If there is one thing you need to remember when following a gluten free diet it’s don’t forget your nuts!
Despite the current fad, gluten free diets are not every day diets for everyone. They are a medical nutrition therapy for those with coeliac disease or gluten intolerance. People with these conditions need to avoid gluten for their entire lifetime. People on a low FODMAP diet need to remove it just to tolerance for those gluten-containing grains. But removing gluten-containing foods from diets can also have long term health consequences so finding the balance is key. The month of March is the Nuts for Life #nuts30days30ways challenge to get Aussies eating a handful of nuts each day. Here’s why eating nuts is always a good idea.
Gluten free foods and diets can be:
• Low in fibre – gluten containing cereal grains wheat, rye, barley and triticale contain a fibre rich outer husk so it’s important to seek out gluten-free, fibre-rich alternatives to maintain a healthy bowel function and gut microbiome
• High glycaemic index (GI) – gluten-free, low-fibre foods and diets tend to have a high GI which can affect blood glucose control, increase hunger and increase the risk of chronic disease such as type 2 diabetes and heart disease. (See this blog on tips to follow a low-GI diet gluten free)
• High in additives – replacing gluten or gluten containing ingredients in processed foods often means a number of additives are required in its place. Gluten-free foods may appear in the Health Food aisles of supermarkets but it doesn’t always mean they are health foods.
One solution to these problems is of course adding nuts such as almonds, brazil nuts, cashews, chestnuts, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts.
• Nuts contain 5-10g of fibre per 100g or about 1.3-3g per 30g healthy handful – especially nuts with brown skins or testas. If buying nut meals as gluten free flour alternatives look out for nut meals with a brown fleck it means the skins were left on before they were ground. Nuts skins are rich in phytochemicals with antioxidant properties and they are thought to act as foods (prebiotics) for gut bacteria (probiotics). Research shows eating nuts can alter gut bacteria by stimulating the growth of specific types of beneficial bacteria (1-5) and the nut fibre may play a role in helping external probiotics survive stomach acid reaching the large intestine intact.(6) Use almonds, chestnut and hazelnut meals or whole nuts as snacks.
• Only cashews and chestnuts contain enough carbohydrate to be GI tested and they rank low GI which means they cause a slow rise in blood glucose after eating. For all other nuts they have a GI lowering effect. The complicated structure and high fat and fibre content of nuts means they are digested more slowly. When combined with foods and meals that also contain carbohydrate they slow the digestion of carbohydrate too. This means a slower rise in blood glucose(7), sustain energy and appetite control. Low GI diets reduce the risk of chronic diseases too. Thinking add almonds and cashews to a stir fry with rice or adding nuts to a gluten free breakfast cereal.
• Raw and roasted nuts are gluten free provided they don’t have any other flavourings added. Always check the ingredients list for any gluten containing additives such as thickeners or maltodextrins if nuts have been coated. Nuts, straight off the tree, are nutrient-rich whole foods with minimal processing so are guaranteed health foods.
• Daily nut consumption has been shown to r educe cardiovascular disease and deaths (8) and type 2 diabetes risk (8), and they also help control cholesterol (9). Despite their high fat content do not cause weight gain and may help promote weight loss (10,11).
Did you know?
Chestnuts are not like other the other tree nuts – they are more like a grain or potato than true tree nuts. Chestnuts are a fresh produce item with a distinct season. They are low in fat but rich in low GI carbs and fibre (8g/100g). Surprisingly for chestnuts they are a source of vitamin C with about 10% of the RDI for vitamin C even after roasting. Chestnut meal is also a perfect gluten free flour alternative. It’s chestnut season right now so enjoy them while they last.
How many nuts should we be eating?
A 30g healthy handful each day either as a snack or as ingredients in meals is an easy health investment to make especially if you have coeliac disease or are gluten intolerant.
What does 30g of nuts equal?
• 20 almonds
• 10 Brazil nuts
• 15 cashews
• 4 chestnuts
• 20 hazelnuts
• 15 macadamias
• 15 pecans
• 2 tb pine nuts
• 30 pistachio kernels out of shell
• 9 walnuts
• a small handful of mixed nuts
What about FODMAPs?
