How to Complete a Gluten Challenge while remaining Low FODMAP (with Seitan Recipe)

How to complete a gluten challenge while remaining Low FODMAP - NOTFROMAPACKETMIX

Updated on 28.01.17

For reasons that I have mentioned before, it is crucial to get tested for Coeliac disease (CD) before you begin any elimination diets that cut out the gluten containing grains – this includes the low FODMAP diet, which eliminates wheat, barley and rye for the two month elimination period due to their fructan content. Oats also contain a protein called avenin, which is very similar to gluten and can also cause issues in overly sensitive individuals. There are many reasons why it’s important to be correctly diagnosed (which includes ruling possible differential diagnoses out) but I’ll expand on the most relevant to fructose malabsorption (FM) or the low FODMAP diet.

What is the difference between Coeliac disease and non coeliac gluten sensitivity?

Coeliac disease is an autoimmune condition in which your body’s immune system reacts to the plant-protein gluten (found in wheat, barley, rye and their derivatives) in such a way that your small intestine lining becomes the target, causing damage to your small bowel and villous atrophy. Villous atrophy in turn leads to a reduced surface area for nutrient absorption, which can contribute to malnutrition, malabsorptive disorders, osteoporosis and many other secondary complications, such as an increased risk of certain cancers. To rule CD in or out, a blood test to check for tissue transglutaminase antibodies is performed and followed up with an endoscopy to confirm any damage to the small intestine.

Non coeliac gluten sensitivity (NCGS), on the other hand, is not as well understood. It is the label given to those who test negative for CD, yet are still apparently affected by gluten. One study suggests that it is not the gluten in the grains but the fructans (acting alone or in combination with the gluten) that are causing sufferers to be symptomatic. Other research hints that it might be an innate immune response, rather than the adaptive immune response of CD, which causes the reaction to gluten-full foods and leads to symptoms that are very similar to those experienced by Coeliacs. Because there is no science-based standardised test to check for NCGS, the diagnosis is one of elimination – other conditions, like CD or a wheat allergy, are ruled out but you find you still improve on a gluten free diet – and NCGS is the possibility that is left.

If you do in fact have undiagnosed CD or NCGS, the low FODMAP diet isn’t anywhere near strict enough to be considered safe for you, as after the elimination phase comes the reintroduction phase, in which you are encouraged to test out foods higher in fermentable carbohydrates – this includes offending grains, which will just make you sick again. If you have CD, you must limit your gluten exposure to basically nothing (less than 20 ppm in the USA is considered safe), so even a contaminated chopping board or deep fryer could make you sick, let alone testing out a full slice of bread. If you have already been diagnosed with CD, you can skip those foods, saving you time and gut hurt… or any of your other symptoms that are caused by gluten.

Furthermore, if you have undiagnosed CD or NCGS, once you have finished the elimination phase and begin to test out wheat, rye and barley, you’ll realise that they bring on symptoms (either IBS or other) and you won’t know whether FM or CD is behind them – and to test for CD, you need to have gluten in your system for an established autoimmune reaction to be visible. If you haven’t been eating gluten, any damage from CD, or any sign of the relevant antibodies, will begin to disappear, meaning that you may test negative, regardless of whether you have active Coeliac disease or not. This is called a false negative result.

How to complete a low FODMAP gluten challenge

If, for one reason or another, you find yourself having been on a long term gluten free diet, yet needing to test for Coeliac disease, there is unfortunately no other way to confirm the diagnosis than to complete a gluten challenge. Instructions vary slightly but, in general, it is recommended that every day, for somewhere between six to twelve weeks (ask your gastroenterologist what they would prefer), you must consume the equivalent of four slices of bread if you’re an adult, or two slices of bread if you’re a child.

Given that:

  • The average bread slice weighs approximately 30 g,
  • Bread is typically at least 10% gluten by weight.
  • This means that the average slice of bread contains approximately 3 grams of gluten.
  • Extrapolating from the number of slices necessary for the gluten challenge, the gluten requirement works out to be 12.0 g of gluten for an adult and 6.0 g of gluten for a child, daily.

