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    Gluten Warning Signs on Packaging


    Chris Bekermeier
    Image Caption: Photo: CC--Andrea_Nguyen

    Celiac.com 03/06/2013 - The hallmark of a healthy gluten-free diet is a grocery cart filled with mostly unprocessed, single-ingredient foods such as fresh produce, nuts, and meat. This is the easiest way to avoid gluten, as well as the healthiest way to eat. When you do venture into the central aisles of the grocery store, look for gluten warning signs on packaging to help you identify foods that contain gluten.


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    Photo: CC--Andrea_NguyenLooking for those warning signs is more important than ever because companies are catching on to the growing popularity of gluten-free diets and many are labeling their products gluten-free. However, the U.S. Department of Agriculture (USDA) does not regulate how or when the designation of gluten-free can be added to food labels. This clouds the decision-making process for people with gluten intolerance that rely on gluten warning signs on packaging to guide them. Without USDA regulation, even products labeled gluten-free may still be processed on equipment that also processes gluten. While this is not a problem for people eating gluten-free as a dietary choice, it can cause issues for people who are gluten intolerant.

    Ingredient Keywords

    Look for warning signs at three places on the ingredient label. The first is underneath the ingredients list, where common allergens such as soy and milk are listed in bold. If wheat is listed there, the product contains gluten.

    The second place to look is the ingredients list itself. The following words may be signs of gluten due to its nature or to cross-contamination:

    • Wheat
    • Malt
    • Wheat starch
    • Barley
    • Oats
    • Soy sauce (made with wheat)

    Even seemingly innocuous products may still contain gluten, so it's important to look at all product labels. For example, yogurt and other dairy products sometimes have gluten-containing thickening agents, many sauces and soups contain gluten, and beer is made with barley hops. 

    The third place to look for gluten warning signs on packaging is at the bottom of the ingredients list. In bold, the packaging will declare whether or not the food was processed on equipment that also processes common allergens, including wheat. Cross-contamination can still cause flare-ups, so these foods should be avoided.

    Safest Foods

    The best way to avoid gluten is to stick to unprocessed, fresh produce and meat. With grains and processed foods, the best way to stay safe generally is to opt for minimally processed foods with few ingredients, or specialized foods. Strategies for gluten-free shopping include: 

    • Foods in the health aisle or in a natural food store are most often accurately marked as gluten-free.
    • Cook what you can at home and take the mystery out of ingredients. Gluten-free bread, for example, can be made at home using the flour of your choice.
    • Do research before shopping - it can save you time and trouble in the long run.

    While reading food labels may seem intimidating at first, after a few shopping trips, you will be a pro at identifying problem foods and cooking gluten-free, while still eating a healthy range of foods.


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    I have found nuts and seeds to be contaminated with gluten. I react to nuts and seeds even when they state they are only processed with other tree nuts. I don't think nuts should be recommended on a gluten-free diet unless they are ordered specially from a gluten-free distributor.

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    My only "argument" with anything stated in the article, is that sometimes those notices declaring the item was processed on the same equipment as (you name it) appears to me to be a blanket covering for the company against lawsuits, rather than an actual statement of fact.

     

    I have celiac disease, so I can't handle cross-contamination, but I don't summarily eliminate a product from my diet because of that warning. Rather, I consider the product itself, the company, and even past experience with similar products. Can't say it's a sure-fire answer, but it has worked for me.

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    Guest Beverly

    Posted

    I read labels and if I goof, I will take an unopened package back to the store. What is in a product changes from time to tome, so buyer beware!

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    Guest LeeAnne

    Posted

    I have found nuts and seeds to be contaminated with gluten. I react to nuts and seeds even when they state they are only processed with other tree nuts. I don't think nuts should be recommended on a gluten-free diet unless they are ordered specially from a gluten-free distributor.

    I have found too that pumpkin seeds that are processed in a facility that produces wheat is off limits for me.

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    Guest LeeAnne

    Posted

    My only "argument" with anything stated in the article, is that sometimes those notices declaring the item was processed on the same equipment as (you name it) appears to me to be a blanket covering for the company against lawsuits, rather than an actual statement of fact.

     

    I have celiac disease, so I can't handle cross-contamination, but I don't summarily eliminate a product from my diet because of that warning. Rather, I consider the product itself, the company, and even past experience with similar products. Can't say it's a sure-fire answer, but it has worked for me.

    Any product manufactured in a facility containing wheat must be cross contaiminated with wheat. It is common sense that the product is more than likely to be laced with wheat.

