		Weight loss

There are currently two methods of diagnosing Celiac Disease, blood tests and intestinal biopsies. To diagnose celiac disease, doctors will test blood for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). Before testing it is important to eat a normal, gluten-containing meal otherwise the results may be a false negative. If the result is negative and Celiac is still suspected, the next step is to have an internal biopsy of the small intestine. During the endoscopy the doctor will remove tiny pieces of tissue from the small intestine to check for damage to the villi. This test is about as accurate as one can get, but depending on exactly where the damage may be located and where the endoscope finds and takes a sample, it is still possible, though much more rare, to receive a false negative. If this occurs and the patient still strongly believes that he/she has Celiac Sprue, the surest test is to simply avoid all glutens for a minimum of 30 days and simply see how they feel.

The current treatment for Celiac Disease is a strict adherence to a gluten-free diet…permanently. In many ways this is a blessing, as there is no need for regular medications, though there is ongoing research into the effectiveness of certain supplemental enzymes. And while this may sound like a simple enough task, adhering to a gluten-free diet requires a complete paradigm shift in how one perceives food. It’s not enough to simply read labels or make a list of foods to avoid, or just substitute non-gluten forming foods in your favorite recipes.

In addition to avoiding all gluten containing foods, it is also necessary to try to avoid all gluten containing non-food products. And believe it or not, there are many! It is impossible to list ALL of the products that may have hidden glutens, but some of the more common are the adhesive on both lick-able stamps and envelopes as well as some self-sticking stamps, stickers and envelopes. The dusting powder used to line latex or rubber gloves are often made from wheat. Glutens can hide in some shampoos, hair dyes, lip balms, soaps, lotions, etc. They may also be found in art supplies, play-dough and glues. Unfortunately, one insidious place glutens hideis in medications and supplements, both over-the-counter and prescription!

Fortunately, now that Celiac Disease and gluten sensitivities are becoming more well known, many manufacturers are getting much more diligent about labeling their products “gluten-free” and “wheat-free”. For a more detailed list of foods, ingredients and products to avoid please refer to www.celiac.com.

Fondue for the Holidays!

Fondue for the Holidays!

What a great Fondue cooking class we had last night!

We delved into a little of the history of fondue first. The cheese variety hails from Switzerland but the beef variety actually hails from France. In fact, there is some version of fondue- or food cooked in hot liquid right at the table- in almost every culture. However, the story behind Swiss fondue goes a little something like this:

Switzerland, being rather cold and blanketed in snow for most for the year, doesn't have the most conducive growing season for year round fresh veggies and fruit. Therefor, the Swiss had to rely on whatever happened to still be in the larder or whatever they could still make in the winter...and cheese and bread didn't require soil or sunlight, so they became an obvious staple of the Swiss winter diet.

Melting the cheese made it more palatable and dipping the bread into it meant that they could use dry, older bread and save the fresh for breakfast. They also realized that the cheese, left on its own, would form small balls in their stomach's and the drinking of wine, as well as adding it to the cheese sauce itself, seemed to counteract this phenomenon. And if a little wine helps, then a lot more must be even better! This gave birth to fondue as almost a drinking game whereby the poor sod who loses his bread in the pot must buy everyone a round of drinks. Soon, Cherry Kirsch was added to the repertoire and now it too is added to the sauce just at the end. Of course, it wasn't fair to the men that only they were 'punished' for the food mishaps, so the punishment for females began as a tradition of kissing all of the males at the table. In America this is often abbreviated to include only the person sitting next to the female- which just so happens to usually be her husband or sweetie anyway. I prefer the more courageous Swiss version, myself!

We began the class by learning how to make sure the wine base for the fondue doesn't pull away from the Emmenthaler and Gruyere cheeses. Since we only had one male student, he was the very lucky recipient of ALL of the kisses bestowed by the poor gals who managed to accidentally drop a bit into the pot!

Then, we made Beef Bourguinon fondue with a Creamy, Curry Rouille sauce, a Bleu Cheese and Horseradish Sauce with fresh Chives, a Bearnaise Sauce with fresh Tarragon...and learned how to correct for the eggs separating from the lemon juice and wine which can happen if the acid base hasn't been neutralized with enough heat first. And lastly, we made a chocolate ganache with cherry kirsch and dipped our fresh fruit and pound cake in for a perfect ending to the meal.

