Delectable, pocket-friendly food options for the gluten intolerant

You needn't give up breads, biscuits, pastas and pies if wheat doesn't suit you. There are millet-based options galore in the market. But consult your doctor first and don't get sold on labels

What's common to Lady Gaga, Anushka Sharma, Virat Kohli and Victoria Beckham? They've all gone gluten-free without giving up their breads, pastas, and noodles, biscuits and cakes. Today you have an entire universe of smart choices stripped of the hard-to-digest protein, and available both online and offline.

What is gluten?

It's a protein found in cereals such as wheat, barley and rye. Some people suffer from something known as celiac disease, in which their ability to absorb gluten is impaired, as their gut lining is damaged. Others may have non-celiac gluten sensitivity disease (NCGS), which is an inflammation of the gut lining, while some may plainly be allergic to the protein. 

A battery of tests is recommended for the gluten-intolerant to find the root cause, which could be a genetic disorder or an allergy. The most popular one is the food allergy IgE food antibody assessment. The best way to test for celiac disease is with the Tissue Transglutaminase IgA antibody test. For NCGS, the recommended one is the IgG food intolerance test. However, tests for non-celiac version are not very accurate as compared to tests for celiac, which are fairly precise. However, the best confirmation of celiac disease comes through endoscopic biopsy, says Delhi-based nutritionist Dr Ishi Khosla. 

Sometimes, one may not find evidence in the tests, in which case one needs to wean off the “culprit grains” and then reintroduce them to check the symptoms. This is known as the “elimination and challenge” exercise. Khosla, who is also founder President of The Celiac Society of India and author of book, Is Wheat Killing You?, says the demand for gluten-free food has been growing exponentially. She adds that 80 per cent of the products at her own health food company, Whole Food, which she started in year 2001, are certified gluten-free.

The harm it does

From severe genetic disorders to inflammation to weight loss, there are various reasons why people shun gluten. But Khosla asserts that it cannot be done casually and must be done only under expert supervision and professional advice, else it could prove harmful.

Many people nowadays are gluten sensitive, which is different from having celiac disease. Many often visit the doctor on eating gluten-laden food to report unpleasant symptoms such as mental fatigue, also known as “brain fog”, gas, bloating, abdominal pain and headache but test negative for wheat allergy and celiac disease. Either way, both issues are resolved when gluten is taken off the diet.

Nutritionist Pooja Makhija attributes the rise in cases of gluten sensitivity to the large amounts of gluten being added nowadays to food. She says until two years back, she would think 'gluten free’ was a whole lot of noise. "But today, after much research, I understand how over the years, there has been a phenomenal increase in the quantity of gluten in our food, The reason our croissants are softer, rotis are fluffier, breads more elastic is gluten. This overdose tends to create problems at some point in our lives,” says Makhija.

Clockwise from top left: Gluten-free eggless muffins, carrot cake, mushroom and spinach quiche, quinoa paneer tikka pizza. Picture courtesy: Whole Foods

Gluten-free alternatives

Take the case of Dubai-based NRI Sudha Tandon, who developed gluten sensitivity “one fine day”, as she put it, at the age of 63. She says she hadn't had such an allergy in the past 62 years, but all of a sudden developed a rash all over the body. There was extreme itching, that worsened by the day, as well as severe diarrhoea. But after some tests, it was certain she was gluten-intolerant. This was five years back on a visit to India, but now she has reconciled to a gluten free lifestyle. Says Tandon, “It was very shocking moment for me as I used to have wholemeal bread and oats for breakfast, and dal-roti-subzi for lunch. But now, my lunch consists of rice and rotis made of makki (maize) atta or gram flour. Tea is usually black with some puffed rice crackers.” Since she is also lactose intolerant, milk is minimal and is in the form of either almond or soy milk. But now, she says she doesn't feel the urge to eat wheat chapatis.

“Let’s cut out gluten as much as we can,” advises Pooja Makhija. In India, one has access to local grains such as ragi (finger millet), bajra (pearl millet), jowar (sorghum), rice, rice idly, dals, cholai, amaranth, besan (gram flour) and kuttu (buckwheat), all of which are naturally gluten-free. Says Makhija, “The west is sold on quinoa while we have our homegrown amaranth or rajgira atta which is just as good, and much cheaper. Then you have millets, which are high on nutritional content. And, of course there is rice, the most easily available grain.” Anything that is easy, natural and accessible should be consumed and one needn't go overboard trying to discover gluten-free labels in the supermarket.

"It would interest you to know that the gut has more neurons than the brain, which is why depression, attention-deficit disorder and autism all begin and end here," says Makhija, “Anything that causes inflammation in the gut and attracts diseases is avoidable. Though a cliché, its true that you are what you eat.”

For Rekha Jain, going gluten-free was a journey from depression towards happiness. A person suffering from epileptic disorder, she was on a high dose of depressive medicines that were not helping her. But when she consulted Khosla, she was advised to stop eating wheat after some tests, and in her own words, “Going gluten-free was a life-changing experience. Within a month I was fine.”

The sensitivity shows as different things in different people. Shivangi Kohli was chasing one dermatologist after another for a skin rash that had become a great source of misery for her daughter. She recalls that just a few months after her daughter Maira was born, the rash started erupting and it was only when she turned eight that someone advised her to get a food allergy test done. It turned out that Maira was severely allergic to gluten and monosodium glutamate, and once she eliminated wheat, capsicum and tomatoes, the rashes were gone. Initially she says it was heart-breaking to accept that this would mean no roti, bread, pastas and normal meals for the young school-going child but now they have come to terms with it. Shivangi says they avoid eating outside because of the restrictions and Maira is extremely fond of her besan cheela and quinoa pasta in the tiffin box.

A word of caution

Today there are FMCG brands marketing everything gluten-free, from flour to flakes, to cookies and cakes. Are these safe for consumption? Experts generally recommend naturally available gluten-free foods are the first choice. But then there are grey areas. Khosla points out that millets are nutritionally superior, but are often ground in common flour mills and tend to get mixed up with wheat. Also not everyone is able to digest millets easily. As against this, flours blended with other ingredients have additives and starches that make them look and work like wheat, which satiates your need for the normal parantha and bread. So a mix of natural with blended flours is most practical.

"Do consult your doctor before starting any particular diet pattern," says Delhi-based wellness coach Avni Kaul. “Simply, getting influenced by TV commercials is not going to do you any good."

One needs to understand that going to completely gluten-free foods may also do harm because it may deprive you of essential nutrients at the same time. "Simply buying from any store is not recommended. You should check all the labels and descriptions properly," Kaul adds. 

An indicative price list gluten-free food items
Cereal	Price (Rs)	Cereal	Price (Rs)
Keto flour with low glycemic index

489 Organic besan/chana dal atta 400 Gluten-free Quinoa 295 Gluten-free oats and oats flour  275 Bajra (pearl millet) flour 249 Jowar (sorghum) flour 240 Amaranth 220

Rice flour

199 Organic poha  190 Organic idly rice  188 Brown rice flour 180 Maize (makki) atta  170 Ragi (nachni) atta (Finger millet flour)  160 Gluten-free wheat flour 157 Standard pack size of 1 kg Product Price (Rs) Product Price (Rs)

Gluten-free snacks: matthi (250 gm) + namakpara (300 gm) + masala chana dal (200 gm) + namkeen mixture (200 gm)

410 Gluten-free cake 380 Organic spaghetti  noodles (moong & edamame), suitable for vegans, gluten-free 350 Gluten-free cookies 350 Gluten-free quinoa pasta  265 Gluten-free bread (100 gm)  120 Pack size of 250 gm unless indicated