Simple {gluten-free} Sourdough Stuffing and a 2020 Thanksgiving Menu

I stumbled upon a twitter thread the other day amongst the celiac community on the topic of the upcoming holiday celebrations. The initial question was about handling cross contamination at gatherings involving food. So many individuals repeated what I’ve felt all year, a sense of not having to worry about it for the first in a long time, due to smaller stay-at-home gatherings this year. As sad as it to think about such a drastic change to our social traditions the last few months, not traveling or eating with others has also been much easier on me. For the first year in more than a decade, I haven’t experienced any of the multi-day ill effects after eating out at restaurants or in others’ households due to cross-contamination.

Even before the pandemic hit, William and I had planned for this year to be a non-travel year for the holidays. What we didn’t necessarily intend was that we would be spending Thanksgiving (and likely Christmas), not with friends or family coming to us, but with only the two of us. A continuation of the norm this year. Instead of lamenting over not catching up with anyone or seeing friends in person, I’ve decided to take the perspective that this year can be a good ‘rest year’ from the constant scurrying about that has become the last 15 years. And because I love to cook, I’ll be making holiday meals of the dishes we truly enjoy. Because I’m married to a traditionalist, and trend towards the traditional as well, I’m planning for a smaller-scale traditional Thanksgiving featuring all my / our favorite sides that I can now enjoy free of gluten-fear.

Below is what I plan to make, along with a little more inspiration if you’re still deciding on your own scaled down semi-traditional Thanksgiving meal. As per usual, all of these recipes are gluten and dairy free. Most are also vegan and soy free. William has ordered a ‘half turkey’ from his favorite local farmer, and though I don’t tend to crave meat left to my devices, we’ve both agreed it’s not really a Thanksgiving meal without the turkey — and stuffing of course! If you do not eat turkey, I suggest adding some sort of protein-rich side to your meal such as the creamy white beans linked below, and then make a centerpiece dish by baking this stuffing in a medium-large pumpkin or winter squash instead.

In whatever way you’re spending the Thanksgiving holiday, I hope you find a little time to reflect on what you are thankful for this year and what has brought joy or peace amidst the rest.

Savory //
Renee’s Harvest Moon Kale Salad
Claire’s Roasted Brussels Sprouts + Mushrooms
Celebratory Turkey (the best you can find, brined and rubbed with thyme)
Celery Root + Potato Mash
Simple Sourdough Stuffing (recipe below)

Other savory ideas:
Roasted Vegetables with Autumn Roots + Mushrooms
Persimmon + Grains with Moroccan Seasoning
For the Joy Salad
Wild Rice Stuffing Balls
Creamy White Beans with Greens
Delicata Squash, Rosemary + Cranberry Flatbread

Sweet //
Cranberry Chia Jam
Apple Pie with a Fabulous Gluten + Dairy-Free Pastry
Pumpkin Pie

Notes about the Menu:
– If you eat turkey and are highly sensitive to gluten, you may need to make sure your turkey has been processed without any gluten-additives. My first recommendation is always to purchase a turkey from a local farmer, if available, but I know that can be asking a lot, especially if you’re not hosting the meal. Otherwise, here is an excellent list of available brands that don’t process with gluten.
– For dairy-free / vegan mashed potatoes, we tend to skip the russet varieties and opt for German Butterball or Yukon Gold varieties. They have more flavor and moisture, and work well by mashing without butter, and just a bit of non-dairy milk, seasoning, and a splash of olive oil, if desired.

Simple Sourdough Stuffing, serves about 4
This is as close to the flavor of my mom’s (and similarly, grandma’s) gluten-full stuffing as I can get, but features whole-grain gluten-free sourdough bread instead. Truly, flavor rich! Growing up, my mom’s thanksgiving stuffing was my favorite dish to look forward to. Years later, when I finally asked what her secret is, she told “me lots of butter”. Though that’s not exactly true because I grew up on margarine. Anyways, I first made this with olive oil and the flavor fell a little flat. I could tell it was the lack of butter. If you can tolerate dairy products, using ghee will be best (flavor and digestibility) and alternatively a good quality vegan butter instead of olive oil. My preferred brand of vegan/non-dairy butter is linked below. My mom doesn’t keep a recipe and relies on tasting to make sure just the right amount of seasoning is added. That’s a good method since we all have a different preference and it will depend a little on the freshness of your dry herbs.

