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    Shaun Wong

    The Differences Between a Gluten-Free and Keto Diet

      A keto diet focuses on consuming only high-fat, moderate-protein and low-carbohydrate foods.

    Caption: Image: CC--zacharydunnam

    Celiac.com 04/11/2019 - Dieting, a word commonly used by people who are in the process of consuming food in a regulated and monitored manner. We normally equate someone who is dieting to someone who wants to lose weight and restricts their food intake to achieve a desired outcome, for example to prevent certain diseases or deal with obesity. 

    For many reasons, the purpose of dieting has evolved. Currently there are many popular diet plans available, such as the gluten-free diet, keto diet, paleo diet and detox diet. But today we are only going to discuss the difference between two more widely used diets, which are the gluten-free and keto diets. 

    What is a gluten-free diet?

    A gluten-free diet is generally a diet that explicitly excludes gluten from meals. This diet is normally used to treat people with celiac disease, or those who have gluten sensitivity and experience discomfort and symptoms after consuming gluten.

    Gluten is found in many foods that we consume today. It is found in wheat and other grains such as oats, rye and barley. Gluten has a glue-like property when mixed with water. For example, the gluten found in wheat bread flour helps create a sticky network that allows bread to rise and gives it a chewy texture. Unfortunately gluten is used very widely in various food additives and ingredients, which makes it difficult to avoid.

    What is a keto diet?

    A keto diet focuses on consuming only high-fat, moderate-protein and low-carbohydrate foods. It involves a substantial reduction of carbohydrate intake which is  replaced with fat. 

    The purpose of the keto diet is to put your body into a metabolic state known as “ketosis.” What happens in this process is that your body will start efficiently burning fat for fuel instead of carbohydrates. 

    What should we avoid in a gluten-free diet

    Gluten is widely used during food production making it difficult at times to maintain a gluten-free diet. Although gluten is safe to be consume by many people, those with gluten sensitivity should avoid it to prevent complications. 

    Below are some basic foods that contain gluten, and some examples that may contain gluten (see Celiac.com's Forbidden List for more info):

    • Baked goods - Cookies, muffins, cakes, pizzas, etc.
    • Bread - All wheat-based bread.
    • Pasta - All wheat-based pasta.
    • Snack foods - Pre-packaged chips, roasted nuts, candy, pretzels, crackers, etc.
    • Beverages - Flavored alcoholic drinks or beer.
    • Cereals - Unless stated gluten-free.
    • Other foods - Sauces, couscous, broth cubes.

    What can we eat on a gluten-free diet? 

    However, even with limited food choices, there are many gluten-free options now available in markets. It isn’t that hard to adopt this diet as long as you keep an eye out for foods labeled with “gluten-free” or better yet, you can prepare home-cooked meals which will definitely be healthier. 

    Below are foods that are naturally gluten-free:

    • Fruits and vegetables - All types of fruits and vegetables are naturally gluten-free so eat away!
    • Meats and fish - Avoid battered or coated meats or fish.
    • Dairy - Products such as plain milk, plain yoghurt and plain cheese are gluten-free as long as it does not contain added ingredients.
    • Grain - Rice, buckwheat, quinoa, corn, oats and tapioca, as long as labeled gluten-free.
    • Starches and flour - Potatoes, corn, chickpea flour, potato flour, corn flour, soy flour, tapioca flour and coconut flour.
    • Nuts and seeds
    • Herbs and spices 
    • Spreads and oils - All butter and vegetable oils (some celiacs avoid canola oil as it's often grown in the same fields as wheat).

    Foods to avoid on a keto diet

    This diet restricts a substantial amount of carbohydrates in your body to ensure that only fats will be burned. Therefore, any type of food with a high carbohydrate content should be limited. 

    Here is a list of high-carb foods that should be limited:

    • Grains and starches – Pasta, rice, cereals, wheat-based products,etc .
    • Sugary foods – Cake, candy, ice cream, fruit juice, etc .
    • Fruits – All kinds of fruits (except limited portions of berries).
    • Beans and legumes – Chickpeas, kidney beans, lentils, peas ,etc.
    • Root vegetables and tubers – Carrots, sweet potatoes, potatoes, etc.
    • Alcohol – Due to alcohol carb content, many alcoholic beverages are not recommended.
    • Sugar-free diet foods – These food are often high in sugar alcohol and tend to be highly processed.

    What can we eat on a keto diet?

    As your body will only be focused to burn fats as fuel, you will require a substantial amount of fatty food. However, this does not mean to consume all the fried food you can find. In a high fat diet, you have to focus on consuming only healthy fat to still achieve your required nutrients. 

