Sure Foods Living - gluten-free and allergen-free living

I’ve already asked the question: Is the gluten-free diet a fad or here to stay? more than once. Now the Today Show weighs in on whether the gluten-free diet is a fad weight-loss diet…

Thoughts?

Q. I was just recently diagnosed with celiac disease after a positive biopsy last week.  I don’t get real sick, other than bloating and gassy.  Those were my only symptoms.  My question is, are there different levels of celiac disease?  If I go to a restaurant and ask for gluten free foods, but they happen to get cross contaminated with something containing wheat, rye or barley, am I at that serious of a risk by dining there since I don’t get the diarrhea and vomiting, etc.?  It’s been real hard on my family and me trying to dine out at a restaurant who has a true understanding of celiac sprue.

A. Ask your doctor to obtain the Marsh classification of your biopsy. The higher the class, the longer it will take to heal on a gluten-free diet. Symptoms often do not correlate with the level of biopsy abnormality.  Those who have been diagnosed with celiac and have their biopsies return to normal — Marsh 0 — will develop damage after being exposed to 7 grams of gluten, or about the amount in a slice of bread. I hope this helps.

Health and happiness,
Dr. Aron

Have a question for the doc?

This is important! All type 1 diabetic patients, regardless of the presence of symptoms, should be regularly screened for celiac disease. This was the message at The Endocrine Society 92nd Annual Meeting, based on findings in a new study of Type 1 diabetics.

I’ll break down the numbers for you, as I understand them:

• 493 patients were screened for celiac disease within roughly 3 months of being diagnosed with type 1 diabetes.
• 25 of these patients had positive celiac blood tests on their initial screening. Of those who tested negative the first time around, 14 tested positive the second time, making the total number of patients with a positive blood test 39, or 8% of those screened.
• Of the patients who tested positive on the blood test, 12 had positive biopsies (one showed a positive biopsy 5 years after being diagnosed with Type 1 diabetes.) 7 have not been biopsied.

Now, these numbers are compelling, but I still believe the number of those with a gluten problem is higher. We know that the tests for celiac miss people. A lot of people. I wonder if the gluten intolerance or sensitivity, undetected by mainstream tests, contributed to the onset of  diabetes. The diabetes gets noticed first, because doctors understand it, are aware of it, know how to diagnose it, and to treat it, but perhaps it is another symptom of gluten wreaking havoc on the body.

Having diabetes is hard. Having celiac is hard. Having them both — well, I can’t speak from personal experience, but I imagine it is doubly hard. I can also imagine that someone with type 1 diabetes or a parent of someone with type 1 diabetes would not want to think about having celiac too. But I hope that my urging to pay attention to gluten will get someone’s attention out there.

Undiagnosed celiac disease or gluten intolerance can lead to very serious problems. As stated in an article about the study, “Undiagnosed celiac disease might cause significant morbidity… Short-term complications include growth disturbances, weight loss, and difficulty achieving glycemic control in type 1 diabetics. Long-term complications can include small bowel malignancy.” And these are just a few of the many symptoms and associated conditions related to celiac disease and gluten intolerance.

To read articles about the study, go to the Global Diabetes Community or to Medscape.com (sign up for a free account).

Does anyone have a personal story about gluten and diabetes?

It is common knowledge now in the gluten-free community that most oats are contaminated with wheat. For this reason, certified gluten-free oats have become available and are increasingly being used in cereals, bars and cookies. I have wondered about other grains — why would oats be the only ones when surely other grains are grown near, processed, stored, and transported with wheat? Though I wondered about it, I didn’t pursue it, probably because I never really wanted to know the answer!

The answer is here, and it’s not good news. In a study conducted by registered dietitian Tricia Thompson, Anne Lee of Schar, and Thomas Grace of Bia Diagnostics, 7 of  22 (32%) samples of naturally gluten-free grains, seeds and flours tested contained mean gluten levels above 20 ppm with amounts ranging from 25 to 2,925 ppm. What does this mean? Some foods we think of as being naturally gluten-free actually contain higher than the proposed FDA amount of allowable gluten (20 parts per million or ppm).

This poses a problem for the FDA’s proposal regarding gluten-free claims on food. Under the proposed FDA rule, gluten-free oats can have a gluten-free claim on them because some oats are contaminated with wheat and are not gluten-free. An “inherently gluten-free” food, on the other hand, such as apples, would not be allowed to have a gluten-free claim on them unless it was stated that “all apples are gluten-free” or something to that effect. Apples are obviously gluten-free so putting a gluten-free claim is considered misbranding of those particular apples. But what about these other grains?

Gluten-free grains, seeds and flours that many of us eat every day were found to be contaminated with wheat. The most contaminated samples in this study were soy flour, millet flour and sorghum flour. Thompson notes on her blog entry about the study that “sampling was not large enough to make any assessment on the overall percentage of contaminated product. Sampling also was not large enough to make any inferences on the specific grains, flours, and seeds more or less likely to be contaminated.”