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    Guest Diana

    Posted

    Because of the issue of cross-contamination on nuts, I have been rinsing raw nuts before eating them. Sometimes I will then roast them myself because of the added peanut oil which I can't have that is on most roasted nuts.

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    Guest Christin Meer

    Posted

    We need a celiac safe label on products. It would make life a lot easier

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  • Related Articles

    Jefferson Adams
    Celiac.com 06/08/2007 - On May 30th, federal judge Elaine E. Bucklo dismissed key parts of a lawsuit against McDonalds regarding the gluten-free status of their famous French fries.
    The case, In Re McDonalds French Fries Litigation (MDL-1784), was brought in February 2006, by two Florida plaintiffs on behalf of their autistic daughter who allegedly suffered ill effects from eating McDonalds French fries. At the time, the company claimed that the French fries were gluten-free.
    The lawsuit claimed in part that McDonalds "failure to disclose the fact that their French fries contained gluten constitutes deceptive, unfair, unconscionable, misleading and fraudulent trade practices," and that "McDonalds unfairly and unjustly profited from their conduct. The judge dismissed claims of fraud, breach of implied warranty, and a request for injunctive relief, but left intact two counts, breach of express warranty and unjust enrichment.
    In its arguments for dismissal, McDonalds claimed that most of the plaintiffs legal causes of action were barred as a matter of law. Basically, McDonalds asserted that the plaintiffs pled themselves out of court by arguing facts that undermined their own claim.
    The plaintiffs fraud allegations were rejected because they failed to meet the specificity required under the federal rules. McDonalds argued that the plaintiffs claim of fraud and misrepresentation failed to state how, when, or where the alleged misrepresentations took place. Federal Rule 9( of Civil Procedure requires that all claims of fraud be stated with particularity; otherwise, they face dismissal.
    Judge Bucklo rejected the plaintiffs claim for injunctive relief because she found there was no threat of future wrongful conduct. The company revised its web site in 2006 to show that its fries and hash browns contain gluten. Also, the publicity brought by the suit arguably eliminated any need for injunctive relief.
    The plaintiffs have 28 days to amend their complaint or the lawsuit will go forward based on the two remaining counts.
    health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

    Jefferson Adams
    Celiac.com 10/18/2011 - Once again, Halloween is around the corner and that means parents of children who must avoid gluten are wondering which candies, especially seasonal and Halloween candies, are safe for kids on a gluten–free diet?
    As awareness of celiac disease and gluten–free diets grows, more parents are demanding gluten–free products, and more manufacturers are responding with gluten–free products.
    Also, more candy makers are clearly marking their candies as gluten–free or containing wheat, gluten, etc. This gives parents and trick–or–treaters a wider range of choices.
    This makes it easier for parents to find gluten–free candies from reliable makers as close as the corner grocery store.
    But, with such a vast array of treats on parade for Halloween night, it can be a challenge to know which ones are safe.
    Below, we feature an updated list of gluten–friendly and gluten–free candies currently available.
    Below that we feature a list of unsafe, NON–gluten–free candies, as well as a partial list of manufacturers with links to their company websites.
    Remember, the list is just a guideline, and should not taken as authoritative or comprehensive. Before consuming any candy on the list, be sure to gauge your purchases according to your own sensitivity levels, or those of your children.