After writing the previous post, it seems almost hypocritical to tell you that I had to complete a three month gluten challenge in 2014. You can read my diagnosis story here but, long story short, I tested negative to Coeliac disease (both the antibody blood test and endoscopy) back in 2006 but then tested positive for fructose malabsorption. However, after eating largely gluten free (I didn’t worry about minute levels of contamination), I found myself, at the beginning of 2014, experiencing worsening IBS symptoms and extreme fatigue/brain fog. Ev even asked if I was broken. Now, I felt pretty certain that the culprit was the spelt flour (non-sourdough) that I had been consuming, after reading that it was low FODMAP – note, only sourdough spelt is considered low FODMAP, I had just read inaccurate information. However, the question stood: was it the fructans or the gluten that was causing this relapse?

I know that many people out there would happily re-eliminate the spelt flour and move on with their lives – but I’m not one of them. If there’s a question, I’m the type of person who needs to know the answer. So, I spoke to my GP, who referred me to a gastroenterologist and I began a twelve week gluten challenge. However, I know that fructans in wheat (and to some extent, rye) make me sick – what was I to do? The answer to your low FODMAP gluten challenge question is: SEITAN.

Seitan is a vegan protein/meat replacement that is made from vital wheat gluten, which is normally 75-80% gluten – and coincidentally, registers as low FODMAP. Now, let’s do some maths… stand back.

  • An adult needs to consume 12.0 g of gluten per day, a child 6.0 g.
  • Let’s assume that the vital wheat gluten (gluten flour) was only 75% gluten, to be safe. However, if you can get a more pure version of it, do so, as the more gluten it contains, the less likely it is to contain any FODMAPs.
  • 12.0 g / 75% = 16.0 g, so an adult would need to consume 16.0 g of the vital wheat gluten, daily, to ensure we are getting at least 12.0 g of low FODMAP gluten. A child would obviously only need to consume 8.0 g.
  • The recipe below is in grams, to keep it simple: 240 g of VWG will give fifteen 16.0 g servings or thirty 8.0 g servings.

You could just pop your seitan chunks like a form of medicine and be done with it but it was fun to experiment with it in cooking and I probably ended up consuming more than the 12.0 g of gluten on the days when we did so… which might have contributed to my gut’s unhappiness and the fatigue.

Seitan with Italian Herbs and Spices

Based off Bob’s Red Mill’s basic seitan recipe.

Seitan Dough

  • 250 ml FODMAP friendly stock or water
  • 1 pinch asafoetida
  • 1 tbsp. dried oregano
  • 2 tsp. salt
  • 1 tsp. pepper
  • 1 tsp. dried rosemary
  • 1 tsp. dried sage
  • 240 g gluten flour/vital wheat gluten

Broth

  • 1.5 L of water
  • 1/4 cup soy sauce

In a large pot (I cannot emphasise this enough, seitan balloons!) bring the broth mixture to a boil.

Meanwhile, mix the gluten flour, herbs, salt and pepper together in a large bowl. Slowly add in the stock and stir/knead until it’s a sponge-like dough. It should be tacky to the touch but not wet. Tip it out onto a well floured bench (use more gluten flour) and knead it for a minute or two, until it becomes tougher and more elastic.

Cut it into sixths, then roll them out into logs and divide each one into twenty. There you go, you now have 120 pieces and four pieces equals one daily serving of gluten for an adult.

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Place the seitan dough in the boiling water and boil for one hour. Watch how it expands – I needed to swap saucepans halfway through.

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After boiling, the seitan still isn’t good to eat. At this point, I like to think of it as “raw” meat. The flavour is nice, thanks to the spices, but the texture isn’t great. Spread the seitan out on a tray to dry, then use it in stir fries, pan fry it, bake it – it all works.

Baked seitan:

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Pan fried seitan with mirepoix as a dipping sauce:

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For those who were just curious, I hope you found this piece interesting. For those who have fructose malabsorption or IBS and need to complete a gluten challenge – good luck. I didn’t find it fun, in terms of fatigue, but I hope you fare differently.

After getting back to a normal diet (still no active Coeliac disease, phew), I have learnt that I can cope with a bit of gluten every now and then, so it’s clearly not as big of an issue for me as the fructans are. Luckily, that means that I can still enjoy (proper) sourdough breads in moderation. Yum.

This post is intended for educational purposes only. Please run anything that I have written here by your doctor or dietitian (etc) to make sure it is suitable for your individual case.

