Chef Marshall gets asked regularly about how to live with gluten and dairy sensitivities. This is not surprising since, by some estimates, more than 20 percent of the population in industrialized countries suffers from food allergies and sensitivities. Dairy and gluten are among the most commonly reported food intolerances. If you have a sensitivity to dairy or gluten, you can take simple steps to remove trigger foods from your diet, reduce inflammation and feel your best.
The Growing Gluten-Free Trend
A couple of decades ago, few people had even heard the term ‘gluten’. These days, a stroll through the grocery store brings you face to face with a host of products labeled “gluten-free.” Whether they are among the one percent of the U.S. population diagnosed with celiac disease, the six percent affected by non-celiac gluten sensitivity or a wheat allergy, nearly 30 percent of Americans are trying to reduce or eliminate their intake of gluten.
Americans are drinking a lot less milk than they used to—almost half the amount they drank in the 1970s. Cow’s milk allergy is the most common food allergy in young children, affecting approximately two percent of children under four years of age. Only 0.1 to 0.3 percent of adults have a cow’s milk allergy; however, approximately 65 percent of the human population has a reduced ability to digest lactose after infancy. Temporary lactose intolerance can develop as a result of gastroenteritis and other illnesses, or after repeated courses of antibiotics. Even those who can digest lactose may be sensitive to other components of dairy.
Food Intolerances Lead to Inflammation
Unlike food allergies, which trigger the immune system and evoke a histamine response, food sensitivities may result in delayed symptoms that are dose-dependent. The most common symptoms of food sensitivity include bloating, stomach ache, irritable bowel, migraines, cough, runny nose, fatigue and brain fog. Consuming foods you are sensitive to may lead to inflammation in your body. Given that inflammation is the underlying cause of most chronic diseases, it is important to identify any food intolerances and remove offending foods from your diet.
How to Identify a Food Intolerance
Chronic tummy aches, bloating, diarrhea, skin problems, migraines or brain fog may be a sign you have a food sensitivity or intolerance. Follow these steps to identify foods you may be reacting to:
- Visit your doctor. The first step in determining whether you have a food intolerance is to see your doctor and rule out a food allergy, lactose intolerance or celiac disease. Avoiding gluten makes it difficult to properly diagnose celiac disease or determine whether you have non-celiac gluten sensitivity, so see your doctor before initiating a gluten-free diet.
- Try an elimination diet. Unlike food allergies, lactose intolerance and celiac disease, there are no scientifically validated tests for food intolerances. Currently, the only reliable way to determine whether you are sensitive to a food is to do an elimination diet.
Steps in an Elimination Diet
- Remove suspect foods from your diet for two weeks.
- If symptoms resolve, reintroduce suspect foods in their purest form, one at a time.
- Consume the test food at least three times on Day 1 at four hour intervals. Start with a small quantity and increase it throughout the day.
- If you do not react, continue to monitor symptoms for the next two days. Do not consume more of the test food during Days 2-3.
- If you are unsure you experienced a symptom, consume the same test food again on Day 4 in a larger quantity.
- If no symptoms develop, consider the food safe.
- If the food causes symptoms, eliminate the problem food and retest in 3 months.
Live Well with Food Intolerance
Once you have identified foods to which you are allergic or sensitive, it is easy to remove those foods from your diet to feel your best.
Gluten is a family of proteins found in grains like wheat, barley and rye. The two main proteins are glutenin and gliadin, which act as a glue that holds food together and trap gas as dough rises, creating airy bread. The most common sources of dietary gluten include:
- Wheat (including bulgur, couscous, durum, farro, graham, kamut, semolina, spelt and wheatberries)
- Oats, if not labeled gluten-free
- Brewer’s yeast
- Triticale (a wheat/rye hybrid)
- Malt, malt extract, malt syrup and malt flavor, which are all derived from barley.
- Hidden gluten in foods like sauces and gravies, energy bars, processed lunch meats, soups, salad dressings, soy sauce and meat substitutes made with seitan
Great Gluten-Free Choices
Emphasize whole foods like fruits, vegetables, meat and poultry, fish and seafood, dairy, beans, legumes and nuts, and gluten-free grains in your diet. Gluten-free grains and flours include amaranth, arrowroot, buckwheat (kasha), cassava, chia, corn, flax, millet, nut flours, gluten-free oats, quinoa, rice, sorghum, soy, tapioca, teff and yucca.
Eating dairy-free is easier than ever. The most common sources of dairy include milk, buttermilk, half and half, cream, butter, cheese, ice cream, milk shakes, yogurt and kefir. Be on the lookout for hidden sources of dairy, like au gratin dishes and white sauces, baked goods, cake mixes, cereal, chocolate, creamed or scalloped foods, mashed potatoes, nougat and salad dressings. Any of the following ingredients indicate a food contains milk proteins: artificial butter or cheese flavor, casein or caseinates, curd, ghee, rennet, whey or whey products.
With an increasing number of people who cannot eat dairy, there is a wide variety of dairy alternatives available in most grocery stores, including:
- Dairy-free milks including almond, oat, soy, coconut, rice, hemp seed and flax seed
- Dairy-free yogurts made of soy or coconut
- Vegan cheese made from soy, vegetable oil, nutritional yeast, nuts and other ingredients
- Vegan butter made from vegetable oil
- Ice cream made from alternative milks
You don’t always need to turn to a dairy substitute for yummy dairy-free eating. In smoothies, try avocado or nut butter instead of yogurt to add creaminess. In sandwiches, skip the cheese and use hummus, avocado slices, roasted red pepper or mayonnaise. Try guacamole instead of sour cream-based dips. And you will love puréed frozen bananas instead of milk-based ice cream.
Once you know which foods you cannot tolerate, you can easily implement a gluten or dairy-free diet that is nourishing, satisfying and won’t cause social isolation. Follow Chef Marshall’s tips to determine whether you have a gluten or dairy sensitivity and have fun experimenting with new foods that not only taste delicious but help you feel your best!