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Update on the gluten-free diet

Todays blog is very brief as I am packing to go to London for the Allergy and Free From Show but I need to tell you about todays events. My tuna pasta salad was a disappointment I managed to eat about 1/3 of it before I gave in and purchased a gluten-free chicken and salad roll from the hospital cafe. This was very reasonably priced – not much different from the other sandwiches on offer, but it was rather high in calories – 500 Kcal per small roll but it was filling and very tasty. My meal tonight was unplanned and because I am really busy I cooked some rice and used a gluten-free butternut squash soup to flavour it – a bit unconventional but it was very nice and filling. I also ate one of my scones 🙂

I have a different type of pasta to try but this will not be until Sunday, which I assume is the final day of the challenge, but I will try even if it is after awareness week. The picture I have posted was of the stand that I arranged with the local coeliac group last year, we were privileged to have a photo of it in Crossed Grain Magazine.

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Day 3 – getting complacent?

Just look at my scones, aren’t they just perfect? Guess what? I made them without the recommended 28g of oil – so slightly lower in fat too, so I’m not just thinking of gluten-free now, but healthy eating – multi tasking diva, lol! They were from a packet mix so I suppose I cheated a little but so what? Just a good food for a treat, they are a little better having been made for a day and they don’t have the ‘bicarbonate’ taste you sometimes can get after eating scones. So all good then?

Well, perhaps I speak too soon – all was not perfect with the pasta I made for my lunch. I followed the instructions on the packet. I always tell people to do this, since a previous experience of ending up with a lump of starch once when preparing gluten-free pasta. I was stirring the pan as advised as tasted the pasta which was a little too al-dente, then in a matter of seconds it went very mushy. I have still prepared my pasta salad for lunch so I will report back how this tastes later today.

I’m up early today, bright-eyed and bushy-tailed and ready for whatever the day may bring. Reflecting on things this morning and I do feel that it is really important as a dietitian not to impose your food likes/dislikes on others, I have always been somewhat aware of this when I recommend sip feed drinks to patients but also in clinic. I recommend those people who are newly diagnosed coeliac, it is really important to try as many different foods as possible as we all like different food. I may not like many of the gluten-free biscuits, for example, but others may – so I would advise to try again with foods if you are struggling with. So don’t let my feelings on gluten free biscuits cloud your judgement, they are worth trying for a treat. This is also good advice for people who have been coeliac for a number of years and who are stuck in a rut of eating the same food all the time – my experience over the past few days is that even in a short period of three years the choice of gluten-free food has improved significantly.

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Day 2 and Counting – no near misses today

Made it – day two, no near misses, up to now, at least! So I had the same breakfast as yesterday, which I am still enjoying – not like my foray into gluten-free in 2009 – I’m unsure what has changed perhaps it’s my improved knowledge of the diet.

My lunch is shown on the right, it consisted of

1 fillet of smoked mackerel

1 boiled egg

5 radishes

2 celery sticks

2 inch slice of cucumber

5 mushrooms

and 2 slices of my wonderful (?) gluten-free bread

Unfortunately I forgot to take some fruit with me today so I arrived home ready to devour ANYTHING,  I would have eaten a scabby donkey if one were available – they are gluten-free :-). The one problem with the gluten-free diet if you are not used to it planning is needed. What to have for my meal? Whilst preparing my meal I had 2 small gluten-free corn cakes and a banana.

My bread has gone stale now – so ready for toast, 2 slices of bread (or brick – which describes it a little better!) with Edam and some ham (packet ham – avoiding contamination.) I did really enjoy this and it has filled me up. The gluten-free carb foods do fill me up I wonder if that is because they can be higher in fat to improve the texture? I don’t think my bread will last another day so I have wasted that mix, about 1/3 of a loaf, I might try freezing some next time, but I don’t think I have enough mix left to make another loaf.

The good thing about following the diet is that I can’t have any biscuits – My one and only weakness!! 🙂 I am going to try to make some scones now – so watch out for another culinary disaster.

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‘G’ day – day one on gluten free diet.