In terms of FODMAPs, vital wheat gluten is generally considered low but it is not recommended for consumption during the elimination phase of the low FODMAP diet. As always, it’s best to not need to do a gluten challenge at all, by testing for gluten/wheat related conditions before an elimination diet has begun but this isn’t always possible, for a variety of reasons.

Unfortunately, you might react during a gluten challenge (that’s the point, after all); this method just minimises the chance of that reaction being due to the fructans in wheat as much as possible.

FODMAP Friendly Christmas Recipe – Gingerbread House & Biscuits

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One of my favourite things about Christmas – apart from friends and family – is getting to play with food.

Not in the way your Mum always told you off for but by being creative. I’m not a talented creative person like some of my friends are but I like to dabble in sewing and one day I will finish that scarf I started to knit… So yeah, an excuse to make something pretty with a deadline means I get to play but also will get it done. Win, win.

Gingerbread is one of my favourite things – combining ginger, golden syrup and biscuits = the best thing ever. Since I’ve been doing my best to cut down on sugary baked goods, I haven’t baked much over the last couple of months except when required to for an event but it’s Christmas so whatever – screw the diet for the next two weeks and I’ll deal with the aftermath later 🙂 We’re dog-sitting two extra dogs at the moment, so I’m going on my fair share of dog walks, anyway.

Notes:

  1. Gingerbread recipes tend to use one or a combination of different syrups – golden syrup, maple syrup, treacle, molasses or even corn syrup (mostly from American websites that I’ve seen). Pure maple syrup is hard to find and quite expensive in Australia but treacle and golden syrup are easy to get – people tend to tolerate these quite differently, though, so I am listing them as possibilities and you can use whichever you know is safe for you.
  2. Gluten free flours are expensive, so if you are not cooking for a coeliac then I recommend making the recipe in halves – half GF and half normal flour. This will save you some money and, if you use the normal flour as the walls of the house, it will give the structure added strength.
  3. If you can’t tolerate wheat because of the fructans but you can still have gluten, I would recommend using gluten powder, rather than xanthan gum, to really add some strength – this is more important if you are making a house, rather than gingerbread biscuits. I would try 1/2 a cup of gluten powder to replace the same amount of flour and work from there. Possibly a combination of xanthan gum and gluten might be best but I haven’t tried this.
  4. If you have any cracks in the slabs of gingerbread that you cut, just use royal icing or melted chocolate to either stick them back together or as a reinforcement along the inside face of the slab.
  5. Royal icing involves uncooked egg whites, so if you are making this for a pregnant woman or an immuno-compromised person, I would stick to melting dark or milk chocolate for assembling the joins of a house. Other sources recommend using meringue powder in this situation but having never used it, I don’t know what the ingredients are and how fructose friendly they would be.
  6. If you malabsorb lactose, then I would stick to the royal icing, rather than the chocolate… unless a lactose free chocolate exists that can melt well – I honestly haven’t ever looked into it.

Gingerbread

Adapted from Ruby M. Brown’s Cakes, Muffins and Loaves to suit my tastes and be a little more fructose friendly.

  • 250 g unsalted butter/coconut butter, softened
  • 175 g castor sugar (or 200 g dextrose)
  • 2 whole eggs
  • 1 tsp. vanilla extract
  • 1/3 cup golden syrup
  • 700 g GF plain flour
  • 1-2 tsp. xanthan gum (add in 1, then the second if consistency isn’t correct) – alternatively, substitute 1/2 cup of GF flour for 1/2 cup of gluten powder
  • 11/2 tsp. baking powder
  • 2 tsp. ground ginger
  • 1/2 tsp. ground cloves
  • 1 pinch salt

Cream the butter and sugar until light and fluffy, then add in the eggs, vanilla and syrup of your choice. Mix until well combined and smooth. Sift the dry ingredients into a separate bowl and then gradually add them in, alternating with mixing, until the batter is complete. This will be much stiffer than a cake batter, more like a cookie dough but not quite.

To make your life easier, wrap the dough in plastic wrap and refrigerate it for 30 minutes before rolling it out.

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To make biscuits

Preheat your oven to 190 C/375 F. Roll the dough out on a lightly floured bench until it is approx 1 cm thick and then cut with a knife or cookie cutters. Place them on a lined baking tray and bake for 15-20 minutes, until golden brown and firm yet soft on top – if you bake them until they are hard on top then they will be like rocks once they have cooled.