    Your meals should be based around these foods:

    • Fatty fish – Salmon, tuna, trout and mackerel.
    • Meat – Chicken, steak, turkey, ham, sausages and bacon.
    • Eggs – Opt for pastured or omega-3 whole eggs.
    • Low carbohydrate veggies – Most green leaf veggies, tomatoes, onions, etc.
    • Cheese – Unprocessed (goat, cheddar, cream, mozzarella or blue cheese).
    • Butter and cream – Opt for grass fed.
    • Healthy oils – Mainly extra virgin oil, avocado oil and coconut oil.
    • Condiments – Salt, pepper or any herbs and spices.

    Benefits of gluten-free diet

    Obviously those who have celiac disease require a gluten-free diet, but even for those who don't a low-gluten diet can be beneficial. Excess consumption of gluten may lead to gut or other inflammation, which can result in bloating, stomach cramps or diarrhoea. 

    Therefore, a gluten-free diet can be beneficial to anyone facing digestive problems such as bloating constipation and many other symptoms. It can help ease your digestive symptoms and reboot your digestive tract. 

    Moreover, dropping gluten allows you to have more energy during your day. Eating an anti-inflammatory diet removes food stressors like gluten, sugary food and genetically modified food that will allow your body adrenals to come be reduced. This improves energy, reduces stress, and can aid one's emotional balance. 

    Benefits of the keto diet

    Although it may sound scary to focus on consuming a high amount of fatty foods, and it may even seem to be in conflict with your health goals, it is actually beneficial in many ways. 

    Burning only fats can help you drop a lot of weight quickly. This is because ketones suppress your hunger hormones which in return reduces your appetite. You will be able to go for longer periods without eating. 

    Next, a keto diet fuels and feeds your brain. As our brain is made up of at least 60% fat, and ketones provide an instant hit of energy whenever you're burning fat. Consumption of essential fatty acids will also help to grow and develop your brain. 

    Possible negative effects of gluten-free and keto diets

    As with all good things, there are sometimes bad things that come with them. Despite having a variety of health benefits, there are certain risks associated with both diets.

    First, you may be at risk of nutrient deficiency due to the elimination of too many foods. This can cause you, for example, to not consume enough fiber from traditional sources. Fiber also assists your body in the absorption of nutrients.

    Furthermore, the lack of fiber can lead you to have bowel issues such as constipation. Gluten-free and keto diets both eliminate many sources of fibre like wheat bran and fruits that promote good bowel movements. Constipation can cause serious issues if not dealt with.

    Conclusion

    Those with celiac disease or gluten sensitivity require a gluten-free diet, and don't have the luxury going off the diet—they must stay on the diet to maintain their health. It is always a good idea to consult a registered dietician before starting any major dietary change, and this is true for both the gluten-free and keto diets. Interestingly the keto diet is mostly gluten-free, or can easily be made gluten-free, so for celiacs who want or need to lose weight, it might be a good option.

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    The keto diet can also benefit those with some other AI issues, it varies from person to person but I took it to deal with my Ulcerative Colitis, and then had to really stick to it when I learned I had blood sugar issues.
    It can also help with people just transitioning to the gluten-free diet as fewer starches/sugars mean less gas and bloat. Some people with compromised intestines are prone to Candida and SIBO Also which feed on sugars, starches, and carbs and a keto diet can help starve them off. 
    Another thing to consider is that often diabetes is an issue with Celiacs, a lower carb diet or a keto diet can help with managing T2 (T1 will still require carb intake).

    In regards to fiber, many find that adding in seeds like flaxseed meal, Hemp Seeds, and in some chia seeds are alright to help boost fiber content on a keto diet, along with various nuts, and dark leafy greens which in my opinion should be consumed with every meal to maintain proper nutrient intake.
    Some find that psyllium husk and Konjac can be added into the diets for added fiber, I use psyllium husk in almond and coconut flour based bread substitutes as a fiber booster in moderation, I also found it can be added to baked egg dishes to help form up and add in more fiber. 
    Konjac fiber of often formed into low carb noodles, pasta, and rice for a keto friendly replacement that can be consumed on the diet. These have to be prepared properly to get good flavor and texture but are available from companies like Miracle Noodle, Julian Bakery, Thrive Market, and Vitacost. Although Konjac falls into a soluble fiber, this does make it good for maintaining healthy gut flora. 

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  • About Me

    After I stumbled upon keto diet, I have dedicated my time and effort to learn more about how this diet work. You can find out more about my work at Keto Survey.

