• Join our community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Ads by Google:

    Get email alertsSubscribe to Celiac.com's FREE weekly eNewsletter
    Ads by Google:


       Get email alertsSubscribe to Celiac.com's FREE weekly eNewsletter

  • Member Statistics

    83,326
    Total Members
    4,125
    Most Online
    dubls
    Newest Member
    dubls
    Joined
  • 0

    Is Sourdough the Future of Gluten-free Bread?


    Jefferson Adams

    Celiac.com 12/28/2012 - Sourdough bread is made by a long fermentation of dough using naturally occurring yeasts and lactobacilli. Compared with regular breads, sourdough usually has a sour taste due to the lactic acid produced by the lactobacilli.


    Ads by Google:




    ARTICLE CONTINUES BELOW ADS
    Ads by Google:



    Photo: CC--GFDoctorSourdough fermentation helps improve bread quality by prolonging shelf life, increasing loaf volume, delaying staling, as well as by improving bread flavor and nutritional properties.

    However, sourdough isn't just good for making better bread. Recent studies show that sourdough fermentation can also speed gut healing in people with celiac disease at the start of a gluten-free diet.

    Over the past few years researchers have been experimenting with sourdough fermentation as a means for making traditional wheat bread safe for people with celiac disease. Recently, yet another study examined the safety of this process with great results.

    "While the study was small, it did show that individuals with celiac disease who ate specially prepared sourdough wheat bread over the course of 60 days experienced no ill effects." Obviously, larger and more detailed studies need to be carried out, but the early results are intriguing.

    In the meantime, sourdough bread made with gluten-free flours might be the best way for people with celiac disease and gluten-sensitivity to get the benefits of sourdough cultures, and to enjoy fresh, minimally processed bread.

    Of course, not everyone can bake their own sourdough bread. That's why I was happy to learn that more artisanal bread bakers are turning to baking their own delicious gluten-free sourdough to share with others.

    One of these small, artisanal bread makers is a local San Francisco baker named Sadie Scheffer, who runs a company called BreadSRSLY. Sadie bakes delicious long-fermented sourdough bread and other products, using gluten-free grains. She delivers most of her products by bicycle.

    Having sampled Sadie's bread, and I can say that it is some of the best sourdough bread I've tasted, gluten-free or not. It isdelicious, dense, and chewy sourdough bread that is perfect for toasting. The loaves are fermented for twelve hours before baking. Folks in San Francisco can find Sadie's delicious gluten-free sourdough bread at BiRite, Gluten Free Grocery and Other Avenues, and at breadsrsly.com.

    Until science establishes the safety of wheat-based sourdough for people with celiac disease, I think that long-fermented sourdough bread, made with gluten-free flour, represents the future of gluten-free bread for people with celiac disease and gluten-sensitivity.

    Here's a recipe for gluten-free sourdough starter.

    Other helpful links:


    0


    User Feedback

    Recommended Comments

    As a bread lover, I hated the transition away from wheat bread, my favorite, but I'm extremely thankful I finally did! Sourdough is delicious and if it helps with recovery, all the better!

    Share this comment


    Link to comment
    Share on other sites
    Guest Dan Cohen

    Posted

    I wonder what it taste like.

    So far people have been using gluten free flour and xanthan gum which is not that tasty.

    Share this comment


    Link to comment
    Share on other sites

    Interesting. My mom finally had test done for celiac disease (both my boys and I have it), and it came back positive. But what is interesting and ties in with the article is that prior to diagnosis, bread was causing more and more issues for my mom, but that sourdough was the easiest on her stomach for her to eat.

    Share this comment


    Link to comment
    Share on other sites

    I am so glad someone can give back bread. I love to bake but have not had good results with gluten-free flours. Thank you.

    Share this comment


    Link to comment
    Share on other sites

    Wishing it was true does not make it so. Fermentation does not change the shape of the offending molecules to the extent that the immune system will not react. It's not worth risking injury. Someday there will be certified gluten-free sourdough, but not rushing into a product backed by garbage science.

    Share this comment


    Link to comment
    Share on other sites

    I tried a full day ferment sour dough. I just tried one piece. Within 10 minutes, I had a stomach ache and then all the other symptoms the following week. I am a biopsy proven celiac. I have been gluten-free for one year. I was curious, thought I'd try it, now I know.

    Share this comment


    Link to comment
    Share on other sites
    Guest Misty

    Posted

    I was wondering why it didn't bother me to eat some sourdough one time. I'm excited!

    Share this comment


    Link to comment
    Share on other sites

    Bread of this sort, is still always gonna be bad for people, as it is not being natural, coming from corn. Original recipe, is linked to rice flour...rice contains up to 2 - 3 times as much starch as potatoes. When will people learn!? This crap, coming from corns, is what causes cancer, high blood pressure, high cholesterol, and the 1,000's other issues, we have in the Western World, and yet, people keep feeding on it!? Last week in Denmark, it was " Break Cancer Week ", and there was a lot of talk about the Budwig Protocol, which has proven to clear Cancer, even for people who have gotten the " Terminated " notice!!! People who have gotten prostate cancer, which spreads to the bones etc, avoid getting chemo, and just drops refined sugars and starches, and processed foods, and boost up their oil intake and protein, and then go from having a PSA of 600 ( 60 Times the amount of showing Cancer ( 10 ) to not being able to measure!!! ) Go Paleo or LCHF people, and live life, like you've never felt before!!!

