The Coeliac Society of Ireland’s resident nutritionist Andrea Murray answers your top questions about eating and living a healthy gluten free life.
Q. I’ve just been diagnosed with coeliac disease, what should I do if I become accidentally glutened?
A. When you have first been diagnosed, it is difficult initially to know what foods to eat and what not to eat – it’s a steep learning curve. Firstly, get in touch with the Coeliac Society to obtain their Food List, which lists all foods suitable for coeliacs (membership is just €30). With the help of the Food List you can go through your store cupboard to remove items containing gluten – beware of condiments and sauces! Initially, until you get to know the foods that are suitable for your glutenfree diet, all you can do is your very best.
A food diary initially is really helpful so if you get symptoms you can track what might have caused the problem. Remember always that foods in their natural state are gluten-free: meat, fish, poultry, fruits, vegetables, potatoes, rice, pulses, dairy and nuts/seeds. In learning some tasty, quick, nutritious meals to prepare and cook, you will ensure you will not be glutened – good luck.
Q. I’m a coeliac, and my boyfriend has been accusing me of overkill in the kitchen as I keep all of our food completely separate. For example, I’ve just invested in a new toaster. Am I going overboard?
A. No, you are not going overboard at all – when preparing food at home there is a high risk of crosscontamination and in purchasing a second toaster you are ensuring this risk is eliminated. Cross-contamination is where gluten grains enter or touch non-gluten grains, hence now making this food not suitable for a coeliac to eat.
If you are away from home or wanting to prepare some food in work, toaster bags are a great solution to ensure no gluten enters your food. It can often be difficult for others to understand your dilemma, so we always recommend that you speak to your loved ones and explain about living a coeliacfriendly diet and how important it is to your health. On our website there is useful information which might support you on this (www.coeliac-ireland.com/ live-gluten-free/telling-others). It may also be helpful to give those close to you a Food List so they know what to cook for you.
Q. I keep hearing different views on oats. Should I avoid them completely in my gluten-free diet?
A. There is a lot of confusion about oats, I totally agree. Many oats and oats products are contaminated by wheat. However, now that pure oats are available, the majority of coeliacs should be able to use pure oats without problems.
Importantly though, we do not recommend oats when newly diagnosed, until your antibodies have gone down to normal – this may take one to two years after starting a GF diet. Even with pure oats, some people will get symptoms and realise they are sensitive to oats. Therefore any coeliac wishing to consume a diet containing pure oats should receive regular followups at a specialist clinic to ensure tolerance. Conventional oats carry a high risk of cross-contamination and it is best to avoid.
Q. I’m following a strict gluten-free diet, but every time I get a blood test, I test positive for coeliac and my antibodies are high. How can this be?
A. Well I am particularly delighted that you are continually being tested. So many coeliacs, once they are diagnosed, forget that they need to be checked one year post-diagnosis to ensure their anti-bodies are reduced, hence reassuring them that their GF diet is working and healing their digestive system. If your anti-bodies are high, firstly I would suggest that you write up a food diary taking a clear note of all the foods you are eating over a period of time – ideally two weeks, but longer if you can.
Once you have done this, you need to become a bit of a detective and see if there is a possibility of gluten sneaking in somewhere. In most instances (not all) there is a possibility of contamination entering the diet somewhere. The key ‘red flags’ are:
• Eating out in restaurants or cafés – cross-contamination is more likely. Most outlets really do try their best and may be able to guarantee a meal without gluten containing ingredients but unfortunately cannot guarantee that the environment in which is it prepared is entirely gluten-free.
• Eat out when loved ones are cooking – unfortunately many of our loved ones do not realise that even the slightest bit of gluten is going to impact health.
• Condiments can always be a bit tricky and you really need to check labels thoroughly. Now if you have done all of this and you are 100 per cent confident that the diet is totally GF, I would advise to revert to your gastroenterologist. Best of luck and keep us posted.
Q. I need a fibre supplement to help with my constipation, what can I take that’s gluten-free?
A. Here at the Coeliac Society we really try to encourage all of members to manage their health through natural means. If you are struggling with constipation, there are lots of natural options that you can try:
• When you first wake have some warm water with the juice of half a lemon. Try to leave 30 minutes until you eat, this is a really great way of naturally clearing toxins from your body.
• Increasing natural oils in your diet, coconut oil is fantastic and is naturally gluten-free*. A teaspoon a day is a great support to constipation as often our bodies are very ‘dry’, by increasing natural oils it lubricates the body allowing for better bowel movement.
• The government say five portions of fruit and vegetables a day however for optimum health the more the better. Ideally each day you would have three portions of fruit and seven vegetables (a portion is the size of your fist). This increased level of fruit and vegetables will provide lots of natural fibre. Great sources of fibre are the ‘green leafy’ kind; spinach, kale, cabbage, broccoli, etc.
• Nut and seeds are also a great source of fibre and all again are naturally gluten free*. A handful a day will also support constipation.
If you have implemented all of the above suggestions and things are still not moving, here is my suggestion:
- Soak a tablespoon of Linseeds in half a glass of warm water overnight and drink it on an empty stomach first thing in the morning – this is an absolute winner in all cases I have worked with.
*Read the labelling of natural glutenfree products to ensure they haven’t been cross contaminated with gluten during the packaging process.
Q. I’m following a strict gluten-free diet, but I’m feeling fatigued a lot of the time. How can exercise help complement my diet?
A. Exercise is an essential part of a healthy lifestyle, here at the Coeliac Society we recommend and support health on all levels: diet, stress management, and of course exercise. Being fatigued can often be a result of a lack of vitamin D, which coeliacs can often struggle with. What I would suggest to combat your fatigue and possible lack of vitamin D is to get your recommended 20-30 minutes outside in the daylight.
Go for a gentle walk initially but over time and as your fitness improves bring this up a notch to a power walk or even a little jogging. When walking (and if its warm enough), wear a short sleeved top as vitamin D is absorbed through our skin so the more skin showing the more nutrients! But remember to apply some SPF as your skin can be damaged by the sun on even the cloudiest of days.
Exercise on any level supports energy, mood and of course our heart. Get outside and enjoy. Walking also reduces your risk of osteoporosis.
Q. I feel like my whole life is consumed by planning and organising since going glutenfree, how do you recommend I manage this so I’m not overwhelmed by it all?
A. Requiring a gluten-free diet for medical reasons can initially be a big change for any household and it does require planning.
Firstly, empty your kitchen of any gluten containing products, hence you know that everything in your home is coeliac-friendly.
Secondly, do a menu plan for the week, this works a treat as once it is done you do not need to think about it. Once a weekly plan is made, you then just need to get the ingredients to enable the foods to be prepared. So with a little initial planning takes all the stress away from the week. When doing your menu plan refer to the Food List, allowing you to choose tasty and totally gluten-free products.
Finally, which works well for most busy people is batch cooking. At the weekend or evenings prepare double – great options for this are soups, casseroles, pies (cottage pie and shepherd’s pie), bolognese and chilli. If you can invest in a good freezer with plenty of space this will allow you to prepare lots of meals in advance.
Andrea Murray works for the Coeliac Society and has a BSc (Hons) in Nutritional Therapy. Andrea is a busy mum of three and her children are the reason for her interest in the benefits of healthy eating, after dealing with food intolerances from a young age. Working with the Coeliac Society, she continues her support of people who wish to maintain a gluten-free diet. www.coeliac.ie www.facebook.com/CoeliacSocIreland www.twitter.com/CoeliacIreland
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