2.

cups oat flour

2.

teaspoons baking powder .

teaspoon baking soda .

cup strawberries, hulled and quartered .

cup raspberries .

cup low-sugar strawberry preserves

1. Preheat the oven to 350F. Line the cups of a 12-cup m.u.f.fin pan with paper liners.

2. In a large bowl, mix the sugar or sugar subst.i.tute and margarine. Add the egg whites, one at a time, mixing well after each addition. Stir in the applesauce and vanilla. Add the oat flour, baking powder, and baking soda. Stir until the dry ingredients are just combined, but do not overmix. Fold in the strawberries and raspberries.

3. Fill each m.u.f.fin cup half full with batter, and spoon a teaspoon of jam in the center of each. Bake 12 to 15 minutes, until the tops of the m.u.f.fins are lightly browned and a toothpick comes out clean when inserted in the center.

4. Turn the m.u.f.fins out on a wire rack to cool. Once cooled, the m.u.f.fins can be stored in an airtight container at room temperature for up to 2 days, or frozen for up to 1 month.

PER m.u.f.fIN.

152 calories, 3 g protein, 24 g carbohydrate, 5 g fat (1 g saturated), 0 mg cholesterol, 167 mg sodium, 2 g fiber CARROT 'N' OAT m.u.f.fINS Oat flour, raisins, carrots, and prunes provide four hits of soluble fiber! And because they taste so good, my 6-year-old daughter has no idea these m.u.f.fins are good for her.

Makes 12

cup brown sugar or sugar subst.i.tute .

cup soft tub, reduced-fat trans fat-free margarine spread

2.

eggs whites

1.

cup natural unsweetened applesauce

1.

teaspoon vanilla extract

2.

cups oat flour

2.

teaspoons baking powder .

teaspoon baking soda

1.

teaspoon ground cinnamon .

teaspoon ground allspice

1.

cup grated carrots .

cup raisins .

cup pureed prunes

1. Preheat the oven to 350F. Line the cups of a 12-cup m.u.f.fin pan with paper liners.

2. In a large bowl, mix the brown sugar or sugar subst.i.tute and margarine. Add the egg whites, one at a time, mixing well after each addition. Stir in the applesauce and vanilla. Add the oat flour, baking powder, baking soda, cinnamon, and allspice. Stir until the dry ingredients are just combined, but do not overmix. Fold in the carrots, raisins, and prunes.

3. Fill each m.u.f.fin cup three-fourths full with batter. Bake 12 to 15 minutes, until the tops of the m.u.f.fins are lightly browned and a toothpick comes out clean when inserted in the center. Turn the m.u.f.fins out on a wire rack to cool. Once cooled, the m.u.f.fins can be stored in an airtight container at room temperature for up to 2 days, or frozen for up to 1 month.

PER m.u.f.fIN.

151 calories, 3 g protein, 24 g carbohydrate, 5 g fat (1 g saturated), 0 mg cholesterol, 176 mg sodium, 2.5 g fiber

CHAPTER 18.

CELIAC DISEASE.

Celiac disease tends to take people by surprise-not just those who receive the diagnosis, but also family doctors, who are shocked when a physically robust patient's blood work comes back positive for the disease. That's because a couple of decades ago the stereotypical celiac patient was a pale, malnourished child, someone who wouldn't be out of place in a Charles d.i.c.kens novel eating gruel and wasting away in an orphanage. As screening tests became more sophisticated, we're learning that celiac disease is surprisingly common-affecting about one in every 100 people in the United States-and it can begin at any time in a person's life. There is no consistent set of symptoms-some people lose a tremendous amount of weight, others experience fatigue, joint pain, or seizures, but sometimes there are no symptoms at all and the disease is discovered quite by chance.

In my practice, clients often learn they have celiac disease when their doctors investigate possible causes for unexplained anemia. One minute you feel fine and you're having blood drawn for tests during a routine physical examination, the next you're facing nonnegotiable changes to your eating habits and the possibility of complications. If that scenario sounds familiar, you're lucky. If celiac disease remains undiagnosed or untreated, it can lead to osteoporosis, reproductive problems, skin rashes, epilepsy, and even some cancers. The good news is that celiac disease is treated entirely with dietary changes, so feeling better is as simple as knowing which foods are toxic to your gut.

WHAT AFFECTS CELIAC DISEASE?.

Celiac disease (also called celiac sprue, nontropical sprue celiac sprue, nontropical sprue, and gluten-sensitive enteropathy gluten-sensitive enteropathy) is genetic, which means that, in some people, the disease lies dormant until it is triggered. No one knows exactly what causes celiac disease to erupt, but experts believe that times of extreme emotional or physical stress-including surgery, a viral infection, pregnancy, or childbirth-can set the stage.

It's important to remember that celiac disease is NOT a food allergy. Some people call it an allergy as a short-hand way to explain why those with a diagnosis need to avoid certain foods, but that description is both misleading and dangerous. Celiac disease is an autoimmune disorder. The body's own immune system reacts to a protein called gluten gluten, which is found in wheat. Related proteins are also found in rye and barley. When even the smallest amount of gluten enters the digestive system, it sets in motion a cascade of inflammatory processes, resulting in damage to the small intestine.