    Share this comment


    Link to comment
    Share on other sites
    Wishing it was true does not make it so. Fermentation does not change the shape of the offending molecules to the extent that the immune system will not react. It's not worth risking injury. Someday there will be certified gluten-free sourdough, but not rushing into a product backed by garbage science.

    Please expound upon how sourdough causes an immune reaction regardless of gluten ppm count. You can make gluten-free true sourdough at home today if you just use gluten-free flour.

     

    I'd love to know of a way to reduce gluten ppm through fermentation without sacrificing texture quality.

    Share this comment


    Link to comment
    Share on other sites
    Guest Chris

    Posted

    Oh well, I'm late to the party. I am in Tasmania, Australia, and have been baking sourdough bread made with gluten free flours. What distinguishes my bread is that I use only one or two, and at most three flours in each bread. One of my favorites is my 100% buckwheat flour sourdough. I am currently working on bread making techniques that enable me to make 100% millet flour bread.

    Share this comment


    Link to comment
    Share on other sites
    Guest LGautney

    Posted

    What I do know, is the American diet lacks probiotics. This is why there is such a large market for it. We get lactobacillus from yogurt and fermented or sprouted bread. Bacteria helps us digest our food! Honestly, it's that slow rise in bread making, that develops the bacteria and effectively breaks down glutens ...which our guts can't handle or digest without thre proper bacteria. The sourdough process does

    just that - it helps us digest bread because the gluten has already been broken down by the lactobacillus bacteria developed in fermentation. Using a sprouted wheat when making sourdough is even better for celiac or the gluten intolerant/sensitive folks.

     

    Why do you think they don't have much celiac issues in european countries? It's because they don't use the quick rise yeast methodology in baking! It's a slow rise on ALL the breads and litterally takes two days to make. They also don't freeze breads...they make them fresh in the mornings and if you don't go get some before dinner, you won't likely get any at all that day!

     

    The science makes complete sense! If you buy store bought sourdough, chances are they used quick yeast to quicken the leavening process. It's best to know your baker or make it at home for pennies on the dollar from what you would pay for someone else to make it. I am gluten intolerant. I get very bad pain, cramps, gas and bloating when I eat regular quick rise breads....pizza is my nemesis! I have honestly found a new & health sandwhich tolerant life again, by making my own sourdough. It's the best thing in the world to smell bread baking in the oven....It also tastes so much better when it's fresh!

    Share this comment


    Link to comment
    Share on other sites
    Guest nathan

    Posted

    What I do know, is the American diet lacks probiotics. This is why there is such a large market for it. We get lactobacillus from yogurt and fermented or sprouted bread. Bacteria helps us digest our food! Honestly, it's that slow rise in bread making, that develops the bacteria and effectively breaks down glutens ...which our guts can't handle or digest without thre proper bacteria. The sourdough process does

    just that - it helps us digest bread because the gluten has already been broken down by the lactobacillus bacteria developed in fermentation. Using a sprouted wheat when making sourdough is even better for celiac or the gluten intolerant/sensitive folks.

     

    Why do you think they don't have much celiac issues in european countries? It's because they don't use the quick rise yeast methodology in baking! It's a slow rise on ALL the breads and litterally takes two days to make. They also don't freeze breads...they make them fresh in the mornings and if you don't go get some before dinner, you won't likely get any at all that day!

     

    The science makes complete sense! If you buy store bought sourdough, chances are they used quick yeast to quicken the leavening process. It's best to know your baker or make it at home for pennies on the dollar from what you would pay for someone else to make it. I am gluten intolerant. I get very bad pain, cramps, gas and bloating when I eat regular quick rise breads....pizza is my nemesis! I have honestly found a new & health sandwhich tolerant life again, by making my own sourdough. It's the best thing in the world to smell bread baking in the oven....It also tastes so much better when it's fresh!

    This is a very good point and you are absolutely right, but I think what we need to realize is that us as consumers have created this problem. the evolution of bread and mass producing has caused these problems with faster mixing times and added enzymes and emulsfiers to make these processes possible. We expect longer shelf life and longer keeping qualities but don't want any hidden nasties etc! consumers have ruined the bread market and gluten free is no expectation with modified starches to give it jelling properties and also addition of more additives and preservatives than normal bread. long story short we need to turn back time reverse evolution and go back to traditional methods where the process happens naturally! Gluten and sugars and braking down with longer fermentation times obliterating the modern day problems we have!!

    Share this comment


    Link to comment
    Share on other sites
    Guest loretta

    Posted

    Have used gluten free flours with excellent results; my guests do not notice any difference. I think that is because there are so many gluten free flours available today. Am excited about the sourdough especially for the digestive benefits. Great site.

