At this time the only way to definitively diagnose Celiac Disease is by doing a biopsy of the small intestine, which is where Celiac Disease does its damage to the body. That said, in this health care environment we doctors can’t just send everyone with abdominal pain to have a small bowel biopsy – the current estimate is that less than 1% of the population has true Celiac Disease. Better to do other, less invasive tests first. Fortunately, there are several blood tests available, but they are not as definitive as a biopsy. They do yield some false positives and sometimes false negatives. Testing for Celiac Disease

The one good thing about most gluten free offerings is that they are more natural than the mainstream frozen meals. There have been an increasing amount of gluten free offerings and it’s good to find a company that has offerings that are OK choices. We reviewed a few previously from Gluten Free Café and they were good choices. Here’s our report on a few more. Three from Gluten Free Cafe

Researchers in Italy tried to improve on previous studies by recruiting 200 women who were actively being treated with assisted reproduction techniques, either In-Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI). These women were paired with a control group of 200 women with no complaint of reproductive problems who had already had one child. Celiac Disease and Infertility in Women

The only treatment for Celiac Disease is to avoid gluten in the diet. While it’s obvious that those with Celiac Disease need to avoid almost all bread products, newly-diagnosed patients are also taught to recognize the “hidden” gluten in many commercially prepared foods. Even restaurant or home-cooked meals that are (presumably) prepared fresh from gluten-free products are considered suspect if they are prepared in a kitchen that also contains gluten products due to the risk of cross-contamination: a cooking utensil could carry gluten molecules from a food containing gluten to an otherwise gluten-free food.

To avoid that risk, many of those with Celiac Disease are extremely cautious about eating in restaurants or kitchens not their own and will often prepare and take their own food when dining with friends or family. This is reasonable, given that the prevailing teaching is that products with “more than 20 parts per million (ppm) of gluten” will cause damage to their small intestine. Is Any Amount of Gluten Safe for Those with Celiac Disease?

Forging forward, I picked up a group of breakfast cereals for the tasting panel. The easiest one to find are Chex cereals. With the exception of their Wheat and Multigrain versions, Chex are gluten free. You know these guys because of Chex Mix recipes (what my mom used to call Texas Trash when I was growing up). That they are easily available is a good thing, but the main issue is they have only a gram of fiber in Corn Chex and the flavored versions. Rice Chex, however, is listed as 0 fiber (that’s right: zero). Since getting a good portion of fiber at breakfast is important, these might not be your best choice. Gluten Free Breakfast Cereals

But if you can’t eat gluten, what works? There are a lot of pasta variations using different flour, including rice, buckwheat, corn and quinoa. Can any of them come close? After all, it’s the gluten content of wheat flour that gives pasta dough its elasticity, and without it making a good pasta is a challenge. Gluten Free Pasta Roundup

Its aroma while cooking was mostly of the veggies, especially the green beans and the peppers. The instructions call for cooking 3 minutes after piercing the plastic and then removing the plastic to stir. I was very careful stirring because rice pasta can fracture and break up. After another 3 minutes the dish looked really good. Two From the New Gluten Free Cafe

Dr. Tim Says….

I don’t write about exercise a lot because it’s not my specialty. While I know a lot about it, exercise regularly myself and always talk with my patients about it, the Dr. Gourmet website is about food and nutrition. We’ve begun to incorporate exercise into our mission because of its importance and you’ll see more info in the future on this topic.

I have, however, as part of our mission written occasionally about nutritional supplements – vitamins and such. Those of you who are regular readers know that I don’t believe the research supports taking vitamins. In the past I have used the premise of “doesn’t help but probably won’t hurt” when it comes to vitamins. There has been some recent evidence that I’ve written on that indicates taking vitamins might actually be bad for you. We’re a long way from knowing for sure, but this past week another study has been published that casts more doubt on the idea of “probably won’t hurt.” One of the medical students I work with who is very interested in exercise sent this one my way. Exercise and Supplements

Featured Recipe

Seared Tuna with Mango-Wasabi Salsa

So I generally do most of the cooking. My wife is a good cook but doesn’t really like to all that much. Mind you, she has a fantastic palate and knows when a recipe is good or not as well as what might be wrong with it. Every once in a while she will come up with a recipe. This is one of those and it’s really fantastic. The tuna works great with the mango salsa and the combination is not just great tasting but great for you.

