Rolling hills, seashores, and fresh, wholesome food always remind me of the Mediterranean diet. The Mediterranean diet includes a combination of eating patterns traditionally found in several countries surrounding the Mediterranean Sea, including Spain, Italy, and Greece. Significant research supports the Mediterranean diet’s ability to promote cardiovascular health and manage blood glucose. The diet is plentiful in fruits, veggies, whole grains, legumes, fish, poultry, eggs, red wine, and monounsaturated fats such as olive oil. It also may include limited amounts of low-fat dairy products, red meats, and sweets.
While the Mediterranean diet easily can be modified to incorporate traditional foods of just about any region, food allergies and other conditions, such as celiac disease, that require eliminating otherwise healthful foods can present greater challenges.
Celiac Disease and the Mediterranean Diet
Given that whole grains are a foundational food group in the Mediterranean diet, modifications for clients with celiac disease require special attention. Classic Mediterranean cuisine includes many whole grains, some of which are safe for those with celiac disease. Wheat, farro, barley, and semolina contain gluten, but buckwheat, oats, polenta, and rice all are naturally gluten-free. (Of note, oats have a high risk of cross-contamination with gluten during processing, so clients must be cautious when choosing oats and look for certain labeling conventions.)
But when it comes to whole grain breads, flatbreads, and crackers, gluten-free alternatives tend to lack the texture and mouthfeel associated with their gluten-containing counterparts. When these products do meet consumers’ taste and texture expectations to some extent, they’re often less than healthful. In general, gluten-free breads are made with a combination of flours, starches, and gums to yield a raised crispy golden crust and chewy texture, but this also results in a highly processed, low-fiber end product, not the whole grain selections individuals want. On the other hand, baking without these types of flour/starch blends typically creates mostly dense, heavy baked products.
To boost the nutrient value of gluten-free baking recipes, clients need to incorporate certain grains, seeds, nuts, and legume flours to maintain balance in line with the Mediterranean diet. Some of the ways I make high-quality gluten-free breads while including more whole grains is by adding lighter whole grain flours, such as millet and amaranth, in place of some of the starches. Moreover, I may use high-protein flours, such as quinoa, sorghum, and bean flours, in place of rice flours, or ground nut meal to provide better texture.
Gluten-Free Whole Grains
The following ingredients and strategies can help clients incorporate gluten-free whole grains into the Mediterranean diet:
- Buckwheat. Clients on a gluten-free diet can replace farro, an ancient wheat often used in grain salads and side dishes, with soaked or lightly cooked buckwheat grouts and flour. Buckwheat is gluten-free and high in antioxidants and fiber and is great as a pilaf and in salads, side dishes, soups, pastas, cereals, and baking mixes. Buckwheat flour also can be folded into a premixed baking mix to bump up the nutritional content.
- Sorghum. Clients can replace barley, often used in soups, sides, and salads, with whole sorghum in recipes that call for barley. Large round grains take a long time to cook, so sorghum generally is used as a flour or is puffed like popcorn. It’s high in protein, B vitamins, magnesium, zinc, and fiber; has a nice flavor; and provides a delightful texture to baked foods, especially gluten-free breads. It’s often used in gluten-free beers but also in cereals, breads, baked goods, and gluten-free blends.
- Quinoa is a great high-protein option that can be used in place of couscous, crushed wheat semolina often used in soups, salads, cereals and sides. Quinoa cooks like rice and comes in a variety of different colors. Clients should buy it prerinsed, or they can rinse it several times before cooking to eliminate any unpleasant after-taste. Quinoa can be consumed with beans and used as a pilaf and in salads, baking mixes, crackers, bars, breads, and cereals. It’s versatile and works perfectly in any recipe that calls for couscous.
Other Gluten-Free Whole Grains and Legumes
- Amaranth. This gluten-free whole grain is popular in South America. It adds a nutty flavor to foods and is available as a seed, puffed, or in the form of flour. Tiny grains almost dissolve while cooking, so it’s great for thickening soups and stews. Amaranth flour works well when incorporated with other gluten-free grains for baking.
- Beans and lentils are loaded with fiber and B vitamins, nutrients that are often scant in gluten-free diets. Clients can include them in salads, soups, dips, side dishes, and salsas, and they can be puréed and mixed with other grains. Clients can find a wide variety of legume-based pastas and baked chips and crackers available in stores.
- Bean flours can be used to make flat breads and added to other gluten-free flour blends, crusts, chips, and crackers.
- Brown rice, available as flour and a whole grain, can be incorporated into any dish in which white rice is used. It also can be baked into a crust, added to flour blends, used as a coating, and more. Clients also can find brown rice as an ingredient in gluten-free pastas.
- Corn is available in many forms and can be used in flour blends, baked goods, breads, chips, cereals, cooked like polenta, made into patties, and more.
- Gluten-free oats. Although oats are inherently gluten-free, cross-contamination can become an issue, so oats must be certified as gluten-free. They can be used in cereals, smoothies, pancakes, baked goods, breads, crackers, bars, and desserts.
- Millet is a light and fluffy grain high in B vitamins that cooks quickly. It’s available as a whole grain or a fine light flour and can be used as a pilaf and in salads, soups, baking blends, crackers, stews, cereals, and more.
- Teff, a popular grain in Ethiopia, can be brown or red in color. This powdery, high-fiber grain works well as an ingredient in flatbreads, baked goods, crusts, hot cereals, bars, and more.
- Wild rice, which isn’t considered a true rice but often is used that way, is high in fiber and B vitamins. Clients can use it as a pilaf and in salads, soups, vegetarian burgers, and other dishes.
Clients with celiac disease or nonceliac gluten sensitivity have several options when it comes to gluten-free whole grains. Gluten-free whole grains add flavor, nutrients, and texture to meals and can be included in recipes geared to create delicious additions to a gluten-free Mediterranean diet.
— Marlisa Brown, MS, RD, CDE, CDN, is an award-winning dietitian, chef, and public speaker. She’s president of Total Wellness, a private nutrition consulting company specializing in diabetes, CVD, gastrointestinal disorders, gluten-free diets, culinary programs, corporate wellness, and medical nutrition therapies, in Bayshore, New York, and is author of Gluten-Free, Hassle Free and Easy Gluten-Free. Marlisa blogs at http://marlisaspeaks.com/marlisas-blog and www.GlutenFreeEZ.com.