  • Related Articles

    Connie Sarros
    This article originally appeared in the Autumn 2003 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 09/17/2014 - The traditional food pyramid of the past shows breads, pasta, rice, cereals (all high in carbohydrates) at the base of the pyramid, the ‘staple’ of the diet.  Recently, this assumption has come under attack.  Experts are telling us that a diet high in carbohydrates is bad for us (Why is it that the things we love to eat are bad for us?).
    We consume carbohydrates primarily from grains, fruits, vegetables (including ‘root’ crops such as potatoes), beer, wine, desserts, candies, most milk products (except cheese), and ‘…ose’ foods, such as sucrose, fructose, maltose, etc.  Eating an excessive amount of carbohydrates will increase total caloric intake, which may lead to obesity, heart disease and higher blood sugar levels.  Consuming too few carbohydrates may lead to an increase in our intake of fats to make up the calories (which also leads to obesity, heart disease and higher blood sugar levels), or malnutrition.
    Right now, it is considered the “in” thing to be on a low carbohydrate diet.  Dr. Atkins has become a household word.  The term “fad diet” refers to a diet that will yield rapid weight loss and is like a quick fix for a particular problem.  It sells the dream that this time you WILL lose weight and your life will be better.  Most diets fail to yield the anticipated results because we set unrealistic expectations of what our bodies can do.  The claim of the low carbohydrate diet is that you should adapt this regimen as a permanent way of life, thereby preventing weight-gain in the future.
    If carbohydrates are totally eliminated from your diet for a prolonged period of time, your body will become deficient in major nutrients.  Fortunately, it is nearly impossible to retain a 100% carbohydrate-free diet, because carbohydrates are found in fruits, vegetables, legumes––nearly everywhere.
    Some who follow the Atkins diet feel that it is permissible to consume large quantities of meat and eggs each day, both high in protein, and ignore their cholesterol intake.  Over a period of time, this may create other health risks.
    That being said, a sensible low-carbohydrate diet has been deemed a healthy one.  Americans consume way too much starch and sugar.  Diabetics must, of necessity, restrict their sugar and carb intake; the rest of us should follow suit.  
    Complex carbohydrates provide calories, vitamins, minerals, fiber, and improve your energy level.  Therefore, it is wise to replace processed carbohydrates (like bread, pasta, crackers, cereal) with complex carbs, such as the following:
    Apple Apricot Asparagus Broccoli Brussels sprouts Cauliflower Celery Cherries Cucumber Grapefruit Green beans Green pepper Lettuce Mushrooms Onions Plums Spinach Strawberries Tomatoes Zucchini The complex carbohydrates that should be limited if you are following a low- carbohydrate diet are:
    Acorn squash Baked beans Butternut squash Cooked dried beans Corn Grains Hummus Peas Plantain Popcorn Potato Rice Sweet potato Yam So what does a low-carbohydrate diet look like?  In the sample menu below, you will notice that ‘toast’ is listed.  One slice of ‘healthy’ toast (with flaxseed or sesame seed or other form of fiber) may be beneficial, even on a low-carbohydrate diet.
    Breakfast:  
    1 cup sliced strawberries (sweetened with ½ teaspoon honey) with 1 cup 0.5% milk.
    1 hard-boiled egg.
    1 slice toast with 1 teaspoon all-fruit jelly.
    Lunch:  
    Salad made with ½ cup shredded lettuce, ¼ cup diced tomato, ¼ cup diced green pepper, ¼ cup diced cucumber, ½ cup broccoli florets, 3 Tablespoons water-packed tuna (drained), 1 Tablespoon gluten-free lowfat Italian dressing.
    1 cup fresh cherries for dessert.
    Dinner:  
    4 oz. broiled salmon topped with 1 teaspoon gluten-free low-fat mayonnaise mixed with 1 teaspoon gluten-free Parmesan cheese.
    Sliced beets and onion salad.
    Zucchini, mushrooms and red peppers sautéed in 1 teaspoon olive oil with Italian seasoning.
    Juice-packed diced peaches folded into gluten-free sugar-free orange gelatin for dessert.
    A few final hints:
    Limit your intake of ‘white’ processed foods, including rice, breads and pastas.  If you need a sugar rush, get it from natural sugars—eat an orange or broil half a grapefruit.
    Use herbs and shredded cheeses to liven up entrees and vegetable dishes.  Read labels, not just for gluten ingredients, but for fat, sugar, sodium, and carbohydrate counts; the lower the numbers, the better it is for you.
    Buy foods in their natural state, eliminating processed foods, and vary your menu.  If you prepare bland foods or foods you don’t like, you won’t stick to any diet.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 10/16/2015 - Y Net News, under their "Health & Science" banner, published an article titled "Israeli researchers propose link between gluten and ALS", on April 17, 2015 (1). ALS refers to amyotrophic lateral sclerosis, or Lou Gehrig's disease, also known as motor neuron disease. Authorship of this article is attributed to the news agency, Reuters. The article refers to a study in which the investigators identify an autoimmune dynamic in the brain (2). The Y Net News article quotes one of these investigators as warning ALS patients against experimenting with a gluten-free diet: "Patients should not be tempted to use a gluten-free diet without clear evidence for antibodies, because an unbalanced diet might harm"(1). This is the kind of advice that frequently appears in the popular media. There can be little doubt that a gluten-free can be unhealthy, just as gluten containing diets can be unhealthy. When contacted on this issue, Dr. Drory said that "Patients with ALS tend to lose weight due to symptoms of their disease and it is well known that weight loss has a negative influence on disease progression and survival. Therefore it is very important for these patients not to lose weight" (3). Although Dr. Drory did not mean to impugn the gluten-free diet for the general population, she is legitimately concerned about the longevity and health of ALS patients, so she believes that only those with positive antibody tests should try the diet, and then only under the supervision of a dietitian. Reuters, on the other hand, have not responded to my request, through Y Net News, to contact the author of this article.