    Share this comment


    Link to comment
    Share on other sites


    Your content will need to be approved by a moderator

    Guest
    You are commenting as a guest. If you have an account, please sign in.
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • Popular Contributors

  • Who's Online   10 Members, 0 Anonymous, 222 Guests (See full list)

  • Related Articles

    Jules Shepard
    Celiac.com 01/18/2009 - This recipe was born of my new year's desire to experiment with new grains and flavors to achieve more nutritious results in my baking.
    I was speaking to a support group last Friday night and one of the audience questions was about this very topic: the concern that gluten-free baking often produces less healthy results. I completely agree.
    Now, much of my gluten-free baking and recipes are already on the low-sugar and low-fat end of the spectrum - something I feel very strongly about in my own diet. Take that statement with a grain of Southern sugar though, because this Southern girl knows that sweets still have their place! As I said in my discussion Friday night, chocolate chip cookies were never meant to be good for you!
    However, wherever possible, I try to reduce the sugar, bake with fruits to reduce the fats, and use alternatives for low glycemic values (like using agave nectar). I also substitute so that most all of my baking now is dairy-free, or I at least offer dairy-free options that are just as good. So many of us celiacs really cannot do the dairy anymore anyway, and gluten-free casein-free diets are finding their way into more and more of our homes as well.
    Enjoy these muffins in good health!
    Multi-Grain Confetti Gluten-Free Muffins
    These muffins are aptly named, as they include a host of alternative gluten-free grains and flours, and when broken open, look like a big new year's party! A beautiful, aromatic and healthy muffin - what a great way to start the year off right! If you don't happen to have any of these other grains on hand, simply use the same measurement of my Nearly Normal All Purpose Flour.*
    Ingredients:

    2 cup chai tea: add your favorite chai mix to 1/2 cup hot water (according to package portion directions) OR steep 3 chai tea bags in 1/2 cup lowfat milk (dairy or soy, rice or almond) ½ cup gluten-free oats (I used Gifts of Nature brand) 4 Tbs. butter or Earth Balance Shortening or Buttery Sticks 1/3 cup granulated cane sugar (or granulated Splenda) 2 Tbs. agave nectar or 3 Tbs. honey 2 eggs ½ cup natural applesauce, apple butter or pumpkin butter 1 cup Nearly Normal All Purpose Flour™ ½ cup almond meal or brown rice flour 2 Tbs. (1/8 cup) flaxseed meal 2 Tbs. (1/8 cup) mesquite flour 2 tsp. gluten-free baking powder ½ tsp. baking soda 1 tsp. ground cinnamon (½ tsp. vanilla + 1 ½ tsp. pumpkin pie spice if not using flavored chai mix) 1 ½ cups chopped berries (cranberries, blueberries, etc.) 1 cup chopped walnuts (optional)
    Directions:
    Coat muffin tins with cooking oil or line with muffin papers. Preheat oven to 325 F convection (preferred) or 350 static.In a small glass bowl (for microwave) or a small saucepan (for stovetop), combine the prepared chai tea with the oats and boil for 2 minutes, stir, cover and set aside.
    Whisk together the dry ingredients and set aside. In a large mixing bowl, cream the butter with the sugar. Beat in the agave nectar or honey, applesauce, eggs and finally, the cooked oat mixture. Gradually stir in the dry ingredients and mix until smooth. Lastly, fold in the chopped berries and walnuts, if using.
    Fill the muffin tins 2/3 full and bake until they are light brown: approximately 15 minutes for mini muffins or 22 minutes for regular muffins. Remove from oven, let cool in the pan.
    *This recipe calls for my Nearly Normal All Purpose Flour. You can find the recipe for this flour in my cookbook, Nearly Normal Cooking for Gluten-Free Eating or in various media links on my website, nearlynormalcooking.com, where you can also by this mix ready-made. It produces amazing results in all your gluten-free baking!

    Finished Multi-Grain Confetti Gluten-Free Muffins



    Jules Shepard
    This is a fun recipe to make with kids – they can pop popcorn and watch it transform into flour before their eyes.  No need to run to the store to get some fancy new kind of flour either: simply pop your favorite corn then grind it to a fine powder in your food processor or blender.  Measure, then add to the recipe below for a neat twist on traditional bread recipes.  In the unlikely event you have any bread leftover the next day, this recipe keeps nicely (especially the pre-mixed all purpose flour using Expandex) but also makes a divine French Toast!
    Gluten-Free Popcorn Bread (Bread Machine Recipe)
    Ingredients:
    2 eggs
    ½ cup hot water + 2 tablespoon flaxseed meal (set aside to steep for 10- 15 minutes)
    1 cup vanilla yogurt (dairy, soy, rice or coconut)
    1 teaspoon apple cider vinegar
    3 Tbs. olive oil
    3 Tbs. light agave nectar or honey
    ½ teaspoon baking soda
    2 teaspoons gluten-free baking powder
    1 teaspoon sea salt
    1 tablespoon rapid rise/bread machine yeast
    2/3 cup dry milk or buttermilk powder
    1 cup popcorn flour
    ½ cup brown rice flour
    1 ¾ cup Jules Gluten Free All Purpose Flour*
    *(As always, I cannot predict the results of this recipe with any other flour, as I have only tried it with my recipe printed in my books, Nearly Normal Cooking for Gluten-Free Eating and The First Year: Celiac Disease and Living Gluten-Free, and on various media links from my website.  A pre-mixed version of my gluten-free flour containing Expandex  is available through my website.)
    Directions:
    Stir the eggs with a fork in a small cup to mix the yolks and whites together.  Add flaxseed to hot water and set aside to steep.  Gather all other ingredients and plug in the bread machine, inserting the pan and paddle attachment.
    Gluten-Free Popcorn BreadSift dry ingredients (except yeast) together in a large bowl and set aside.
    Add all liquid ingredients to the bread machine pan first.  Add the dry ingredients next and make a well in the center for the yeast.  Add the yeast last and set the machine to the gluten-free setting or a setting with only one rise cycle.
    During the knead cycle, periodically check to see that the dry ingredients have been fully integrated into the dough, scraping down the sides with a rubber spatula if necessary.  If you want, add any toppings like sesame seeds, sea salt, poppy seeds, etc. at the conclusion of the knead cycle.  Remove pan when the baking is completed and remove the bread to a cooling rack, slicing when fully cooled (if you can wait that long!).


