Newly diagnosed – then you will referred to a dietitian to help you will your transition to gluten free. From experience, I would like to offer a few words of advice for dietitians consulting with those new to coeliac disease.
To the Dietitian supporting a newly diagnosed Coeliac disease sufferer…..
- Know a little about your client and be prepared – the dietitian we visited bumbled his way through his notes mumbling that he wasn’t quite sure the condition my son was referred to him for but as he was a teenager and was referred to by a gastroenterologist then it was most likely one of two conditions. The fact that he knew my son was a teenager and the specialist who referred him meant that he did in fact receive the referral and should have been prepared but ….
- Remember that one size does not fit all– have age specific literature at hand – our dietitian showed us a pamphlet, said he only had one copy and would post a copy in the mail. The pamphlet we received was actually targeted for those aged 6 – 10 year old and was not the one we had been shown. My son was 15 years old. Be mindful that a client with coeliac disease is different to a client who is going ‘gluten free’ for other reasons. Be mindful that an 80 year old eats and cooks differently to a 20 year old uni student. Be mindful that emotionally a 55 year old will deal with a diagnosis differently to a 10 year old.
- Acknowledge that you have two clients in your room – the parent and the child. Both have specific and very different needs. Address the primary client – the person with coeliac disease. Our experience saw my son largely ignored with little attempt to engage him in conversation or ask questions of him. My son felt alienated as was clear by his body language as he pulled the hoodie of his jacket over his head and slumped down into the chair. A friend had the dietitian eye her other child and launch into the urgent need for him to also be screened. In an instant my friend had two insecure children and she felt even more overwhelmed than she did before her visit.
- Acknowledge that in the short to medium term the journey is difficult and confronting and time consuming – Never say “but there are some many products you can buy these days that are gluten free” or “a gluten free is relatively easy to adjust to if you make a few little changes” or ‘there is a whole aisle of gluten free products in the supermarket”.
- Speak from Experience – purchase a range of gluten free products and taste test them. Have a staff taste test. Have a family taste test. Experience for yourself how disgusting ‘Aussie Mite’ tastes or maybe have one of your own children taste test for you and get their honest feed back. Try some of the gluten free biscuits and experience how different the texture and taste is. Try a sandwich using gluten free bread to see how well it handles. Have a go at baking gluten free bread and experience how different the texture is. And please please don’t suggest to a teenager gluten free weetbix – taste it and see what I mean.
- Be Realistic – Is it really realistic to send a teenager off to school with a can of baked beans and a fork and expect them to sit with their friends on the school oval and eat cold baked beans for lunch? This suggestion we were given was wrong on so many levels and certainly did not take into account how different the teenager with coeliac disease is already feeling and at a time when teenagers don’t want to be conspicuous, the dietitian was suggesting the teenager make themselves even more conspicuous. This suggestion was not one of transition and small changes but a total shift from what used to be “normal”. It was like telling someone they need to fly to the moon to get a cup of water.
- Support the guidelines of Coeliac Queensland – A friend told me that the dietitian said that it was okay to eat products with the statement ‘may contain gluten’. FYI – Coeliac Queensland’s statement is : ‘It is also important to avoid cross contamination by avoiding products with statements such as ‘may contain gluten’. More importantly, it is one thing as an adult with coeliac disease to ‘take risks’ but it is another thing for a parent of a child to encourage their child to ‘take risks’. As the parent, we have a duty of care to teach our children about the importance of their need to be ‘gluten free forever’. We have a duty of care to teach our children to take responsibility for their life long gluten free diet and therefore we should NEVER EVER encourage our children to take risks. We must teach them so much about their new gluten free lifestyle and ‘taking risks’ is certainly not one of those lessons. An adult coeliac who takes a risk can then honestly evaluate if they suffer from the possible contamination. A parent encouraging their child to take a risk cannot honestly evaluate the possible side effects of contamination. More importantly for a sufferer of coeliac disease who is asymptomatic then how can they judge whether their health is being compromised other than another round of blood tests and gastrostrophy.
