Nuts for Nuttzo

I met Nuttzo in October.

I was in West Virginia at Revolution Why and Julia Hanlon, the blogoddess behind RunningOnOm, brought it for us to add to breakfast bowls, toast, whatever…

She brought multiple flavors, so I got to try all of them and was hooked.

What’s great about Nuttzo is everything:

• It’s healthy: as in 1 gram of sugar, no added oil, non GMO and vegan. One serving gives you 12% of your daily fiber and it has Omega-3.
• It’s gluten-free: notice, healthy and g-f are not (always) the same.
• It’s a gift: proceeds of purchases go towards orphans and neglected children around teh world through Project Left Behind.
• You can’t go wrong: every flavor rocks in it’s own way. The Seven Nut & Seed Butter (crunchy) has so much texture; it’s super filling, and I love that. I just ordered the chocolate one, because well, duh.

However if you love what most people think of when they hear “peanut butter,” the super smooth, sugary and slightly sweet tasting spread, you’re not going to find Nuttzo to be a replacement.

If you’re ready to switch away from that Nuttzo is the best alternative.

I especially enjoy it in breakfast bowls.

The breakdown of the best breakfast bowl I’ve ever made is*:
*don’t quote me on measurements because I don’t do that in the kitchen anymore

• Bob’s red mill gluten-free oatmeal already cooked (1/2-1 cup)
• gluten-free granola brand of choice (1 cup)
• Nuttzo (4 tbsp)
• crushed pecans (handful)
• dried cranberries (handful)
• sliced banana (1)
• almond milk poured over

Do you have some kick ass gluten-free recipes to share with me?

Leave them in the comments below!

Celiac simplified: the Gastroenteroligist’s perspective

In an effort to continue to provide you with rants, reviews, recipes and relevant information, I sat down with a physician to get their perspective on Celiac disease and the gluten-free diet.

Talia Zenlea, an Internist and Gastroenterologist, and I met on Twitter.

After reading her bio, I knew that she was the perfect person to chime in on the medical facts and feelings surrounding treating patients with Celiac.

Talia Zenlea, MD is the founder of bellyblog.ca. She completed her medical training at University of Vermont, residency in internal medicine at Yale-New Haven Hospital, and gastroenterology fellowship at Harvard/BIDMC. She currently practices gastroenterology in Toronto. She is committed to empowering women to take charge of their own health and well being.

Q: What inspired you to become a doctor? Was there any moment or event that drew you to Gastro work?

A: When I was in high school and undergrad, I did a lot of volunteer work in the mental health and addictions fields, so I first went to medical school to become a psychiatrist.

Though I loved psychiatry, I also loved surgery and internal medicine. There wasn’t a specific “ah ha!” moment for me, but gastroenterology was a really good fit because I like the emphasis on preventative care (I do a lot of colon cancer screening and prevention), and I like helping people understand and appreciate the interplay between their symptoms, the foods they eat, and the world around them.

Q: That’s great! What’s your favorite thing about your job?

A: The best part of my job is getting to meet people from all walks of life, and understanding how their unique circumstances have shaped them. It’s my job to understand where they are coming from and how I can help them “make it work” in a way that’s in keeping with their beliefs and individual goals.

Q: I love that philosophy. So, of your patient base, how many have Celiac?

A: A lot! And a lot have non-Celiac gluten sensitivity.

Q: That’s actually what my doctor thinks I have, but I beg to differ. For those readers who are still unclear on what Celiac really means, will you break it down for us?

A: Sure! Unlike gluten-sensitivity, Celiac disease is an inherited, autoimmune disease characterized by inflammation of the small intestine, triggered by consumption of gluten.

By inherited, I mean that people do not get Celiac because of their lifestyle choices or health habits- they carry a gene that made them susceptible.

The autoimmune part means that in people with Celiac, consuming gluten triggers a response where their bodies “wage war” upon the small intestine. This attack damages the parts of the small bowel that are necessary for absorption of certain nutrients.

Q: It’s so fascinating to me that different people can have such different reactions when eating the same foods. My boyfriend eats bagels on the regular yet when I eat even a french fry (with a tiny bit of flour,) I definitely experience that wage war you’re referring to. 

A: Definitely! The autoimmune attack damages the parts of the small bowel that are necessary for absorption of certain nutrients. This is why people with celiac can sometimes have very low vitamin levels, or low blood counts. Because the autoimmune-mediated inflammation is triggered by gluten.

The good news is that for most people, stopping any exposure to gluten also stops the attack, and the bowel can usually heal itself.

Q: Yeah, my doctor says that my bowel has healed itself through years of strictly following the gluten-free diet.

A: Exactly.

Q: What does untreated Celiac (or breaking the gluten-free diet) do to our body? Can you explain the short and long-term impact?

