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    Kudos: Disney Takes Lead on Gluten, Food Allergens


    Jefferson Adams

    Celiac.com 06/03/2011 - The folks at Disney are earning major kudos from people with celiac disease, gluten intolerance, and other food allergies. That's because for more than a decade, Disney has worked to provide information and options for guests with food allergies.


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    In 2011, Walt Disney Parks and Resorts received an award recognizing its leadership and commitment in the area of food-allergy awareness by the Food Allergy and Anaphylaxis Network.

    Disney's journey from a provider of traditional food offerings to a leader in best practices for food allergies began 12 years ago when a Disneyland Resort chef received phone call from a mother concerned about gluten-free options for her child.

    Since that time, Disney has worked to craft an extensive food program that offers meals to suit the needs of guests with food allergies and other dietary preferences.

    According to Disney network chief executive officer, Julia Bradsher, Disney's Parks and Resorts operation has the most extensive program that she is aware of. She adds that the parks have "been doing this for quite some time, so I think they were ahead of the curve."

    Disneyland Resort recently set up a web page that lists comprehensive information to help guests make informed decisions about where they can find food in the parks meets their needs.

    The company has also set up a special hotline number where park guests can call ahead with specific food requests. That number is 714-781-DINE.  If you’re planning a trip to Walt Disney World and would like to call ahead to discuss special dietary needs, guests may call 407-824-5967. Certified executive chef Bill Orton says that “the resort helps thousands of visitors" with their dietary needs, and handles most needs immediately.

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    Guest Cindy Tornes

    Posted

    I recently was at Disney World for my birthday and before I ordered they had a representative discuss my gluten allergy with me and tell me what was available at that particular booth. When I chose a different booth the same person helped me there. If you tell them you have an allergy the person at the register will not take your order until you talk to the allergy representative. All good for safety sake. They also had gluten free buns. Marvelous!

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    Guest Paul

    Posted

    We go to Disney World for 2 weeks a year, every year and it is the best 2 weeks of my son's life because of his food choices. For those 2 weeks he doesn't feel like a child with celiac.

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    Guest barbara

    Posted

    Excellent and true article. A chef will visit your table every meal if necessary and adjust the menu to fit your needs.

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    Guest Jim Serian

    Posted

    I am glad that Disney is ATTEMPTING to meet the needs of those who cannot take gluten, but I ate at two restaurants at Disneyland that claimed to have gluten free food (after placing my orders with each of the managers) and I was sick for the next three weeks. I haven't trusted them since and now bring my own food to the park.

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    Guest Colleen Huxter

    Posted

    I spent two weeks in Disney World, Orlando and had exceptional service with respect to gluten intolerance. I felt very well cared for.

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    Guest Karen Tennant

    Posted

    Disneyland in Anaheim, CA also caters to those with celiac disease. When you enter the park, go to the city hall building on main street next to the fire station and pick up a list of all the restaurants within the 2 parks and downtown disney that have gluten-free food. It even lists the items which are safe to order. Simply fabulous. Also, expect a visit to your table from the chef... he or she will assist you in ordering.

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    Guest Donna Brasfield

    Posted

    We recently visited Disney World and I was very impressed. The chef came to our table at every restaurant before we ordered and went over the menu or buffet line with me. They even brought me gluten free bread, rolls and cornbread.

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    Guest Kristi

    Posted

    On our first day at Disney in the summer of 2011, my son ordered a salad without croutons. The Disney employee asked if he had an allergy and he said he has celiac disease. She explained the gluten-free options and we talked to a manager. My son was grinning ear to ear eating pizza with his cousins. I should have known Disney would think of that too.

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    Best experience ever at Disney in Anaheim. Leave it to Disney to live up to the HAPPIEST PLACE ON EARTH!!! I also had a great meal at the Winery in California Grand Adventure. The chef made sure I was SAFE and when the bread came out for my family, she brought me gluten-free rolls and said 'can't let everyone else have the fun'. AWESOME!