    Connie Sarros
    Sweetening Without Sugar
    This article originally appeared in the Summer 2003 edition of Celiac.com's JournalofGluten-Sensitivity.
    Have you ever taken a bite of unsweetened chocolate?  If you have, I’m sure your taste buds revolted!  Sugar is what makes most of our desserts palatable and desirable.  But sugar adds empty calories to the diet and little else nutritionally speaking.  So how are you going to bake foods to satisfy your sweet tooth if you refrain from using refined sugar?  There are always viable alternatives.
    Sucrose (a fancy word for sugar) usually encompasses the following:

    Brown Sugar:  Much less refined than white sugar, is derived from molasses (sorghum cane) and contains very small amounts of minerals. Raw Sugar:  May come in crystalline form that is very similar to brown sugar. Turbinado Sugar:  Is partially refined sugar crystals that have been washed in steam. White Sugar:  Derived from cane or beets, and no matter what form it takes, offers nothing but empty calories. First consider the less desirable sugar replacements:
    Maltose:  Not a good option because it comes from the breakdown of starch in the process of malting grains, usually barley, so it is not always gluten-free. Corn syrup:  A blend of fructose and dextrose; its effect on blood glucose is similar to that of sucrose.  Dextrose:  Usually made from plant starches, in the U.S. it is mostly made from corn, but can also be obtained by the inversion of cane sugar or sucrose. Honey:  Derived from flowers where bees have collected nectar, is a more concentrated form of carbohydrate than table sugar, and is converted to glucose in the body.  It is only slightly better for you that refined sugar.  If you are using honey to replace sugar, for 1 cup sugar, substitute ¾ cup honey; reduce liquid in recipe by 2 Tablespoons, and add ¼ teaspoon baking soda. If you still opt to use refined sugar, in most recipes you may reduce the amount of sugar called for without any noticeable effects on the finished product.  There are several “sugars” on the market that do not have the negative effects of refined sugar:
    Date Sugar:  Derived from dates, it is not as sweet as sucrose but has far more nutritional value.  For 1 cup sugar, use 2/3 cup date sugar and add a little water to form thick syrup. Fresh or Dried Fruits:  Offer a natural sweetness and can be used in baking to reduce the amount of refined sugar used. Fruit Juice Concentrates:  While high in sugary taste, have nutritional value not found in sucrose. Fructose:  Sweeter than any other sugar in equal amounts, comes from fruits and honey.  Because of its concentration much less of this sweetener is needed in recipes. Invert Sugar:  A mixture of equal parts of glucose and fructose resulting from the hydrolysis of sucrose. It is found naturally in fruits and honey and produced artificially for use in the food industry.  It is sweeter than sucrose, so the amount used may be lessened, and it helps baked goods stay fresh longer. Molasses:  A thick syrup produced in refining raw sugar and ranging from light to dark brown in color. Maple Syrup/Sugar:  Both made from the sap of maple trees.  For 1cup sugar, use ¾ cup maple syrup or maple sugar.    Stevia Sugar:  Fairly new on the market this extract from the stevia leaf is combined with a pre-biotic nutritional supplement and is ten times sweeter than sugar.  It has a glycemic index of zero, and is nutritionally beneficial.  For 1cup sugar, use 2 Tablespoons stevia. Unsweetened Coconut:  When toasted the natural oils in coconut are exuded adding sweetness to a baked product. Unsweetened Applesauce:  When added to a cake or bread batter it adds sweetness, flavor, moistness and nutrition. Experiment until you find a sugar substitute that you enjoy, and one that works well with your recipes.Pineapple Sticks
    Ingredients:
    2 cups gluten-free flour mixture
    3 Tablespoons stevia
    ½ teaspoon salt
    ¾ teaspoon cinnamon
    ½ teaspoon gluten-free baking powder
    ¾ cup MF/gluten-free margarine
    ¾ teaspoon vanilla
    ¾ teaspoon lemon juice
    6 Tablespoons water
    1/3 cup all-fruit pineapple jamCorn-free diets:  Omit cornstarch from gluten-free flour mixture.  Use CF vanilla.  Use baking soda in place of the baking powder.  Use butter in place of the margarine.  Omit nonstick spray; use olive oil to brush baking sheet.
    Rice-free diets:  Omit rice flour from gluten-free flour mixture
    Soy-free diets:  Use butter in place of margarine.  Omit nonstick spray; use oil to brush baking sheet.
    Directions:
    Over a bowl, sift together flour mixture, fructose, salt, cinnamon and baking powder.  Cut in margarine until mixture resembles coarse crumbs.  Sprinkle vanilla, lemon juice and 2 Tablespoons water over flour mixture; toss with a fork.  Continue adding water, 1 tablespoon at a time, and tossing until mixture is evenly moistened.  Form into a ball, cover, and refrigerate for 1 hour.  Divide dough into 4 even pieces.  Roll 1 piece into a 12 X 4 inch rectangle; spread with half of the jam.  Roll the second piece into a 12 X 4 inch triangle; gently lift dough and place over jam.  Repeat with remaining 2 pieces of dough and remaining jam.  Trim edges.  Cut each rectangle into 12 one-inch strips.  Twist each strip, pinching ends to seal.  Place on a baking sheet that has been lightly sprayed with gluten-free nonstick spray.  Bake at 375F degrees for 20 minutes or until lightly browned.  Yield:  24 cookies.
    Note:  For variety, use apricot or black raspberry jam in place of the pineapple jam.
    Calories (per cookie): 83; Total fat: 4.4g; Saturated fat: 1g; Cholesterol: 0mg; Sodium: 121.4mg; Carbohydrates: 10.1g; Fiber: 0.3g; Sugar: 2.8g; Protein: 3g


