The Rise of Celiac Disease

Celiac disease is an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats. Gastrointestinal symptoms include : abdominal pain, abdominal swelling, bloating, indigestion, nausea and vomiting, and a host of other symptoms. Other symptoms include: Anemia, bone and joint pain, bruising easily, depression, fatigue, hair loss,and the list goes on. This truly is a debilitating condition that seems to truly be on the rise. The condition is four times more common than it was 50 years ago, and only 5% of the people affected know they have it. It's estimated that 1% of the population suffers from celiac disease.

Where is the increase in this and other food allergies coming from? The Mayo Clinic did a study of blood samples from soldiers in the 1950's compared to those of soldiers taken today. They expected to find a comparable rate, but were surprised to find that it was extremely rare. The assumption is that something changed in the grain supply starting in the 1950's. I'm certainly not a scientist, but I do have an extensive background in chemistry and biology in addition to my culinary education. In the 1950's two scientists, Crick and Watson, discovered the structure of DNA molecules. I won't get into it to deeply, but suffice it to say these discoveries made genetic engineering possible.

When I was a kid, no one I knew had a food allergy but me. I was and still am allergic to milk. It's not life threatening and I can enjoy the occasional scoop of ice cream, but consume too much and it's not good. Does strange things to my metabolism among other things. Milk allergy is very common, relatively speaking, and is not a new phenomenon and is usually outgrown. So why today is there an epi pen behind every classroom door? Why is celiac disease seeing such an increase? I am by no means an alarmist. Genetic engineering has done wonders to increase the food supply especially to feed the starving in third world nations. It is one of those things, however, that makes you go Hmmm... Another possible factor sited could be environmental changes. This is all above my pay grade so I won't speculate further. On to the culinary options for celiac patients.

One excellent company for gluten free products is Bob's Red Mill http://www.bobsredmill.com/ I've worked with their products and heard good things about them from other chefs as well as celiacs.

We have been working with an addiction recovery firm for three years now. Part of thee program is a detox diet that eliminates anything from the diet that could cause an allergic reaction. In addition to providing gluten free meals, the diet eliminates beef, soy, corn, dairy, citrus, eggs, and sugar. As you would expect, this can be quite challenging for a chef! Two of the biggest thickening agents in a chef's arsenal are eliminated: flour and cornstarch. In the process of developing a menu, we stumbled upon quite a unique alternative in potato flakes. Yes, instant mashed potatoes! We're an upscale chef service using Classical French culinary techniques so this was a bit hard to swallow so to speak, but unique solutions were called for. One of the more popular dishes we prepare for them is a Country French Chicken dish. In the original dish, the chicken breast is dusted with flour and sauteed. The flour provides the thickening agent for the sauce. The dish thickens as it cooks and the stock reduces. In the dish for the special diet we actually thicken it by adding the potatoes at the end. To insure you don't wind up with chicken and mashed potatoes, add the potato flakes a bit at a time until the desired thickness is achieved. It's not Classical French, but definitely gets the job done! Another dish that we do that would normally require a gluten product for a binder is turkey meatballs. Normally breadcrumbs, cracker crumbs, or a similar binding agent would be necessary. Once again the potato flakes come to the rescue. The potato flakes not only help to bind the meatballs together, but also lend some extra flavor and nutrition.

We have a good friend, Alison Chapman, that is a chef and she also has celiac disease. We have learned a lot about substitutions from her. She contributed the following recipe for fajitas.

Chicken or Beef Fajitas

Servings:4

1 Tbsp chili powder
1 tsp salt
1/2 tsp cumin, ground
1/2 tsp onion powder
1/4 tsp garlic powder
1 Tbsp cornstarch
1/4 cup water
3 Tbsp olive oil
1 pound chicken breast, boneless, skinless, 2 whole chicken breasts OR ...
1 pound skirt steak, sliced
2 red bell peppers, sliced
2 yellow bell peppers, sliced
1 large onion, sliced
1 Tbsp olive oil
1 Tbsp butter
1 Tbsp sour cream
2 avocados
1 seasoning mix, no salt, for guacamole
1 Roma tomato
2 cups Cheddar cheese
6 flour tortillas, Teff Wraps (may be purchased here: http://www.glutenfree.com/index.cfm/manufacturer/La-Tortilla-Factory/952019-___-Ivory-Teff-Wraps.html)
2 limes
Romaine lettuce

Directions -
Chicken and skirt steak:
Combine chili powder, salt, cumin, onion powder, garlic powder, cornstarch, water and (3 tablespoons) olive oil in a bowl. (Double amounts when making both chicken and beef fajitas.) Cut chicken into strips and stir in mixture to coat. Cut skirt steak into strips and stir in mixture to coat in a separate bowl. Let marinate for approximately an hour. To cook, heat a pan to medium-high. Lay chicken strips in pan and saute, careful not to overcrowd the pan. Turn and saute, then place in warm oven while preparing the skirt steak. Cook skirt steak in same pan as chicken, in the same
manner.

Peppers and onions:
Seed and slice peppers into julienne strips. Cut onion into julienne strips. Melt 1 tablespoon of butter and 1 tablespoon olive oil in pan set on medium heat. Saute until slightly golden.

Guacamole:
Cut avocados in half, remove pit and scoop avocado into a bowl. Add seasoning mix and the juice of the lime. Cover tightly with plastic wrap to keep air off mixture.

Dice tomatoes. Clean and shred Romaine lettuce. Heat teff tortillas in oven or microwave before serving. Serve tortillas with cheddar cheese and sour cream.

Eating gluten free doesn't have to mean eating flavor free. It just takes some research and creativity!