Sunday, November 7, 2010
Gluten-Free Basics 101: Gluten Whahuh?
Ping Sha - a gluten-free Tibetan dish of mushrooms, beef and cellophane noodles
One of the biggest challenges for celiacs and gluten-intolerant people in Malaysia is the ignorance that we run up against when we say we are gluten-free. This usually involves explaining a) what gluten is b) what we can't eat, and of the two, it is usually easier to list what we can't eat rather than attempt an explanation of a).
While most people are understanding, in a rather bemused fashion, the real difficulty lies in when we want to eat out, and have to ask the restaurant what sort of ingredients are in the foods we'd like to order. Which will generally lead into having to explain yet again for the umpteenth time what we can't eat (gluten) and the things which have gluten in them that we can't eat (wheat, rye, barley, spelt, malt, etc.) More often than not, this doesn't really work so well and it ends up with restaurant staff getting frustrated with us, and us getting frustrated with explaining - and then probably gluten-poisoned at the end of it all despite everyone's best efforts.
Half the problem lies in the fact that most Malaysians don't take a very serious view of what they perceive as 'food allergies'. "It's just a little bit mah...how can it hurt?" "Whylah, so picky, just eatlah, you'll be fine later I'm sure."
Well. No, it's not ok actually, and we will not be fine later on.
The Celiac Disease Foundation has this to say about celiac disease:
'Celiac Disease (CD) is a lifelong inherited autoimmune condition affecting children and adults. When people with CD eat foods that contain gluten, it creates an immune-mediated toxic reaction that causes damage to the small intestine and does not allow food to be properly absorbed. Even small amounts of gluten in foods can affect those with CD and cause health problems. Damage can occur to the small bowel even when there are no symptoms present.
Gluten is the common name for the proteins in specific grains that are harmful to persons with celiac disease. These proteins are found in ALL forms of wheat (including durum, semolina, spelt, kamut, einkorn and faro) and related grains rye, barley and triticale and MUST be eliminated.'
- quoted from 'About Celiac Disease' on their site
That's right folks. It isn't an allergy, even though for some of us (like me) who aren't full-blown celiacs, it masquerades as the pernicious IBS (Irritable Bowel Syndrome) or stomach discomfort, and thus gets shrugged off by doctors most of the time. It's an autoimmune condition. It really does do some serious damage to our bodies. People can die from it - heck, children die of it, I've read cases. Food is not something we can afford to play with when it involves our health and such serious consequences.
What I'd really love to get across somehow, via this blog or maybe via some of the links I'll be cross-posting, is that we aren't just simply picky about our food when we ask about everything that's in it. Sure, there are some health nuts out there who are extremely picky about what they eat, but that is a lifestyle choice. For us? It isn't a choice. If we don't eat right, we get very sick. Some of us have lived for years being very sick, until we finally figured out what was wrong. And in order to maintain our health, we have to eliminate gluten from our diets.
Let's just take a hypothetical scenario now - a day in the life of any ordinary Malaysian. You go out for breakfast - capati with assam fish curry. Half an hour later or even less, you have stomach pains and maybe even diarrhoea. So you go out for lunch and get a nice bowl of rice porridge with yau cha kwey (fried dough sticks) on top. You feel ok for about ten minutes, then less than an hour later, you're back to stomach pains and more stomach upset, maybe even with an added headache now. So you drink a warm cup of Milo and have some bread. And the headache not only doesn't go away, it becomes a migraine and the stomach upsets have settled into a sort of dull pattern. By dinnertime, all you want is a nice bowl of clear fishball soup. But even that doesn't stop the stomach discomfort and by the time you go to bed, you're exhausted.
Sounds unpleasant doesn't it? Well, that's what some of us have had to deal with every single day of our lives for months and maybe years. So don't even try telling me that I'm being unrealistically picky about what I eat. You try living this way for even two weeks, and tell me how much you like it.
Why should any of the above foods have such an effect, you might ask. Let's do a quick run down here.
1) Capati and curry - capati is made from wheat flour. That's already a no-no. The assam curry? Shouldn't that be gluten-free? That depends. Some curry mixes contain wheat flour as a thickener, or modified starches, which are usually made from wheat. So you've poisoned your system twice already.
2) Rice porridge with dough sticks - rice is inherently gluten-free. So that shouldn't be a problem, right? But look at the dough sticks. Yau cha kwey is made from fried dough made from wheat flour. Not only that, the rice porridge might have been flavoured somehow with soy sauce. Soy sauce contains wheat as an additive. If you don't believe me, go read the labels on the soy sauce bottles in the supermarket. Unless it's specifically labelled 'wheat and gluten-free', it will have wheat added.