    Connie Sarros
    Gluten-Free Time Saving Tips in the Kitchen
    This article originally appeared in the Winter 2004 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 09/25/2014 - Every year, life seems to get more hectic.  There is never enough time to get the things done on the ever-growing “to-do” list, let alone find time to relax.  Then you are diagnosed with celiac disease and suddenly realize you can no longer stop at Subway for a hoagie sandwich on your way home.  You get a sinking feeling in the pit of your stomach as you acknowledge that you will have to actually cook most of your own meals at home!  
    There is no need to panic.  There are many shortcuts that can help you get in and out of the kitchen faster.  Here are just a few:
    Make a list of all the items you buy at the grocery store.  Make your list very specific, organized by aisles at the store.  Print off multiple copies.  As you run out of things during the week, put a check mark next to the item on your list.  When it is time to go shopping, most of your list will already be done. Keep a “basic pantry.”  These are items you should always have on hand.  Not only does this include spices, household cleaners, paper products, and canned goods, but a back-up pantry meal is always good to stock as well.  This can be anything from cans of beans for a bean salad, gluten-free pork and beans or a can of tuna fish, to gluten-free spaghetti and gluten-free spaghetti sauce. Make extras.  If you are making soup, chili, spaghetti sauce, marinated chicken breasts, cookie dough, etc., make two or three times the quantity you need; freeze the extra portions so you have meals that just need to be popped into the microwave on the days you don’t have time to cook. Use disposable foil cookware for those really messy recipes.  Also, dish out dinners in the kitchen, from pot to plate; that way, you won’t have serving dishes to wash. Soak whole potatoes in hot water before baking them—they will cook much faster.  When potatoes need peeling, peel them after they are cooked when they are cool enough to handle and the skins will slip right off. Use leftovers to make a different meal.  Open a bag of ready-to-use lettuce and top it with last night’s leftover corn, taco filling, diced tomatoes, and sprinkle with gluten-free cheddar cheese.  Or top the salad with thin slices of the leftover roast beef, diced leftover asparagus spears…you get the idea.  You can also chop leftovers into bite-sized pieces and place them in a resealable freezer bag, and the next time you have leftovers toss them in.  When the bag is full, open a large can of gluten-free chicken or beef broth, add the contents of the bag, and voila—you have Recycled Soup! Save the crusts.  If you can’t get the kids to eat their crusts, trim them from their bread and store them in a resealable freezer bag (gluten-free bread is too expensive to buy and too time-consuming to make to throw out the crusts!).  When the bag is full, let the crusts dry out for 24 hours, then run them through a food processor or blender, adding spices like dried parsley, garlic powder, paprika, and/or Italian seasoning, and make breadcrumbs. Use a crock pot.  There are many meals that can be made in crock-pots, such as the recipe that follows.  Cut up your leftover veggies and meat from the night before.  You can also cut up potatoes ahead of time and soak them in cold water in the refrigerator.  In the morning, layer everything in the crock pot, add some liquid (gluten-free barbecue sauce, gluten-free spaghetti sauce, tomato sauce, gluten-free broth, or salsa), turn the temperature to low or slow cook, and eight hours later your meal is ready. With a little practice and planning, you can enjoy healthy, quick, gluten-free meals.  Planning ahead is the key to saving time.  Plan your meals for the week, including how you are going to use up the leftovers.  There definitely is time for “life after cooking” on a gluten-free diet.  You can find more quick meal ideas in my book, Wheat-free Gluten-free Cookbook for Kids and Busy Adults.
     