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    Guest Jennifer Hughes

    Posted

    Our family was in Disney World last week and was looking forward to my 11 year old daughter-with-celiac enjoying a gluten free experience due to the many positive comments about Disney on many websites. For the most part, Disney WAS great, with a chef coming to our table and taking her order for every meal. Unfortunately, at the Spirit of Aloha Luau, the chef didn't come; instead, the waiter told her that the meal was gluten-free (it wasn't) and she ate everything. A chef and a manager came over to our table to tell me what happened, apologize and offer me a free drink (insulting!) as well as their "Claim Center" attorney's card (which I didn't ask for, by the way). I was so upset that she was sick for part of our trip -- just a reminder NEVER to let your guard down, even with the much-exhalted Disney dining.

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    Phyllis Morrow
    Celiac.com 04/29/2008 - We were unloading our rafting gear at Lee’s Ferry, about to plunge into a 19 day private (self-guided) trip on the Colorado River through the Grand Canyon. Very hungry after a long travel day, people were happily handing around the pizzas that they had picked up en route. I was walking back towards the pick-up truck, looking forward to the gluten-free supper of stuffed grape leaves, rice and salad that I’d stashed on the front seat. My anxieties had been crowding around me all day long, shoving each other like a bunch of rowdy teenagers. I was nervous about big water, scorpions, rattlesnakes, rock scrambling, new traveling companions and, of course, food. To my dismay, the truck was gone, off on a distant errand in town. Suddenly, one, lone sniveling child of an emotion stepped out in front of the others. “You’re going to starve,” she whimpered. Turning my back so my fellow travelers couldn’t see my distress, I felt tears run down my face. Rationally, I knew that the pick-up would be back in a few hours. I knew, too, that the boxes and boxes of food that I had helped to select would arrive later that evening. But at that hungry moment, desolation and self-pity threatened to overwhelm me. 
    It can feel scary to venture away from the familiar settings in which you have a high degree of food control. But outdoor activities – and outdoor eating – are too much fun to pass up. With a positive attitude, smart planning, and a measure of trust, you can get out and enjoy camping, hiking, biking, boating and picnicking. That day on the banks of the Colorado, I gently prodded my hunger back into the crowd of emotions, scrounged around for some nuts, and, yes, survived until my dinner returned.  Over the next 220 miles of rocks and rapids, I turned my mind to other thrills and chills. And I had plenty to eat.
    While not always in such remote surroundings, I regularly enjoy a wide variety of outdoor activities and have, over the years, developed some strategies for going gluten-free from the mountains to the sea. Here are some suggestions that will variously serve from the local state park to the Grand Canyon and the Alaskan backcountry.
    First, preparing and eating gluten-free foods outdoors comes with a particular set of challenges. Here are some things to consider.