The small intestine is not merely a smooth tube connecting the stomach to the colon. The inner lining of the small intestine is jam-packed with protruding ridges called villi villi, which absorb nutrients as food pa.s.ses through. In celiac disease, inflammation damages and sometimes destroys the villi, which means they can't do their job, and nutrients your body needs pa.s.s through your digestive system and are eliminated by waste. The outcome of this damage varies depending on the extent of the disease. In mild cases, there are no overt symptoms, but blood tests might reveal a deficiency in certain nutrients, especially folate, vitamin B12, or iron (which can result in anemia). Over time, poor calcium absorption can lead to osteoporosis. In some people, celiac disease causes embarra.s.sing and sometimes life-altering gastrointestinal symptoms, including gas, bloating, diarrhea or constipation, or weight loss. Other problems a.s.sociated with celiac disease include nerve damage, migraines, seizures, infertility or miscarriages, joint pain, and even some cancers, including non-Hodgkin lymphoma and cancer of the esophagus or small intestine. The longer the disease goes untreated, the greater the risk of harm.

HOW FOOD AFFECTS CELIAC DISEASE.

There is no cure for celiac disease, and the only treatment is to eliminate gluten from your diet. If you get a diagnosis early enough, your villi will eventually heal, and, with the right foods, you can replenish stores of the nutrients you've been missing. In terms of limiting damage, nutritional treatment for celiac disease is all about which foods to avoid. However, because the list of forbidden foods is so extensive, it is also critically important that you pay attention to the vitamins and minerals that most people normally get from gluten-containing foods, and be sure your diet is rich in other sources.

AVOIDING FOODS THAT CONTAIN GLUTEN.

If you have an allergy to cats, or know other people who do, you've probably noticed that not every cat-allergy sufferer suffers in the same way. Some people start to sneeze if they are just in the same house with a cat, others remain sneeze-free until they bury their face in the animal's fur. That's not the case with celiac disease. Even the tiniest bit of gluten-the amount found in 1/8 teaspoon of wheat flour-can signal the body's immune system to respond with a full attack. The tricky part of celiac disease is that damage can occur without you noticing much in the way of symptoms. But the longer you eat foods containing gluten, the greater the damage until eventually, you become sick.

I wish the guidelines for avoiding gluten were as easy as telling you to stop eating wheat, barley, and rye bread. That's part of what you need to do--but it is much more complicated than that. There are many hidden sources of gluten, and beyond that, some common gluten-free products can be contaminated with gluten.

Here are lists of foods, ingredients, and additives to avoid. Photocopy the list-make more than one-and carry a copy in your wallet, and others your car and anywhere else you'll be able to refer to one easily when you're shopping for or eating a meal. Eventually, you'll have the foods memorized.

COMMON FOODS THAT CONTAIN GLUTEN.

Barley (and anything with the word barley in it, such as barley malt)Beer (all types)Bleached flourBleu cheese (sometimes made with bread mold)Bran (also called wheat bran)Bread flourBulgurCommunion wafersCouscousDurumFarinaFaroFlour (this usually means wheat flour)Graham flourGroatsKamutMalt (and anything with the word malt in it, such as rice malt, malt extract or malt flavoring)Malt beveragesMatzoOats and oat bran (see FAQ, Chapter 18)OrzoPasta (all varieties made with wheat, wheat starch, oats, barley, rye or any ingredients on this list)Rye (and anything with the word rye in it)SeitanSemolinaSoy sauce (check ingredients, often made with wheat)SpeltSuetTabboulehTeriyaki sauceTriticaleTritic.u.mUnbleached flourWheat (and anything with the word wheat in it, such as wheat gra.s.s, wheat starch; buckwheat is okay, and is the only exception)Wheat germ LESS COMMON FOODS THAT CONTAIN GLUTEN.

Abyssinian hard (a wheat product)Amp-isostearoyl hydrolyzed wheat proteinBrewer's yeastCereal bindingDextrimaltoseDisodium wheatgermamido Peg-2 sulfosuccinateEdible starchEinkornEmmerFillerFuGranary flourMirUdon (wheat noodles)Whole-meal flour FOOD ADDITIVES THAT MAY MAY CONTAIN GLUTEN CONTAIN GLUTEN.

If a favorite food contains one of the following ingredients, contact the company and ask questions-depending on the manufacturing process, these suspect ingredients can sometimes be gluten-free.

Artificial colorArtificial flavoringBouillon cubesCaramel colorColoringDextrinsDried fruit (may be dusted with wheat)Flavored coffeeFlavored vinegarFlavoringFood starchGlucose syrupGravy cubesGround spices (wheat is sometimes added to prevent clumping)Hydrolyzed plant protein (HPP)Hydrolyzed vegetable protein (HVP)MaltodextrinMaltoseMisoModified food starchModified starchMono- and diglyceridesMonosodium glutamate (MSG)Mustard powder (some brands contain gluten, check ingredients)Natural flavoringProcessed cheese (check ingredients)Processed meats (cold cuts, hot dogs, sausages, and canned meats which contain wheat, barley, rye, oats, gluten fillers, or stabilizers)ShoyuSmoke flavoringSoba noodlesStarchStock/boullion cubesSurimi (imitation seafood)Textured vegetable protein (TVP)Vegetable starchVitamins MORE THINGS TO KNOW ABOUT.

HEALTHY EATING WITH CELIAC DISEASE.

- Don't cheat. I can't say this strongly enough. A miniscule amount of gluten can cause real damage to the small intestine. If you cheat, even a little, you can't help but get a toxic amount of gluten. A single cookie, half a slice a bread, even a single cracker is too much gluten for your system. I can't say this strongly enough. A miniscule amount of gluten can cause real damage to the small intestine. If you cheat, even a little, you can't help but get a toxic amount of gluten. A single cookie, half a slice a bread, even a single cracker is too much gluten for your system.