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Whether it is a vow to begin a regular exercise program or to lose those five pounds you gained over the holidays, getting started is usually the hard part. For parents of autistic spectrum children - often the pickiest of eaters - starting a dietary intervention program may seem more overwhelming than all your New Year's resolutions combined!
Relax! It doesn't have to be that way. There are now so many people out there 'doing the GF/CF diet,' that you're not alone. Even for the cooking-impaired, readily available terrific mixes will enable you to begin this diet without too much difficulty. I will caution you, however, that the first time you open your pantry and realize exactly how much food must be removed - well, it can be very discouraging. It was for me.
So, how do you overcome this initial inertia? I recommend starting on a positive note. First, think of all the foods your child will be able to eat. Meat, poultry, fish, legumes, vegetables and fruits are all generally acceptable on this diet. Then, think of how much healthier your whole family will become with this program. Consider, too, taking advantage of nutritional supplements that have been specifically developed for children with autism.
Anecdotal reports from parents who have begun a GF/CF Diet include many positive changes in their child's autistic symptoms and overall behavior:
Increased attention span; Increased language; Decreased aggression; Decrease in self-stimulatory behavior; Less "spaciness"; More alert; Normalized bowel movements; Ability to feel / indicate pain; Ability to toilet train.
Breads, crackers, pretzels and other starches will remain part of your child's diet, but they will have to be, as my son calls them, "special." The same is true for dairy products - from now on, anything that was derived from cow's milk should be left for its originally intended recipient: calves!
Even though this sounds simple, I have spoken and corresponded with enough parents to know that I have just eliminated nearly every food item the "typical" autistic child will eat. That's the bad news. The good news is that the pickiest kids tend to be the best candidates for the diet, and that most ultra-picky kids will expand their own food choices once they've gone through the "withdrawal" associated with removing opioid peptides from their systems. A simple, significant first step in your child's new diet is to begin using a non-dairy milk alternative.
Depending on your child's current diet, breakfast, lunch or dinner may be the trickiest meal for you to make gluten- and casein-free. If your child will eat waffles, pancakes or muffins (all of which are easily adapted to a GF/CF diet) breakfast should be a breeze for you. Lunch often consists of a sandwich or finger foods, which can be put together using gluten-free breads, crackers or rice cakes. For many, dinner is the most daunting meal to prepare.
Dinner would be easy if your child liked to dig into steak, salad, baked potato and a side of string beans. My son didn't, and I imagine your child doesn't either. Hundreds of parents have told me that dinner is a real problem, because their child will only eat a very limited number of foods. Among the favorites: chicken nuggets, pizza, macaroni & cheese, cheerios, hot dogs, yogurt, and American processed cheese. So what are you to do?
First of all, don't panic! While you're removing gluten and casein from the diet, you should not worry if your child subsists on fries or white rice for a few weeks. No, I am not saying that fries alone make a well-rounded diet. Just keep the overall objective in mind. Our goal here - which I firmly believe is attainable - is to remove gluten and casein from the diet, and gradually broaden his food choices.
Let's start with those fries. I have rarely heard of a child who will not eat them, and while they may not be the most healthful way to serve a potato, they are still a reasonable part of a child's diet. Are all fries OK? You would think so, since they are just made of potatoes, right? Wrong. Welcome to your new hobby - label reading! You will find that many popular and widely available brands of frozen fries are coated with wheat flour. Since just a little gluten will hurt in this case, immediately eliminate any brand of French fry that contains wheat or unspecified starch on the label. Many brands are fine, but you must read the label every time you buy, since ingredients change often. If you cannot find a GF brand in your supermarket, go to a health food store and you'll probably have better luck. You can even make fries yourself, in a regular pan (though a deep fryer is helpful if you decide to do this often.)
McDonald's® policy is to fry their potatoes in oil that is kept separate from the oil used for nuggets and other breaded items. Make sure that this is true at your local McD's and if it is not, find one that follows company policy. (You might also want to contact their corporate headquarters to report any violations.)
Chicken Nuggets®* may well be the most popular food among autistic children - very few kids refuse them. Nuggets made by fast food restaurants are off limits (more of that gluten), but they are delicious and easy to make at home, using gluten free breading.
If necessary, resort to deception to get your own nuggets into your child. Most McDonald's will be happy to give you a stack of the little paper envelopes that nuggets are sold in. Put your homemade nuggets in an envelope and chances are, they will be eaten.
Gluten-free pizza crust* is a snap to make, and there are even some good crusts available at health food stores. The problem with pizza is the cheese. There really is no good cheese substitute available yet. If your child is more interested in appearance than taste, and can tolerate soy (many children cannot), then try Soymage® brand soy cheese. It can be grated and works equally well for macaroni and cheese (using gluten free noodles, of course) or for pizza. Beware of the cheese substitutes available at most stores - nearly all contain sodium caseinate or some other form of casein. These are not acceptable on a GF/CF diet.
Hot dogs are not great for any of us. Most contain nitrites, which, when subjected to temperatures required for cooking, are converted to nitrosamines, powerful carcinogenics that should be avoided as much as possible. Look for nitrite-free hot dogs - generally found in the freezer section of your store; many are delicious. Beware of other processed meats such as bacon and ham, which also contain nitrites. They can be used in moderation to get started on the diet, but as soon as the goal of eliminating gluten and casien is accomplished, switch to the nitrite-free alternatives.
Children often enjoy eating child-sized foods; I have long believed that much of the appeal of the chicken nugget is their size and shape. That said, why not prepare other foods in child-sized dimensions? Tiny meatballs*, prepared with cooked rice or gluten free breadcrumbs as the filler, are often appealing to even picky little ones. Most children prefer to eat them plain, while others will accept a red or brown sauce. If your child likes gravy, be sure to make your own and freeze leftovers whenever you prepare a turkey or a roast. Use sweet rice flour (available in health food stores and Asian markets) instead of wheat flour. Gravy, frozen in ice cube trays, is particularly convenient when you need just a little to put on meatballs or some mashed potatoes.