    Control over food selection – from choosing the menus to purchasing food and beverages – can be especially problematic if your trip takes you far from the road and the grocery store. Unless you plan to trap rabbits and eat wild greens, you’ll need to make sure that you have enough gluten-free food for the duration. Keeping cooking surfaces, eating surfaces, and utensils free of gluten contamination takes care when you have little or no hot running water. Fellow travelers need to be educated about your needs. That’s important whether they are sharing cooking duty or just helping you keep some ravenous 12-year old from eating up all of the gluten-free cookies (that inexplicably look more delicious than the Oreos packed for the rest of the group). Depending on the type of trip, more general food restrictions, such as concerns about perishability or weight, may compound your gluten restriction by narrowing the choice of what you can bring. Packing gluten-free baked items (bread, crackers, cookies) takes special care because of their comparative fragility. The ability to access your gluten-free food items requires logistical packing decisions; you need to be able to find your dinner for day one on day one, not buried at the bottom of the supplies with items that nobody plans to excavate until day six. Accidents and moments of disappointment are bound to occur. Imagine the “oh no” second when someone bumps your elbow just as you are about to tuck into the one and only gluten-free bowl of chili. You watch your lunch cascade, as if in slow motion, into the dirt. At some point, you can expect someone to absent-mindedly put a gluten-contaminated knife in the jam. You can figure on a meal where you belatedly discover gluten on an ingredient label although the cook assured you that you could eat “everything” he prepared.
    Don’t be daunted. I’ll give some suggestions for dealing with all of these challenges. But let’s start with overall approaches to food planning:
    Using a separatist approach, you can plan your own menu and essentially eat apart from others. Depending on the duration and complexity of the planned trip, this can be a simple alternative that guarantees you full control over what you eat. For example, I just did a cross-country ski day trip with friends and we each packed our own sandwiches. I brought some gluten-free chocolate cake and a thermos of tea to share, and my friends shared their carrot sticks and nuts. Bingo, everyone was happy and felt sociable. Separatism is generally not a good approach on a multi-day trip, though, where people plan to cook together. For one thing, separate planning and preparation mean duplication of effort. Worse, you’ll be left out of the social interaction of cooking in camp and you may feel like a leper when everyone else sits down to some delicious meal and you are trying to make the best out of a reconstituted cup of gluten-free dried soup mix. A second option is to make the outing gluten-free for everyone. This works well if you have the time and the skills to take the lead in arranging food. If you have good taste and are a competent trip/food planner, nobody will be the wiser and, in fact, they’ll generally appreciate having you do the work. Since other people don’t think about gluten one way or the other, they certainly won’t care that they are using mustard or ketchup or soy sauce that happens to be gluten-free. They’ll be perfectly happy with meals based on rice, potatoes, corn tortillas, gluten-free pancake mix, brownies and other gluten-free foods. Tasty and filling meals make most people happy, and unless they are unreasonable (in which case you shouldn’t invite them along next time) they won’t get bent out of shape if they can’t have their favorite brand of sausage in the morning. Bread is the obvious exception, since few gluten-free breads meet the criterion of “I can’t tell the difference.” So have someone else bring the bread, if that’s an issue. A third, often very practical, option falls somewhere between these two extremes. In this case, you participate in the menu planning and make sure that as many staples and other items as possible are gluten-free (e.g., peanut butter, condiments, canned goods). Where planned meals call for some gluten-containing items, you provide gluten-free equivalents for yourself. You label each item visibly (e.g., a masking tape label with black permanent marker reading “Gluten-free Bagel for Susie”) and pack it so that it will be accessible for the appropriate meal. So you make sure that the spaghetti sauce purchased for the entire group is gluten-free but you include a package of gluten-free pasta for your own meal. You bring your own bread, cookies, cereal and crackers for all meals and snacks. You also participate in cooking so that you can avoid cross-contamination and, where necessary, set portions aside before gluten-containing ingredients are added. For example, if everyone else wants their fresh trout dredged in flour, you just reserve your portion, dredge it in cornmeal, and fry it in a separate pan. You also request to serve yourself first before others accidentally contaminate a dish.
    The Grand Canyon trip that I mentioned at the start was one of two that I have taken where I had to trust strangers to provision the group. Although we guided our own trip, we hired professional outfitters to supply the rafts and food. In that situation, I consulted extensively on the menu choices and requested that processed foods be kept at a minimum; instead I asked that they supply mostly basic ingredients (fruits, vegetables, eggs, butter, cheese). I also asked if items would be in their original packages so that I could check labels for gluten. I brought a variety of gluten-free starches to supplement and substitute for items on the planned menu. I picked up gluten-free snacks at a Trader Joe’s – more than I needed, in the end. The kids with us were thrilled when, after having consistently shooed them away from my goodies, I was able to generously share them towards the end of our time together.The second trip provisioned by strangers turned out to be an unexpectedly relaxed and gourmet experience for me. In this case, it was not possible for me to participate directly in the food planning. But I was touched and surprised by the kindness and care of my traveling companions. I found out that the two men who had volunteered to take food responsibility were doctors (as well as fine cooks). A phone conversation and e-mail exchange during the planning period reassured me that they understood about celiac disease. They went out of their way to make meals that were safe and delicious. There was another unexpected benefit to that trip. A physician’s assistant who was also with us contacted me a few weeks after we all returned home. She told me that having just traveled with me made her pick up on some likely symptoms in a young patient. A celiac diagnosis was confirmed, and she had called to ask for some advice on contacts and reliable sources of information, which she passed on to the patient.
    Implicitly, I’ve brought up the need to educate your fellow travelers here. In general, it’s a good idea both to describe your gluten-free needs in advance and to participate in cooking and clean-up during the trip. Unless and until you can trust that other cooks and food-handlers “get it,” you’ll want to be in or near the food action most of the time. There, you can demonstrate what’s required, take care of cooking portions separately when necessary and serve your own food. While maintaining a scrupulously uncontaminated washing environment is tough while camping, I strongly suggest that you at least reserve one cooking pot for water only. That pot will never get pasta residue or other gluten scraps stuck to the bottom and you will always have a source of clean hot water for cooking (i.e., for hot beverages or adding to instant foods) and washing up. The others may appreciate this rule, too, since it will prevent their morning hot chocolate from having oatmeal or bits of last night’s curried lentils floating in it!  If you are lucky enough to have a pre-educated friend along, or if your traveling companions are quick and considerate learners, at times you’ll be able to relax your vigilance. Whenever my husband is cooking or washing-up, for example, I can go help out with other chores – or sit down with a glass of wine and a book.
    Because your companions are likely to be gluten-oblivious, though, you can expect an occasional mishap. For those moments of disappointment, when your dinner has just been ruined or has driven off in the cab of the pick-up truck, you should keep an easy meal in reserve. Make it something that you like (how about that Annie’s gluten-free Mac and Cheese?) so that you don’t feel too deprived. Or set aside a favorite dessert so that if you have to make do with a minimal supper you can at least have a special sweet.
    Whether you are supplying your own food or relying primarily on others, a few tricks will help you keep your edibles edible.  There are things that I always carry with me: at least one thin, flexible plastic cutting board; one or two plastic containers; and a set of utensils. The light plastic cutting board allows you to create an instant clean surface for food preparation or consumption anywhere you go. In fact, I keep one or two in my suitcase for ordinary travel and they are also essential in my home kitchen.  If the mats you purchase are too large for convenience, cut them down to a size (6” x 8” or 8” x 11”) that fits easily into your backpack, bike pannier, or food box. They are so flat that they take up virtually no space and you’ll have solved the problem of gluten-y picnic tables (or airline trays or food court counters, for that matter). The mats are very easy to wash, rinse and dry and can be kept clean in a plastic bag for the next use; you might want to size yours to fit into a half-gallon Ziploc bag. Having your own set of utensils is useful for obvious reasons, but for camping and picnics a good pocketknife is essential. When someone else takes out his or her knife to cut food for everyone, volunteer yours for the purpose, since you can be sure it’s gluten-free. Plastic containers will help you keep your gluten-free baked goods intact, particularly if you try to pack them just tightly enough that the goods will not rattle around inside. I find a couple of sandwich-sized plastic containers very useful, as well as a few others of assorted sizes. Small containers that fit into a waist pack or day pack will protect your lunch much better than a plastic bag. Mark your containers “Gluten-free foods only” so that they do not become mixed up with containers for general food storage.
    There is one caution about keeping your foods separate that I can illustrate with a little story. On one overnight biking/camping trip, I forgot to remove my gluten-free snack bars from my bicycle pannier. When I saddled up the next morning, I discovered that small campground thieves (probably squirrels) had chewed right through the fabric to get at them. My bag was ruined, but at least we weren’t camping in bear country that night…a reminder that wild animals are just as happy to eat gluten-free as anything else.
    Camping foods usually need to be relatively compact even if you have the luxury of carrying a lot (in a car, RV, motorboat or raft). Weight is, of course, an additional issue if you are backpacking, bicycling, or kayaking. Depending on which activity you’re doing, you can pick and choose among some of these easy options:

    Trail mix: It’s a snap to make your own with gluten-free dried fruits, nuts, coconut, chocolate chips, and/or gluten-free cereal. Just use care in your selections. For example, while whole dates are usually gluten-free, chopped dates are often dusted in barley flour so that they will not stick together. Snack bars/energy bars: Take some of your favorites (check the nutrition/health food section of your grocery store as there are an increasing number of possibilities out there) or, if you are so inclined, you can even make your own granola bars based on gluten-free granola, such as Bakery on Main or Trader Joe’s brands, or by using gluten-free rolled oats. Boil-in-bag foods and pre-cooked foods: If weight is not an issue, these are convenient and non-perishable. Heat up a pan of water, slip in the pouch, cut it open and eat: if you are worried about keeping pans clean, this completely solves any cross-contamination problem. Tasty Bite makes a variety of gluten-free Indian and Thai foods packaged in “smart pouches.”  They are commonly available in regular grocery stores. To save packing room, toss out the boxes at home and bring only the pouches, but be sure to label them with a permanent marker if the pouches do not have the contents printed on them, since they will all look alike. Pre-cooked polenta rolls are similarly convenient. Instant cereal: For gluten-loving campers, instant oatmeal in individual serving packs is a standard breakfast item. I don’t know of anyone marketing gluten-free oats this way, but an equivalent for gluten-free campers is quinoa instant hot cereal, similarly packaged (Altiplano Gold makes several flavors that can be ordered on-line). You can also pre-measure quick-cooking cereal, such as rice cereal, in Ziploc bags with a little salt and flavorings (cinnamon, sugar, etc.) of your choice. Pre-measure in the drinking cup that you plan to bring camping with you. Then you can use the same cup to measure water proportionately. I use the same method for measuring and packing other dried foods such as rice, quinoa, or polenta, often including herbs and spices: mark the contents, amount of water needed, and cooking time on the plastic bag. Cured or dried meats: Freybe makes salami-type sausages that are compact and keep well. Shelton makes gluten-free turkey jerky. Though quite expensive, it is very lightweight. S’mores: A facsimile of everybody’s camping favorite is easy to make. Marshmallows are typically gluten-free (find a brand that is labeled as such), as are plain Hershey’s chocolate bars. Substituting gluten-free cookies for graham crackers makes gluten-free s’mores even more decadent than the originals. Dried foods:  A variety of dried foods, such as bean flakes, potato flakes, and vegetables are available in gluten-free versions and make packing light and camp cooking quick. As always, you need to read labels. Rice (including brown rice) that has been partially pre-cooked and dried does not take long to prepare. If you are using a small camp stove, quick-cooking items save on fuel weight, too. Dutch oven baked goods: If your trip is such that you can carry an aluminum (lighter than cast iron) Dutch oven and some charcoal, you can turn out cornbread, brownies, and cakes that will make you the hit of the crowd. Bring your favorite gluten-free mixes, or mix up your own dry ingredients from your favorite recipes. Don’t forget to bring the necessary wet ingredients, too, of course. Search for Dutch oven camping recipes on-line to learn the basic technique. It’s not hard.
    Okay, now you have no excuses not to get out there. Have a great gluten-free summer and remember that getting active and outdoors is as important as eating well.

