21730 Swordfish or Tuna, Ginger or Garlic: Cooking “Outside The Box” for Those with Food Intolerance - Celiac.com
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Swordfish or Tuna, Ginger or Garlic: Cooking “Outside The Box” for Those with Food Intolerance

Celiac.com 01/25/2009 - It’s a brand new year with a brand new vibe.  I’m excited to be launching a new year of education and advocacy on behalf of the gluten-free community, beginning with an upcoming speaking engagement.  On February 10th, I’ll have the opportunity to speak with and hold a gluten-free cooking demonstration for chefs-in-training at the Western Culinary Institute, in Portland, Oregon.  They may be a challenging audience, as I attempt to encourage them to think “outside the box” of more is better when it comes to exotic ingredients.  The trend of the past decade seemed to be “vertical food”, with a sauce, a base, a main ingredient, another sauce, topped by two or three garnishes.  While dishes resembling food-as-art may tickle the taste-buds, they are a minefield for those with food allergies and sensitivities.

The incidence of food allergies, which were once rare, has increased 18% in recent years and the numbers of people affected continue to grow. [The top eight food allergens are:  dairy (cow’s milk), eggs, peanuts, tree nuts (almonds, pecans, walnuts, hazelnuts etc.), wheat, soy, fish, and shellfish – and corn is another top allergen]     Food allergies seldom come individually - chances are that the person allergic to peanuts is also allergic to eggs or dairy, or both.  So, what’s can a foodie with food allergies to do?  Forgo attending family events, parties, and other social engagements, or worse, bring their own food in an attractive Tupper-ware container?   Sadly, these are options that many of the food-allergic have to consider.

Handling a life with food allergies is a challenge for adults, and must be especially difficult for parents of kids with multiple food allergies, who bear the responsibility of safe-guarding their children's health.  It may surprise you to know that four million American children have food allergies - that’s a sizable portion of future consumers for any business to consider.   

Food sensitivities are also a big issue with many adults.  Lactose intolerance and gluten intolerance are problems for many people, and finding safe, healthy and interesting food choices is not easy.

Here’s a story that illustrates how we’ve had to adapt.  Recently we spent a ski weekend in Bend, Oregon.  I baked my own gluten-free bread, and brought along other treats to keep in our hotel room.  I asked the maitre de at our hotel to check with the chef about the preparation of foods in the breakfast buffet, so I would know what, if anything, I could eat.  Mostly I made do with tea, fresh fruit, and my home-made gluten-free challah bread.  Lunch was a no-brainer – there wouldn’t be much that I could safely eat at the ski resort, so I brought along some gluten-free Larabars – (ingredients:  dates, almonds, dried apples, cinnamon) and we planned an early dinner.  Later that evening, in a popular Bend landmark, I was happy to see a few choices I thought I could eat, with a few modifications.  When my entree of seared Ahi tuna arrived, my son commented, “Mom, you must be an expert on that dish by now – I’ve seen you order it in a dozen restaurants!”  He was right.  Plain seared Ahi tuna, coated only in sesame seeds, served on greens, with a rosette of pickled ginger and wasabi, is my restaurant stand-by.  I love Japanese food, but this popular dish is often served at seafood restaurants and sidewalk cafes too.  With a side of green salad, or maybe the vegetable of the day, I’m set.

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I do wish there were more offerings to choose from, and it’s a shame that there aren’t.  Very fresh seasonal ingredients, simply prepared, are truly wonderful and full of flavor that doesn’t need to be covered up by crusts, sauces, or heavy spices.  A glance at the top eight is evidence that allergies to fruits, vegetables, or fresh herbs are less common than allergies to high protein foods.  So, why not use them in abundance? 

