A second interview on My Life in a Pyramid … already? Yes, my friends, I am serious about my 2011 blog resolutions (a year late isn’t too bad, right?)  This time, I bring to you Diana Ghazzawi, whose recent gluten-intolerance discovery has made her familiar with the subject of gluten and its dangers, but it has also reinforced her love of cooking real food. In this post, she answers my questions about gluten in very digestible terms (her answers don’t make the gluten any more digestible though, hah). Diana blogs at Free Kitchen, a site dedicated to simple recipes that are free of many common allergens (gluten being the obvious one, but also soy), and also free of sugar and caffeine. She admits she doesn’t use recipes when cooking, a fact that is easy to verify if you take a look at her minimalist and easy-to-follow blog. Many of her posts consist of a picture and a few lines of descriptive text, but measurements don’t feature heavily. That’s because cooking is all about creativity! To follow her posts for awesome gluten-free inspiration, like her blog’s page on Facebook.

Real quick – I wanted to clarify my personal stance on grains. I mentioned in a previous blog post that I have drastically cut down my grain consumption as of late. However, with the Orthodox Lenten fast focused on vegan meals, I’m eating brown rice and quinoa quite frequently, but still avoiding glutenous grains. I haven’t touched bread since last August, mostly because all the ones sold in stores are overly processed (I’ve been vowing I’ll make sourdough sprouted bread ever since, but uh, my baking skills aren’t quite ready to be put to the test). Anyway, whether or not you’re thinking about taking gluten out of your diet, you need to read this post. I am personally not advocating a gluten-free diet for everyone, because who am I to tell you what to eat or avoid? I simply wish that more people are informed. When you have the knowledge, you are better equipped to make your own decisions. Okay, I’ll stop babbling now and make way for Diana’s excellent answers!

Interview with Diana Ghazzawi, author of the blog Free Kitchen

1. Tell us a little bit about why you are drawn to real food and health. What inspired you to start Free Kitchen?

I grew up in a household, and an extended family, that ate almost exclusively real, whole foods. This is how my family cooked when they lived in the Middle East, as do most people there. When we moved here, there was nothing particularly appealing about the typical American diet or style of cooking that would have convinced my family to change their ways. We’ve always cooked practically everything from scratch; we’ve never even owned a microwave! Now, to be fair, there is the occasional quick dinner of hot dogs and potato tots, but those sorts of meals are very few and far between. At my house, you’re more likely to find a freshly made, bubbling lentil soup or a crisp salad rather than something that comes in a box or pouch. Additionally, I’ve always been exposed to natural foods as medicine: mint and sage tea for abdominal pain, parsley as a blood purifier, etc. The only big mistake my family has been making is eating gluten all these years, up until my experience in the summer of 2010.

I’ve been cooking since I was a kid, and in recent years I often considered having a blog that showcased my dishes, but I never got around to it. Once I figured out I was gluten intolerant, I knew that the mission of my blog would be to share my dishes with the world, dishes that just happen to be gluten-free. I also label the dishes according to the allergens they are free of. Free Kitchen really is about being free to eat well, being free from potentially unsafe foods, and being freed of the idea that gluten-free food is complicated.

2. You quit gluten after discovering you have gluten-intolerance. Let’s start with the basics: what exactly is gluten?

Gluten is a protein found in wheat, rye, barley, and a few other grains. The immune system, much of which is housed in the digestive system, has to recognize the various substances that we consume as food, thus allowing them to pass through unmolested, so that they can be properly digested and absorbed. However, many people’s immune systems have not evolved to recognize the gluten protein as food. In an effort to protect you, the immune system attacks this unrecognized oddity, because it sees it as unsafe. Your immune system is just doing its job. The problem is, by eating gluten, you are introducing an overwhelming amount of this molecule, which your immune system will immediately begin attacking. This unrelenting attack ends up wreaking havoc on your health. I outline the process more fully here.

3. What is the difference between gluten-intolerance, gluten-sensitivity, and celiac disease?

Gluten intolerance and gluten sensitivity are terms that are often used interchangeably. (I use gluten intolerance.) In both gluten intolerance and celiac disease, the immune system attacks gluten and creates a host of problems, as you can read about in the link I provided. With celiac disease, there is the added autoimmune component of the immune system attacking and destroying the cilia of the small intestine; this does not happen in gluten intolerance, though there may still be severe irritation to the intestines.