    Jill Schaefer
    Celiac.com 08/07/2008 - We'd begun practicing basic Italian⎯buon giorno! We'd practically memorized the Frommer's travel guide. We'd scoured multitudes of online travel sites and finally made all the arrangements for our once-in-a-lifetime romantic getaway to the sun-kissed shores of the Amalfi Coast.
    As the date of our departure approached, we grew more excited to spend our first major vacation together, tucked away in cliffside hotels, taking in sweeping views of the Mediterranean from our seaside balconies. We had some lingering doubts, though. Jeff follows a gluten-free diet, and I was concerned about how well he'd be able to eat in Italy, the land of pizza, pasta and bread. I know how difficult it can be to dine out, even in our neighborhood in San Francisco. What could he possibly find that would be gluten-free in Italy? And, with the language barrier, how would we be able to easily communicate his needs?
    Jeff: I know a little Italian, but solo un po’ (only a little), as the Italians say. So I, too, was a bit worried. At home, I keep tight control over what I buy, prepare most of my own meals and eat out only at select places that I know are safe. I was worried that consuming every meal at a hotel or restaurant for two weeks straight would present challenges. Like so many people with celiac disease, I've lost more than a few days to gluten contamination. That's the last thing I wanted to happen on such a special trip.
    One of the first things we did was to e-mail the hotels several weeks in advance to see what gluten-free options they might offer. We crafted a short inquiry in English, and just in case the staff only spoke Italian, put it through a free online translation service called Babel Fish. We included both versions in our messages. All four hotels responded within a day or  two, most in English. Three confirmed gluten-free options in the hotel and/or its restaurant. One pledged a solution upon arrival, suggesting that Jeff could communicate a preference for breakfast, and the hotel would meet his needs.
    Jill: I was especially impressed with Casa Astarita, a bed and breakfast along the first leg of our trip in Sorrento. The staff at Casa Astarita noted that we could request food without wheat or barley, recommended a restaurant in the square and pledged to help us during our stay in Sorrento. In addition, the Hotel Margherita in Praiano, a charming seaside town off the beaten path, assured us of gluten-free pasta and biscuits (probably what we would call crackers) in the hotel.
    Another step we took about two weeks before our flight was to contact the airline about gluten-free meal options. We wondered if Jeff would be able to eat gluten-free on both legs of the trip⎯from San Francisco to Chicago, and more importantly, the nine-hour haul from Chicago to Rome. Either way, we planned to pack plenty of gluten-free snacks to have on hand as a precautionary measure.
    Jill:  The American Airlines customer service representative told me the airline did not offer gluten-free meals on the short flight from Chicago to San Francisco, and we'd need to bring our own food. However, on the longer flight from Chicago to Rome, they could accommodate gluten-free needs. The representative confirmed a special meals code for the gluten-free food request (GFML is the code) that was entered into the reservation.
    American Airlines also pointed us to its Web site, which lists sample menu options that may vary month to month:

    Brunch/hot breakfast - Mushroom cheddar omelet with sweet potato hash, yogurt, seasonal fruit Cold breakfast - Yogurt, seasonal fruit, breakfast cookie Lunch/dinner - Sweet chili salmon, green beans, white rice, salad, fresh fruit Snack - Penne pasta  with artichokes, fresh fruit
    The quick and positive responses from the hotels and airline immediately put us at ease. A little online research into gluten-free travel in Italy promised a smooth experience.Jeff: It turns out that the Italians are actually at the forefront of celiac disease awareness and treatment. In fact, all Italians are screened for celiac disease before they are six years old. [1,2]
    Those with celiac disease receive excellent support, including monthly payments from the government for gluten-free food, as well as more vacation to offset extra time used to shop for and prepare gluten-free food.
    Italians are also on the vanguard of the gluten-free food movement. The country's robust celiac association, called the Associazione Italiana Celiachia (AIC), the Italian government and several large Italian companies that make and distribute gluten-free foods have joined together to promote awareness and understanding of celiac disease. This makes for knowledgeable restaurant owners, managers, chefs and waiters. [3]
    Italians are among the most expert crafters of gluten-free pastas and baked goods. Italian companies like Beretta and BioLand make delicious gluten-free rice pasta and a variety of other gluten-free food products, while others produce numerous gluten-free specialty items for import, such as chestnut flour.
    AIC has a helpful Web site and convenient 24/7 telephone hotline. Both offer celiac information and support in English and Italian, along with tips on gluten-free food and dining in every region of Italy. [4]
    So, all of the useful information we turned up in our search made us hopeful that our first vacation together just might be a gluten-free gastronomic delight.
    Tune in next month to find out how things turned out on the ground. Until then, happy gluten-free travels and, as the Italians say, Mangia bene! Eat well!