- Don’t Give False Hope aka Don’t Give False Information – My friend told me that Allens Red Frogs were okay because the dietitian told her daughter that she could eat them. My response was that I was 99% sure Red Frogs contain wheat, because if they didn’t, then I would have a jar full of them at home. I also do acknowledge that over time companies do change recipes and that possibly this had happened with Red Frogs. However: Ingredients of Red Frogs: Glucose Syrup (Wheat or Corn), Cane Sugar, Thickener (1401 or 1420) (Wheat), Gelatine, Food Acid (Citric Acid), Flavour, Colours (120, 122). When one consults Coeliac Australia’s Ingredients List it identifies 1400-1450 (wheat): meaning that the thickener in Red Frogs contains gluten and is therefore a ‘no go’ item.
- Don’t Confuse – It is all well and good telling someone about Teff and Quinoa and Sorghum and Millet and Buckwheat as a way of communicating that there is a range of grain options out there that are gluten free, but when the newly diagnosed is struggling with restrictions and major changes to their lifestyle and diet, then they are not going to want to experiment with ‘new’ produce. One really needs to be a confident cook to branch out, especially in the beginning. Don’t say: if you like your porridge then you can cook quinoa porridge. This is not a substitute in any shape or form; it might be trendy, but it is most definitely not palatable.
- Set Your Client up for Success and Confidence – Additionally to the advice and guidelines and list you provide your client with, tap into another valuable resource: other coeliac disease sufferers or mothers of children with coeliac disease. It might be worthwhile contacting your local Coeliac Support group for some grass roots advice: easy and simple recipes, tried and tested handy hints, a list of realistic and acceptable lunch box suggestions, seeing if there are members with whom you could pair your client eg another mother of a teenager, another adult who has Type 1 diabetes and coeliac disease.
My son’s experience at his dietitian’s appointment will most likely mean that he will never again visit a dietitian. He felt alienated, he felt ignored and he realised that ‘the experts’ really don’t understand how frightening and confronting a diagnosis is. Unfortunately, this is not the outcome I wanted for my son. I wanted my son to be guided and supported and should in the future he need advice about his diet, then he would have no qualms about booking another appointment with a dietitian.
Please also take time to undertake a little self-evalutation and put yourself in the client’s shoes and walk around in them for a week or a day or for just a lunch and try to see their gluten free journey through their eyes.
A Mum of a teenager with coeliac disease
gluten free preparedness clarity REALISTIC
honesty PERCEPTIVENESS coeliac disease
We have a family favourite chickpea dish that connects us to our roots in Catalonia Spain: Cigrons. Unfortunately, our recipe has two complications: we prepare dried chickpeas by soaking overnight and then cook them in a pressure cooker and the recipe is difficult to commit in the written form. The quantities of olive oil, vinegar, bacon, garlic and salt and pepper all rely on taste and feel and sight and smell. Those who have shared house with me always reminisce about Cigrons and it is one of those meals that is prepared for when all the family is home.
You can however make chickpeas your way or try one of the recipes below. Canned chickpeas doesn’t have to only be used for Hummus.
Sherry-Glazed Chorizo and Chickpeas
2 teaspoons olive oil
125 g dried chorizo, sliced
1/3 cup dry sherry* for extra depth of flavour use a Sherry Vinegar
400 g can chickpeas, drained and rinsed
Chopped flat leaf parsley to serve
Heat oil in fry pan over medium to high heat.
Add chorizo and cook, turning for 3 – 4 minutes or until crisp.
Add ¼ cup sherry, then cook, stirring occasionally for 3 minutes or until chorizo is glazed and the liquid has evaporated.
Add chickpeas and remaining 1 tablespoon sherry then cook stirring occasionally, for a further 5 minutes or until chickpeas are warmed through.
Sprinkle with parsley and serve.
600 g chicken thighs, chopped
2 tablespoons olive oil
2 garlic cloves, crushed
1 teaspoon smoked paprika
1 teaspoon cumin
250 g chorizo, sliced
400 g can chick peas, rinsed and drained
1 tablespoon balsamic vinegar
1 tomato chopped
1 long red chilli, sliced
¼ cup chopped parsley
In a bowl, combine chicken, 1 tablespoon oil, garlic, paprika and cumin. Toss to coat.
Cover with plastic wrap and refrigerate for 30 minutes.
Heat 1 tablespoon oil in a frying pan over high heat. Cook chicken for 2 -3 minutes each side or until golden. Remove from pan.
Cook chorizo and chickpeas in same pan, stirring for 2 – 3 minutes or until golden.
Return chicken to pan with any juices.