3) Milo and bread - by now you'd have realised that the bread definitely is a no-no because it's practically bursting to the seams with wheat. But Milo? Well. Milo contains malt - and malt is usually a mix of barley and wheat, both of which have gluten in it.
4) Fishball soup - Fish is gluten-free. Fishballs, however, may contain some form of starch as binder, at least commercially made ones. This might very well be modified starch, and as previously mentioned, that's normally made from wheat unless it's specified 'modified corn starch'. The soup could have been flavoured with soy sauce. And even if the soup and fishballs were totally free of gluten, how about the cooking utensils that were used for making it? They could have been used to cook things previously which had gluten in it. It's called cross-contamination and yes, even that can make a celiac very ill.
Now think about having to ask any and all of these questions every single time one has to go out to eat. Every day. And think about how it feels like to live like this for the rest of your life.
It's daunting, yes. But it IS possible to live gluten-free even in a society where street foods contain hidden gluten additives everywhere. I've managed it. And that's what this blog is about - to at least show people that they don't have to resort to despair and settling for being sick for the rest of their lives.
So. We've touched on everything we can't eat. But what can we eat safely? Here's a quick run down of foods in general, based on the most common Malaysian ingredients.
1) Rice - rice is naturally gluten-free. It's what you eat WITH rice that usually is the problem.
2) Fresh fruits and vegetables
3) Meat - again, there's no inherent gluten content in meat, but it's what you season it with that proves to be problematic. I'm talking about fresh, raw meat here, not seasoned meats that you find at the meat counters in the supermarkets. For those, bacon is usually a safe bet. If you can't eat pork, stick to chicken or beef you marinate yourself.
4) Fish, seafood and shellfish - some people are allergic to these, but if you can eat 'em, more power to you.
5) Millet, sorghum and amaranth - these are grains that are usually found in health food stores. Flours made from these grains are usually safe, bar cross-contamination.
6) Corn and tapioca
7) Potatoes - yes, this is usually considered a vegetable but it's actually a tuber.
8) Rice noodles - kuey teow, bi hoon, tang hoon (cellophane noodles made from mung beans)
9) Textured soy protein - now those with soy allergies as well can't have this, obviously. But I've used it at times to substitute for meat and to cook for vegan friends, and it's not given them or me any trouble. If it does, that might be due to cross-contamination at the manufacturing plant.
4) Most pure spices - now if you're talking about curry powder mixes though, read the label. A lot have wheat as an additive so be careful.
5) Lemon and lime
6) Balsamic vinegar - I've not had any problems with this, and quite a few of my other celiac friends haven't either. Again, read the label.
7) Wheat-free/gluten-free tamari or soy sauce - Jaya Jusco, Cold Storage and health food stores carry this, I've been using variations of it for years. The label will say 'Wheat Free' if it doesn't have wheat in it. But check the labels again, just in case (are we sensing a pattern here? Yes. READING LABELS IS IMPORTANT.)
8) Rapunzel vegetable bouillon cubes - this brand is an all-natural alternative to stock cubes, and contains no gluten. I've used it for a while without problems now. It can be found in Jaya Jusco, Cold Storage, and some health food stores.
9) Herbs - any herbs. Unless you're allergic to them, upon which be smart and don't use 'em.
10) Canned tomatoes - or, let me put a disclaimer, canned tomatoes that don't list anything like wheat or modified starch in them.
11) Heinz Lite Mayonnaise - this one apparently is gluten-free, but I haven't checked it out for myself.
12) Dry mustard - you have to be careful with mixed mustards; those with alcohol content may have gluten contaminants depending on how the alcohol was produced. If you get a can of dry mustard and mix it yourself, there should be no problems. Colman's Dry Mustard can be found at Cold Storage.
I'll add to this list as time goes by, and will also give a more comprehensive list of where to find safe foods as I compile lists and addresses of shops and so on. So do bear with me, but for now, this is a quick and dirty run down.
Gluten-free bacon and cheese muffins that were adapted from a wheat recipe
Living gluten-free in Malaysia may be bewilderingly inconvenient at first, especially if you don't cook. I can't stress it enough - cooking for yourself is the best way to make sure you don't poison your system. And cooking gluten-free is not difficult. If I can do it (and I came to cooking very late in the game, only halfway through my graduate school days) then I know most people can, with just a little bit of guidance.
I will also be posting a list of restaurants that are safe to eat at, or that I haven't had any adverse reactions to, as time goes by and I try them out myself. For now though, Woods Macrobiotics in Jln. Telawi, Bangsar seems to be all right. Do tell the server that you need a complete gluten-free diet, and have them check with the resident dietitian what they would recommend. When I called up to ask, they were very helpful indeed, which is a plus, and they understand what gluten-free means, even better.