Leading a gluten-free life is getting easier
When Megan Pine was born, she weighed just over 7 pounds.
When she was a year old, she weighed 9 pounds.
Megan's weight was healthy until about a year into her life, when she started shedding pounds at an alarming rate. Her doctors suspected a food allergy, and her mother, Linda Wagner-Pine, documented everything she ate.
As Megan continued to deteriorate without a diagnosis, one doctor made a terrifying prediction: If the problem wasn't pinpointed in four days, Megan could be dead.
"It was the hardest thing in the world to hear," says Wagner-Pine of McCandless.
A team of nine doctors devoted themselves to Megan's condition. Finally, they found she had celiac disease, defined by the National Institutes of Health as a digestive condition that damages the small intestine and interferes with absorption of nutrients from food.
People who have celiac disease cannot tolerate gluten, a protein found in wheat, rye and barley. Symptoms can include abdominal bloating and pain, chronic diarrhea, vomiting and weight loss.
More than 2 million people in the United States have the disease, or about 1 in 133, according to the National Institutes of Health. As more Americans are diagnosed with celiac disease, Mark Dinga, a dietician at UPMC Presbyterian, Pittsburgh, says he's seeing an increased awareness of the condition.
A decade ago, finding food that is safe for people with celiac disease required a trip to a specialty store, and eating out often was a gamble. Today, mass-market food producers, including General Mills, sell gluten-free products, like Betty Crocker cake mix and Chex cereal, at local grocery stores. Restaurants have become involved, as well, offering designated celiac menus and gluten-free versions of their meals.
Dinga, who has celiac, says he has seen varied reactions from the newly diagnosed when they learn staples like white flour will be off-limits.
"Some people say, 'Personally, I'm relieved,' " Dinga says. "It's like a ton of bricks off their shoulders. Now they know why they were sick all those years. For others, it's the fear of the unknown. It's, 'What do I do next• What am I going to eat?'
"The diet is the pill. If you don't get the diet right, you won't get better."
For two weeks after her diagnosis, Megan, now 7, lived on scrambled eggs and fresh fruits and vegetables while her parents learned about her condition. Through the Greater Pittsburgh Celiac Support Group, they were referred to Dinga, who helped them modify Megan's diet.
When the dietician asked Megan's parents whether either of them had celiac disease, which can be passed down genetically, they said no. But testing showed both Linda and husband John, had it.
"To this day, (Dinga) is my savior," Wagner-Pine says.
After their diagnoses, the Pine family, which also includes daughter Marie, 9, who does not have celiac disease, spent a lot of time and money trying to find food that is right for them.
Elizabeth Gordon knows the feeling.
When Gordon, author of this year's "Allergy-Free Desserts" (Wiley, $22.95), first was diagnosed with celiac disease, she thought she would have to "give up taste and was doomed to eat food that didn't look very visually appealing." She thought she'd have to settle for food that looked "brown and goopy" and was "dry and chalky."
Her options were simple: Cry into an empty cookie jar or get baking.
The trick, she realized, was to find the right mixture of safe flours, including garbanzo bean and tapioca, to give her baking the desired texture. Her experimenting with baking led to some of her favorite recipes, all of which are in her book -- pineapple upside-down cake, red velvet cake, crispy rice squares and her ultimate favorite: cinnamon buns.
"I've burned my mouth so many times because I can't wait to taste them," she says.
Carol Fenster, author of seven cookbooks including "1,000 Gluten-free Recipes" (Wiley, $35), is the daughter of a farmer who grew wheat. She also married into a wheat-farming family. So when, at age 42 in 1988, she was diagnosed with a gluten intolerance -- which is different from celiac disease and involves more delayed, subtle reactions -- she kept it a secret for five years.
"Nobody wanted to hear about it," she says. "I had major leading allergy doctors tell me it was all in my head. It was very hard."
Fenster, who always had liked to cook, returned to the kitchen and got started adapting her longtime recipes.
"You have to give up so much when you become gluten-free, you hate to give up your style of cooking, too," she says.
At first, Fenster says, gluten-free cooking can be a challenge.
"The first question is: Where do I find it• If you've never been to a health-food store, it can be a little intimidating. Then it's like, 'What is xanthan gum?' " she says, referring to an ingredient commonly used to make baked goods rise in the absence of gluten.
"Once you get past the notion you have to make the change, you see it is, in a way, a healthier lifestyle if you choose the right foods."
While people avoiding gluten can find ways to re-create their favorite meals, one of the most commonly craved foods post-diagnosis is pizza. Based on what's happening in the local restaurant scene, there is relief at hand.
Little E's Pizzeria in Greensburg started offering gluten-free pizza crusts shortly after opening in November. Owner Kevin Ereditario's sister-in-law has celiac disease.
"It's been taking off," he says. "You find out after you start providing something like this for how many people this is a huge part of their diet. When you talk to people about how much they're really appreciative of it, you feel good."