If you are following a low FODMAP diet then you will need to avoid some nuts but can eat others. Pistachios and cashews are high in FODMAPs while almonds and hazelnuts are low FODMAP provided fewer than 10 nuts are eaten in a serve.(12) And it all depends on your personal tolerance levels, so check with your Accredited Practising Dietitian about which are suitable for you.
For more information and recipes visit http://www.nutsforlife.com.au and to join in on the #nuts30days30ways challenge visit http://nutsforlife.com.au/media/nuts30days30ways , follow @nutsforlife on twitter, @nuts_for_life on Instagram or search nuts4life on Facebook.
1 Ukhanova M et al Effects of almond and pistachio consumption on gut microbiota composition in a randomised cross-over human feeding study. Br J Nutr. 2014 Jun 28;111(12):2146-52.
2 Mandalari G et al Potential prebiotic properties of almond (Amygdalus communis L.) seeds. Appl Environ Microbiol. 2008 Jul;74(14):4264-70
3 Liu Z et al In vitro and in vivo evaluation of the prebiotic effect of raw and roasted almonds (Prunus amygdalus). J Sci Food Agric. 2016 Mar;96(5):1836-43.
4 Calani L et al Colonic metabolism of polyphenols from coffee, green tea, and hazelnut skins. J Clin Gastroenterol. 2012 Oct;46 Suppl:S95-9.
5 Liu Z et al Prebiotic effects of almonds and almond skins on intestinal microbiota in healthy adult humans. Anaerobe. 2014 Apr;26:1-6.
6 Blaiotta G et al Effect of chestnut extract and chestnut fiber on viability of potential probiotic Lactobacillus strains under gastrointestinal tract conditions. Food Microbiol. 2013 Dec;36(2):161-9.
7 Viguiliouk E et al Effect of tree nuts on glycemic control in diabetes: a systematic review and meta-analysis of randomized controlled dietary trials. PLoS One. 2014 Jul 30;9(7):e103376.
8 Afshin A et al Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2014 Jul;100(1):278-88.
9 Del Gobbo LC et al. Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Am J Clin Nutr. 2015 Dec;102(6):1347-56.
10 Flores-Mateo G et al Nut intake and adiposity: meta-analysis of clinical trials. Am J Clin Nutr. 2013 Jun;97(6):1346-55.
11 Mattes RD, Dreher ML. Nuts and healthy body weight maintenance mechanisms. Asia Pac J Clin Nutr. 2010;19(1):137-41.
The holiday season is a wonderful time for socialising with family and friends. Of course that means our intake of ‘sometimes’ foods can become a little out of control, which can cause later regret. We know that eating a balanced diet contributes to a healthy body and a healthy brain which also means greater vitality and a better quality of life as we grow older. So, although it’s the holiday season, try to remain focussed on healthy habits.
We’re spoilt in Australia at this time of year with so many wonderful fresh foods around. They’re full of flavours, textures and nutrients that will keep us bouncing out of our skins. So revel in those delicious foods and lead by example by sharing fresh seasonal foods at social occasions and at home on a day to day basis.
Managing the lead up to Christmas
When it comes to your food shopping over the holiday season, remember that Christmas day itself is just one day. This means you’re better off avoiding tempted by the likes of fruit mince pies, rum balls, Christmas choccies or shortbreads in the lead up to The Big Day, and save your purchases of these ‘sometimes’ foods for your shop for Christmas Day if you really do want them. If you buy them earlier, chances are that you’ll be tempted to have them beforehand. Everyone knows that if you don’t have something in the pantry at home you can’t be tempted to snack on it.
When you consider that these ‘sometimes’ foods that some people associate with Christmas are also considered luxurious, why not fill your shopping trolley with healthy luxurious fresh foods such as:
People will appreciate the food even more if they know that you’ve gone to the trouble of preparing fresh and healthy foods that will satisfy the flavour cravings and fill those tummies while also looking after their health.
If you feel that it’s important to have a Christmas cake on hand to serve guests, then why not make your own. That way, you know what’s going into it and your loved ones will appreciate that you made with love by your own hands. This also gives you the opportunity to modify the recipe to include more nutritious gluten free flours such as lentil and chickpea flour rather than refined flours, a little less sugar and healthier fats that are higher in mono- or poly-unsaturated fats such as canola or light olive oil (light in flavour) or even Greek yogurt rather than saturated fats such as butter.