This recipe is safe for Coumadin (warfarin) users and is low in sodium. It is both lactose-free and gluten-free. Those with GERD / Acid Reflux should avoid it as it is likely too spicy.

Eating Gluten Free
with Julie Gee

It is not always easy to stick to a gluten-free diet. The good news is that there are many resources for folks trying to eat gluten-free. One of your best resources is your local Celiac Disease support group. Support groups help you to feel normal and provide you with a place to talk about the issues you face every day. In addition, your local support group is an invaluable source of information and experience. You don’t have to reinvent the wheel if you can instead rely on others to help discover new places to eat and shop. Since Celiac Disease affects approximately 1% of the American population, most cities or counties have a support group. These groups also welcome individuals who have wheat allergies or gluten-intolerance.

It is always a good idea to seek out a support group for Celiac Disease when you are in the process of being diagnosed. Some doctors in the United States aren’t as educated about Celiac Disease as we might like, so it is important to find a physician who is experienced and knowledgeable about Celiac Disease and the many related health issues. Your local support group is an excellent way to find a physician who can help you get a diagnosis. Getting Help

Chef Tim Says….

People ask me all the time what I eat day to day. “Do you cook every night?” is a frequent question. I do eat out but mostly I cook, partly because I love being in the kitchen but also to create recipes and do research for DrGourmet.com. As a result, it’s not very common for me to cook the same dish twice in the Harlan household. As with most of us, however, there are evenings when I just don’t have the time to cook and need to make something quick and easy.

Even though it’s rare to have the same recipe twice at my house, there are a few recipes that I particularly love that are quick and easy when I am tired or pinched for time. Quick and Easy Does It

Featured Recipe

Pantry Meal: Quick Barbecued Pork

This is the quick and easy pantry meal that everyone in your family will love. Choose your favorite barbecue sauce. I look for a sauce that has no more than about 50 calories for two tablespoons. The lower the sodium the better: most come in around 200 mg for two tablespoons, and low sodium versions are 50 mg. If you do use the regular versions, it’s best to cut the added salt to 1/4 teaspoon.

This recipe is safe for Coumadin (warfarin) users and is low in sodium. It is both lactose-free and gluten-free. Those with GERD / Acid Reflux should avoid it (unless they know of a barbecue sauce that does not cause GERD symptoms).

Eating Gluten Free
with Julie Gee

Your friends, family, and colleagues probably won’t understand why, all of a sudden, you’re not eating the same things they are. It helps to develop a brief explanation that explains your health issue in a simple way. For example, I typically say, “It turns out that I have Celiac Disease, which is an autoimmune response to the gluten found in wheat, barley, and rye; since those ingredients are found nearly everywhere, it’s safest for me to eat things I know are gluten-free.”

This brings us to the next tough social situation: a party or social gathering at someone’s home. Eating Gluten-Free in Social Situations: Friends and Family

A Healthy Pregnancy
with Faith Bontrager, RN, BSN

According to researchers, over 70% of women suffer from nausea during early pregnancy. Despite the name “morning sickness,” pregnancy nausea happens throughout the day for many women. It is most common in the first trimester but 13% of women had nausea past their 20th week of pregnancy.

What causes this nausea? Researchers are not certain but the most common explanation is that a rise in HCG (human chorionic gonadotropin), a growth hormone plays a large part. We do know that nausea is lower in women who subsequently miscarry and higher in women who are carrying twins. Treating Nausea and Vomiting

Dr. Tim Says….

There are a few nights a month where I really don’t have time to cook. I need something simple to put together and this usually takes the form of a quick Mediterranean sauce. I can use this on almost anything – fish, beef, pork or pan roasted chicken. I have started a few times to write up these recipes but each time I make theme they are a little bit different. There is a pattern to how I create this, however.

I always start by placing a large skillet in the oven and preheating it to about 375°F. This is the pan that I will roast the protein in, making it easy to cook the meat but also allowing for simple clean up. I set the olive oil spray next to the oven because I will need it in a bit. The Mediterranean Sauce Kit

Featured Recipe

Tortilla-Crusted Chicken

Look carefully at the tortillas you buy. Even though most are low in sodium some have a fair amount of salt.

This is a great coating and one key is the medium-hot non-stick pan. The tortilla will crisp while the cheese melts slightly. This dish is great with Cumin, Black Eyes and Corn Salad (Low Sodium Version) and topped with your favorite salsa.