    While Dr. Drory's concerns are reasonable, I think that she has missed an important feature of the gluten-free diet and she puts too much faith in the connection between TG6 and ALS [an abbreviation for a recently discovered enzyme named tissue transglutaminase six] apparently believing that it will identify all ALS patients who might benefit from avoiding gluten. However, if we can judge based on those who have celiac disease, it is a diet that is more likely to increase the body mass of someone who is underweight. Dr. Drory also seems to have missed the sentiment expressed in the abstract of her own report. It says: "The data from this study indicate that, in certain cases, an ALS syndrome might be associated with autoimmunity and gluten sensitivity. Although the data are preliminary and need replication, gluten sensitivity is potentially treatable; therefore, this diagnostic challenge should not be overlooked" (1). Thus, when dealing with an otherwise irreversible and unstoppable disease, patients are cautioned not to try the diet without these marker antibodies which the authors identify as "preliminary" findings.
    Dr. Drory's caution also assumes that dietitians will generally be competent to guide the ALS patient in their gluten-free diet. However, it is important to recognize that the neurological patient needs to be even more strict with the diet than a person with celiac disease, and there are many uncertainties and debates around this diet. The average dietitian may not be up to date with the application of the gluten-free diet for such conditions, or the relevant controversies, or their application. Also, the beneficial results of a gluten-free diet are widespread across so many ailments and much medical research currently lags well behind patients' positive experiences. This is what has led to the continuing debate about the frequency and importance of non-celiac gluten sensitivity. Until very recently, it was usually given no attention at all. Further, since "gluten sensitivity is potentially treatable," and the current life expectancy for an ALS patient is about 2 years, it seems irresponsible to warn patients to wait for further research results before trying a gluten-free diet.
    This latter sentiment captures the essence of my current view of the gluten-free diet. Until I was diagnosed with celiac disease, more than twenty years ago, I would have ignored Dr. Drory, and subscribed to the bias inherent in the Y Net News article. Sadly, I used to dismiss people who talked about diet in the same way that I responded to those who talked about "astro travel" and Astrology. I viewed them as foolish concepts that were popular fads among drug-crazed hippies of the 1960s and 1970s, and other similarly deranged individuals. I still question many other diets, astro travel, and Astrology, but hope I do not do so with the same arrogant certitude of my youth.
    You see, I experienced a startling change of perspective shortly after I was diagnosed with celiac disease. Just three days after beginning the gluten-free diet, I awoke to an altered state of consciousness. The closest I can get to describing it is that I felt somewhat like I remember feeling as a kid when I awoke on Christmas morning. I felt optimistic, hopeful, and I looked forward to the day ahead. That was a big change. I was used to waking up feeling tired, depressed, and usually with a sense of foreboding about the coming day. I also found, after about the first six months or so of avoiding gluten, that my mind was becoming sharper, I was more aware of my surroundings, and my memory seemed to improve. My reflexes also seemed quicker. My sense of balance got better and my reaction time was faster. When I looked at others, I saw that many people were similarly challenged and didn't seem to be aware of their limitations—or perhaps they had just become used to them. Thus, I now believe that many people unknowingly suffer from the myriad harms induced or facilitated by gluten consumption. I also see, given the many venues in which the diet made a difference for me, why others might be skeptical.
    But how did Dr. Drory get from the notion that since gluten sensitivity is treatable, and should therefore be investigated as a potential factor in some cases of ALS, to the notion that ALS patients should be cautioned against experimenting with a gluten-free diet because it can cause weight loss? The gluten-free diet can be an effective weight loss strategy for some people. As I have mentioned in previous columns, the gluten-free diet seems to reduce the appetites of overweight individuals with celiac disease by about 400 calories per day. Equally, underweight celiac patients usually gain weight. Dr. Drory's concern about weight loss for those with ALS might be well founded if it was a universally good weight loss strategy. But it isn't. The data regarding weight loss on a gluten-free diet are only available, to my knowledge, with regard to celiac patients, where underweight patients almost always gain weight and about half of overweight patients lose weight. She also thinks that experimentation without a positive antibody test and the oversight of a dietitian might be risky. So her concerns may not be as valid as they first appear. If those ALS patients are gluten sensitive, then they might behave similarly to those with celiac disease, at least with regard to weight gain and loss. Further, how can anyone say, without trying it, that a gluten-free diet would not benefit those ALS patients who do not show TG6 antibodies?
    The Reuters article goes on from there to state: "It’s also worth remembering that an association is not the same as a cause. At least one earlier study concluded that there was no association between TG6 antibodies and either neurological disease or gluten itself" (1). The preceding comment refers to a retrospective research report in which the records of patients, on a Swedish data-base, who had been diagnosed with celiac disease, were further examined for an additional diagnosis of ALS (4). This is more than a little strange, since the very study the Reuters journalist used to distinguish between associations and causality, seeks only evidence of an association between the ALS and celiac disease. The notion that correlation is not causation is valid. However, using a study that looks for a correlation between celiac disease and ALS is not a reasonable basis for differentiating between correlation and causation. Neither is it a valid example of a causal relationship.