Here’s another story that illustrates my point.  While in Costa Rica a few years ago, my family had many wonderful meals.  The food was always very fresh, and naturally gluten and dairy free.  I never needed to check with the staff – I only needed to read the menu like anyone else.  But we all agree that the very best meal we had was the night we drove down a rutted dirt road to a shack on the beach, where the sun was just beginning to set.  The place looked deserted, with no lights and no customers.  I asked my husband, “are you sure this is the place?”  He said he’d followed the directions he’d been given.  My mind began to spin some of the scary scenarios I’d seen in movies.   As soon as our car pulled to a stop, we were surrounded by the ubiquitous barking dogs found in every village in Central America.  A screen door slammed shut, and a slightly built man came up to the car.  My husband rolled the window down and said in Spanish that we’d heard that this was a great place to eat. 

The gentleman led us into a gazebo, lit some candles, and seated us at a rickety table.  He did not hand us any menus.  Our host told us that he had caught two kinds of fish that day – swordfish and tuna.  He said we could have them prepared with either ginger or garlic.  He did not describe the method of preparation or what else came with the meal.    Since we were rapidly being devoured by mosquitoes, we chose our options quickly.  A few minutes later we were handed a can of “Deep-Woods OFF” Mosquito repellant, with a smile, and our host/fisherman, and presumably chef, left to prepare our dinner.

In about twenty minutes, he arrived bearing four large platters of steaming hot grilled fish, well-coated with our seasonings of choice and garnished by fresh grilled vegetables and greens, warm home-made corn tortillas, salsa, and rice.  Nothing else.  It was the freshest, most deliciously prepared meal I had ever eaten.  And I think it cost about twelve dollars for the four of us.

So, I’m going to talk with these aspiring chefs about the importance of including simply prepared but still delicious foods on their menus.    I may never tire of seared tuna, but it may not be someone else’s cup of tea.  Reasonable choices should be part of any menu, and can be, with a conscious effort.  At my husband’s Christmas party, I was pleasantly surprised by a buffet I could actually eat.  The menu consisted of three types of small kabobs:  plain grilled vegetables, grilled shrimp still in the shell, and grilled chicken, a huge tray of freshly prepared sushi, with ginger and sauces on the side, and another huge tray of Vietnamese salad rolls in rice paper wrappers.   I asked first about marinades, avoided any dipping sauces, and was just fine.  It was fun to be able to partake of the beautiful buffet, and I went out of my way to personally thank the catering crew. 

Some of the worst food from a nutritional stand-point, and certainly the worst from the perspective of someone with food allergies, has been served in the cafeterias of hospitals where I’ve worked or visited patients.. In these institutions dedicated to promoting health, nearly every entrée is breaded, sauced, cheese-coated, or poached in a pool of milk.  Thanks goodness for the salad bar.  Even the soups are suspect, as they are usually mass-produced, or made from a dry mix containing ingredients that the food-allergic cannot tolerate.  Surely our institutions and hospitals can do better.

Whether these future chefs work in a food service, or an up-and-coming tapas bar, I’m hoping to inspire them to use their creativity in a different way, to offer the freshest, healthiest food possible, and minimize the number of sauces and extraneous ingredients in at least a portion of the dishes they develop.   I’ll also talk about the growing epidemic of gluten-intolerance in this country and the possible impacts it will have on the food industry.  In fact, I think I’ve found the topic for my next article!

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5 Responses:

JoAnn Andrus
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said this on
01 Feb 2009 1:32:09 PM PDT
A good cook who uses fresh foods doesn't have to add gravies and sauces. I wonder.....

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said this on
01 Feb 2009 2:44:41 PM PDT
Inspiring -- Hope for the sad-but-true. My husband and I also had a similar experience in Costa Rica. We traveled there fortified with our usual bag of meal/snack gluten free foods, but found the simplest roadside restaurants fed us quite well with grilled plantain, fresh fish, and other items with local ingredients. We came home healthy after eating out most every day.
Let's keep praising the mindful chefs and educating the others!

L E Finney
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said this on
01 Feb 2009 6:20:20 PM PDT
Cudos for challenging the chefs! I am just beginning to learn about gluten free, as I have family members recently identified as gluten intolerant. Keep up the good work.