This study might open a can of worms for the FDA, which must decide what a gluten-free label claim means. It also opens a can of worms for the gluten-free community… what are we to do now? Trace every grain, seed and flour, including those used as ingredients in gluten-free products, back to its origin to ensure that it has not been contaminated with wheat? Let’s hope that testing continues and that more information becomes available regarding this issue.

Read more about the study:
Abstract from the Journal of the American Dietetic Association
Contamination of Naturally Gluten-Free Grains

I can’t believe it has been three years since I posted an article called Is gluten-free a fad? Since then, more and more people have started eating gluten-free and it seems that the gluten-free world has just exploded wide open (finally!) And, just like three years ago, the gluten-free diet has been termed a fad diet in news articles, on blogs and in comments like this one posted on my site just a few days ago:

Of course this is a fad! …  If wheat or barley were unhealthy to the general population, I’m fairly certain we would’ve come to that conclusion over the last 6,000 years of cultivation. I guess we should all “make the choice” to not eat other things, like fruit (MANY food allergies related to fruit proteins) or any type of nut (nut allergies are much more common than celiac) or breathe the air which contains pollen (by far most common allergy) Come on people, think about this before you write ridiculous things, or decide not to eat an important group of foods. There is no doubt in my mind of “fad” status. Just like anti-sugar, pro-agave, or anti-gelatin, pro-pectin, whatever it may be. Most people ARE NOT SMART ENOUGH to think about these things, and come to their own sound conclusions, so PLEASE stop spreading the inane “hype” which only inflames the ignorance. IF YOU ARE DETERMINED TO BE GLUTEN INTOLERANT, DON’T EAT GLUTEN. IF NOT, FEEL FREE. Simple as that. Apply this to other food-allergy-related questions as necessary.

My response:

The fact is that we are eating more gluten than ever before. And more dairy. And more soy, etc. Even sesame allergies are increasing… why? Because people are consuming more and more sesame. Same goes for sugar consumption. So there is the reality that our environment (what we eat) is changing and our bodies cannot cope with the change.

Unless your statistics are different than mine, there are about the same number of people with nut allergies as there are with celiac. This doesn’t include the many more who are non-celiac gluten intolerant. Food allergies are also much different than gluten intolerance or celiac disease — with food allergies, you generally know right away that you are reacting to it. With intolerance or even celiac disease, the symptoms can be more subtle and can develop over time. There is no reason to avoid a food if you are not allergic or intolerant to it. But if you are, then you should.

It doesn’t take determination to be gluten intolerant, but it does take determination to get diagnosed, to recognize that gluten and other foods really are responsible for people’s ill health and to stay on the diet. I personally write about being gluten-free and hope to educate others so they don’t have to be sick like I was. It’s frustrating and depressing to think about relatives whose lives could have been longer and healthier if only we had known about the problems that gluten can cause.

I wonder why you are so anti-gluten-free?

I believe the logic that is being used to call the gluten-free diet a fad is as follows:
1% of the population has celiac disease (every article and doctor quotes the celiac statistic as this). Of this 1%, only 3% are diagnosed (another statistic often quoted). So clearly, more than just diagnosed celiacs are buying and eating gluten-free food. Therefore, the people buying gluten-free foods who are not celiacs don’t really need to be eating it and are doing it because it is popular or to lose weight.

Here is the key point that is missing from this logic and continues to be my frustration… there exist more people with gluten sensitivity than people with celiac disease! It is a real condition, just like celiac disease. Just because there are no official statistics does not mean that it doesn’t exist. And this will change in the next few years, I’m sure. (For more of my opinions on this, read Think Outside the Celiac Box.) People buy gluten-free food because it makes them feel better. Couldn’t this mean that they are gluten intolerant? That is my simple logic. Also, the definition of a fad is something that is embraced very enthusiastically for a short time. This gluten-free thing is not going away!

What do you think? Fad or here to stay? How would you respond to the commenter who seems to think that gluten-free people are pushing their agenda on others?

I want to let you know about my revised Gluten-Free Diet Guide for 2010!

The gluten-free diet can be overwhelming at first, especially when presented with huge lists, or even books, explaining what you can and can’t eat. My goal in creating this guide has always been to make this diet easy to understand, and to give people immediate knowledge to begin the gluten-free diet with confidence instead of confusion.

I also have a new print feature on the website — just click the Print button above any article to display it in print-ready format. The Gluten-Free Diet Guide is a great one to print!

To find the Gluten-Free Diet Guide in the future, click on the Celiac and Gluten-Free Info link - you will find it listed there!

Q. Could symptoms labeled as Burning Mouth Syndrome be caused by gluten intolerance?  These symptoms have been constant for 5 2/3 years and include pain in roof of mouth, tongue, cheeks and under the tongue at all times except when eating. Additionally during the night I have pain above the roof of the mouth and into one ear and down the throat.

I have had nightly GERD for 8 years that doesn’t respond to any medications,  thyroiditis and nodules and increased vascularity in the thyroid, sometimes a fine tremor in my hands, and involuntary movement of my tongue and extremities. I also have had post nasal drip and phlegm for 25+ years which doesn’t respond to any medication nor was it improved by surgery to correct a deviated septum (which my doctor said left me with “perfect sinuses”.)