A: Without treatment, there’s ongoing attack on the small bowel. This can lead to impaired absorption of certain important vitamins and nutrients, which can lead to deficiencies in those things.

So, for example, low calcium or vitamin D can lead to low bone density (osteoporosis or osteopenia,) low levels of certain B vitamins can lead to numbness and tingling… You can also have symptoms like belly pain, abnormal bowel habits, headaches, skin rashes, even infertility!

There’s a small risk of a very serious small bowel cancer in people with uncontrolled celiac disease.

Q: Wow. It’s terrifying actually – especially for young women hoping to one day have a child. So what’s one piece of advice that you would give someone who is just starting to follow the gluten-free diet?

A: My advice is – stick with it, and do the best you can.

One of the best parts of my job is when I see someone who was in tears at the idea of giving up pizza or bread, but then comes back a month later with a huge smile saying they didn’t even realize how bad they felt before, until they stopped eating gluten, and now they feel like a whole new person.

Q: It’s amazing, right? So do you have any advice for someone who is a bit more seasoned? Someone like myself who has been following the diet for years? Are there any specific foods I should steer clear of, or vitamins I should be taking, to stay healthy?

A: I think something that even “seasoned” individuals sometimes don’t realize is that gluten can be found in things that aren’t even food – like vitamin supplements or even medications, as well as cosmetics like toothpaste, lipstick, body creams…

So, always read labels, and when it doubt, call the manufacturer!

As for vitamins, I sometimes recommend a gluten-free multivitamin, and supplemental vitamin D if levels are low. This is something you should discuss with your doctor first.

—

While I was horrified to realize that there could be gluten in creams and toothpaste, I was glad to learn that now as I am trying to make a switch to more natural, organic products.

Talia’s advice is definitely helping me to make adjustments as a consumer.

Want to learn more? I encourage you to join the conversation on Talia’s blog!

Pumpkin Roulade with Ginger Buttercream

The holidays can be stressful for everyone, especially for people with Celiac. When you’re surrounded by glutenous sweets and treats, sticking to the gluten-free diet can be challenging.

If you have a sweet tooth like I do, you can agree there are few things more heartbreaking than sitting in a room watching others enjoy a dessert to which you’re allergic.

Not only is it heartbreaking, but it can result in serious levels of “hanger.”

As someone who loves the holidays and hates the feeling of missing out on treats of any kind, I thought what better way to kick off Christmas than with a great recipe that’s been adapted to be gluten-free.

Joined by my sister, who is notably better in the kitchen than me, we set out to make one of our favorite holiday recipes that our mother has made for Thanksgiving, Christmas and winter birthdays for years: Pumpkin Roulade with Ginger Buttercream.

Worth noting is that this recipe is rated as difficult by Ina Garten, so it’s best to save this dessert for a time when you have an extra hand (or two, or even three) to help.

While my sister and I succeeded in our first attempt at the gluten-free pumpkin roll, we learned a few lessons along the way that are definitely worth paying attention to if you decide to tackle this recipe:

• Read the entire recipe through before you go grocery shopping. (For example: you need parchment paper, a large board, a drying rack, and a clean, thin cotton dish towel)
• Don’t be stingy with the powered sugar on the dishtowel; the more the better.
• For the cake: while the recipe suggests a baking time of 10 to 12 minutes, we suggest baking the cake for 13 to 14 minutes.
• For the buttercream: add the confectioners’ sugar to the mascarpone cheese slowly.
• Refer to this instructional video for more details on how to complete the recipe. (Note: this video was crucial in showing us how to roll, unroll and re-roll the cake)

Gluten-Free Pumpkin Roulade with Ginger Buttercream:

Total time: 1 hour 57 minutes (1 hour and 45 minutes prep, 12 minutes cook / bake time)

Ingredients:

For the cake:

• 3/4 cup Bob’s Red Mill flour
• 1/2 teaspoon baking powder
• 1/2 teaspoon baking soda
• 1 teaspoon ground cinnamon
• 1 teaspoon ground ginger
• 1/4 teaspoon ground nutmeg
• 1/2 teaspoon kosher salt
• 3 extra-large eggs, at room temperature
• 1 cup granulated sugar
• 3/4 cup canned pumpkin (not pie filling)
• 1/4 cup confectioners’ sugar, plus extra for dusting

For the filling:

• 12 ounces Italian mascarpone cheese
• 1 1/4 cups sifted confectioners’ sugar
• 2 tablespoons heavy cream
• 1/4 cup minced cried crystallized ginger (not in syrup)
• pinch of kosher salt

Directions:

To begin, preheat the oven to 375 degrees. While the oven is preheating, grease a 13-by-18-by 1-inch sheet pan. (Note: we used a 17.25-by-11.5-by 1-inch sheet pan and it was fine.)