5 cups gf / whole-grain sourdough bread cubes (~ 1-inch)
2 Tbs. vegan butter (this one is preferred) or ghee
2 Tbs. dried sage leaves
2 tsp. dried thyme leaves
1/2 tsp. sea salt
1 small onion, chopped (~ 1 cup)
2 celery stalks, finely chopped (~ 1 cup)
1/4 cup fresh parsley, minced
1 3/4 – 2 cups mineral broth, or low-sodium vegetable broth
black pepper to taste

  • A couple days before you make the stuffing, place the bread cubes on a baking sheet and let them dry uncovered. Or speed up the process by putting them in the oven at 275 degrees F for about 25 minutes, or until they are dry.
  • Heat the oven to 350 degrees F. Then, heat the oil or ghee in a large skillet over medium-high heat. Add the sage and thyme leaves, as well as the salt. Cook for a few seconds until you can smell the herbs, then add the onion and celery. Saute for 6-8 minutes, or until the onion is soft and clear. Reduce the heat to low.
  • Stir in the bread cubes, along with the parsley and 1 1/2 cups mineral broth. Turn off the heat, and add black pepper, any additional sage or thyme, and more broth until the mixture tastes flavorful, and is soft and wet. If the bread is still a bit dry, add more broth.
  • Transfer the stuffing to a deep baking dish such as a 9 x 5 loaf pan. Alternatively, bake it inside your Thanksgiving turkey or inside a large pumpkin / squash, for a centerpiece effect.
  • Cover the baking dish with foil and bake for 20 minutes. Then uncover the dish and bake for an additional 20 to 25 minutes until the edges are starting to get a little crispy and golden brown.

Strawberry Rhubarb Scones {gluten + dairy-free} and Celiac Awareness Month

I was listening to an interview a few days ago with a nutritionist who was immediately asked, “So you’re a nutritionist. What diet are you on?”

Before she responded, I visibly cringed because let’s face it, most of us who work within the nutrition world follow a style of eating that is a type of diet. The reason for this varies but is usually because many of us that spend our days helping others with food and health came to it because we struggled ourselves.

And that’s true of myself as well.

The individual on the podcast quickly and proudly clarified that she has no food restrictions and isn’t on a diet. Had I been a nutritionist more than a decade ago when I first began to realize I was being called and pulled in this direction, I would have said the same. At that point, is was very helpful for me to eat the full spectrum of foods and to not have any restrictions, as is true for many individuals.

But then a lot more health challenges came along and here I am, a veteran of a gluten-free (and dairy-free, mostly vegetarian) diet. My journey was and continues to be one of a food as medicine approach. But I’m certainly not the type of person that believes everyone needs to prescribe to my way of eating. We’re all so different with life circumstances, genetics, preferences, and yes, food choices or dietary restrictions as a way to remain in balance with our health.

Celiac Disease Awareness

May happens to be Celiac Awareness Month, and as an individual that has had to eat strictly gluten-free for the last eight years, the better part of those years has been in educating others about what it means to live with a food restriction that when contaminated with even a little gluten, leaves longer-term symptoms than ‘just’ having a stomachache for a day or so.

What that means is also different for each person. 80 percent of individuals with celiac disease have difficulty remaining gluten-free, 70 percent are still exposed to gluten while on a strict gluten-free diet, half of all children with celiac are anxious about eating, many individuals have symptoms of depression, and nearly all have sacrificed major life experiences such as not being able to travel widely, enjoy a meal out with friends, enjoy the full experience of a wedding or birthday celebration and the like.

For me, it means I rarely eat out because I react to most restaurant meals unless it’s made in a strict gluten-free kitchen. Pizza, bakeries, gastropubs, and the like that serve a traditionally floury mix of foods and/or have one grill, fryer, or oven are generally the worst — ethnic cuisines that tend to be gluten-free by their nature are less risky. This is similar when eating in the homes of friends or family. (Wheat) flour in the kitchen tends to mean it floats and ends up in foods and surfaces you wouldn’t think about unless you have to.

On the flip side, there are many options to live fairly comfortably with a gluten-free lifestyle these days. More restaurants are beginning to understand the major issue of cross-contamination. Usually these restaurants have a family history and they’re the ones to trust because they take it seriously.