This recipe is safe for Coumadin (warfarin) users, is low in sodium and gluten-free. Those with GERD / Acid Reflux and those who are lactose-intolerant should avoid it.

Eating Gluten Free
with Julie Gee

For people with Celiac Disease, eating at restaurants is a challenge. Unless you are sure that a restaurant has a good understanding of Celiac Disease and cross-contamination, I suggest avoiding eating at most restaurants. A good way to be social and still eat safely is to bring your own food. I suggest calling a restaurant ahead of time to let them know you have Celiac Disease, and would like to bring your own meal to be reheated there. You can usually give the meal to the waiter, have them reheat it in the microwave, and serve it on a plate when the rest of your group is served (this is a great strategy for weddings or catered events).

Often, when you call to discuss this with the chef, restaurant staff may offer you some gluten-free alternatives. This is a great time to work with the staff and design a gluten-free meal, but be wary of hidden cross-contamination from less-than-knowledgeable staff. Although it may seem like you’re a difficult customer, restaurants are often happy to accommodate you, since you’ll create a lot of repeat business and bring your friends back with you. Eating Gluten-Free in Social Situations: Eating Out

Dr. Tim Says….

Last week I discussed the structure of dinner and what a good healthy and balanced evening meal should look like. I have felt for a long time that eating sensible regular meals and snacks is the key to being healthy and maintaining a healthy weight. In listening to my overweight and obese patients I often hear them say, “Well, I don’t eat during the day. I only eat dinner.” Sometimes they will talk about eating late in the day.

While this is only anecdote, hearing it over and over has made me think that there’s something to this. Yet there’s not a lot of definitive research to prove that skipping meals during the day and eating only dinner contributes to weight gain. We do have some indirect information from studies showing that eating breakfast makes a difference in maintaining a healthy weight. There’s less info about lunch, however. We do have a lot of research on snacking. Everything from time of snacks, type of snack, how much is consumed and on and on.

There’s also a lot of research on the volume of food and calorie density that helps us to understand how satisfying various meals and snacks are throughout the day. Just recently there was published a great addition to our knowledge with a group of researchers in Sweden reporting on whether meal patterns might have an effect on obesity. Three Meals a Day

Featured Recipe

Seared Sea Scallops with Potato Viniagrette

This is really a fabulous dish with the soft texture and flowery flavor of the warm potato salad complemented by the seared sea scallops. It’s a simple dish that can easily be served for a weeknight meal since the whole thing takes all of a half hour (OK, you do have to roast the garlic first, but you should have that around the house for other recipes).

This recipe low in sodium and both gluten and lactose free. Those with GERD / Acid Reflux and those who are on Coumadin (warfarin) should avoid it.

Eating Gluten Free
with Julie Gee

As you continue to plan menus and shop for gluten-free items, you may miss certain foods that contain gluten or feel deprived. This is a great time to make use of gluten-free products made by Glutino, Pamela’s, Bob’s Red Mill, and other labeled gluten-free products. These product lines offer pasta, bread, cookies, pretzels, and cereals. Be sure to read labels on gluten-free products as well. Some are made from whole grains such as quinoa or brown rice, which are great sources of fiber. I suggest that you avoid stocking up on a gluten-free product until you’ve tried it; however, once you’ve decided that you like the product, feel free to stock up from sites like glutenfreemall.com or amazon.com. I have found that each grocery store stocks different items that I use as mainstays. Rather than visit three stores every week, I stock up when I see a particular product that I know isn’t carried at other stores. Supermarket Strategies for a Gluten-Free Diet, Part Two

Dr. Tim Says….

When I was growing up we had the typical diner special of “a meat and two veg.” This isn’t too far from what makes sense for a healthy dinner. We know that combining protein with carbs helps with feeling satisfied for longer after a meal. One issue is, however, what to actually put on your plate.

One issue is that serving sizes have become so large in many restaurants. This has carried over into folk’s dinner tables at home and portions have gone from big to bigger to huge. So when you’re considering dinner ideas think in terms of right-sizing your meal.