Drizzle over balsamic and simmer, covered, for 5 minutes or until chicken is cooked and heated.
Stir through tomato, chilli and parsley
Louise’s Chickpeas in Spanish Sauce
2 cans drained chick peas
1 green capsicum
1 red capsicum
1 clove garlic
1 red chilli
1 tablespoon parsley
2 cans tomatoes
Chop the capsicums, chilli, onion and garlic.
Lightly fry in olive oil for a few minutes.
Add the parsley, tomatoes and chick peas. Season.
Cool on a low heat for about half an hour, stirring occasionally.
4 chorizo, sausages, thickly sliced
100 g jamon Serrano, diced
100 g salami, diced
100 g pancetta, diced
5 pink eschallots, quartered
5 garlic cloves, sliced
1 bunch of thyme, leaves only
2 x 400 g chickpeas, drained
500 ml chicken stock
1 bunch parsley, chopped
Heat a large saucepan. Add all the meats. Cook stirring occasionally, over a medium heat for about 10 minutes or until lightly browned and fat in the meat has started to break down.
Add eschallots, cook stirring occasionally until soft (5 minutes). Add garlic and thyme. Cook for a further 2 minutes.
Stir in chickpeas. Cook stirring occasionally for 5 minutes so chickpeas can absorb the flavours of meats and herbs.
Stir in stock. Bring to boil. Simmer for about 20 minutes until slightly thickened.
Garnish with parsley.
Like most gluten free shoppers, I shop around: Woolworths, IGA, Coles, organic shops depending upon what specific gluten free product I am looking for. Shopping at Woolworths yesterday, I picked up a copy of their April 2016 Fresh.
Well done to Woolworths for their Fresh April 2016 Free in-store magazine. Supporting Coeliac Awareness Week this edition of Fresh has a two page spread on gluten-free living highlighting gluten free products available in-store.
But the good news for gluten free-ers does not stop there. Not only does the magazine contain tagged gluten free recipes, there is also a number of other recipes that are either gluten free by ingredient or can be gluten free with a few quick substitutions.
If you are looking for inspiration, then pick up a copy of Fresh Issue 119 April 16 to find these recipes mentioned below:
Banana Pancakes page 102
Chocolate Cake page 104
Gluten Free Hot Cross Buns page 89
Gluten Free by Ingredient
Asian-Style Mandarin Chicken page 10
Vegetable Tortilla page 14
Marinated Lamb Steaks with Roasted Vegetables page 19
Hash Brown Quiche page 28
Buckwheat Crepes with Poached Apple and Pear page 54
Baked Sweet Potatoes, Avocado and Feta page 62
Passionfruit Possetts page 72
Sticky Sesame Prawns with Zingy Rice Noodle Salad page 82
Sweet Potato, Quinoa and Avo Crunch Salad with Balsamic Beets and Broccolini page 82
Ham and Rockmelon Bites page 93
Ham Caprese Skewers page 93
Gluten Free with Substitutions
Fettuccine Alfredo with Mushrooms page 16
Smashed Avocado & Feta page 34
Brunch Salad page 54
Classic Minestrone page 57
Mexican Chicken Chilli page 58
Prawn and Zucchini Spaghetti page 58
Broad Bean, Fennel, Chilli and lemon Risotto with Prawns page 61
Sicilian Meatballs Al Forno page 61
Papaya and Lime Cheesecake page 73
Rosemary and Garlic Lamb with Root Veg Mash page 84
Hot Cross Bun Toppers page 88
Laksa is a popular spicy noodle soup in the Peranakan cuisine, which is a combination of Chinese and Malay cuisine. Laksa consists of rice noodles or rice vermicelli with chicken, prawn or fish, served in spicy soup; either based on rich and spicy curry coconut milk, or based on sour asam (tamarind or gelugur). (wikipedia)
Fragrant. Fresh. Flexible.
While my son preferred his Laksa on a bed of rice and without the snap peas this is an easy and versatile recipe.
