Fit Foodie: Going Gluten-Free

Millions of people suffer from celiac disease, an autoimmune condition triggered by gluten. After a health scare, Alexandria-based dietician Cheryl Harris learned to live with it. Now she teaches clients how to do the same.

Seven years ago, Cheryl Harris logged on to a dietician message board, terrified for her life. Seemingly out of nowhere, she’d dropped 40 pounds in a month and doctor after doctor couldn’t find a cause. The best answer she got was from a gastroenterologist who said, “Looks like food’s bothering you—you figure it out.” Her diagnosis: irritable-bowel syndrome, a somewhat vague, catch-all label for intestinal discomfort.

But Harris was more than just uncomfortable. “I was in tremendous pain and really afraid,” she says. She was down to just 90 pounds.

At her wits’ end, Harris, a registered dietician based in Alexandria, asked the online community for help. Someone suggested trying a gluten-free diet, one that eliminates all wheat, barley, and rye and some oat products. Within two weeks, she says, she felt better.

Although Harris was never given a formal diagnosis, she suspects she has celiac disease, a condition in which the tiny projections that line the small intestine—called villi—become damaged and are unable to absorb nutrients from food. When people with celiac disease ingest gluten, the immune system responds by attacking the villi and wearing them down. So gluten is a trigger, says Harris, which “tells the body to attack itself.”

Left untreated, those who suffer from celiac disease are at far greater risk for potentially life-threatening or irreversible complications, such as osteoporosis, diabetes, liver disease, infertility, and cancer. The condition can be difficult to diagnose because the early symptoms—diarrhea, constipation, unexplained weight loss, vomiting—vary from person to person. Over time, as the body accrues major deficits of vital nutrients, other symptoms might crop up, such as depression, nosebleeds, skin rashes, and hair loss.

A blood test is needed to diagnose celiac disease, but if the test comes back positive most patients undergo an endoscopy and biopsy of the small intestine to confirm it. In Harris’s case, she had blood drawn, but the doctor failed to run the right test. By the time she realized what she might have, she was already on the mend—once a person with celiac disease eliminates gluten, the body heals itself and the disease becomes undetectable.

As she watched her body heal, Harris became more and more passionate about the disease. She had received a bachelor’s degree in nutrition from Cornell and a master’s in public health from Berkeley. She remembers learning the basics about the disease during an hourlong lecture in school, but the teacher said it was such a rare condition—1 in 10,000 people were thought to have it—that it was unlikely anyone in the room would ever see a celiac client. “That was ten years ago,” she says. “Now we know the prevalence is much higher—1 in 133.”

In fact, a 2009 study found that celiac disease is four times more common today than it was just 50 years ago. The reason why is unclear, but some experts, including Harris, think it might have something to do with changes in the foods we eat, particularly when it comes to processing. “If you don’t have gluten in your diet you can’t develop celiac disease,” says Harris. “It seems like the more you eat the more likely it is.”

After she began studying the disease in earnest, Harris became a bit of a self-made expert. Now she sees a large number of clients who have the disease. She helps them learn how to live gluten-free. Her oldest newly diagnosed celiac client is 83. He’d never experienced a single symptom until he late in his life. “For a lot of people there’s a trigger, whether it’s illness or surgery or a physical or emotional stressor,” says Harris. But others, such as her six-month-old clients who experience symptoms after eating a Cheerio, seem to be born with it.

The hardest part about going gluten free, says Harris, is learning what you can and can’t eat. There are the obvious culprits, such as pizza, beer, and bread. But gluten shows up in some surprising places, too; licorice, soy sauce, cough drops, and even some lipsticks contain gluten. “The range of things that contain hidden gluten is quite vast,” says Harris. “You can use a list or even an iPhone app when you first start out, but at the end of the day you need to learn how to read labels.”

The National Institutes of Health recommends seeking guidance from a registered dietician. Harris says a good one should be able to teach you how to read labels and offer recommendations for a nutritionally balanced gluten-free diet. “A lot of times when people start out, they’ll be like, ‘I learned that Fritos are gluten free!’ but they’re still not good for you,” says Harris. “It can be a big transition at first, but the key is settling into a normal diet and lifestyle that you can stick to.”

Harris also says support groups can be helpful. “People can get ideas and share recipes and vent and learn,” she says. “It’s really a necessary thing to do.” Harris works with the Washington DC Celiac Support Group, which holds meetings in Arlington, Bethesda, and Silver Spring. Members also organize gluten-free potlucks and outings to restaurants. A database of gluten-free restaurants in Washington and beyond is here.

More than anything, Harris says, those just starting gluten-free diets should keep it simple. “Don’t go out on the first weekend and try to bake a gluten-free cake,” she says. Instead, focus on eating naturally gluten-free foods, such as fruits, vegetables, nuts, beans, chicken, and eggs. To help get you started, Harris gave us a recipe for one of her favorite—and simplest—gluten-free desserts. Try it out, then tell us what you think in the comments.

Caramelized Bananas
Serves 2 to 3

1 tablespoon butter
2 firm bananas, cut in half lengthwise, then in half crosswise
2 tablespoons brown sugar
¼ cup dark rum, orange juice, or pineapple juice
Pinch of cinnamon and nutmeg

In a , melt butter over medium-high heat until no longer foamy. Add bananas, cut side down and cook about a minute. Remove from heat, add sugar and liquid of choice, and then return to heat. Shake the pan to prevent bananas from sticking and cook for 1 minute; add cinnamon and nutmeg. Serve with sorbet or plain flavors of ice cream, such as vanilla or chocolate. Enjoy!

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