Begin with the main course. By that I mean the fish, lean meat, shellfish, chicken, turkey, lamb, etc. that you will have. The rule of thumb is 4 ounces by weight for each portion. When you are reading recipes keep this in mind because many call for double or even triple this amount. With a 4 ounce serving coming in at around 150 to 200 calories it’s easy to see how in today’s world folks can easily get too many calories. What to Put on Your Dinner Plate

Featured Recipe

Gnocchi with Tomato Mushroom Sauce
Gluten-Free Version | Low Sodium Version

I love gnocchi and this rich tomato mushroom sauce just makes it that much better. In the first iteration of this I used a single pepperoncini instead of the paprika. These are small pickled Italian peppers and the slight spiciness adds a lot to the sauce.

This recipe is safe for Coumadin (warfarin) users and those who are lactose-intolerant. Those with GERD / Acid Reflux should avoid it.

Crimini Mushrooms

Crimini mushrooms are marketed under many names, including Baby Bella, Roman, Italian, Brown or Classic Brown mushrooms. They are similar in size to white mushrooms but are a light cocoa color and have a firmer texture. They are much more flavorful than white mushrooms, having a richer, earthy taste that activates the umami taste buds. Their flavor has often been referred to as “meaty”.

Portobello mushrooms are actually large crimini mushrooms and, because of the savory meaty flavor, have become popular in the last few years. As mushrooms mature, the ring that protects the spores breaks and as a result there is loss of moisture. Young mushrooms contain as much as 80% water and, as they lose water (as portobellos do by having their gills exposed), the savory mushroom flavor is increasingly concentrated. Crimini Mushrooms

Keep Up With Dr. Gourmet

Follow Dr. Gourmet on Twitter!

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Make Comments on DrGourmet.com!

Did you know that you can now make comments on the recipes on the DrGourmet.com website? If you have a Facebook account, you can make comments on the recipes and have those comments posted to your Wall for you to share with your Facebook friends. (If you don’t have a Facebook account, you don’t have to have one to make comments.) Let us and your friends know what you think of our delicious healthy recipes!

Over the next few weeks you’ll see the comment boxes added to all of the pages on DrGourmet.com, from “Ask Dr. Gourmet” to the special dietary needs sections such as Coumadin (warfarin), gluten and lactose intolerance, and low sodium diets.

eatTHISdiet for Coumadin Users:
The Cookbook

eatTHISdiet for Coumadin Users is now available in both spiral-bound paperback and PDF format!

Over 200 pages of what you need to know while on Coumadin (warfarin), including food lists – so you’ll know what you can eat! Includes a complete six-week eatTHISdiet for Coumadin users, with weekly meal plans, shopping lists, and over 90 recipes. Just $31.52 for the spiral-bound book and $14.95 for the eBook. Order yours now!

Dr. Tim Says….

I was giving a talk the other night and as part of it there was a discussion of how the perceptions of what we eat can guide our consumption. One of my favorite researchers, Brian Wansink, has published numerous studies showing that how we think about food influences what we eat. His work has both the ability to help us understand how we look at food but also to laugh at ourselves a bit over how easily we can be duped by our perceptions. Perception Matters

Featured Recipe

Halibut with Lime-Cilantro Salsa

This recipe is proof that the more you are around good food and good cooking the better you get. When my wife and I met it was clear that she has a terrific palate. She had been around food – our brother in law is a very accomplished chef. Over the last few years she has gotten better and better as a critic and as a cook and this recipe is evidence of that.

Here’s a recipe created spontaneously by Morgan Harlan. You’ll love this one (I did). It’s the perfect Spring recipe. Bright, slightly spicy and fantastic with the halibut, this is one terrific salsa! Best of all, it takes all of about 15 minutes to put together. That’s faster than you can drive to the pizza place for dinner.

This recipe is safe for Coumadin (warfarin) users, is low in sodium, and is both gluten-free and lactose-free. Those with GERD / Acid Reflux should avoid it.

Living Gluten Free
with Julie Gee

This week, I’m going to tell you about a final set of 15 gluten-free foods that you can eat right now. This gives you a total of 45 readily available foods in your pantry and fridge. While you continue to learn which mainstream products are gluten-free, you can safely rely on these items, as well as other items marketed as gluten-free. Another 15 Gluten-Free Foods You Can Eat Right Now

A Healthy Pregnancy
with Faith Bontrager, RN, BSN

How do you choose a menu that will benefit you and your baby? Googling the phrase “healthy pregnancy diet” returns more than two million responses. Even reputable groups like the USDA and Harvard School of Public Health disagree. Where do you start?