Line the pan with parchment paper and then grease and flour the paper.

In a small bowl, sift together the flour, baking powder, baking soda, cinnamon, ginger, nutmeg, and salt, then stir to combine.

Place the eggs and granulated sugar in the bowl of an electric mixer fitted with the paddle attachment and beat on medium-high speed for 3 minutes, until light yellow and thickened.(Note: we used a hand mixer and found that it worked fine. However, I would recommend using an electric mixer if possible.)

With the mixer on low, add the pumpkin, then slowly add the flour mixture, mixing just until incorporated.

Finish mixing the batter by hand with a rubber spatula.

Pour into the prepared pan and spread evenly.

Bake the cake for 10 to 12 minutes (we recommend 13 to 14), or until the top springs back when gently touched.

While the cake is baking, lay out a clean, thin cotton dish towel on a flat surface and sift the entire 1/4 cup of confectioners’ sugar evenly over it. (This will prevent the cake from sticking to the towel.)

As soon as you remove the cake from the oven, loosen it around the edges and invert it squarely onto the prepared towel. *Refer to this video for guidance on the next few steps of the recipe.

Peel away the parchment paper.

With a light touch, roll the warm cake and the towel together (don’t press!) starting at the short end of the cake.
*Watch how Garten does it before you start the process! Allow to cool completely on a wire rack.

While the cake is drying, make the filling: in the bowl of an electric mixer fitted with the paddle attachment, beat the mascarpone, confectioners’ sugar, and cream together for about a minute until light and fluffy.

Stir in the crystallized ginger and salt.

To assemble, carefully unroll the cake onto a board with the towel underneath. (Note: do this step slowly)

Spread the cake evenly with the filling.

Reroll the cake in a spiral using the towel as a guide. (Refer to the video for additional assistance)

Remove the towel and trim the ends to make a neat edge.

Dust with confectioners’ sugar and serve sliced.

—

This dessert is a great choice for a festive, flavorful and relatively healthy way to satisfy your sweet tooth this holiday season.

While slightly difficult to make, this would be a great dish to bring to a family holiday dinner or a dinner party at a friends house.

Even better is that due to the small amount of flour needed for the recipe, your guests won’t even know it’s gluten-free!

The g-f diet vs. the military

Did you know that the United States military won’t accept you if you have Celiac disease?

I only recently found this out, and it was from a new friend (Tom) that I recently met. Tom and I started chatting about health and wellness, and I mentioned that I follow the gluten-free diet. He mentioned his friend Matthew who also was on the g-f diet and even prevented from serving because of it.

I froze hearing that. Then I got pissed and knew that I’d have to connect with Matthew to hear his story:

Q: Did you start following the gluten-free diet because of a sensitivity to gluten, or do you have Celiac?

A: Celiac disease. I was diagnosed as an infant. When I was 3 weeks old, I suddenly grew bloated and my abdomen ballooned out. My mother, having been a Neonatal nurse in the Navy, knew to take me to the hospital immediately.

The doctors found that I had an intestinal malrotation and severe inflammation of my small intestine. I had to have a very serious surgery with a high possibility of mortality. The procedure was successful, though, and I went home after a brief NICU stay with the newfound diagnosis of Celiac disease, which was assumed to have been the cause of the episode.

Q: Oh wow, that’s really interesting. I’ve never heard of such a severe reaction. Do you think that your mom working as a neonatal nurse in the navy influenced your desire to serve? 

A: My mom has definitely influenced me, and still continues to. (She’s in her early 60’s and still going strong as a veteran ER nurse.) She has been the main driver influencing me to go into the healthcare field.

I come from a family with a long history of military service. Hearing the stories of family members who have served really makes you proud of your roots.

Q: That’s really interesting. So, have you been following the gluten-free diet forever? 

A:  I followed the diet off and on since the surgery in ’88. My parents kept me pretty gluten-free while I was younger, but living in the 80’s/90’s in a small town, gluten-free food was hard to come by. Awareness was very low.

My symptoms were also minimal, since the surgery removed a large portion of my intestine that normally would be damaged by gluten. Wanting to be a normal kid in the school lunch line led me to deviate from the diet between the ages of 6 to 20.

During undergrad, I studied health sciences and got back on the gluten-free diet for good. I’ve been pretty strict for 8 years now.  I’m not a “freak” about everything being “certified GF” but that’s kind of luxury due to my minimal symtomology. I still make every conscious effort to be gluten-free.

Q:  Have you seen/can you speak to the increase in availability and/or quality of gluten-free products since you first starting following the diet?

A: We’ve come a long way in my lifetime. My mom would drive 45 minutes away to buy gluten-free, cardboard-tasting bread in the past.