The idea is often touted that gluten intolerance is not as bad as celiac, or that someone “only” has gluten intolerance, as opposed to the more severe celiac. This concept of gluten intolerance being less dangerous than celiac is totally wrong. The two conditions are virtually identical, other than the aforementioned autoimmune component. They have all the same symptoms and are treated in the exact same way: a life-long gluten-free diet. In fact, someone with advanced gluten intolerance can be far worse off than someone at the early stages of celiac.

There’s also the misconception that if your celiac tests come back negative, you’re in the clear. This is absolutely false. Just because you don’t have celiac, it doesn’t mean you are not gluten intolerant. Celiac affects 1 in 133 people (most of whom are undiagnosed). Research estimates that anywhere from 1 in 7 to 40% of people are gluten intolerant; almost all of these people are also undiagnosed. In other words, there is a very good chance that you, dear reader, are gluten intolerant. There are some blood tests for gluten intolerance, but they aren’t accurate. In fact, mine came back low enough to be considered negative, but there is no doubt that I have this condition.

Quick note from Heba: If you’d like an in-depth look, check out this video from Dr. Peter Osborne, a chiropractic doctor and certified nutritionist, who founded the Gluten Free Society to educate the public and those in the medical profession about the condition.  In this 37-minute video, he discusses the difference between gluten sensitivity, gluten intolerance and celiac disease:  

4. For those who are not gluten-intolerant, are there any merits to going gluten-free, in your opinion?

Actually, the problem is that most people assume that they are not gluten intolerant. I know I did. When my aunt suggested that it might be my issue, I was lying on a couch, my entire body in extreme pain, barely able to move. My response to her? “No, I don’t think that’s the problem.” After all, I’d been eating wheat my whole life. Little did I realize that my long-time anemia, my years of thinning hair, my gallstones that caused my gall bladder removal, and my lactose intolerance were all caused by gluten.

The point is, gluten intolerance is so common that you should probably assume that you have it. Try a strictly gluten-free diet for at least 3 months (to give your body time to clear out the gluten and then to repair itself), and see what happens. Maybe that tiredness you always experience will go away. Or your hair will get thicker, like mine did. Perhaps you’ll no longer have indigestion or that rash that keeps popping up. Maybe your thyroid problem will settle. If you stop eating gluten and your symptoms improve or disappear, guess what? You’re gluten intolerant. It makes sense, right? If you eat gluten and you have a reaction, and this reaction stops when you don’t eat gluten, then, logically, your problem is the gluten!

Do not be fooled by the pharmaceutical companies and the wheat industry, who control much of the information in mainstream media on this topic. They do not want to you to stop buying their products, be they endless drugs for your gluten symptoms or the gluten products themselves. They’ll pay news shows to tell you that it’s dangerous to go gluten-free, or that gluten-free eating is too expensive, or that you need a doctor for a diagnosis, and other ridiculous, intentionally misleading claims. Additionally, about 80% of the medical research in America is done by drug companies, and the skewed, drug-centered results are passed on to doctors. As a result, many of even the best-educated, best-intentioned doctors will know little or nothing about the effects of gluten. Sadly, you can’t always trust your doctor’s information on the topic, because it’s usually limited at best.

Don’t have any reservations about going gluten-free. It’s not dangerous. No one needs gluten; in fact, there are entire cultures that traditionally have eaten little or no gluten for thousands of years, and they are perfectly fine. Gluten-free diets need not be expensive. Yes, the typical gluten-free loaf of bread is much more expensive than a loaf of wheat or rye, but bread, pasta, cake, and cookies, even the gluten-free variety, should not make up the bulk of your diet anyway. Shift your diet towards more vegetables, fruit, beans, and healthy meat and seafood, and the more expensive gluten-free foods should fit easily into your budget.