  • Recent Articles

    Alexander R. Shikhman, MD, PhD, FACR
    The Connection between Gluten Intolerance and Sjogren’s Syndrome
    Celiac.com 08/17/2018 - Mucosal dryness is among the top non-gastrointestinal complaints of patients with gluten intolerance and celiac disease.
    Prolonged eye dryness, itching and chronic inflammation of the eye lids (blepharitis), mouth dryness, excessive thirst, frequent yeast infections, skin dryness and vaginal dryness in women may represent clinical symptoms of Sjogren’s syndrome. Named after Swedish ophthalmologist Henrik Sjögren, Sjogren’s syndrome is one the most common (and one of the most commonly underdiagnosed) rheumatic/autoimmune diseases. The disease most frequently affects women (10 women for every man) and usually appears in women around and after menopause. However, the disease can affect either gender at any age.
    In addition to mucosal and skin dryness, Sjogren’s syndrome can cause joint pain and stiffness, damage to peripheral nerves leading to numbness and tingling of fingers and toes, fatigue, brain fog, inflammation of blood vessels, hair loss, poor food digestion due to pancreatic damage and various problems with the cardiac muscle and its conduction system causing arrythmia and myocarditis. Patients suffering from Sjogren’s syndrome quite frequently deal with recurring yeast infections, chronic periodontal disease, recurring canker sores and poor dental health.
    The diagnosis of Sjogren’s syndrome is based on:
    Demonstration of mucosal dryness upon physical examination Specific blood tests (positive anti-SSA/Ro and anti-SSB/La antibodies, elevated levels of serum immunoglobulin G) Ultrasound imaging of salivary glands On rare occasions, a diagnosis of Sjogren’s syndrome requires confirmation through a small salivary gland biopsy or special nuclear medicine studies.
    It is well documented that patients with gluten intolerance and celiac disease have an increased risk of Sjogren’s syndrome. Similarly, patients with Sjogren’s syndrome are characterized by the increased prevalence of gluten intolerance and celiac disease.
    The connection between Sjogren’s syndrome and gluten intolerance is not a coincidental one: there are well-studied molecular mechanisms explaining this link. In the late 1980s/early 1990s genetic studies in Sjogren’s patients demonstrated an increased presence of the class II major histocompatibility complex protein HLA DQ2. Furthermore, HLA DQ2 positivity was found to be associated with increased titers of Sjogren’s specific anti-SSA/Ro and anti-SSB/La antibodies. The link between gluten and Sjogren’s syndrome became obvious in the mid to late 1990s when it was discovered that HLA-DQ2 binds to deamidated gluten peptides and presents them to mucosal CD4+ T cells thus initiating a chain of events eventually leading to autoimmune responses.
    The second set of data came from the discovery of BM180 protein. This protein regulates tear secretion in the lacrimal acinar cells. Suprisingly, amino acid sequence of BM180 has a similarity with alpha-gliadin and, therefore, can attract inflammatory cells activated by gluten thus contributing to the development of eye dryness.
    The actual prevalence of gluten intolerance in Sjogren’s patients based on published data varies from 20% to 40% depending on the criteria used to define gluten intolerance. The data from our clinic (Institute for Specialized Medicine) indicate that gluten intolerance can affect almost half of patients with Sjogren’s syndrome. Additionally, our data show that one third of patients with gluten intolerance have evidence of mucosal dryness and Sjogren’s syndrome.
    The frequency of documented celiac disease in patients with Sjogren’s syndrome is in the vicinity of 5%.
    The following is a patient case history from our clinic:
    A 28 year old woman was seen in our clinic due to her complaints of long-standing irritable bowel syndrome and recent onset of eye dryness. Her initial presentation included abdominal pain, bloating and irregular bowel movements. She was seen by several gastroenterologists and underwent several upper endoscopies and colonoscopies with mucosal biopsies which were non-diagnostic. Her lab test results showed positive IgG anti-gliadin antibodies and she was told that “this is a common finding among healthy people, and is not indicative of any illnesses.” She was seen by her ophthalmologist and prescribed with contact lenses which she could not wear due to significant eye discomfort and irritation. Further eye examination showed that she had diminished tear production and was referred to our clinic to rule out Sjogren’s syndrome. Upon physical examination in our clinic the patient not only demonstrated profound eye dryness but also showed evidence of dry mouth, fissured tongue and patchy areas of thrush as well as very dry skin. A sonographic evaluation of her major salivary glands was suspicious for moderately advanced Sjogren’s syndrome. Her laboratory test results showed: positive anti-SSA/Ro antibodies, elevated serum immunoglobulin G, low neutrophil count as well as low levels of vitamin D and ferritin (a serum marker of iron storage state). Also, the patient was found to have positive serum IgG and salivary IgA anti-gliadin antibodies as well as positive HLA DQ2 (a molecular marker associated with gluten intolerance).
    Based on a combination of clinical history, physical findings and laboratory test results, the patient was diagnosed with gluten intolerance and Sjogren’s syndrome. In addition to the aforementioned tests, the patient underwent food intolerance testing based on serum IgG4 antibodies which showed not only gluten but also cow’s casein intolerance. Her treatment options included a traditional route of therapy based on drugs or an integrative approach based on dietary modifications and food supplements. She opted for the integrative approach and started a gluten-free and dairy-free diet as well as iron glycinate, vitamin D, specific probiotics and digestive enzymes.
    After the first month on the diet and supplements, she reported a remarkable improvement of her irritable bowel symptoms and in three months, she started noticing an improvement of the dryness. Laboratory tests performed six months after initiation of the therapy showed normalization of the IgG level, disappearance of anti-SSA/Ro antibodies and a slightly suppressed neutrophil count. Through following the prescribed diet and supplements she is now symptom free.
    Why do we need to treat Sjogren’s syndrome? Left untreated, Sjogren’s syndrome can cause debilitating dryness affecting gastrointestinal and respiratory tracts. Clinically, this manifests as difficulty in swallowing solid foods, heartburn, malabsorption of nutrients and minerals, bloating, weight loss, chronic sinus infections and prolonged dry cough. Sjogren’s syndrome also significantly increases the risk for malignancies affecting lymphatic nodules, known as lymphomas.
    Therapy for Sjogren’s syndrome is based on the treatment of mucosal dryness and the autoimmune component of the disease. In addition, patients affected by Sjogren’s syndrome need to have regular screenings for malignancies (specifically lymphomas) and premalignant conditions.
    Traditional therapy for Sjogren’s syndrome (treatment of dryness):
    Cyclosporin (brand name Restasis) eye drops and artificial tears for dry eyes. Numoisyn lozenges and liquid, as well as Caphosol for mouth dryness and mucositis. Cevimeline (brand name Evoxac) and pilocarpine (brand name Salagen) for systemic dryness therapy. Treatment of autoimmune disturbances:
    Hydroxychloroquin (brand name Plaquenil). Leflunomide (brand name Arava). Severe autoimmune conditions associated with Sjogren’s syndrome are treated with the biologic drug rituximab (brand name Rituxan). Integrative therapy for Sjogren’s syndrome. Ear acupuncture (auricular therapy) and body acupuncture to stimulate tear and saliva production. Elimination diet based on individual food-intolerance profiles. Oral probiotics (for example, BLIS K12) and intestinal probiotics. Digestive enzymes. Fish and krill oils. Black currant seed oil. Cordyceps sinensis in combination with wormwood extract to treat the autoimmune component of Sjogren’s syndrome. Zinc and elderberry lozenges. N-acetyl-L-cysteine and glutathione. Our extensive clinical experience demonstrate that early cases of Sjogren’s syndrome can be completely reversed (by both clinical and laboratory criteria) by the strict gluten-free and elimination diet. The advanced cases cannot be reversed; however, even in advanced cases the gluten-free and elimination diet can slow the progression of the disease.
    If you’re concerned that dryness may represent Sjogren’s syndrome, see a rheumatologist for further evaluation and management of your condition.
    References:
    Alvarez-Celorio MD, Angeles-Angeles A, Kraus A. Primary Sjögren’s Syndrome and Celiac Disease: Causal Association or Serendipity? J Clin Rheumatol. 2000 Aug;6(4):194-7. Asrani AC, Lumsden AJ, Kumar R, Laurie GW. Gene cloning of BM180, a lacrimal gland enriched basement membrane protein with a role in stimulated secretion. Adv Exp Med Biol. 1998;438:49-54. Feuerstein J. Reversal of premature ovarian failure in a patient with Sjögren syndrome using an elimination diet protocol. J Altern Complement Med. 2010 Jul;16(7):807-9. Iltanen S, Collin P, Korpela M, Holm K, Partanen J, Polvi A, Mäki M. Celiac disease and markers of celiac disease latency in patients with primary Sjögren’s syndrome. Am J Gastroenterol. 1999 Apr;94(4):1042-6. Lemon S, Imbesi S., Shikhman A.R. Salivary gland imaging in Sjogren’s syndrome. Future Rheumatology, 2007 2(1):83-92. Roblin X, Helluwaert F, Bonaz B. Celiac disease must be evaluated in patients with Sjögren syndrome. Arch Intern Med. 2004 Nov 22;164(21):2387. Teppo AM, Maury CP. Antibodies to gliadin, gluten and reticulin glycoprotein in rheumatic diseases: elevated levels in Sjögren’s syndrome. Clin Exp Immunol. 1984 Jul;57(1):73-8.