It was tough in the 90’s and early 2000’s. It can still be tough in rural areas, but around 2005 I started to notice increasing awareness, labeling efforts and some mentions on menus at restaurants in Michigan.

Between 2006 and 2010 is when I saw the biggest increase in g-f friendliness (however my perception may be skewed because I spent those years in Ann Arbor).

Now, I live in Flint for school and it feels like I’ve regressed a half decade in terms of g-f friendliness, but I still get by. To put it simply, the days of driving 45 minutes to get a loaf of sand are long gone, but the majority of Michigan still has a way to go.

Q: What is the best gluten-free friendly place you’ve got around you? Any favorites?

A: Michigan has never quite been on the culinary cutting edge, but within the past 5 years I’ve seen some interesting changes. My opinions are slightly skewed having lived in Ann Arbor (which is foodie heaven, and very accommodating).

With the advent of social media, the microbrewery boom here, an increasingly farm to table/organic focus, and the whole Detroit youth culture revival, I’ve seen Michigan come a long way.

Local Favorites include: Buddy’s (Detroit Metro) has the best  gluten-free pizza in the WORLD and g-f beer/ciders always on. Jolly Pumpkin (In Ann Arbor) has a gluten-free menu and a g-f IPA ON TAP! Flint is still in the dark ages when it comes to gluten-free, but the foodie culture is slowly picking up speed.

Q: Thanks for sharing! Buddy’s sounds awesome. Tom mentioned you’ve experimented with brewing your own g-f beer. That’s pretty admirable! How’d that go? Is that still something you dabble in?

A: I did get into home-brewing during undergrad. I bought a 5 gallon pail of sorghum malt, and got about 12 brews out of it before getting too busy with school to keep up the hobby.

My initial brews were awful but as I refined my skills, while living with Tom (his excellent taste in beer rubbed off on me), I began to brew lighter ales with heavy dry hopping and minimal “interesting” adjuncts.

What ensued were mostly IPA style. I even decided to enter a contest with a brew I called “Celiac Soda”. It was my attempt at making a gluten-free beer to replace the tailgate “versatility” of light American party beers.

I was amazed when it got ranked into the “Very good” class. I plan to pick the hobby back up after I finish my Master’s next year.

Q: That’s awesome, you totally should! It’s not easy to make a good g-f beer. So, I know you had your heart on serving in the military but you were rejected due to your dietary restrictions. Can you explain how that process worked? How did you feel finding this out?

A: This is a complex and personal subject for me. I entered the Army ROTC while in undergrad. I wanted to be a Ranger Medic. These valorous dudes and chicks are like guardian angels for our nation’s grim reapers.

Ironically enough, I currently train side by side with them.

Q: Cool! In what capacity?

A: I currently am training in nurse anesthesia. We’re the majority of the providers who put you to sleep and keep you safe and comfortable during surgery; we also provide safe pain and sedation medication therapy and take charge in emergency/code blue situations.

These are skills that the Ranger and Seal medics must also become proficient at. In an ironic twist of fate, the Special Ops Command has chosen the very same hospital where I am undergoing my training to train their medics (1 of 2 hospitals in the nation).

I even coached one of them through his first intubation a few weeks ago. Here’s a quick read about it.

(Back to story)

I needed to successfully pass DODMERB (Department of Defense Medical Exam Review Board) for medical clearance. At the time, dodmerb listed “any current or history of malabsorption disorders” as a dis qualifier of military service. (They have since adjusted wording to directly state “Celiac disease”.)

I had to apply for a medical waiver. Meanwhile, I was taking this ROTC thing to heart and getting very entrenched in the culture. The people I met were my new found brothers and sisters.

It took 2 waiver applications and 7 months total before I found out I was forever denied. I was heartbroken. The fact that I wouldn’t be there for the exemplary young men and women who might end up wounded on the battlefield in need of help… It was gut wrenching.

It wasn’t until a few days later that I began to realize that, for the first time in my life, I had a physical disability which prevented me from pursuing my dreams. I had never considered myself handicapped until that moment. It was like an aftershock.

No longer could I fulfill my duty to serve and protect those new-found brothers and sisters fighting bravely for each others’ lives. It was a rough year, and it still bothers me every-time I see soldiers or hear the national anthem. Like a chip on my shoulder with nobody to blame.

Q: It doesn’t seem fair. I feel like we could get a petition going… or something. Do you think there is a solution at all? 

A: There is no solution. What it boils down to is that the military operates in the most efficient way possible. The brilliant minds behind our military have purposefully cut us out because of multiple reasons: liability, selectivity and MRE chowline.

The only way to get Celiacs in the military would be to get the MRE manufacturers and chowline food/aid conglomerate contractors (Sara Lee, ConAgra, Aramark, etc) to convert to gluten-free options. (In other words, about a snowball’s chance in hell.)