Finally, you don’t need a doctor to officially tell you you’re gluten-intolerant. (Actually, it’s very difficult to find one who even has a true understanding of the condition.) The only true test is how you respond to a gluten-free diet. Keep track of your symptoms before, including any blood test results, and see what happens to them after going gluten-free. I diagnosed myself, and the more research I did, the more I realized that all of my mother’s family is gluten intolerant. I do not work in the medical field but I diagnosed them; those relatives who have gone gluten-free are now free of their symptoms, some of which they’ve had for years. Furthermore, there are quite a few friends and acquaintances to whom I, upon hearing their symptoms, suggested that they were gluten intolerant. They went gluten-free, and lo and behold, their symptoms have improved or disappeared. I say this not to pat myself on the back, but to prove that you don’t need a doctor to discover what the problem is.

5. What are some gluten-free cooking and health-related resources that you would recommend for someone who wishes to learn more about the subject?

The doctors at HealthNow Medical Center are doing great work in the fields of gluten intolerance and other nutrition-related conditions. In addition to their book, they have videos you can watch and articles you can read.

I realized I had a gluten problem when I read the message boards at Celiac.com, for which I am eternally grateful. There are people on the site who aren’t very well informed, so you have to be a little careful, but it’s still a great resource that offers personal experiences that you can learn from. For example, my most extreme symptom was the intense muscle and joint pain and borderline paralysis. If I relied on the limited, superficial information given out by most hospitals or other medical organizations, I would have deduced that gluten can cause nothing more than some simple aches and that what I was experiencing was not gluten-related. I would have assumed I had some other “more serious” disease. But when I did a search in the message boards for these symptoms, I got people’s accounts of the very same severe pain and immobility I had, accounts I was totally shocked to read. I then started searching to see if people had my other symptoms (lactose intolerance, gallstones, thinning hair, anemia…) and it all finally made sense! To clarify, you don’t have to have celiac specifically to have gluten intolerance; most people have a non-celiac gluten intolerance. But as I mentioned previously, because the conditions and their symptoms and treatments are virtually one and the same, almost any information on celiac (such as what is on Celiac.com) applies to gluten intolerance.

Celiac.com also offers very extensive lists of safe and unsafe ingredients for gluten-free eating. They also have a list of safe alcoholic beverages. Some of these “safe” ingredients, such as food coloring and aluminum, are not healthy and should not be part of a natural, whole foods diet. They should be avoided, even if they are gluten-free.

6. For those who are intolerant or sensitive to gluten, eating a whole foods diet (as opposed to eating processed food from packages) is critical. Why is that?

If you’re gluten intolerant, most likely your health has been comprised for quite some time. It is likely that you haven’t been absorbing the vitamins and minerals you need. For example, I had almost no iron or vitamin D in my body, and I was low on B12 and folic acid, in spite of my healthy eating. You may also have some joint damage, osteoporosis, or other conditions. Your body can and will repair itself, but you must give it the building blocks in the form of clean, unprocessed, nutrient-rich (gluten-free!) food for it to do so. As long as you offer your body these natural essentials, it will know what to do with them. Moreover, the less processed food you eat, the less chance there is of consuming hidden sources of gluten.

Eggs, Potatoes and Onions – a recipe from Free Kitchen

7. How difficult is it to avoid gluten? Please share some of your favorite substitutions for common foods that contain a lot of gluten.

It depends on what your cooking and eating habits were before going gluten-free. If you were totally reliant on eating out and packaged food, you may have some difficulty. For most people, it is neither the easiest nor the most difficult thing you will do. Rather, just like any undertaking, it will take some effort. I do not feel deprived at all, but I do feel I have to be constantly vigilant. Even something like chewing a piece of gum is no longer done mindlessly. I have to check what’s in it first. This vigilance, too, soon becomes second nature. I think most people struggle with willpower more than actually finding gluten-free foods. (In my case, the experience was so traumatic that I have no desire to eat even a single crumb that would cause me that much pain again.)

There are so many gluten-free options, that it shouldn’t be a problem to cook almost any dish you like. (And yes, you’ll probably have to do more cooking for yourself, because you can’t trust everything cooked in a restaurant or that comes in a package.) In addition to breads and dessert items, I’ve seen gluten-free lasagna, pizza crusts, chicken nuggets, bread crumbs…. This is not to say that you should start gobbling down boxes of processed gluten-free chicken nuggets, but they are out there should you ever want some. And anything you can’t find at your local stores you can probably find online.