Traditionally, fondue is served on New Year's Eve in Switzerland, where I actually had the opportunity to experience it in person many years ago in Interlaken. The meal itself can take several hours and by the end everyone is not only quite full, a bit tipsy but also on a much more intimate basis with everyone else. For me, food and affection make a perfect partnership so of course, Fondue is one of my all time favorite Holiday traditions!

Local Food x 1300!

Catering annual Bioneers Conference in Bozeman, MT

"We are indeed much more than what we eat, but what we eat can nevertheless help us to be much more than what we are."
-Adelle Davis

Food means many things to many people and sadly, in our culture, it often means grabbing whatever is quick and/or cheap and shoveling it into our mouths and down to our bellies without even a seconds worth of consideration. There are so many questions many of us simply don't take the time to ask about our food, and we can't answer what we fail to ask. I may not have all the answers, but I do know that cooking for someone is one the most intimate things we can do for each other. For me, every aspect of creating a beautiful meal is about love, passion and commitment. From the tiny grains of barley to the tender, heirloom lettuces and succulent meats there is an underlying theme of devotion.

Being able to share an actual connection with the source of our ingredients elevates our culinary experience to new heights. "New" is perhaps a bit misleading as we've only truly lost that connection in the last half century as a society. Preparing meals for the 2007 Bioneers Confernece here in Bozeman, Montana has been quite the eye-opening experience! When I first agreed to head up the catering team I was told that we wanted the ingredients to come from our immediate bio-region. "Yeah!” I thought. "This will be a fabulous challenge. Let's get started". Well, little did I realize at the time that in order to pull this off we would, in fact, have to "get started" right away. That was in early August.

You see, I realized that if I was going to prepare four separate meals using only local ingredients ... that fed 325 people each... over the course of three days... in late October...in Bozeman, Montana (!), well, I'd better get a move on NOW before the growing season is all but a distant memory.

So, the first ingredient ready for harvest was Basil. Twenty-five pounds of basil, to be precise. I spent the better half of a week stripping leaves from stems, soaking, spinning, drying and chopping basil. We found out a few weeks later that the local farmer's remaining crop of basil had been destroyed by that unexpected cold spell in early September. *eeek*

Basil has a lovely aroma, which is a good thing as there is still definite Eau du Basil permeating my kitchen 2 1/2 months later! And if I thought twenty-five pounds of basil was an olfactory challenge it was nothing compared to the next ingredient that was ready to harvest.

Garlic. A grand total of fifteen pounds of garlic needing to be peeled and packed, or peeled and chopped and packed or roasted, peeled and chopped and packed. I was unable to scare up any sort of human contact for about a week after prepping out so much garlic! My own children begged me NOT to tuck them in to bed at night for a good 5 days.

Then came the tomatoes…washing, coring and quartering then slow oven-roasting twenty-five pounds of tomatoes, which in the end only gave us about 4 gallons. *sigh*

Plums were next on our list. Fortunately I had friends, acquaintances and newly found comrades all begging me to take a few pounds of plums off their hands. Apparently the little buggers can create quite a mess if not picked when ripe-- early September. An accurate weight measurement would be difficult to gauge, but after washing, pitting, cooking, pureeing and putting through a hand cranked food mill, then a cheese cloth lined strainer, I ended up with about 18 quarts of plum juice. Not bad, eh?

Then it was time for the apples, which Lori, my co-chef-in-arms, hand picked herself! Four days later we had 24 quarts of washed, cored and sliced apples! Whew...we're on a roll now, I thought. I'd better hurry up and start the apple cider vinegar so I can then make the homemade mustard for the juniper infused, plum-mustard glaze we'd be using for the roasted pork loin dinner on Saturday night.

In any case, nearly every single *ingredient used in these meals came from our immediate Bio-region, and those ingredients that we couldn't find already prepared locally (like mustard and apple cider vinegar) were made by us prior to the conference. Because we've formed a connection to all this food, as well as the gardeners, farmers and ranchers that lovingly nourished the food we used, we now have a palpable bond formed with you, the diner.


*Salt and pepper came from outside of our bio-region, though mined salt is available through Bingham, Utah.

Chef Kryssa