500 g chicken sliced into strips (or use leftover roast chicken and add with coconut cream and chicken stock)
3 cloves garlic, finely sliced
2 cm piece ginger, peeled and grated
2 cups chicken stock (gluten free)
1 tin coconut cream (or lite coconut cream)
Pad Thai Rice Noodles
2 tablespoons Laksa paste (or use ‘Always Fresh’ Chilli Jam)
1 tablespoon Fish Sauce
* snow peas or snap peas (or capsicum strips or vegetable of choice for colour and texture)
1 lime, juiced
coriander to serve
red chilli, finely sliced to serve
* fresh bean sprouts (for texture)
- Fry chicken with oil in a heated fry pan. Add the garlic and ginger and cook for a further 2-3 minutes.
- Add laska paste and fish sauce and stir.
- Add coconut cream and chicken stock, stir and simmer for 10 minutes.* Add snow peas or snap peas in the last 3 – 5 minutes.
- Add lime juice and heat through.
- Prepare noodles by soaking in hot water for 5 – 10 minutes. Drain noodles and place in bottom of bowls.
- Pour chicken laksa over the noodles.
- Garnish with sprigs of coriander and red chilli slices.* Add fresh bean sprouts.
Another Mexican favourite for our household.
Beef and Marinade
700 g tender beef steak (rump or sirloin) cut into strips
½ lime, juiced
1 – 2 tablespoons olive oil
Large pinch of chili powder
Large pinch of cumin ground
Large pinch of paprika
Olive oil for frying
1 – 2 avocados diced and tossed with juice from ½ lime
125 ml sour cream
Tomato Salsa (4 ripe tomatoes diced, 2 shallots sliced finely, 1 red chili finely diced, 3 tablespoons coriander chopped, salt and pepper to taste)
1. Combine steak strips, garlic, lime, chili powder, cumin, paprika, oil, salt and pepper and mix well. Cover and refrigerate for 30 minutes.
2. Assemble the tomato salsa.
3. Heat a little oil in a frying pan. Cook the beef mixture in batches and stir fry over high heat until browned and just cooked through.
4. Serve with heated tortillas, salsa, avocado and sour cream.
A gluten free diet for a child or teenager of coeliac disease requires a team effort.
Family members and friends become an important support network to minimise gluten contamination.
Siblings accept some changes to their own diet and also have to learn protocols regarding cross-contamination.
Parents source gluten free products and step outside their comfort zone to bake gluten free bread and make gluten free look appetising.
Grandparents scan magazines for new gluten free recipes and also learn to cook ‘gluten free’ for those special occasions.
Friends take on responsibility to make sure gluten free is on the menu at social events and functions.
Last week had my gf son, KJ and myself bond over a team effort to make Strawberry Jam. At this point, I will point out that I have never made jam myself. At KJ’s instigation, I purchased the ingredients.
Mum: Have you had a look at a few recipes for how to make Strawberry Jam?
KJ: No, but it can’t be that hard. (I hope she doesn’t take over like she normally does)
Mum: Well I printed three recipes that I think you should read first as they all different regarding ratio of sugar to strawberries. Do you want to use lemon juice, chia seeds, vanilla seeds as there are many variations on a theme?
KJ: How many strawberries do we have?
Mum: Well I think you should sterilize the jars first and I like this recipe but you have to let the strawberries and sugar sit for 1 – 2 hours. And don’t wash the strawberries, I am sure I read somewhere that the excess water will make the strawberries too soft.
KJ: Any chance of you doing the jars and I’m not waiting 2 hours before I can cook the jam. (Weighing, cutting and sterilising jars all at the same time)
Mum: Have you decided which recipe to use?
KJ: Simple… I’ll use the recipe on the (jam setting) sugar packet. I don’t know why you make things so complicated.
Mum: (Neither do I, but I always thought research was a good way to start if you wanted to succeed) Have you put two plates in the freezer yet?
Mum: Because it says here in MY recipe that you need cold plates to test if the jam is ready.
KJ: Yep, this is looking good and EASY. (I told her so)
……continued banter regarding colour, what a rolling boil is, how long to boil for, if the sample was set etc…
KJ: What other kinds of jam can we make? What goes in a marmalade? What about mango chutney? Grandad used to make mango chutney.
Mum: (I wish KJ was more careful when he poured the jam into the jars and cleaned up the spills) What great colour! (Maybe this time I can entice KJ to have a photo taken for my blog) You do know that I am already drafting a blog in my mind while we have been doing this!
KJ: Do you think Grandad would like a jar of jam?
Team Work : Success Guaranteed
Life is good and life without gluten is… the new normal .