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said this on
02 Feb 2009 11:20:07 AM PDT
Way to go, Wendy! I'll be rooting for you during your presentation! I bet some of those chef-students are gluten intolerant themselves and don't even know it!

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said this on
04 Feb 2009 12:40:35 PM PDT
The more info the better it is to live gluten free. Thanks for the tips.

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I wanted to collect some of the info on NCGI in one place so that visitors who test negative but may still have an issue with gluten can be directed there. I'll add to this post as I find new links, but feel free to add or contribute anything you think may be of use! Matt --- Useful links: An overview from Alessio Fasano, one of the world's leading researchers on celiac and gluten sensitivity: https://www.youtube.com/watch?v=VvfTV57iPUY A scholarly overview from celiac disease magazine: https://www.researchgate.net/profile/Knut_Lundin/publication/232528784_Non-celiac_Gluten_Sensitivity/links/09e415098bbe37c05b000000.pdf A good overview from a sceptical but fair perspective: https://sciencebasedmedicine.org/a-balanced-look-at-gluten-sensitivity/ Another overview: https://celiac.org/celiac-disease/understanding-celiac-disease-2/non-celiac-gluten-sensitivity-2/ University of Chicago's excellent celiac site's take: http://www.cureceliacdisease.org/category/faq-non-celiac-gluten-sensitivity/ A compelling account in the British Medical Journal from an NCGI patient: http://www.bmj.com/content/345/bmj.e7982 Here's some positive news about a potential new test: http://www.medicaldaily.com/non-celiac-gluten-insensitivity-blood-test-392850 NCGI in children: NCGI and auto immune study: https://www.ncbi.nlm.nih.gov/pubmed/26026392 Also consider: Fodmaps: http://www.kcl.ac.uk/lsm/research/divisions/dns/projects/fodmaps/faq.aspx This Monash study: http://fodmapmonash.blogspot.co.uk/2015/03/the-truth-behind-non-celiac-gluten.html suggested some who think they're reacting to gluten should actually be reducing fodmaps Sibo: http://www.webmd.boots.com/digestive-disorders/small-intestinal-bacteria-sibo

I was just diagnosed in March and I totally feel you. I'm having a hard enough time with determining which lip glosses are safe, let alone all my face products etc. I feel like this 'grey area' is the biggest annoyance with Celiac. So many foods/cosmetics I thought were safe after reading the ingredient list are actually not safe at all! One website says it's safe, one says its not. All these unfamiliar ingredients and even after googling term after term still so many grey areas!! I'm sure in time it gets easier and second nature and you learn by trial and error but holy this constant uncertainty is super annoying haha.

This place is great. Learning a lot. Honestly, I've known people with celiacs in the past, but it never occurred to me that that's what could be wrong with me. But the more I learn, the more it fits. One more thought, the articles I'm reading seem to say that we need to avoid gluten meticulously. I'm certain that I didn't accidentally eat gluten, because I've basically only eaten meat and veggies. But, my family has continued eating as normal. My kids making pancakes and it getting in the air, toast with all the crumbs everywhere, etc. Could that exposure be enough to keep my blood antibodies high? Or does it need to be ingested?

Hey, I had Hashi's some 15 years prior to my celiac disease diagnosis. My doc put me on a very lose dose of Armour. It did bring down my antibodies (by half), but they were extremely high to begin with (anything over 30 was positive and mine initially were close to 4,000). My nodules and enlargement stayed constant. Both actually went away since I have been gluten free! Like Gemini, I am on Armour for life! But that's okay. Just had my TPO checked yesterday, in fact, and now the number is 360. So, better, but that lab range is anything over 15 is positive. No reappearance of the nodules or enlargement. I am also on a low carb high fat diet to treat my diabetes too.

Yes! Call University of Chicago! Switching you from one medication that's not working to another and back again isn't helping you. It's definitely time to look at something else. I'm so sorry that you're not feeling better.