    Further, it is difficult to imagine a study design that would be less likely to reveal an association between transglutaminase TG6 and any other ailment, than one based on recorded data from a large number of patients who were diagnosed with celiac disease between 1969 and 2008. All, or almost all of these patients were diagnosed prior to the first published report of the discovery and diagnostic utility of transglutaminase 6 (5). So if one looks through records that predate the discovery of TG6 to find evidence of a connection between TG6 and any other disease, one is highly unlikely to find it.
    The abstract of the study that asserts there is no association between these ailments is based on a very weak design. It also ends with the statement: "Earlier reports of a positive association may be due to surveillance bias just after celiac disease diagnosis or expedited diagnostic work-up of ALS" (4). They are so confident of their own findings that they suggest that contrary findings are either due to bias or fast, careless work. I will leave it to the reader to infer whether there is bias among the authors of this report. Additionally, the Y Net News article, by one or more journalists at the Reuters News Agency, reports that this study found no association between TG6 antibodies and ALS, even though the study in question examines data that predates the use of TG6 antibody testing. While the study in question does appear to claim that there is no connection between celiac disease and ALS, the mention of TG6 and whether there is a connection between these antibodies and ALS appears to be information added by Reuters.
    Regardless of this possibly 'added' information, it really is quite a stretch to warn the public or ALS patients of the dangers of a gluten-free diet in reporting about research that has found evidence of a possible connection between ALS and gluten consumption. In a balanced report, the Reuters journalist would have mentioned the seven other research publications that have reported associations, and/or cause to suspect such associations, between gluten and ALS (5-11). It really isn't rocket science. It is just ethical, balanced reporting, which should serve as a minimum standard for an organization that is engaged in reporting the news. Since there are always at least two sides to almost any argument, both sides should at least have been acknowledged. Thus, in addition to the weak study reporting that they didn't find an association, the seven other reports of possible associations really should have been mentioned.
    It would also have been informative to their readers to mention Stephen Hawking, the longest living patient who was diagnosed with ALS. Dr. Hawking is still alive and has been on a gluten-free diet for the last 40+ years (12). He had already lived well beyond the two year life expectancy predicted by his doctors when, in 1963, Hawking's ALS had progressed to the point where he had begun to choke on his food. That is when he eliminated gluten, sugar, and plant oils from his diet. He has continued to avoid gluten for all these years and has also added several vitamins and supplements to his diet. Whether any or all of these measures have made "the" life extending difference, or if it is all of these measures combined that have allowed him to continue for so long, we can't know. Nonetheless, it may be that the gluten-free diet has been a determining factor in Dr. Hawking's longevity in the context of ALS. We also don't know if he would have tested positive for TG6 back when he was first diagnosed. However, he might not still be with us if he had opted to wait for this research to emerge and be confirmed.
    Since Hawking began his self-directed dietary experiment, researchers at the Royal Hallamshire Hospital in Sheffield, UK, have shown that the TG6 antibodies, while present in some celiac patients, are also found in some patients with non celiac gluten sensitivity and either neurological disease or an increased risk of developing one (5).
    Others, reporting a case study, had diagnosed ALS, then identified, diagnosed, and treated co-existing celiac disease with a gluten-free diet. They then retracted their ALS diagnosis saying: "Ultimately, improvement in the patient’s symptoms following treatment for celiac disease rendered the diagnosis of ALS untenable" (6). It would appear that any improvement in ALS symptoms obviates a diagnosis of ALS. It also raises the possibility that some cases of ALS can be effectively treated with a gluten-free diet.
    Similarly, in another case study report, the authors state: "ALS is a condition with relentless progression; for this reason, the simple observation of an improvement in symptoms is most pertinent in rendering the diagnosis of ALS untenable" (7). Again, the patient's ALS symptoms regressed following institution of a gluten-free diet.
    Yet another report that connects ALS with autoimmunity in general states: "The significance of increased premorbid celiac disease in those with ALS, and in family members of patients with MMN [multifocal motor neuropathy] remains unclear at present."(9). Still others have offered genetic evidence of connections between gluten sensitivity and ALS (10).
    Thus, the Reuters article raises an important question. Why are we seeing so many media attacks on those who are taking responsibility for their own health and experimenting with a gluten-free diet? It might come as a surprise to the Reuters journalist to learn that we humans had evolved and spread into most habitable areas of the world long before a few farmers began cultivating grains in regions of what are now known as Iraq and Iran. She/he might also be surprised to learn that we have known, for decades, that variants of wheat, rye, and barley have a deleterious impact on human neurological tissues (13, 14, 15) and that a variety of neurological ailments arise both in the context of celiac disease and non-celiac gluten sensitivity (14).
    The conclusion in the abstract of the 'no relationship' study dismisses reports of opposing findings as either due to "surveillance bias" or "expedited diagnostic work-up" (4). (This latter is a euphemistic statement suggesting that the work that led to these other reports was conducted too quickly and errors resulted.) Whatever your personal view of the attitude expressed there, the greater concern may be that the media continue to identify the gluten-free diet as potentially harmful (1) while researchers and individuals experimenting with a gluten-free diet have found evidence connecting gluten sensitivity with, at least, some cases of ALS (2).