How do we manage Christmas parties?
In the lead up to Christmas Day we look forward to the series of Christmas parties that we all love to attend. Some really helpful tips include:
One of my favourite dips to take to Christmas parties just uses a drained tin of cannellini beans with zest and juice of a lemon or lime, a big handful of fresh parsley, a fresh chilli or two and a clove of fresh garlic or two, salt and pepper to taste, and extra virgin olive oil and water to loosen – just whizz it all together and serve. I find this is very popular with the men with the bold chilli and garlic flavour! The green colour adds to the Christmassy feel when served with green blanched veggies and bright red baby sweet tomatoes. It also works as a good dip for fresh prawns!
For Christmas Day do you have family traditions? Many of us do. In Australia, many families are changing the old fashioned cooked hot Christmas meal for a lighter, cooler option. If your family is one like that does the old-fashioned cooked option and after Christmas day you’re left feeling bloated and heavy, perhaps it’s time to suggest a lighter Christmassy alternative.
It’s also easier to prepare as most if it can be done in advance and stored in the refrigerator, and just brought out on the day to make a delicious smorgasbord of fresh luxurious ingredients that everyone will remember and talk about with their friends. Not to mention, they’ll be left with extra energy and vitality to get on with enjoying our beautiful Australian outdoors.
A nice idea is to start the celebration off with a glass of bubbly to help get everyone in the mood. This can be accompanied by fresh summer fruits such as plump cherries, blueberries, raspberries and strawberries and for something savoury try deliciously marinated olives and macadamia nuts (or whichever nuts you prefer).
For the entrée, try something light and fresh that might be as simple as slices of rockmelon wrapped in prosciutto, or a duo of cold Christmas coloured veggie soups (my family’s favourite). We make a green zucchini soup which is just zucchini, potato and fresh tarragon cooked in chicken stock then cooled and whizzed into a smooth soup. It’s delicious and popular with the whole family! And a red soup of course is a tomato based soup full of fresh herbs for added flavour.
For the main, you might still serve the traditional meats, but they can be served cold. In our family, we have a choice of two: a whole leg of ham with a special glaze, and cold turkey with cranberry sauce. Cold seafood selections also work well here. These are served alongside a wonderful array of salads including:
And then we finish off with a small serve of home-made Christmas cake and a selection of spectacular cheeses served with rye bread or wholegrain crackers, quince paste and summer grapes and figs.
Remember to keep in mind basic food safety tips at Christmas time to avoid food poisoning. The NSW Food Authority has some handy hints, including a fact sheet on ‘Summer Eating’.
All this wonderful, nutrient-rich food will leave you and your guests with very happy tastebuds, tummies and will contribute to everyone’s wellbeing. You’ll be the star of Christmas for sure!
Some useful sites in building your healthy Christmas:
Thanks to Accredited Practising Dietitian Joanna Baker of Everyday Nutrition for this helpful blog on identifying gluten on labels, helping us to Be Well Gluten Free :
If you have Coeliac disease, the only way to allow your gut to heal and to avoid symptoms is to follow a strict gluten free diet. Since gluten can be hidden in all sorts of unexpected places, learning to read a label will become one of your most essential skills. It may seem overwhelming at first, but with a little practise you will be able to take charge of your health and find freedom in being able to confidently decide for yourself if something is safe to eat or not.
Many foods are naturally gluten free. They are usually cheap to buy and can easily make up a large portion of a healthy diet. These include fresh fruits and vegetables, unprocessed and un-marinated cuts of fresh meat, poultry and fish, eggs, bottled water, plain cows milk (flavoured or soy milks may contain gluten), nuts and legumes, fats and oils, plain rice and other gluten free grains. These products may or may not be labelled as “Gluten Free” and unless they are contaminated in processing (see “allergen statements” below) are all suitable for a gluten free diet.
2. Gluten free declaration.
If a product is labelled clearly as “gluten free” this overrides all other statements. To carry this statement, the product must have been tested and gluten should be listed as 0g/100g in the nutrition information panel, as shown in the image to the right.