Because of the pizza's popularity, Ereditario included gluten-free hoagie buns on his menu recently and hopes to soon add gluten-free pasta. While he says the effort is worth it, gluten-free products cost Ereditario about eight times more than his usual crusts, he says.
"There are some places that do offer a gluten-free product but don't provide it in the way it should be provided," he says, referring to cross-contamination. At Little E's, before the gluten-free crust is taken out of the freezer, Ereditario says the cook must wash his or her hands and put on latex gloves. The pie has its own separate area, and the paddles used to take it out of the oven touch only gluten-free crusts.
Steve Negri, owner of Mandy's Pizza in West View, also knows the importance of avoiding cross-contamination. He started offering gluten-free pizza crusts after his son, Brandon, 8, developed a wheat allergy. Negri and his wife, Veronica, make sure all the necessary precautions are taken -- they even have a dedicated machine used only for making the crusts.
While Negri wasn't initially sure the effort would be worth it, he now sells about 150 gluten-free pies a week.
"I get more satisfaction out of seeing people come down who haven't had pizza in 10 years," he says.
Jon Liss, general counsel and corporate chef with the Original Pancake House with locations in Scott and Ross, knows his company can't avoid risk of cross-contamination, but still wanted to give those with wheat sensitivities the option of eating at his restaurant. The eatery began offering gluten-free versions of most of its pancakes two years ago.
About half of the company's 112 franchises offer the gluten-free options.
"Some people know there's a risk or that cross-contamination exists, but they thank us for helping those who this will help," Liss says.
While he urges caution, dietician Mark Dinga sees restaurants offering alternatives as a positive step.
"It's promising from the standpoint that we can feel normal -- they are trying and working on this and offering alternatives," says says. However, he stresses the importance of communication when ordering a gluten-free meal.
"You have to start looking the waiter in the eye and telling him this is very important. Make sure they're taking this seriously."
He also suggests talking to a manager and even the chef, if possible.
"But the bottom line is: When they step away, it's a trust factor. At the same time, you can't live in a bubble. But don't take it nonchalantly."
Other gluten-free options in the Pittsburgh area:
• Uno Chicago Grill. in addition to dedicating a section of its menu to pointing out gluten-free options, offers gluten-free pizza in pepperoni, cheese and vegetable. Chris Gatto, vice president of food and beverages for the Boston-based company, says the response has been great. "It's our No. 1 gluten-free item," he says.
• The Sunset Cafe, 302 S. Urania Ave., Greensburg, offers a gluten-free menu with selections including salads, fish, chicken, steak and desserts.
• Bella Frutteto, 2602 Brandt School Road, Wexford, has gluten-free appetizers, salads, pasta, steak, chicken and fish dishes.
• Eat N'Park offers a designated celiac menu, as well as gluten-free hamburger buns.
• StonePeppers Grill, 1614 Washington Road, Upper St. Clair, and Adams Shoppes on Route 228 in Mars, has gluten-free options including steak, pasta, salads and desserts.
• P.F. Chang's, The Waterfront, Homestead, offers a 17-item gluten-free menu with selections including Moo Goo Gai Pan and Singapore Street Noodles.
• The Outback and Mitchell's Fish Market also offer gluten-free menus.
This recipe is from Elizabeth Gordon's "Allergy-Free Desserts" (Wiley, $22.95).
• 3 tablespoons water
• 1 tablespoon ground flaxseed meal
• 1 1/4 cups Bob's Red Mill Gluten Free All-Purpose Baking Flour
• 1 teaspoon baking powder
• 1/2 teaspoon salt
• 1/2 teaspoon xanthan gum
• 1/2 cup organic palm fruit oil shortening
• 1/2 cup granulated sugar, plus extra for pressing down cookies
• 1/2 cup packed light brown sugar
• 1/2 cup sunflower seed butter
• 1/2 teaspoon vanilla extract
Heat the oven to 375 degrees and line two baking sheets with parchment paper.
In a cup or small bowl, combine the water and flaxseed meal and allow to thicken for 3 to 5 minutes. In a large bowl, whisk together the flour, baking powder, salt and xanthan gum.
In the bowl of a stand mixer, cream together the shortening, sugars and sunflower seed butter. Scrape down the sides of the bowl, then beat in the flaxseed mixture and the vanilla. Scrape down the sides of the bowl again. Stir in the dry ingredients until thoroughly combined.
Using a small ice cream scoop, drop the dough 2 inches apart onto the prepared sheets. Press the cookies down with the tines of a fork (dipped in sugar) in the crisscross pattern characteristic of peanut butter cookies.
Bake the cookies for 10 to 12 minutes or until the edges are golden and the tops no longer look wet. Transfer the baking sheets from the oven to cooling racks and cool for 10 minutes, then transfer the cookies directly onto the racks to cool completely. Store the cookies in an airtight container at room temperature for as long as 5 days, or freeze for as long as 3 months.
Makes about 20 small cookies.