    http://healthlink.mcw.edu/article/1009402816.html http://celiac-disease.emedtv.com/celiac-disease/ celiac-disease-screening.html http://www.prlog.org/10063446-at-last-the-gluten-free-guide-to-italy-guide-to-the-gluten-free-land-of-pasta.html http://www.celiachia.it/default.asp
    Co-written by Jefferson Adams

    Jill Schaefer
    Celiac.com 09/11/2008 - After a two-leg flight and multiple trains, Jeff and I finally stepped off the local Circumvesuviana train in sunny Sorrento, our first destination on the fabled Amalfi Coast. It was hot, or as the Italians say, molto caldo. We’d been traveling for nearly 24 hours straight, and as we lugged our bags along the final stretch of cobbled sidewalks toward Casa Astarita, we both felt exhausted, ravenous and more than a bit disoriented.
    Jill: Any nourishment from our 10-hour flight from Chicago to Rome had long since faded. However, American Airlines had made good on its promise to provide Jeff with decent gluten-free meals. The attendant had confirmed his special meal selection at the beginning of the flight, and at both dinner and breakfast he was among the first to be served (much to the envy of the other hungry passengers!).
    Jeff: For dinner American served me a gluten-free meal of blackened chicken on a bed of quinoa, with green beans, melon and a gluten-free German chocolate cookie. Now, airline food is never going to win any Michelin stars, but I was grateful that my meal was gluten-free, hot and reasonably palatable.
    As we checked into Casa Astarita, the helpful receptionist Marella suggested that we try Bar Syrenuse, a nearby ristorante with gluten-free menu options. Marella even gave us a referral card good for a 10 percent discount. After freshening up, we sauntered a couple blocks to the Piazza Tasso, the main square, where we easily found the cheerful and airy establishment.
    Jill: Bar Syrenuse offered a separate gluten-free menu selection. Many of the items, such as the meats and salads, were regular staples on the menu. Jeff had many options to choose from – including gluten-free pasta. I opted for a club sandwich, stuffed with local ham and cheese, and a caffe alla nocciola (hazelnut coffee).
    Jeff: The intense heat of the day was just beginning to break, and I wasn’t in a pasta mood at that moment, so I ordered pollo al forno (grilled chicken with balsamic vinegar, parsley and chili flakes) and an insalata verde (green salad). The food was delicious, and sitting on the terrace made for a lovely introduction to Italy. All this for two for under 25 euros. Perfecto!
    Day Two: Our stay at Casa Astarita included breakfast, and we’d been assured via email of gluten-free options. The staff did not disappoint and even offered to prepare an omelet if Jeff wished. He ultimately chose from the standard offerings of orange/pineapple yogurt, fresh juices, individually brewed coffee, cheese and corn flakes (which for some might best be avoided) before we began our morning walk.
    Jill: During our meanderings through the town and along the cliffs overlooking the spectacular Bay of Naples, we checked out a few potential lunch spots and perused their menus. We decided on a simple outdoor restaurant, Angelina Lauro, near that train station that offered shaded tables and faced a grassy piazza bearing the same name. Jeff had a vegetable and cheese omelet along with fries, which would frequently become his reliable substitute for bread. I had a scrumptious margherita pizza. It was so big that I was able to save half for lunch the next day.
    Jeff: After a short nap followed by another evening walk along the Marina Grande, we again headed for Bar Syrenuse – this time, with gluten-free pasta in mind! We decided to share a few dishes and ordered gluten-free penne pasta with tiny tomatoes, grilled seasonal vegetables and an insalata caprese. The pasta was nicely cooked, with a flavorful sauce. Jill commented it tasted so good she’d have never known it was gluten-free. It was then I realized just how good it felt to be in Italy, sitting outside and eating pasta, an almost forgotten favorite, as the sun went down.
    The manager of Bar Syrenuse is a personable gentleman named Toni. We were able to pull him aside during a pause in his busy dinner rush and ask a few questions about how the restaurant came to offer gluten-free options. Toni explained that there are so many special diets that it is important to offer many choices to attract the fullest clientele, and noted that a wide range of food options is a reflection of good service, which is good for business. Consequently, Bar Syrenuse offers numerous items that cater to a number of specialty diets.
    Day Three: After a torrid afternoon spent traipsing through the ruins at Pompeii, where we’d consumed just a few snacks – gelato, granita and coconut snack bars – we were ready for a proper meal. The day before, we’d spotted several quaint restaurants tucked away in the alleys near our hotel, and so we headed in that direction.
    We nestled in at Ristorante Sorrento, a charming establishment with a large awning and phalanx of outdoor tables adorned in crisp white tablecloths. Jeff started with minestrone soup, followed by a main course of fresh local white fish with tomatoes in a white wine sauce and a green salad. I choose lemon risotto with shrimp and an order of pane (bread). Jeff got a little extra protein that night as I quickly passed over the jumbo shrimp to his plate. Their heads, with those little black eyes staring back at me, were more than I could take!
    During our stroll back to the hotel, we stopped to purchase a few postcards and sip some cappuccino before settling in for a good night’s rest, before moving on to what would be the absolute gem of our trip, picture-perfect Positano. Check back for our next article featuring our gluten-free gastronomical adventures in this serene oasis by the sea!