    Gluten–Free  and Gluten-Safe Halloween Candy and Treats

    3 Musketeers fun size
    3 Musketeers Mint with dark chocolate
    A
    Act II Popcorn Balls
    Albert’s Gummy Eyeballs
    Albert’s Iced Halloween pops (lollipops)
    Almond Joy fun size bars
    Amanda's Own Confections Chocolate shapes and chocolate lollipops
    Annie's Organic Bunny Fruit snacks
    Applehead, Grapehead, Cherryhead
    B
    Baby Ruth original and fun size
    Barrels of Candy
    Bazooka Big Mix (includes bubble gum, bubble gum filled candy, candy chews, and bubble gum filled lollipops)
    Betty Crocker Fruit by the Foot Wicked Webs Berry Wave mini feet
    Betty Crocker Halloween fruit flavored snacks, including Fruit Gushers, Fruit Roll–ups, and Mini Rolls
    Bit•O•Honey
    Butterfinger original and fun size
    Big Blow bubblegum
    Black Forest Gummy Tarantulas
    Black Forest Gummy Fun Bugs Juicy Oozers
    Bubbly lollipop and gum
    C
    Candy Checkers (made for Target)
    Caramel Apple Pops (made by Tootsie Roll)
    Charleston Chew original and fun size
    Charms Blow Pops and Blow Pop Minis – may contain milk or soy
    Charms Candy Carnival Package  – Blow Pops, Sugar Babies, Zip a Dee mini pops, Sugar Daddy, Pops, Sugar Mama Caramel, Tear Jerkers sour bubble gum, Blow Pop Bubble Gum – may contain milk or soy
    Charms Fluffy Stuff Spider Web cotton candy
    Chewy Atomic Fireballs
    Chewy Lemonheads and Friends
    Child’s Play
    Colombina Scary Eyeballs bubblegum
    Colombina Fizzy Pops
    Comix Mix Candy Sticks – Tom and Jerry, Flintstones, Scooby
    Doo, Teenage Mutant Ninja Turtles, Popeye
    Cracker Jack caramel coated popcorn and peanuts
    D
    Disney Halloween Candy Mix – jelly beans, gummies, candy bracelets and characters from Cars, Tinkerbell and Toy Story
    Dove pieces – Dark Chocolate, Milk Chocolate, Peanut Butter Milk Chocolate, Caramel Milk Chocolate
    Dots Gumdrops – including Candy Corn Dots, Ghost Dots, and Bat Dots
    Dubble Bubble bubblegum – may include milk or soy
    Dum Dum Lollipops (including Shrek Pops) –  no peanuts, tree nuts, milk, eggs, wheat or gluten. Manufactured on dedicated equipment.
    Dum Dum Chewy Pops –  no peanuts, tree nuts, milk, eggs, wheat or gluten. Manufactured on dedicated equipment.
    F
    Farley’s Kiddie Mix - Smarties, SweetTarts, Now and Later, Jaw Breakers, Super Bubble and Lolli-pops
    Ferrara Pan Caramels - may contain milk or soy. Distributed in a facility where peanuts and tree nuts are used to make other products
    Ferrara Pan Lemonhead & Friends candy mix – including Applehead, Cherryhead, Grapehead, Chewy Lemonhead & Friends, Chewy Atomic Fireball, and Red Hots
    Florida’s Natural Healthy Treats Nuggets, Sour String, Fruit Stiks
    Fright Fingers Popcorn Kit
    Frankford’s Bugs Gummy Candy* – reported issues
    Frankford’s Gummy Body Parts* – reported issues
    Frankford’s Marshmallow Pals* – reported issues
    Fun Dip
    Fun Dip Sour
    G
    Game Night boxes of candy game pieces (includes Operation, Sorry!, Monopoly, Life, and Clue)
    Grave Gummies (Yummy Gummies)
    Gummy Pirate Choppers
    H
    Heath milk chocolate English toffee bar and snack size - does contain almonds
    Hershey’s Bliss (Milk Chocolate, Milk Chocolate with Almonds, Milk Chocolate with Meltaway Center, White Chocolate with Meltaway Center, Milk Chocolate with Raspberry Meltaway Center, Dark Chocolate)
    Hershey’s Kisses (Candy Corn flavored candy, Caramel, Caramel Apple flavored filling, Milk Chocolate, Chocolate Meltaway, Pumpkin Spice, Hugs, Hugs & Kisses, Cherry Cordial Creme, Milk Chocolate with Almonds, Special Dark)
    Hershey’s Milk Chocolate bars and snack-size bars
    Hershey’s Milk Chocolate with Almonds snack-size bars
    Hot Tamales
    Humphrey Popcorn Balls
    J
    Jelly Belly beans – gluten–free, dairy–free
    Jolly Rancher hard candy and Doubles Candy
    Jolly Rancher Hard Candy Stix, Lollipops and Fruit Chews
    Jr. Mints fun size – may contain eggs
    Jujifruits
    Just Born marshmallow treats
    K
    Kellogg’s Spongebob Squarepants fruit flavored snacks
    Kraft Jet–Puffed Boo Mallows marshmallows
    L
    Lemonheads
    LifeSavers Gummies including Big Ring Gummies, Sweet ‘n’ Sour, and Scary Assortment
    M
    M&M’s – original, peanut, peanut butter
    Mars M&M's – except pretzel M&M's
    Mars Dove chocolate products
    Mars Munch Nut bar
    Mars Snickers, Snickers Dark bars, fun size and mini’s – may contain almonds
    Mallo Cup
    Marvel Heroes Candy Sticks (Hulk, Spiderman, Wolverine)
    Melster Peanut Butter Kisses
    Milk Duds
    Mike and Ike
    Mini Mentos
    Mini Sour Dudes Straws
    Monstaz Pops (jack–o–lantern lollipops)
    Monster Hunt plastic monster eggs filled with candy bones, skulls and pumpkins (made for Target)
    Mounds dark chocolate fun size bars –  made on equipment that processes almonds, in a facility that processes peanuts
    Mr. Goodbar – does contain peanuts
    N
    Necco’s Sky Bar 4 in 1 chocolate bar
    Necco Wafers
    Necco Mary Janes
    Necco Mary Jane Peanut Butter Kisses – does contain peanuts
    Necco Sweethearts Conversation Hearts (available for Valentine's Day only)
    Necco Canada Mint & Wintergreen Lozenges
    Necco Haviland Thin Mints and Candy Stix
    Necco Clark Bars
    Necco Skybars
    Necco Haviland Peppermint & Wintergreen Patties
    Necco Candy Eggs
    Necco Talking Pumpkins (available at Halloween only)
    Necco Squirrel Nut Caramels and Squirrel Nut Zippers
    Necco Banana Split and Mint Julep Chews
    Necco Ultramints
    Nestle Milk Chocolate fun size bars
    Nestle Baby Ruth
    Nestle Bit–O–Honey
    Nestle Butterfinger (NOT Butterfinger Crisp or Butterfinger Stixx)
    Nestle Goobers – does contain peanuts
    Nestle Nips (both regular and sugar–free)
    Nestle Oh Henry!
    Nestle Raisinets –  made on equipment that processes peanuts
    Nestle Sno–Caps
    Nestle Wonka Pixy Stix
    Nestle Wonka Laffy Taffy
    Nestle Wonka Lik–M–Aid Fun Dip
    Nestle Wonka Spree
    Nik-L-Nip wax bottles with juice
    Now and Later
    O
    Operation Gummy Candy
    P
    Palmer Peanut Butter Cups – does contain peanuts
    Pay Day peanut caramel bar snack size
    Peanut M&M’s
    Pearson’s Bun candy –  maple and roasted peanuts
    Pearson’s Mint Patties,
    Pearson’s Nut Goodies
    Pearson's Salted Nut Rolls
    Peeps Jack–o–lanterns, Ghosts and Chocolate Mousse Cats – “Gluten Free”
    Pez candy – “Gluten Free”
    Pop Rocks
    Pixie Stix
    R
    Rain Blo Bubble Gum Eyes of Terror
    Raisinets
    Razzles candy gum
    Red Hots
    Reese’s Fast Break candy bars and snack size
    Reese’s Peanut Butter Cups snack size and miniatures
    Reese’s Peanut Butter Pumpkins
    Reese’s Pieces
    Reese’s Select Peanut Butter Cremes
    Reese’s Select Clusters
    Reese’s Whipps
    Rolo chocolate covered caramels
    S
    Sixlets
    Skeleton Pops (lollipops)
    Skittles includes Original, Sour, Wild Berry, Fizzl’d Fruits, and Crazy Core, including fun-size
    Smarties – the small pastel–colored candies sold in rolls, not Nestle’s chocolate version) – “Contains NO: gluten, milk, egg, fish, crustacean shellfish, tree nuts, wheat, peanuts, or soy.
    Snickers
    Snickers Fudge bar
    Sour Patch
    Starburst Fruit Chews and fun-size
    Starburst Gummibursts and Sour Gummibursts – “Gluten Free”
    Sugar Babies
    Sugar Daddy Caramel Pops
    Super Bubble bubble gum
    Swedish Fish
    Sweethearts conversation hearts Forbidden Fruits (candy packaging of The Twilight Saga, New Moon the movie)
    Sweet’s Candy Corn Taffy
    T
    Tootsie Pops – original and mini
    Tootsie Rolls Midgies and snack bars
    Transformers Canpeasron's salted nut rolldy Mix – gummy shields, fruit chews, candy shields, gum rocks
    W
    Warheads – Extreme Sour hard candy and Sour QBZ chewy cubes
    Wonka Bottlecaps
    Wonka Chocolate Laffy Taffy
    Wonka Giant Chewy Nerds Jelly Beans
    Wonka Giant Pixy Stix
    Wonka Gobstopper Everlasting
    Wonka Gobstopper Chewy
    Wonka Laffy Taffy Ropes
    Wonka Mix–Ups
    Wonka Monster Mix–Ups – SweetTarts Skulls and Bones, Spooky Nerds, Howlin’ Laffy Taffy
    Wonka Nerds – carry a cross contamination warning on the Spooky Nerds orange and fruit punch flavors
    Wonka Pixy Stix
    Wonka Runts
    Wonka Runts Chewy
    Wonka SweetTarts
    Wonka Sweetarts (regular)
    Wonka Sweetarts Chew
    Wonka Sweetarts Giant Chewy
    Wonka Sweetarts Mini Chew
    Wonka Sweetarts Chewy Twists
    Wonka Sweetarts Shockers
    Wonka Tart N Tinys,
    Wonka Tart N Tinys Chew
    Wonka SweetTarts Boo Bag Mix – SweetTart Chews OK, but other packages had a cross–contamination warning!
    X
    X–scream Mouth Morphers Fruit Gushers
    Y
    York Peppermint Patties Pumpkins
    Z
    Zed Candy Skulls and Bones
    With all these selections, finding some good, gluten–free candy should be a snap. As always, be sure to read labels, as some ingredients can vary.