Day one – the gluten-free challenge – how is it going? Well fine actually – I have done good so far, but less than 24 hours in so perhaps that isn’t too surprising. Nearly had one mishap this morning though, or what would be classed in the health service as ‘a near miss incident!’ My alarm clock decided to ring VERY early – I don’t know why, this woke me up, disturbed my sleep and when I eventually managed to drag my body out of bed and go down for breakfast, I reached in the cupboard and took out the box of cereal that is too high in barley malt – poured a bowl – then realised. Had to put the cereal back in the box and get a new bowl. Opened the gluten-free cereal and had that with skimmed milk, a handful of raisins and two tablespoons of gluten-free cherry yoghurt – nice!

The picture above was my lunch consisting of

1/2 packet of brown rice fine noodles – pour on boiling water till soft, then drain and cool.

2 inch slice of cucumber – cut lengthways

100g prawns

2 sticks of celery – cut lengthways

2 radishes (for colour)

2 tablespoons of gluten-free sweet chilli

Mix well

I had this with 1 apple and 1 banana.

Waiting now for my evening meal of jacket spud and gluten-free baked beans – yum!

Last night I emailed the hotel and requested a gluten-free breakfast – they were very fast in responding, but I also need to ask them to bring my breakfast separately should it be a free for all buffet – breadcrumbs included! 😦

This is what I requested – we will see what happens, although it might be difficult to tell if some contamination has occurred 😉 but this is no different to what some people will experience.

Dear Sir/Madam
I have a reservation on the 17th and 18th of May and I am sending this email to request a gluten-free option for breakfast, if you would be so kind to provide this. This is required because of coeliac disease and consuming gluten can make me ill, should you need more information on how to provide a gluten-free diet please check the following link, which will take you to coeliac UK’s website where you can find further information. It is important that any contamination with gluten during preparation and cooking is avoided, this can sometimes be a problem. I am more than happy to answer any questions, or check foods for you, should this be needed.
If you can’t provide a gluten-free option I will bring my own cereal, so please let me know if this request is problematic.
Thank you
Tummy rumbling now – need my meal
Will blog again tomorrow!

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Less than 24 hours to G Day!

I have been challenged to have another try at following a gluten-free diet by Coeliac UK Wessex, to see what changes have come about in the last 3 years, I am aware of the changes as I do have to advise people, but as I have blogged previously – nothing like ‘living it.’ This time to make the challenge a little more difficult I am going to the Allergy & Free From show on Friday and Saturday necessitating a hotel stay and no doubt two days of eating out and all the difficulties that may present.

So with less than 24 hours to go to G day (gluten-free day 1) I have been preparing – I have to say I am a little more comfortable in following the diet this time as I am very knowledgable about what the requirements are, much less daunting than my first foray in gluten-free living. I have made my bread (see attached picture) not a pleasant sight, but very tasty non the less ;-). I have a fridge full of naturally gluten-free salad and fruit and I have planned what I am going to eat. The one thing I am finding a little unsettling is the fact I am going to have to contact the hotel to request a gluten-free breakfast – this is a little fraudulent, I feel, as I don’t have coeliac disease, but it is necessary to immerse myself fully in the experience. I am going to have to open a new box of rice breakfast cereal (as the one we are currently using contains greater than 100 ppm of gluten – as barley malt) and a new jam pot (to avoid contamination) and prepare my meals for work, I am actually looking forward to the experience. My lunch has been made for ‘G day’ brown rice noodles, gluten-free sweet chilli sauce, prawns, cucumber and celery salad and I have planned to be able to have a yummy breakfast with rice cereal, gluten-free cherry yogurt and some dried fruit (containing iron and calcium.) Wish me luck – will blog again tomorrow 🙂

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Self care for your irritable bowel – worth a look?

This month The IBS Network launched is new interactive on-line self-care plan for IBS, you may be wondering what it’s all about, and possibly not being a member you wouldn’t have access to it to try it out. Well, this blog will give you some more information to allow you to make your mind up before taking the plunge. Some questions you may be thinking of:

Why should I take responsibility for my IBS – surely I pay my taxes or health insurance to pay doctors to sort this out for me? 