In the beginning, and every coeliac disease sufferer can tell you at least the month and year of the beginning of their gluten free life, the transition to a gluten free diet is chaotic.
There is no one easy one-size fits all collection of recipes.
There are no guidelines to warn you about how the transition will affect you emotionally, socially and mentally.
There is no simple list of packaged gf products that the individual will ‘like’.
There is no longer the luxury of only shopping at one supermarket.
It is said that “time is a great healer” and this is certainly true for coeliac disease sufferers.
Time does heal your body because gluten free food is your medicine.
Time does heal your soul as you centre your life around this major life changing shift.
And in time, you master your gluten free life and you find that your life is not defined by coeliac disease.
What have I learnt!
It is three years since by teenage son was diagnosed with coeliac disease and two years since I launched my blog so what has the last three years taught me as a gluten free cook.
1. Be creative
2. Be resourceful
3. Experiment with colour and texture
4. Make food interesting and enticing and colourful
5. Insist on honesty when trying new food and as a blogger write with integrity and always acknowledge the owners and sources of recipes you use
I clearly remember our first gluten free cookbook with unappetising photos of food all in shades of beige, off white, light brown and white. I thought, how am I going to sell gluten free food if it all looks so boring and colourless.
I clearly remember the unpleasant smell of our first store bought gluten free meat pies. I tried to lie my way through how tasty the pie was, but this lasted less than 2 minutes. From that point forward if my son rejected food on taste, look, texture or smell, then I listened and acknowledged his need to take control of his gf food preferences.
And I clearly remember the emotional roller coaster ride of those first 18 months to 2 years.
I have learnt that community is integral to a coeliac disease sufferer. Family, friends, teachers, doctors, bloggers, cookbook writers…
I am grateful to the many people who support my son and his gluten free diet and those friends, family members and bloggers who continue to provide me with new gf recipes to try.
Life is good and life without gluten is… the new normal .
If you are looking for inspiration for the 500 g mince you have on hand, then give this recipe a try.
2 tablespoons vegetable oil
2 garlic cloves, finely chopped
3 shallots, finely chopped
2.5 cm ginger finely grated
500 g pork mince
1 tablespoon fish sauce
2 tablespoons gf soy sauce
1 tablespoon Thai red curry paste
1 tablespoon kaffir lime leaves
10 cherry tomaotes diced
2 tablespoons coriander chopped
Salt and pepper
- Heat the oil in a large frying pan over medium heat. Add the garlic, shallots and ginger and stir fry for 2 minutes.
- Stir in the pork and continue stir frying until golden brown.
- Add in the fish sauce, soy sauce, curry paste and lime leaves and stir fry for a further 2 minutes on high heat.
- Add the chopped tomatoes and cook for a further 5 minutes, stirring occasionally.
- Stir in coriander and salt and pepper to taste.
- Serve on a bed of rice vermicelli noodles or serve in a lettuce cup.
Tomorrow is 100 years since the Australian and New Zealand armed forces landed at Gallipoli. As part of the commemoration is an amazing display of hand crafted poppies in Federation Square in Melbourne. What started out as a call for 5 000 poppies to be made is now a field of 250 000 poppies.
Lest we forget.
ANZAC Biscuits and Slices…an ongoing tradition…
Oats are traditional to an Anzac biscuit recipe, but I substituted quinoa flakes in this recipe and the result was still delicious. Flaked almonds is another substitute.
1 cup GF self raising flour, sifted
130 g melted unsalted butter
1/2 cup desiccated coconut
1/2 cup brown sugar
1/2 cup quinoa flakes
30 g melted unsalted butter
1 cup shredded coconut
1/3 cup golden syrup
1 can (380 g) caramel filling
Preheat oven to 180 degrees C.
Place the flour and desiccated coconut, sugar and 120 g butter in a bowl and stir until the mixture resembles coarse breadcrumbs.
Using the back of a spoon, press the mixture into the base of a 20 cm x 30 cm tin lined with baking paper.
Bake for 20 – 25 minutes or until golden.
Allow to cool for 10 minutes.
Place the shredded coconut, quinoa flakes, golden syrup and 30 g butter in a bowl and mix to combine.
Spread the caramel over the cooled base and spoon over the cococunt and flakes topping.
Bake for a further 20 – 25 minutes or until golden.
Allow to cool completely before cutting into squares.