And gluten-free flours and baked goods are much more plentiful in the last several years.

But that doesn’t always mean we should be eating them.

What do you mean? I have to eat gluten-free because of celiac or similar and you want to take away my GF baked goods too?

Inherently, most gluten-free baked products have a lot of “junk” ingredients in them, ie starches, gums, and excess sugar (hello boxed gluten-free cake mix whose main ingredient is sugar). What most of these ingredients turn into in the body is a simple sugar, and sugar is extremely inflammatory, especially for individuals with an autoimmune disorder–which means the body tends to be really good at making inflammation a regular event. Not so good for daily comfort, being pain-free, having a positive mood, or long-term health.

So while I’m not a proponent of too many gluten-free baked goods — especially if they’re made with lots of refined flours, starches, gums, and sugars, I tend to be of the mindset that fresh baked bread, cake, cookies, and pastries and even the kind that are actually just not that good for you, can make their way into a Celiac friendly diet. Though maybe as just sometimes foods rather than everyday.

Depending on your personal health needs, of course. See last week — Are You Eating Enough for Your Activity Level? — as an example.

And while this is a celiac disease and gluten-focused article, I’m fully aware that other restrictive diets due to food allergies and/or medical necessity can be just as or more challenging to navigate. Despite this, my goal as a food as medicine eater and nutritionist is always to increase the diversity of our daily food choices, rather than limit them.

Strawberry Rhubarb Scones, makes 8
These are the Irish style of scones, so they’re usually made round, low in sugar or without, and delicious sliced in half and eaten with a little cream (traditional), yogurt, or honey.

I’ve made these with vegan butter here (Melt Plant Based Butter Sticks), but unrefined extra virgin coconut oil and Kerrygold butter also work well . Freeze your butter or oil and then grate it into the flour mixture. If you have no reason for avoiding true dairy butter, opt for that instead and choose a good brand, like Kerrygold. 
The addition of sugar and vanilla are optional because I left them out in my first try of this recipe and found them still delicious. You’ll know by now I tend to be acclimated to eating very little sugar so keep that in mind.

160 g oatmeal
110 g buckwheat groats
10 g arrowroot starch or cornstarch
25 g sugar (optional)
4 teaspoons / 20 g baking powder
½ teaspoon salt
60 g / 4 Tbs. frozen grated butter or coconut oil
¾ cup chopped strawberries
1/3 cup finely chopped rhubarb
2/3 cup cold non-dairy milk
1 tsp. vanilla (optional)

  • Preheat oven to a very hot 475°F
  • In a spice grinder or food processor, mill the oatmeal and buckwheat until they’re ground into a fine flour.
  • Combine all the dry ingredients in a mixing bowl.
  • Rub the frozen grated butter or oil into the dry ingredients until it resembles very coarse bread crumbs with some pea-sized pieces.
  • Stir in the chopped strawberries and rhubarb.
  • Add the milk and vanilla at once and stir until it just forms a sticky dough. They will seem a touch wet, but they will end up more tender this way!
  • Turn the dough out onto a lightly floured board and lightly flour the top of the dough. To achieve a layered effect in your scones, knead very gently once (do not press too firmly) then fold and turn the kneaded dough about 3 or 4 times until the dough has formed a smooth texture. Scones require a light hand so be gentle and err on working the dough less.
  • Pat or roll out the dough into a 12 inch by 8 inch rectangle or circle that’s a little more than 1-inch thick. Cut or separate it into eight equal portions and gently form into rounds.
  • Place the rounds just touching on a baking dish and bake in the preheated oven for about 12 minutes (check at 10 minutes so as to not overbake!) until the scones are well risen and are lightly colored on the tops.
  • Immediately place the pan onto a cooling rack and serve while still warm, or gently reheated.

Other Seasonal Strawberry Recipes:
Strawberry Tabbouleh
Strawberry, Asparagus + Radish Flatbread
Strawberry Cardamom Lassi
Berry Bran Muffins
Strawberry Rhubarb Pie

Celiac Disease, Gluten Sensitivity and Wheat Allergy: what’s the difference and what are the concerns?