To make a house

Preheat your oven to 190 C/375 F and lay out baking paper on the bench (if your biscuit tray has raised edges like mine does) or if you have a completely flat baking sheet, just lay the baking paper on that. Spread a column of the batter along the length of the tray and place wax paper on top, then roll it out to make it as rectangular as possible. Believe me, the more accurate you are with this, the more of the end product you can work with to cut out the walls and roof pieces later on.

You can see from this picture that I didn’t do a particularly good job of it and I had to make another half batch to make the front and back walls.

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Bake for 20 minutes, until golden brown and firm-ish in the middle – a little bit of softness is okay, as it will continue to harden while cooling – but you don’t want it to be completely hard while baking or it will be a crumbly rock once cooled. Have paper cut outs of your house pieces ready to go, because it is easier to cut without cracks forming when it is fresh from the oven and still retains some softness.

Let the pieces cool for a day to harden completely, otherwise they might crack while you are trying to assemble the house. Other shapes to try could be a Christmas tree or a bell shape, with four pieces.

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Royal Icing

The following gave me plenty of icing to construct and decorate my house, however the rule of thumb is 1 egg white to 1 cup of icing sugar.

  • 2 egg whites
  • 1 tsp. vanilla extract – optional
  • 2 cups of icing sugar (or 3 3/4 cups icing sugar, 1/4 cup dextrose)
  • Food colouring of choice – optional

Softly beat the egg whites and vanilla extract in the bowl of your stand mixer and then add in the icing sugar gradually until the mixture becomes smooth and shiny. Beat it on a high speed for at least 5 minutes, until the mixture is able to form stiff peaks. Transfer it to an icing bag (or a zip lock bag with the corner snipped off) to pipe the icing accurately. It stores well in an air tight container for 1-2 days, after which I find it is too hard to use anymore. If you just need to leave it on the bench for an hour or so, cover it in a damp cloth to help it retain its moisture, as it forms a crust and hardens when it is exposed to air.

Softly beaten eggs.

Softly beaten eggs.

Royal icing.

Royal icing – you can see the stiff peak that has formed.

Assembling a gingerbread house

  • Gingerbread shapes
  • Royal icing
  • A large, flat platter to build the house on
  • 2 sets of hands, preferably

Pick one side wall and one end wall and pipe icing onto the base of each piece and also the corner that will meet. It makes life so much easier if there is one person to pipe icing and another to hold the pieces in place until the icing has set but it’s not crucial.

Continue to construct the house. You should start with a side wall and the rear facing wall and then let them dry completely. Next, ice and stick the bottom and adjoining side of the front panel and hold it in place until the icing has set. Make sure the joins are all at right angles, so that all the pieces fit together as they should. Finally, ice and stick the remaining side wall in place and let the walls completely dry for a couple of hours before contemplating sticking the roof pieces in place – houses can collapse.

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I mentioned in the notes section that you can reinforce pieces with either royal icing or melted chocolate allowed to set – this can be quite useful for the inside faces of the roof pieces, as they will have quite a bit of downward force going across them eventually, both from gravity and all the lollies you will be decorating it with. Now, as I was doing this to a roof piece that had a visible crack running through it from moving while still warm and soft (my bad), I carelessly wiped the spatula away from me and pulled the piece in two… whoops. I glued it back together with the icing and threw in a couple of wooden skewers cut to size for good measure. This roof isn’t going to collapse on my watch.

Whoops. This is why you should be careful.

Whoops. This is why you should be careful.

Reinforced roof piece

Reinforced roof piece.

Once the walls are dry and you have reinforced any possible cracks (and let that dry as well), pipe icing along the tops of the wall pieces and lay the roof slabs down. The shallower the angle of your roof, the less likely they will be to slip down before the icing dries.

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Once more, let this dry completely before you use the remaining icing to decorate and stick on the lollies of your choice. The photos I’m posting are of the last two houses I made – in Australia Christmas 2010 and in Seattle Christmas 2013. You can see the difference in lolly varieties in the two countries and also an improvement in my icing skills, although they still leave much to be desired.

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Melbourne – Christmas 2010

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Melbourne – Christmas 2010

Seattle - Christmas 2013

Seattle – Christmas 2013

Finally, demolish the house. The best part of all!

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