    Jefferson Adams
    Can a Gluten-Free Diet Normalize Vitamin D Levels for Celiac Patients?
    Celiac.com 08/16/2018 - What is the significance of vitamin D serum levels in adult celiac patients? A pair of researchers recently set out to assess the value and significance of 25(OH) and 1,25(OH) vitamin D serum levels in adult celiac patients through a comprehensive review of medical literature.
    Researchers included F Zingone and C Ciacci are affiliated with the Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; and the Celiac Center, AOU San Giovanni di Dio e Ruggi di Aragona, University of Salerno, Department of Medicine and Surgery, Salerno, Italy. 
    Within the wide spectrum of symptoms and alteration of systems that characterizes celiac disease, several studies indicate a low-level of vitamin D, therefore recent guidelines suggest its evaluation at the time of diagnosis. This review examines the data from existing studies in which vitamin D has been assessed in celiac patients. 
    Our review indicates that most of the studies on vitamin D in adult celiac disease report a 25 (OH) vitamin D deficiency at diagnosis that disappears when the patient goes on a gluten-free diet, independently of any supplementation. Instead, the researchers found that levels of calcitriol, the active 1,25 (OH) form of vitamin D, fell within the normal range at the time of celiac diagnosis. 
    Basically, their study strongly suggests that people with celiac disease can recover normal vitamin D levels through a gluten-free diet, without requiring any supplementation.
    Source:
    Dig Liver Dis. 2018 Aug;50(8):757-760. doi: 10.1016/j.dld.2018.04.005. Epub 2018 Apr 13.  