I remember the beginning nearly exactly. Lower GI pain that began in the afternoon, dull enough at first I tried to ignore it, and would only go away after eating dinner, coming back at nearly the same time the next day without any apparent linkage to what I had eaten. I was in the first month of my one-year graduate program for teaching at the time, age 22. I was otherwise healthy and relatively stress-free. Over the next two and a half years, without doing anything about it, the pain intensified and some days was nearly constant.

And I developed more symptoms, many of them far beyond my GI system.

After the first couple hour-long meeting with my doctor, a naturopath, she told me she highly suspected what was going on, but we’d confirm with further testing. It was nearly Thanksgiving then and some of my symptoms were overwhelming anxiety, daily headaches, acne that was far worse than I ever had as a teen, and a nearly complete inability to concentrate. Having formerly struggled with an eating disorder, I was weary of having restrictions in what I ate. Plus, I was making incredibly delicious homemade bread and pastries regularly and I didn’t enjoy the idea of changing that. So I pushed the testing off, dug in my heels, and waited to confirm or change anything until after the holidays. What we confirmed was that I was significantly depleted in nutrients despite eating normally, and highly reacting to gluten. In addition to those other symptoms above, test results also showed a bunch of the wrong type of bacteria hanging out in my system, further contributing to my complete sense of not-at-all-wellbeing. At the time I had many other life events happening with tight finances, job/career uncertainty, and an upcoming wedding halfway planned–so I didn’t push for further testing or a celiac disease biopsy like I should have. Instead, I grudgingly and not altogether stringently, took out gluten from my diet with the knowledge I had.

I felt better very very slowly, but after six months, I was only better enough to know I was still reacting to more than gluten. So we tested again and found more problem foods.

Celiac Disease

Celiac Disease is an autoimmune condition characterized by damage or destruction of the villi in the small intestine resulting in malabsorption of nutrients and widespread pathophysiological symptoms throughout the digestive tract and often in other areas of the body (1, 2)

The only current long-term treatment to successfully stop the autoimmune response that occurs in celiac disease is to strictly adhere to a life-long gluten free diet. This includes avoiding wheat and its relatives (spelt, kamut, emmer, einkorn, triticale, etc.), barley, rye, and in some individuals, oats (3). In celiac disease, the inflammatory response invoked by the gluten proteins leads to destruction of enterocytes, the cells in the small intestine, then atrophy of the intestinal villi, the tiny, fingerlike projections along the small intestine lining that enable nutrient absorption to occur.

The lining of the small intestine is one cell thick, and these cells are semi-permeable, which allows for tiny molecules of nutrients to pass through into the bloodstream. The cells of the gut lining are also joined together by what are known as tight junctions, which are supposed to be tight, but damage can cause larger particles to slip through. When the body negatively reacts to gluten proteins, chemicals that are released in their presence causes the lining of the small intestine to become much more permeable, and substances that normally would not be allowed to pass through now can, causing even more inflammation.

When the area of the body that is responsible for nutrient absorption is so critically damaged, decreased nutrient absorption quickly follows. Likewise, the immune complexes attacking the small intestine don’t just stay there. They travel throughout the body and can damage other organ systems, which is why it is common to see symptoms that are far beyond the gut in those negatively responding to gluten, such as depression or anxiety, headaches or migraines, joint and muscle pain or weakness, skin conditions, fatigue, infertility or repeat miscarriages, frequent bruising, brain fog or difficulty concentrating, osteoporosis, tooth enamel damage, canker sores, and many more associated with lack of adequate nutrients. Lastly, if not diagnosed, or one does not adhere to a strict gluten-free diet, those with celiac disease are at much more risk for developing secondary autoimmune and other diseases, such as cancer.  

When gluten is no longer triggering the immune system, the enterocytes and then villi can begin to heal (3). The goal in implementing a strict gluten free diet is to heal the gut lining so nutrient depletion and widespread symptoms stop occurring. After just one meal containing gluten, symptoms can appear for up to six months in those with celiac disease, which makes paying close attention to cross contamination, and educating friends and family who prepare meals a primary concern. So too is being particularly careful about eating out at restaurants that pay strict attention to cross contamination, or that don’t prepare any food with gluten, which is rare but a real haven for those that need to avoid it.