Gluten is the protein found in Wheat, Barley, Rye, and Oats. In some countries, Oats are considered as suitable for a gluten free diet, however Coeliac Australia recommends Oats are not included as part of a gluten free diet, unless the person has undergone a supervised Oat challenge including biopsy. You can read more about Oats here .
Some foods are gluten free because they don’t include any gluten containing ingredients. Read the ingredients list and look for wheat (including spelt, semolina and durum), barley (malt), rye, oats and their derivatives. Since Australian law specifies that certain allergens including Wheat or Gluten must clearly be labelled, these are often listed in bold, as shown below.
There are 2 important considerations here:
If you are after more information about a product credible sources of information include your local chapter of the Coeliac Society, your own Accredited Practising Dietitian, or the manufacturer of the product. Facebook, twitter, Instagram etc are not reliable sources of information for basing healthcare decisions.
Being diagnosed with coeliac disease can come as a relief if you’re sick and tired of feeling sick and tired all the time. At the other end of the spectrum it can be a shock for people who don’t suffer with symptoms and feel perfectly well. Either way there’s quite a steep learning curve and old habits can be hard to break.
It can also be a big adjustment for the other people in your family and other parts of your life. You may feel that it’s all about you, but for people who love you it can be quite traumatic, so try to be mindful of that. It’s important too that blood relatives know that they’re in a high risk group for developing coeliac disease too. Especially if they’re suffering any symptoms they should be tested before starting a gluten free diet. You can find a letter about family screening on the left hand-side of the screen when you follow this link .
It is a large learning curve for you and for others in your life, which can seem overwhelming at first. The good news is that there is lots of support out there for you and your loved ones.
The other good news is that you have been diagnosed! This puts you a very strong position to move forward and learn how to be well gluten free and still enjoy a delicious range of foods.
For some years now, gluten free diets have been a huge trend and one that continues to grow.
News from the CSIRO , recently published in the Medical Journal of Australia, called the trend a “real phenomenon” and stated that in a CSIRO study as many as one in seven Australian respondents , not diagnosed with Coeliac Disease, reported avoiding wheat or dairy foods.
This is in addition to the one in 70 Australians with medically diagnosed Coeliac Disease.
For those living gluten free or avoiding wheat, breakfast is often the toughest meal to master.
So here’s a reference that outlines the facts about going gluten free and easy options for brekkie, including details to clear up confusion about whether oats are in or out.
Who needs to go gluten free?
A strict lifelong gluten free diet is required for treatment of medically diagnosed Coeliac Disease . People who have a medically diagnosed wheat allergy also find gluten free foods helpful because gluten free foods are always wheat free.
A gluten free diet may be used for non-coeliac gluten sensitivity , but the diagnosis and treatment of this is controversial.
The CSIRO study , which identified one in seven Australian respondents followed a wheat or dairy free diet, confirmed the dietary change was largely self-initiated as a result of an adverse food reaction. It also outlined the resulting risks, including nutritional imbalance and delayed diagnosis of potentially serious medical conditions.
It is extremely important to ensure adverse reactions to gluten are medically diagnosed because self-diagnosis does not work. Even if you feel better reducing gluten, it may not be the cause of your symptoms and you need to identify the real problem and get the right treatment.
For example, for people with gastrointestinal symptoms, like Irritable Bowel Syndrome (IBS), the cause is often a group of food components called FODMAPS .
There are also many Australians who have adopted a gluten free diet (or are avoiding wheat or grain foods) to lose weight. There is no evidence to support this and you may lose or gain weight on a gluten free diet. Going gluten free unnecessarily is not the best option because many grains, especially wheat, are important sources of prebiotics that help create a healthy population of gut bacteria and protect long-term health.
What is gluten?
Gluten is a protein found in rye, barley, triticale, oats and wheat, including wheat varieties spelt, farro, kamut, durum, plus bulgur and semolina. It’s the very thing that keeps wheat bread light and fluffy after you bake it. A gluten free diet means avoiding all gluten-containing grains, all foods containing related ingredients and any food that may have been cross-contaminated with gluten e.g. a gluten free cake on the same plate as cakes containing gluten.