So, has this happened then? If your IBS has been helped you probably wouldn’t be looking for answers. IBS is a chronic condition that is poorly understood by the medical profession, and they freely accept this is the case. This condition is very similar to other misunderstood syndromes such as chronic fatigue and fibromyalgia, IBS is a problem of how the digestive system functions, or moves – looking at it using tests and instruments doesn’t lead to a diagnosis, as there is nothing yet that can be seen. This is either because it is caused by something that researchers haven’t yet found or it is purely a dysfunction in the way the gut moves (think of it as being similar to the different speeds your heart can beat.) It does not mean that it’s all in your head, or you do not feel pain or you do not suffer from difficult diarrhoea or constipation. The plan can give you information that will help you think of what else it could be, but sometimes accepting IBS for what it is will allow you to move on and try to help yourself. Everyone’s IBS symptoms are different, you are best placed to be able to help with your own IBS as you understand what makes your IBS flare up.

But I don’t understand what affects my IBS – it’s so complicated! 😦

This is where the self-care plan can help, you can use the symptom tracker for two to three weeks, it is a simple tool that helps you log areas that affect your IBS such as life events, diet, medication, disturbed sleep and exercise. We have kept it fairly simple so that you can focus on general areas initially making it easier to design your self-help package. You can then print a report that will show you when you feel better or worse and what happened to cause a change. This is also a very good report to take along to your healthcare provider, to help them to identify the best course of treatment for you.

For example – So my symptom checker has shown that every time I eat pasta I feel worse and every time I have a meeting with the MD at work I get diarrhoea. You can then use the information contained in the plan to check out how to change your diet to help you feel better and what can be done to relax before your meeting or what medications may help you.

This is fine to talk about but I find it really difficult to change my life!

The answer to this is we all find it difficult to change from time to time. Make one change at a time if you can, this will make it easier for you to use your symptom tracker to see if the change has helped – be SMART with your changes

Specific goals – makes them easier to manage. e.g. “I wish to reduce my levels of stress”, this is not specific enough, how are you going to reduce stress? By doing what?

Measurable – you need to be able to see the effect to feel really great about your achievement – use your symptom checker, or a food & mood diary.

Achievable – How are you going to make the change? Try to choose parts of your plan to change that you feel are much easier to achieve, this will give you lots more confidence to try the harder changes. For each change ask yourself the following question

‘on a scale of 1-10, 1 being very easy and 10 being very difficult – what would I score the ease of making this change?’ Try the ones that score lower initially.

Realistic –  Think about if you can really achieve what you have planned – if it’s just too difficult to do, you will be setting yourself up to fail. Sometimes we can’t change some aspects of our lives, it is fine to accept this and PUT IT TO ONE SIDE, don’t keep focussing on what you can’t achieve. Another question to ask would be, is it the right time for me to make this change?

Time focussed – how long is it going to take? It may take a minimum of three weeks to change some aspect of your life and thinking how long you will need will help you to keep focussed.

Changing our lives, what we eat or how much exercise we do is a challenge, we all behave in a way that makes it easier to live our lives, but think about your symptoms – if you always do the same thing you will always get the same result – ask yourself do you want this to continue? what are you gaining from your IBS? What will changing mean? The care plan will help you think about your IBS and it contains exercises to help you understand your condition. Changing can take time and lapses are to be expected, it is what you do about a lapse that’s important – don’t put yourself down and feel a total failure, put it behind you as something that has happened (and was probably likely to happen!) and try again – small steps! Think and plan what you would do if you have a lapse in your planned changes before they happen and this will help. Don’t allow a lapse to become a relapse. Also plan to reward yourself when you reach each goal this will positively reinforce the changes you have made.

I have heard that having a practitioner actually helps with IBS? How will helping myself work?

All the information contained in the care plan has clinical evidence or experts in health have come to a consensus through experience that the information will help – we don’t yet have evidence that the self-help plan works as a whole, as it has only just been developed – this is something we hope to prove when people are starting to use it. There is a study that on-line self-help for other chronic conditions such as chronic fatigue* works, and whilst this doesn’t directly relate to IBS, with 10 – 20% of the population diagnosed a new way of helping needs to be developed.

If you are interested in the plan follow the link on the right hand side of this page or copy and post the following link

http://www.theibsnetwork.org

*Nijhof, Bleijenberg, Uiterwaal, Kimpen, Putte (2012) Effectiveness of an internet based cognitive behavioural treatment for adolescents with chronic fatigue syndrome (FITNET): a randomised controlled trial The Lancet published on line March 1, 2012

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