    Over the years, I have heard many reasons for resisting this diet, but the one that is probably the least defensible is the assertion that it is potentially harmful. Almost any dietary regimen can be hazardous, of course, but the assertion that it might cause a harmful dietary imbalance fails to recognize that gluten has only been part of the Human experience for a very short time, in evolutionary terms. The simple fact is that we humans have spent far more of our evolutionary past eating a gluten-free diet than we have spent eating gluten. Some populations have only been eating these grains since European incursions over the last several hundred years. Some of these populations have only been eating it for less than one hundred years. Still others have been eating gluten for a few thousand years. In Israel, where Dr. Drory's study originated, grains were probably incorporated into the diet much earlier than in most of the rest of Europe, probably sometime between 15,000 and 10,000 years ago. It is difficult to imagine that after hundreds of thousands of years of eating a gluten-free diet, that avoiding gluten can pose a health hazard. The Reuters journalist appears to have another axe to grind, but I continue to wonder why we are seeing so many journalists on the attack against the gluten-free lifestyle?
    The driving force behind these journalists' attacks may well be similar to the perspective that I experienced before my diagnosis with celiac disease. Perhaps they suspect, whatever their reasons, that the gluten-free diet has little or no merit, and their only concession is to grudgingly allow that it may be helpful to those with celiac disease. My suspicion is that this attitude is driven by an insecurity. We want to believe conventional wisdom that gluten grains are healthy and that our medical professionals, and the institutions in which they serve, are above reproach. Nobel Laureate, Kary Mullis, is one highly vaunted physician's voice, among many, who dismiss most diets as fads, arguing that we are omnivores whose secret of successful adaptation to a wide variety of environments is the result of our flexibility in sources of nourishment (18). Many of us want to be able to rely on our physicians. We don't want the insecurity of knowing that our medical establishment is a flawed, human institution. The self-directed experimentation with a gluten-free diet poses a threat to that credibility, and hence, our sense of security, especially when it results in improved health. We don't want to feel the resulting uncertainty that comes from doubting the medical cornerstone of our civilization.
    It is not long ago that Don Wiss, myself, and others, argued extensively with physicians and researchers who insisted that the rate of celiac disease in the USA was variously one in 12,000 persons or one in 25,000 people. Sometimes these discussions became quite heated. Some of the people posting to these newsgroups were asking for suggestions for how they might proceed with various health complaints. When Don or I saw a post asking about symptoms that had been reported in the peer reviewed literature, in association with untreated celiac disease, we suggested a trial of a gluten-free diet. Some of the physicians and researchers contacted these individuals privately, saying things to discredit us. It seems doubtful that they would not have said such things where they were likely to be held accountable for what they said. Their reactions, I suspect, were driven by a sense of feeling threatened. As soon as controlled testing was done, it became clear that the rate of celiac disease, among Americans, is at least 1 in 133 Americans, and many of those individuals we advised to try a gluten-free diet might well have had celiac disease. Yet many journalists, physicians, and researchers have a great deal invested in the current status quo. Any threat to the established order is likely to incite the ire of many members of these groups.
    Thus, while others may consider it prudent to await the end of the current debate about ALS and a gluten-free diet, the ALS patient might be better advised to take dietary steps to ensure against weight loss, while trying a strict gluten-free diet. I know what I would do if were diagnosed with ALS...on second thought, since I've been gluten-free for more than twenty years, maybe I won't ever be diagnosed with ALS. I will continue to hope. In the meantime, Thomas Kuhn clearly outlined this stage of acceptance of new ideas in science (19). We appear to be in the "denial" stage, which is the last one before we can expect the emergence of widespread claims that 'we knew it all along'. If so, then broad acceptance is in the offing, and these nay-saying journalists will move on to some other controversial new discovery, and we can be spared the condescending remarks suggesting that the gluten-free diet is a mere placebo and a 'fad diet' for most of those who follow it.
    Sources:
    http://www.ynetnews.com/articles/0,7340,L-4647994,00.html Gadoth A, Nefussy B, Bleiberg M, Klein T, Artman I, Drory VE. Transglutaminase 6 Antibodies in the Serum of Patients With Amyotrophic Lateral Sclerosis. JAMA Neurol. 2015 Apr 13. Drory V. Personal communication via email Ludvigsson JF, Mariosa D, Lebwohl B, Fang F. No association between biopsy-verified celiac disease and subsequent amyotrophic lateral sclerosis--a population-based cohort study. Eur J Neurol. 2014 Jul;21(7):976-82. Hadjivassiliou M, Aeschlimann P, Strigun A, Sanders D, Woodroofe N, Aeschlimann D. Autoantibodies in gluten ataxia recognize a novel neuronal transglutaminase. Ann Neurol 2008;64:332-343 Brown KJ, Jewells V, Herfarth H, Castillo M. White matter lesions suggestive of amyotrophic lateral sclerosis attributed to celiac disease. AJNR Am J Neuroradiol. 2010 May;31(5):880-1. Turner MR, Chohan G, Quaghebeur G, Greenhall RC, Hadjivassiliou M, Talbot K. A case of celiac disease mimicking amyotrophic lateral sclerosis. Nat Clin Pract Neurol. 2007 Oct;3(10):581-4. Ihara M, Makino F, Sawada H, Mezaki T, Mizutani K, Nakase H, Matsui M, Tomimoto H, Shimohama S. Gluten sensitivity in Japanese patients with adult-onset cerebellar ataxia. Intern Med. 2006;45(3):135-40. Turner MR, Goldacre R, Ramagopalan S, Talbot K, Goldacre MJ. Autoimmune disease preceding amyotrophic lateral sclerosis: an epidemiologic study. Neurology. 2013 Oct 1;81(14):1222-5. Auburger G, Gispert S, Lahut S, Omür O, Damrath E, Heck M, BaÅŸak N. 12q24 locus association with type 1 diabetes: SH2B3 or ATXN2? World J Diabetes. 2014 Jun 15;5(3):316-27. Bersano E, Stecco A, D'Alfonso S, Corrado L, Sarnelli MF, Solara V, Cantello R, Mazzini L. Coeliac disease mimicking Amyotrophic Lateral Sclerosis. Amyotroph Lateral Scler Frontotemporal Degener. 2015 Feb 3:1-3. Hawking J. Travelling to Infinity: My Life with Stephen. Alma Books, Richmond, UK. 2014.