Gluten Intolerance

Beyond celiac disease, there is the slightly more common gluten sensitivity (also called gluten intolerance), which often displays the same or similar symptoms as celiac disease, but does not cause intestinal damage, often will not take as long for healing and symptom remission to occur, and is not always lifelong. Gluten sensitivity also is not autoimmune, and does not appear to have a genetic linkage. When enough healing has occurred in one that is gluten sensitive but does not have celiac, the individual can often reintroduce gluten in small amounts and/or return to eating it normally.

The one caveat in determining between lifelong strict avoidance of gluten for those with celiac disease, and perhaps less stringency with those with gluten sensitivity, is that the only way to definitely diagnose those with celiac disease is with an intestinal biopsy, and damage will only be ‘complete’ enough to diagnose with daily consumption of gluten for at least six months. I had an unfortunate episode a couple years after I removed gluten in which I unknowingly was eating contaminated oatmeal every day for a month. After realizing and removing it, it still took me over six months to be symptom-free, and that very small amount of gluten daily for about 30 days was nowhere near enough gluten to be able to diagnose. So if one suspects gluten is a problem, I always recommend ruling out celiac disease before completely removing gluten from the diet.

Wheat Allergy

Now, for a slightly different but similar condition—wheat allergy.
Those with wheat allergy have developed an antibody to a particular structure in wheat. Similar to a peanut allergy, symptoms can occur immediately after eating, up to within two hours later, and include swelling, itching or irritation of the mouth or throat, itching, hives, or skin rash, itchy watery eyes, GI concerns such as diarrhea, cramps, nausea, vomiting, difficulty breathing, chronic hay fever, heart palpitations, etc. Like other food allergies that cause similar reactions, even a trace of the food allergen can trigger a severe reaction, and the way your body reacts to a food allergen one time does not predict how it will react the next time. So a mild response in the past does not mean the response will always be mild, and vice versa for severe reactions.

Gluten-Free Diet for other Autoimmune Conditions

A question and/or concern that comes up routinely in those that have been diagnosed with other autoimmune conditions is why is a gluten-free diet commonly suggested if one has something like Hashimotos thyroiditis, Lupus, or others?
The answer here is slightly complicated—but the simplest way to describe it is that it is commonly believed that the gluten proteins are highly complex and difficult molecules to break down, and they are mildly inflammatory in most individuals, but highly inflammatory in others. For those individuals that already have an autoimmune response occurring in the body, an immune system that is “on alert” does not need more inflammatory molecules entering the system. That is why many feel better when removing gluten and other inflammatory foods, such as refined sugar, dairy, processed meat, etc., and load up on anti-inflammatory foods to help heal the whole system.

Sourcing Gluten-Free Products

If one does need to avoid gluten and/or wheat, pay particular attention to sourcing, packaging, and labeling of all foods, and in particular grains that might be processed in the same facilities as wheat and other gluten-containing grains. Flours that are certified gluten-free, or that at least say on the label they are not processed on a line that also processes gluten-containing grains is essential –that’s how I got into trouble with the oats! This means purchasing flours and grains from bulk bins needs to be done with care, as well as knowing the source and details of the processors so as to avoid cross-contamination. Edison Grainery (my favorite source currently), Arrowhead Mills, Bob’s Red Mill (which has two lines so pay attention to whether food is from the gluten-free line!), and One Degree Organics are great companies, but there are many more to be found as long as you read the ingredient list, look for a gluten-free certification, and read the small print about allergen cross-contamination.

I hope this informational article clarifies some of the myths and misconceptions about these challenging dietary conditions. Feel free to comment below or contact me with your further questions or for more information on working with me if you or a loved one are concerned about gluten and/or wheat. In addition to my own experience mentioned above, I studied gluten-associated pathophysiologies extensively while in graduate school for clinical nutrition.

References:
1: Lipski, L. (2012). Digestive Wellness (4th ed.). New York, NY: McGraw Hill.
2: Hardy, M.Y. and Tye-Din, J.A. (2016). Coeliac disease: a unique model for investigating broken tolerance in autoimmunity. Clinical and Translational Immunology, 5(11): e112. doi: 10.1038/ct.2016.58.  
3: Barker, J. M., & Liu, E. (2008). Celiac Disease: Pathophysiology, Clinical Manifestations and Associated Autoimmune Conditions. Advances in Pediatrics55, 349–365. http://doi.org/10.1016/j.yapd.2008.07.001.