    Jefferson Adams
    Could Gluten-Free Food Be Hurting Your Dog?
    Celiac.com 08/15/2018 - Grain-free food has been linked to heart disease in dogs. A canine cardiovascular disease that has historically been seen in just a few breeds is becoming more common in other breeds, and one possible culprit is grain-free dog food. 
    The disease in question is called canine dilated cardiomyopathy (DCM), and often results in congestive heart failure. DCM is historically common in large dogs such as Great Danes, Newfoundlands, Irish Wolfhounds, Saint Bernards and Doberman Pinschers, though it is also affects some Cocker Spaniels.  Numerous cases of DCM have been reported in smaller dogs, whose primary source of nutrition was food containing peas, lentils, other legume seeds or potatoes as main ingredients. These reported atypical DCM cases included Golden and Labrador Retrievers, a Whippet, a Shih Tzu, a Bulldog and Miniature Schnauzers, as well as mixed breeds. 
    As a result, the U.S. Food and Drug Administration's Center for Veterinary Medicine, along with a group of veterinary diagnostic laboratories, is investigating the possible link between DCM and pet foods containing seeds or potatoes as main ingredients. The good news is that in cases where the dog suffers no genetic component, and the disease is caught early, simple veterinary treatment and dietary change may improve heart function.
    According to Nutritional Outlook, an industry publication for makers of dietary supplements and healthy foods and beverages, there is a growing market for “free from” foods for dogs, especially gluten-free and grain-free formulations. In 2017, about one in five dog foods launched was gluten-free. So, do dogs really need to eat grain-free or gluten-free food? Probably not, according to PetMD, which notes that many pet owners are simply projecting their own food biases when choosing dog food.
    Genetically, dogs are well adapted to easily digest grains and other carbohydrates. Also, beef and dairy remain the most common allergens for dogs, so even dogs with allergies are unlikely to need to need grain-free food. 
    So, the take away here seems to be that most dogs don’t need grain-free or gluten-free food, and that it might actually be bad for the dog, not good, as the owner might imagine.
    Stay tuned for more on the FDA’s investigation and any findings they make.
    Read more at Bizjournals.com
     

    Jefferson Adams
    Did You Miss the Gluten-Free Fireworks This Past Fourth of July?
    Celiac.com 08/14/2018 - Occasionally, Celiac.com learns of an amusing gluten-free story after the fact. Such is the case of the “Gluten-Free Fireworks.” 
    We recently learned about a funny little event that happened leading up to Fourth of July celebrations in the town of Springdale in Northwest Arkansas. It seems that a sign advertising "Gluten Free Fireworks" popped up near a fireworks stand on interstate 49 in Springdale. 
    In case you missed the recent dose of Fourth of July humor, in an effort to attract customers and provide a bit of holiday levity, Pinnacle Fireworks put up a sign advertising "gluten-free fireworks.” 
    The small company is owned by Adam Keeley and his father. "A lot of the people that come in want to crack a joke right along with you," Keeley said. "Every now and then, you will get someone that comes in and says so fireworks are supposed to be gluten-free right? Have I been buying fireworks that have gluten? So then I say no, no they are gluten-free. It's just a little fun."
    Keeley said that their stand saw a steady flow of customers in the week leading up to the Fourth. In addition to selling “gluten-free” fireworks, each fireworks package sold by Pinnacle features a QR code. The code can be scanned with a smartphone. The link leads to a video showing what the fireworks look like.
    We at Celiac.com hope you and your family had a safe, enjoyable, and, yes, gluten-free Fourth of July. Stay tuned for more on gluten-free fireworks and other zany, tongue-in-cheek stories.
    Read more at kark.com
     

    Jefferson Adams
    Stress-Related Disorders Associated with Higher Risk for Autoimmune Disease
    Celiac.com 08/13/2018 - It’s not uncommon for people to have psychiatric reactions to stressful life events, and these reactions may trigger some immune dysfunction. Researchers don’t yet know whether such reactions increase overall risk of autoimmune disease.
    Are psychiatric reactions induced by trauma or other life stressors associated with subsequent risk of autoimmune disease? Are stress-related disorders significantly associated with risk of subsequent autoimmune disease?
    A team of researchers recently set out to determine whether there is an association between stress-related disorders and subsequent autoimmune disease. The research team included Huan Song, MD, PhD; Fang Fang, MD, PhD; Gunnar Tomasson, MD, PhD; Filip K. Arnberg, PhD; David Mataix-Cols, PhD; Lorena Fernández de la Cruz, PhD; Catarina Almqvist, MD, PhD; Katja Fall, MD, PhD; Unnur A. Valdimarsdóttir, PhD.
    They are variously affiliated with the Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; the Department of Epidemiology and Biostatistics, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; the Department of Rheumatology, University Hospital, Reykjavík, Iceland; the Centre for Rheumatology Research, University Hospital, Reykjavík, Iceland; the National Centre for Disaster Psychiatry, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden; the Stress Research Institute, Stockholm University, Stockholm, Sweden; the Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; the Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; the Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; the Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
    The team conducted a Swedish register-based retrospective cohort study that included 106, 464 patients with stress-related disorders, 1,064 ,640 matched unexposed individuals, and 126 ,652 full siblings to determine whether a clinical diagnosis of stress-related disorders was significantly associated with an increased risk of autoimmune disease.
    The team identified stress-related disorder and autoimmune diseases using the National Patient Register. They used Cox model to estimate hazard ratios (HRs) with 95% CIs of 41 autoimmune diseases beyond 1 year after the diagnosis of stress-related disorders, controlling for multiple risk factors.
    The data showed that being diagnosed with a stress-related disorder, such as post-traumatic stress disorder, acute stress reaction, adjustment disorder, and other stress reactions, was significantly associated with an increased risk of autoimmune disease, compared with matched unexposed individuals. The team is calling for further studies to better understand the associations and the underlying factors.
    Source:
    JAMA. 2018;319(23):2388-2400. doi:10.1001/jama.2018.7028