Eating gluten free
For people who need to follow a gluten free diet, the good news is there are plenty of grains that are naturally gluten free. These include corn, rice, millet, sorghum and teff, plus the ‘pseudo-cereals’ amaranth, quinoa and buckwheat. These grains are the basis of many gluten free foods.
Fresh plain fruit, vegetables, legumes, dairy foods, meat, fish, eggs, nuts, seeds, fats and oils are also naturally gluten free. Gluten-containing ingredients may be added to these foods in recipes, in restaurants and in food manufacturing. It is best to check the ingredients list and Nutrition Information Panel and on all packaged foods or contact the food manufacturer or restaurant to be sure.
In Australia, foods labelled gluten free are required to contain no detectable gluten.
Confused about oats?
Oats and products containing oats cannot be labelled gluten free in Australia and New Zealand. In Australia, oats are not recommended for people with Coeliac Disease because some people with Coeliac Disease are not able to tolerate oats.
However, food standards in Europe and the USA do recognise gluten free oats as suitable for people with Coeliac Disease. More research is clearly required to identify who can or cannot tolerate oats.
Which breakfast cereals can I eat?
If you are eating gluten free or wheat-free, there are a wider range of products available than ever before, including new gluten free versions of family favourites and some liquid breakfast products for when you need brekkie on-the-go.
It can be more difficult to get enough fibre on a gluten free diet, so choose whole grain and higher fibre breakfast cereal options often. You can also add extra fibre by topping your cereal with nuts and seeds (chia, linseeds, sunflower) or gluten free grain products (rice bran, psyllium husks, buckwheat).
Here are some Australian made breakfast cereals to try (listed by manufacturer):
Always get the best advice
This information is not a substitute for medical advice. Please seek advice on your personal health and nutrition needs from your trusted medical advisor and an Accredited Practising Dietitian that specialises in treating Coeliac Disease and/or Irritable Bowel Syndrome.
Leigh Reeve is an Advanced Accredited Practising Dietitian and Director of the Australian Breakfast Cereal Manufacturers Forum (ABCMF). Leigh has many years experience as a dietitian across a broad range of practice areas.
So that leaves us with fruit and veggies. These are two food groups where you can take the brakes off when it comes to being vigilant about making sure what you are eating is gluten free as fresh fruit and vegetables are all naturally gluten free! Of course if you are buying processed fruit and vegetables (like frozen potato wedges or yoghurt with fruit pieces), or you are eating out, you should always to check to make sure there is no hidden gluten or cross contamination.
When it comes to fruit, eating the whole fruit is a much better option than getting fruit in a juiced form. Eating a whole piece of fruit means you don’t miss out on any of the fibre or other nutrients that can be left behind when a piece of fruit is juiced. Eating a whole piece of fruit is also much more substantial than sipping on a juice and is more filling which helps to satisfy hunger. You can see in the image below that fruit juice and dried fruit are recommended only occasionally and this is due to their high sugar content.
For the most part, it is pretty simple working out what a serve of fruit is. If you eat a whole apple, banana, orange or pear, you have eaten a serve of fruit. It gets a little trickier when the piece of fruit is small (like plums or apricots) or is a type of fruit that you don’t eat by the ‘piece’ (like strawberries, blueberries and grapes). The following are also considered to be one serve of fruit:
How big is a serve?
We’re very fortunate to have one of our contributors to the Be Well Gluten Free Facebook group, who is very close to becoming a qualified APD, to cover the next couple of blogs for us. Thanks Nina Mills for your guidance on these sometimes tricky issues! And over to Nina:
Sally introduced the Australian Dietary Guidelines in her earlier post How to follow the Australian Dietary Guidelines Gluten Free and discussed in detail how to make gluten free choices from the Grains group. I am picking up where she left off to discuss one of the other topics requested on the Be Well Gluten Free Facebook page. And that was: what are the food groups and what is a healthy amount of each to eat?
In these posts we will be focussing on what is recommended for an adult in each of the food groups. Healthy eating guidelines for children and pregnancy are available on the Eat For Health website.
So, given that the grains group has been covered, over the next couple of blog posts let’s take a look at the other four food groups and what the best options are if we are aiming to be well, gluten free. Let’s kick things off with the food groups previously known as ‘meat’ and ‘dairy’.