    **WARNING! THESE UNSAFE CANDIES CONTAIN GLUTEN:
    AIRHEADS
    Airheads Xtremes Rolls contains wheat flourANNABELLE’S
    Rocky Road – contains barley malt and wheat flour
    BRACH'S
    All Brach's candy should be considered NOT gluten–free
    HERSHEY
    Kit Kat – contains wheat
    Reese's Minis
    Twizzlers – contains wheat
    Whoppers –  contains barley malt and wheat flour
    MARS and WRIGLEY
    Milky Way –  contains barley malt
    Twix –  contains wheat
    NESTLE
    Butterfinger Crisp or Butterfinger Stixx  –  contains wheat flour
    Crunch –  contains barley malt, “made on equipment that also processes wheat.”
    Hundred Grand Bar –  contains barley malt, “made on equipment that also processes wheat.”
    Wonka Oompas and the Wonka Bar are NOT gluten–free.
    RUSSELL STOVER'S  – Products have been produced on shared equipment with peanuts, tree nuts, eggs and wheat.
    WONKA
    Sweetarts Gummy Bugs –  contains wheat/gluten
    Sweetarts Rope –  contains wheat/gluten
    Oompas
    Wonka Bar
    A more comprehensive list of unsafe candies for Halloween can be found at celiacfamily.com.
    Here is a partial list of major candy manufacturers and how to contact them:
    Hershey's – 800–468–1714
    Jelly Belly – 800–522–3267
    Just Born – 888–645–3453
    Mars Chocolate – 800–627–7852
    Necco – 781–485–4800
    Nestle USA – 800–225–2270
    Pearson's – 800–328–6507
    Tootsie Roll – 773–838–3400
    Other resources:
    About.com
    DivineCaroline.com
    Surefoodliving.com