    Jefferson Adams
    Celiac.com 12/08/2016 - People with celiac disease are supposed to follow a strict lifelong gluten-free diet. Celiac patients should receive regular follow-up dietary interviews and blood tests to make sure that they are successfully following the diet.
    However, none of these methods offer an accurate measure of dietary compliance. The only way to know for sure, is to test. A team of researchers recently set out to evaluate the measurement of gluten immunogenic peptides (GIP) in stools as a marker of gluten-free diet adherence in celiac patients and compare it with traditional methods of gluten-free diet monitoring.
    The team conducted a prospective, nonrandomized, multi-center study including 188 celiac patients on gluten-free diet and 84 healthy controls. Subjects were given a dietary questionnaire and fecal GIP quantified by enzyme-linked immunosorbent assay (ELISA). They simultaneously measured serological anti-tissue transglutaminase (anti-tTG) IgA and anti-deamidated gliadin peptide (anti-DGP) IgA antibodies.
    A total of 56 of the 188 celiac patients, about 30 percent, had detectable GIP levels in stools. There was significant association between age and GIP in stools that revealed increasing dietary transgressions with advancing age. Nearly forty percent occurred in in subjects 13 years of age or older, with 60% occurring in men 13 years of age or older.
    The team found no connection between fecal GIP and dietary questionnaire or anti-tTG antibodies. However, they did spot a connection between GIP and anti-DGP antibodies, with seven of the 53 GIP stool-positive patients testing positive for anti-DGP.
    The detection of gluten peptides in stool samples shows the limits of traditional methods for monitoring a gluten-free diet in celiac patients. The GIP ELISA provides direct and quantitative assessment of gluten exposure soon after consumption, and might improve diagnosis and clinical management of non-responsive celiac disease and refractory celiac disease.
    Basically, doctors need to take a much more hands on role in monitoring celiac patients who are following gluten-free diets.
    Source:
    Am J Gastroenterol 2016; 111:1456–1465; doi:10.1038/ajg.2016.439; published online 20 September 2016 The research team included Isabel Comino PhD1, Fernando Fernández-Bañares MD, PhD2, María Esteve MD, PhD2, Luís Ortigosa MD, PhD3, Gemma Castillejo MD, PhD4, Blanca Fambuena MS5, Carmen Ribes-Koninckx MD, PhD6, Carlos Sierra MD, PhD7, Alfonso Rodríguez-Herrera MD, PhD8, José Carlos Salazar MD9, Ángel Caunedo MD10, J M Marugán-Miguelsanz MD, PhD11, José Antonio Garrote MD, PhD12, Santiago Vivas MD, PhD13, Oreste lo Iacono MD, PhD14, Alejandro Nuñez BSc13, Luis Vaquero MD, PhD13, Ana María Vegas MD12, Laura Crespo MD12, Luis Fernández-Salazar MD, PhD11, Eduardo Arranz MD, PhD11, Victoria Alejandra Jiménez-García MD10, Marco Antonio Montes-Cano MD, PhD15, Beatriz Espín MD, PhD9, Ana Galera MD8, Justo Valverde MD8, Francisco José Girón MD7, Miguel Bolonio MSc6, Antonio Millán MD, PhD5, Francesc Martínez Cerezo 4, César Guajardo MD3, José Ramón Alberto MD3, Mercé Rosinach MD, PhD2, Verónica Segura BSc1, Francisco León MD, PhD16, Jorge Marinich PhD17, Alba Muñoz-Suano PhD17, Manuel Romero-Gómez MD, PhD5, Ángel Cebolla PhD17 and Carolina Sousa PhD1
    They are variously affiliated with the Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville, Spain; the Department of Gastroenterology, Hospital Universitari Mutua Terrassa, and CIBERehd, Terrassa, Barcelona, Spain; the Pediatric Gastroenterology, Hospital Universitario Nuestra Señora de La Candelaria, Tenerife, Spain; Pediatric Gastroenterology, Hospital Universitari de Sant Joan de Reus, IISPV, URV, Reus, Spain; the Unit for the Clinical Management of Digestive Diseases and CIBERehd and Gastroenterology and Nutrition Unit, Hospital Universitario Virgen de Valme, Seville, Spain; the Pediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Universitario y Politécnico La Fe, Celiac Disease and Digestive Inmunopatology Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; the Pediatric Gastroenterology and Nutrition Unit, Hospital Materno-Infantil, Malaga, Spain; the Gastroenterology and Nutrition Unit, Instituto Hispalense de Pediatría, Seville, Spain; the Servicio de Gastroenterología Pediátrica, Hospital Universitario Virgen del Rocío, Seville, Spain; the Hospital Universitario Virgen Macarena, Seville, Spain; the Mucosal Immunology Laboratory, Instituto de Biología y Genética Molecular (IBGM), University of Valladolid, CSIC and Gastroenterology Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; the Clinical Analysis and Pediatrics, Hospital Universitario Río Hortega, Valladolid, Spain; the Servicio de Aparato Digestivo, Hospital Universitario de Leon, Leon, Spain; the Sección de Aparato Digestivo, Hospital del Tajo, Madrid, Spain; the Servicio de Inmunología, CIBER de Epidemiología y Salud Pública, Hospital Universitario Virgen del Rocío/IBiS/CSIC/Universidad de Sevilla, Seville, Spain; with Celimmune, Bethesda, Maryland, USA, and with Biomedal SL, Seville, Spain