Most substitutions are easy to make. Spaghetti and meatballs? Use rice pasta; it tastes practically the same as your typical wheat pasta. Need a crispy coating? Cornstarch works well on its own, or you can mix it with rice flour or corn meal. Replace regular soy sauce (which usually has wheat in it) with a gluten-free one. Experiment! I found that I became more adventurous in my cooking after I went gluten-free.

Rice Pasta with Pesto, Andouille, and Red Pepper – a recipe from Free Kitchen

For more tips on gluten-free shopping and eating, click here.

8. What about eating out? How do you navigate the menus at restaurants?

Growing up, we rarely went out to eat. Even in my adult gluten-eating days, I didn’t eat out much, because I would often get sick, though this was not related to gluten but likely to the cleanliness of the food preparation. Now that I’m gluten-free, I still rarely eat out, but I do have a few tips. First, try out restaurants that have gluten-free menus, such as your local P.F. Chang’s or an independent place that has special selections. Additionally, some cuisines, such as Thai or Mexican, are more likely than your local pizzeria to have naturally gluten-free options. Indian cuisine and sushi (don’t forget to check the soy sauce!) are also fairly safe options. Second, opt for dishes that probably do not contain gluten. You obviously shouldn’t be choosing the breaded chicken cutlet or the apple pie, but a roast chicken or the sorbet may be safe. Once you’ve made a potentially safe selection, ask your server how it’s cooked and explain your gluten-free needs. Make it clear that you food needs to be cooked in a clean pan with clean utensils. Ask what’s in the sauce or broth. You also have to think a few steps ahead. For example, potatoes are gluten-free, but almost all restaurants coat their fries with flour and/or fry it in the same oil as their battered and breaded foods, making restaurant fries unsafe to eat. Opt for the baked potato, which is likely to be safe. If you don’t feel comfortable that the server or chef understands your needs, or don’t believe the food is safe to eat, don’t eat it. Finally, pack a snack. It may not sound glamorous, but if you end up not finding something to eat, you can always order a juice or water and munch on your snack. It’s much better than getting sick!

Massaman Curry – a recipe from Free Kitchen

9. Do you have any tips for beginners to gluten-free cooking?

Very little of my cooking has changed since going gluten-free. Why? Because most whole foods are naturally gluten-free! The most important tip is this: do not be daunted, and do not make it more difficult for yourself than it needs to be. Many people, upon going gluten-free, start attempting gluten-free soufflés and crepes, and get discouraged if they prove to be difficult. This is not necessary, at least not at first. Why not make a simple omelet? How about some roasted sweet potatoes? Grilled fish? Shrimp sautéed in olive oil and garlic? A rice pilaf? Grass-fed steak? Vegetable soup? Fruit salad? Soon you’ll realize that there are so many foods that you can eat without having to make substitutions, and others that can be made gluten-free with the simplest changes. In fact, this is the idea behind Free Kitchen: I make healthy, delicious food that doesn’t require you to go out of your way to convert to gluten-free.

Potato and Mushroom Soup – a recipe from Free Kitchen

10. What are your favorite on-the-go healthy snacks?

Fruit! I’ve been salting my fruit recently; I love the saltiness and sweetness together. And if I’m truly on the go, dried fruit! Trader Joe’s unsweetened, unsulfured dried mango is a favorite.

Who is Diana Ghazzawi?

Diana Ghazzawi has been cooking since she was about 11 years old, using whole, natural foods almost exclusively, an outlook on cooking and nutrition which she learned from her family. In 2010, soon after discovering she is gluten intolerant, she started Free Kitchen, a blog that archives the dishes she cooks. Though her favorite cuisine is her own Arab one, she does cook dishes from a variety of traditions, as well as ones she improvises. The goal of Free Kitchen is to show that gluten-free cooking is not restrictive or complicated, and that many recipes are naturally gluten-free. The dishes are labeled according to the other allergens they are free of, so that readers can decide what fits into their nutritional needs.

**This post was submitted at Butter Believer’s Sunday School and The Healthy Home Economist’s Monday Mania blog carnival.