Empanadas* are little pastries filled with meat and baked. They are delicious, and if you make them small (hand-sized), your child will probably enjoy eating them without utensils. A tasty filling can be prepared by combining cooked meat with onions and moistening it with a little GF broth or salsa. Even if you sneak in some cooked vegetables, they will probably be eaten without complaint.
If your child tolerates corn and likes to "dip", try serving tortilla chips with a high-protein dip. A mild salsa* can be mixed with black or refried beans for a tasty but nutritious snack or meal. If your child is sensitive to texture, process the dip thoroughly in a blender or food processor. Dips are another good place to add some vegetables that have been blended until imperceptible.
Fruits and vegetables contain many of the same vitamins and nutrients, but since fruit also contains sugar, they are far more likely to be eaten and enjoyed by your child. If your child will eat fruit but not vegetables, serve fruit with every meal. Peas may be a more traditional side dish for dinner, but if your child won't eat them, why not serve peaches instead?
Both contain Vitamin A and potassium, but the difference is that the peaches are more likely to be eaten! Even if your child will only eat one fruit, serve it often. As the opioids leave his system, it's likely that he will accept additional fruits very soon.
Finally, look to other cultures and cuisines for ideas about serving dinner for your family. Many grocery stores, particularly those in or near large cities, carry root vegetables common in Latin American and Caribbean communities. Taro, yucca, malanga and boniato are all inexpensive root vegetables well worth seeking out. They are easily digested and tolerated even by people with many food allergies. All can be baked, or boiled and mashed to make rich purees - more flavorful than plain mashed potatoes. When deep-fried, they make wonderful fries or chips (depending upon how thickly they are sliced.) These roots give flavor, nutrients and creaminess when added to soups and stews. Basically, they can be cooked in any way you would cook a potato.
Although we tend to use many wheat and milk-based foods in the United States, rice is the staple food for most of the world's population. Seek out Asian, Mexican and Indian cookbooks - you will be amazed at the many ways rice and other grains can be prepared. Most public libraries have extensive cookbook selections; look through several and decide which ones are most useful before you spend a fortune on a set of new cookbooks. There is a huge difference between Chinese cuisine and Thai or Korean, and all use rice-based foods (including noodles) in unique and delicious ways. Go to an Asian or Indian market - they can be treasure troves to those of us avoiding wheat-based foods.
And lastly, remember that it may take a while for your child and your family to become comfortable with your new way of eating. But, if you're willing to try new foods and experiment with new recipes, and you don't take rejection personally (not everything you try will be a winner), you will soon find that your new dietary regimen is not only beneficial, but has become second nature. In all probability, a GF/CF diet will help your child expand his choice of foods. Stay the course and you may reap very great rewards!
What's For Lunch
Lunchboxes - the bane of existence for those of us with children on special diets. It is hard enough to think of nutritious lunches and snacks for children who have no dietary restrictions, but start removing foods and the picture gets far uglier! Some kids prefer a monotonous diet of peanut butter sandwiches, but even those lucky moms (and dads) hate sending in the same fare day after day.
So how do you handle lunch? Perhaps the best tip about lunchtime is this: it's just a meal! In other words, if your child loves chicken legs for dinner there is no reason not to send it in his or her lunchbox. Ask the school to microwave it, or heat the food in the morning and place it in a thermal container. The Gluten Free Pantry sells a wonderful thermos that has no glass (an important point when you see how your kids toss their backpacks around!) Food stays hot for hours and since many of our kids prefer a hot lunch to a sandwich, this may be a good option. We have sent in pasta, leftover Chinese food, rice pilaf, chili, stew and even soup! One potato-loving child we know often takes a spud for lunch - microwaved during breakfast and then packed hot in a thermos with a little Spectrum Spread® and salt, it is a favorite lunch. A thermos will keep food cold too, so you could send in potato salad, cold pasta salads or anything else your child likes to eat.
Fresh fruit is a "no-brainer," and we put some in every lunch we pack. Most fruit comes conveniently "wrapped" in a peel or skin, and if you child cannot remove a peel easily you can always pre-peel and wrap tightly. If apples are tolerated, you can find applesauce (no added sugar or additives please) in individual containers. Tiny Tupperware® containers make it possible to send in your own fruit sauce made of pears and/or any fruit your child tolerates and will eat. These small containers can also be used to send in "ersatz yogurt," either plain or blended with fruit. (See recipe on page 7.)
We know one mom who makes a batch of Marcibread* and freezes the dough into roll-sized balls. In the morning, she pops one in the oven while the kids are having breakfast. When the roll is done, she puts in some peanut butter or leftover chicken and voila - fresh rolls every day! (Of course, not everyone is that ambitious in the morning...)
A GFCF cookie makes a good dessert, washed down a cup of DariFree™.
*Recipe can be found in Special Diets for Special Kids
LISA S. LEWIS, Ph.D. is the author of the highly regarded book, Special Diets for Special Kids, published by Future Horizons. Drawing upon her own success with removing gluten and casein from her son's diet, Lisa wrote the book to help other parents and professionals understand gluten and casein sensitivities and how these problems affect the behaviors of individuals with autism. The book offers scientific principles, practical advice and over 150 good-tasting recipes to help parents implement the diet. Available at bookstores, AutismNDI and Vances Foods Bookstore.
Lisa lives in New Jersey with her husband, two
sons, a cat, dog and zillions of fish.