The good news is that you can probably follow any of the reputable sources and be OK. Further good news is that there are more similarities to these plans than there are differences. A Pregnancy Menu for You and Your Baby

Dr. Tim Says….

A couple of years ago I wrote about two related strategies for reducing the number of calories in a dish. The first was to enhance flavor by choosing lower calorie, high-flavor ingredients. The second, and more difficult, strategy was to pay careful attention to those ingredients that have more calories by weight and to use them very carefully.

As it turned out, a recent study had compared the overall daily caloric intake for subjects on four different diets: If It Satisfies, It Satisfies

Featured Recipe

Steak Au Poivre

I simply love Steak Au Poivre. It was a standby in my restaurant days and it’s unfortunate that you don’t see it on many menus these days. It is so simple yet so perfect. The key is to cook the steak at a little lower heat so as to not burn the cracked pepper. The result brings a more savory flavor to the pepper and mellows the spiciness.

Traditional recipes call for using heavy cream and you could, if you like, choose to use it instead of the sour cream. It will add a few more calories, but I don’t use it day to day because I don’t keep it on hand. The sour cream also adds a bit of tartness that I like in the sauce. You have to make sure the sauce is not too hot when you add it to the sour cream or it will curdle the sauce.

This recipe is safe for Coumadin (warfarin) users, is low in sodium, and is gluten-free. Those who are lactose intolerant and those with GERD / Acid Reflux should avoid it.

Living Gluten Free
with Julie Gee

Last week, I told you about 15 foods that are gluten free and may already be in your pantry or fridge. This week, I’m adding 15 more foods to the list to help you vary your diet and continue eating gluten-free. 15 More Gluten-Free Foods You Can Eat Right Now

Chef Tim Says….

There’s no doubt that eating by yourself and eating healthy can be a challenge. There are a few considerations and first and foremost is that there’s no one to share the shopping, cooking and cleaning up. With couples and families often one person will cook and the other clean up. Or sometimes people will switch off making different meals on chosen days. With a larger group of 4 or 5 in a family it can be easier to cook because most recipes are scaled for two or more.

Back when I first started helping people build menus to eat healthier it became clear that these issues were important for folks living alone. At the time I was also living by myself. Here are a few tips for making your life easier, delicious and healthy if you are on your own: Eating Healthy Alone

Featured Recipe

Mustard Glazed Salmon with Lentils

This is one of my favorite dishes. It’s a variation of one created by a chef friend of mine that he used to serve in his restaurant. It is an almost perfect meal. High fiber, legumes, salmon full of monounsaturated fats, rich flavors and veggies make it a complete Mediterranean Diet meal. Best of all it’s really easy to cook and the whole recipe is less than 30 minutes start to finish.

This recipe is safe for Coumadin (warfarin) users, is low in sodium, and is gluten-free provided that your ingredients are gluten-free. Those who are lactose intolerant and those with GERD / Acid Reflux should avoid it.

Living Gluten Free
with Julie Gee

If you’ve just been diagnosed with Celiac Disease or a gluten allergy, you may be wondering what to eat today. Your gluten-free life has already started. It’s time to look in your pantry and find a few safe and delicious items. You’ll learn more about cross-contamination and how to read ingredients in the coming weeks. Today I’ll going to tell you about 15 items that are gluten free and probably already waiting in your pantry or refrigerator. 15 Gluten-Free Foods You Can Eat Right Now

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New Features in
The Quality Calorie Diet!

You asked for it! Now those who follow a lacto-ovo vegetarian diet can create their own two-week meal plans. Just choose “Vegetarian” in your profile.

Plus, now you can add Dr. Gourmet recipes to your Recipe Box! Just click the “Add to My Recipe Box” icon on the recipe’s page (below the Print icon) and if you’re logged in to The Quality Calorie Diet, it’ll be added to your Recipe Box at the bottom of the page. Log in to The Quality Calorie Diet to see the new features!

eatTHISdiet for Coumadin Users:
The Cookbook

eatTHISdiet for Coumadin Users is now available in both spiral-bound paperback and PDF format!

Over 200 pages of what you need to know while on Coumadin (warfarin), including food lists – so you’ll know what you can eat! Includes a complete six-week eatTHISdiet for Coumadin users, with weekly meal plans, shopping lists, and over 90 recipes. Just $31.52 for the spiral-bound book and $14.95 for the eBook. Order yours now!