I know the thyroid symptoms may improve if gluten-free but are any of the other symptoms likely to be improved?

A. Sores or aphthous ulcers and taste disorders are common in celiac disease, as is reflux esophagitis, and thyroiditis.  You must get tested for celiac disease, and you must have a thorough investigation into your reflux, with endoscopy biopsy and manometry studies.You may contact my office at www.gut-check.com.

Health and happiness,
Dr. Aron

Have a question for the doc?

Did you enjoy summer camp as a child? Have you been hoping your child would have the same opportunity to learn and grow in a summer camp environment? This can be difficult, even impossible, if your child struggles with food related health problems. That is why Camp Westminster on Higgins Lake in Michigan (www.campwestminster.com) is offering camp opportunities for children who require special menus. GFCF camp will be the week of June 20-26, 2010.

The summer camp program allows children and youth to develop a sense of responsibility and self-worth in a Christian community. The enthusiastic, gifted, and multicultural staff are carefully selected and thoroughly trained. The camp director is year-round staff at the Westminster Presbyterian Church of Detroit.

NEW THIS YEAR: A gluten free menu will be available, with advance registration, during any week of camp in 2010. If your child has other food issues, contact us to discuss accommodations. Last year we accommodated kids with allergies/sensitivities to gluten, casein, eggs, soy, corn, nuts and legumes. If you have food related camp questions, please contact Deanna at dkseng99@voyager.net or Pam Jann at pamelajann@hotmail.com.

Other gluten-free camp info:

Camp Celiac

Remember animal cookies or animal crackers from our childhood? What fun to experience them again through your kid’s eyes! But if your child can’t have gluten or has other food allergies, most animal cookies are off-limits. Don’t worry… there are several brands now making them free of gluten and other allergens!

Kinnikinnick Foods

In addition to being gluten-free, Kinnikinnick’s animal cookeis are also dairy-free, nut-free and egg-free. (They contain soy lecithin and pea protein.) Three flavors of animal cookies are available:

• Kinnikritter Animal Cookies
• Kinnikritter Chocolate Animal Cookies
• Kinnikritter Graham Style Animal Cookies

Orgran

In addition to being gluten-free, Orgran’s animal cookies are also dairy-free, egg-free, and nut-free. Several flavors of animal cookies available:

• Outback Animals Vanilla (also in Mini)
• Outback Animals Chocolate (also in Mini)
• Itsy Bitsy Bears

Nature’s Path Organic

In addition to being gluten-free, Nature’s Path’s animal cookies  are also egg-free, dairy-free and nut-free. (They do contain soy.) Flavor:

• Envirokidz Vanilla Animal Cookies

Jo-Sefs Gluten Free

In addition to being gluten-free, Jo-Sefs animal cookies are dairy/casein-free, lactose-free, egg-free, and nut-free. (They contain soy.) Products are processed in a dedicated nut free and gluten-free kosher facility. Flavors available:

• Vanilla Animal Cookies
• Chocolate Animal Cookies

Mi-Del

Not all cookie flavors made by this company are gluten-free, but the Arrowroot Animal Cookies are. They do contain egg, soy and milk. Regarding nuts, the website says: “Only Pecans are run on the MI-DEL line of bagged cookies. Peanut Butter Cremes are sometimes produced on the same line that makes the MI-DEL Sandwich Cookies but strict sanitation/allergen procedures are in place to avoid any potential contamination.” Flavor available:

• Arrowroot Animal Cookies

Now go make that little person in your life happy!

Valentine’s Day is about love. And who doesn’t LOVE pizza? Better yet, gluten-free pizza?

Decorating cookies is fun, but decorating a heart-shaped pizza is another great activity to do with kids. Bonus: you have dinner made!

To make heart-shaped gluten-free pizzas, I make the pizza dough using the Chewy Pizza Crust recipe on the bag of  Pamela’s Gluten-Free Bread Mix. I add some salt to the dough while mixing because it cuts the sweetness a bit which I like better for a pizza crust. This pizza is also dairy-free, soy-free and egg-free!

You can do the following for any pizza dough recipe:

1. Grease baking sheets or pizza pans or heat a pizza stone.
2. Divide the dough into as many pizzas as you want. You can make the pizzas as thick or thin as you want, or as big or little.
3. Pour some olive oil on a little plate and press your palm into it.
4. Use only your palm to spread the dough. Don’t get your fingers in the dough because they will get sticky! If you get dough stuck on your hands, wipe it off and start again with a clean palm in the olive oil. Kids can try spreading the dough themselves!
5. Shape the dough into a heart and let rise as directed. After dough rises, reshape the heart if needed.
6. Partially bake as directed.
7. Put out different toppings and let the kids decorate their pizza. Sliced olives and salami (not spicy like pepperoni) are a favorite. We make some without cheese since my kids don’t eat dairy. You could go for an all red pizza — sauce, tomatoes, red peppers, pepperoni.



8. Bake as directed. The longer you bake, the crunchier it will get. Also, judge the baking time based on how thick or thin you made the dough.
9. Say “I love you” and/or “I love pizza” as you bite into your delicious  gluten-free Valentine pizza!