    Jim Swayze
    Celiac.com 09/08/2017 - For for the overwhelming majority of our time here on this planet we've all followed a paleo, or hunter-gatherer, diet. This is not a way of eating invented by the latest Hollywood guru – though truth be told there are now plenty of stars who eat this way. It's common sense, really, if you're able to unlearn a good portion of the dietary wisdom we've been force-fed over the last generation or two.
    Paleo means little more than, in the words of Ray Audette, what you could find to eat if you were "naked with a sharp stick.” And the foods you'd find would have to be, at least in theory (though usually not in practice), edible raw. So what foods would have been available to our ancestors?
    Meat, for sure. There are no known hunter gatherer populations who were vegetarian/vegan. Animal protein is vital to human health. Why then do we hear about healthy vegetarian diets? Because they are healthy as compared to the modern Western diet, with its ubiquitous high fructose corn syrup, artificial fats and sweeteners, and high-glycemic carbohydrates.
    Ok, so animal protein. What else could have been found by our ancestral hunter-gatherers? Fruit and true vegetables, in season.
    That's basically it: meat, fruit, vegetables. And of course, plenty of good, cold water.
    What did we not eat then? Grains in any form, gluten-free or not. Legumes, which are extremely toxic raw and have to be soaked and cooked in order to be edible. (Hint: peanuts are legumes!) New world foods like chocolate, coffee. The list goes on and you should have the hang of it by now. Again, the standard: foods edible raw that would have been available to our ancestors.
    Question: Would dairy have been available to our ancestors? The answer is clearly no, other than in the form of human breastmilk for the first few months or years of life. Bovine milk, meant for calf populations, is not a natural human food.
    Sound overly restrictive? Let me tell you today's menu: For breakfast, three eggs over easy with bacon and a glass of fresh-squeezed orange juice. Lunch was tuna on romaine lettuce with sliced almonds and a vinaigrette with iced green tea to drink. And dinner, a mere five minutes away, is grassfed flank steak lettuce-wrap tacos with roasted hatch green chile guacamole. And a nice glass of New Zealand Sauvignon Blanc.
    Give paleo a try. It's the ultimate gluten-free way of eating.

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