    Vanessa Oakley
    Celiac.com 08/06/2013 - I recently went camping with a good friend of mine and her boyfriend. This was a last minute trip that I knew I was kind of going solo. I have never been camping without a partner or at least a tent mate. So this was the first time I only had to think of me. How cool is that?!
    I start every out of town adventures the same way—I make a trip calendar to plan out my clothes, meals and supplies (If I could only show you guys all the lists I make!).  I find that when I'm camping there is a level of community in the supplies and food department. I forgot forks, no worries buddy I brought extra. Try this, I made it myself or I brought too many hot dogs, eat them. This can be dangerous for a celiac. No one wants to be the guy that has to read everything in sight before they touch it. Or maybe you do, that's cool too—be yourself. I have always subscribed to the theory that if I don't know what it is or what's in it, I simply say "no thank you," even if it kills me to say no, and makes me think about how yummy that thing could have been.
    The day before I went camping I took my list and headed to the grocery store. When I got home and packed I was pretty happy with my haul. I know that I have a lot—more than enough to feed myself for the trip, including snacks. I am self-sufficient…as long as they have some sanitizer and some biodegradable soap for dishes. But I had everything else I needed...I hoped.
    To my delight and surprise my lovely friend and her lovely boyfriend had over-packed in the food department with stuff that happened to be gluten-free. I know that some things she would have packed with me in mind (thank you Lindsay!), but other things were as much a surprise to her as they were to me. Between the both of us we all ate like kings that weekend!
    It is a bit difficult to write about gluten-free trials and tribulations when everything works out. Where there is no worry about cross-contamination or drunken mix-ups. I was the only person to bring out "bread." I found some hotdog buns that looked promising. They got toasted over the fire in a wire basket thing and were so good!
    There are, of course, some things to look out for when you are camping. Be aware of a stove top or grill if you have things like that at the site. You never know what someone else cooked on that, even if it's just meat it may have been seasoned with things that contain gluten. Also, don't mix up your hotdog stick with someone else, unless everyone also has gluten-free dogs. Don't borrow shampoo or face wash. There are so many things that can have gluten in them!
    I definitely learned some stuff about myself on this trip. I learned that I am lucky enough to have surrounded myself with good caring, thoughtful people.  I love camping and I never knew how easy celiac disease would eventually become for me. Did I mention that I am also terrified of spiders!

  • Recent Articles

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023