    Jefferson Adams
    Celiac.com 11/09/2011 - The Publix supermarket company recently pulled its fall issue of Publix GreenWise Market magazine, because it included a recipe that was erroneously labeled as 'gluten-free.'
    The company also announced plans to mail a follow-up warning about the recipe to print subscribers.
    The recipe for Orange-Honey Sweet Rolls included wheat germ and yeast, some brands of which contain gluten. The recipe appeared on Page 18 of the magazine.
    Publix's swift and decisive action to correct the mistake shows a strong level of commitment to gluten-free consumers.
    The letter to print subscribers said that "the recipe for Orange-Honey Sweet Rolls, which appears on page 18, calls for the use of gluten-free flour as an ingredient; however, the complete recipe was not intended to be gluten-free. In fact, the recipe includes ingredients which contain gluten, therefore, it is not suitable for those with celiac disease or gluten intolerance."
    Publix operates 1,039 stores in the Southeast, including GreenWise Markets in Palm Beach Gardens and Boca Raton, Florida.
    Source:

    http://www.palmbeachpost.com/news/publix-recalls-magazine-over-gluten-free-gaffe-1907091.html

    Jefferson Adams
    Celiac.com 03/06/2015 - The Kellogg Co. has announced the launch of Eggo Gluten Free Waffles in both original and cinnamon flavors.
    Coming on the heels of General Mill’s move to take Cheerios gluten-free, the announcement marks the latest move by major cereal manufacturers into the realm of gluten-free products.
    Eggo Gluten Free Waffles are available nationwide in the frozen food aisle of grocery stores.
    The gluten-free waffles contain eight vitamins and minerals and are considered an excellent source of calcium and iron, with 25% daily value of each. They also contain 15 grams of whole grains per 70-gram serving.
    Kellogg's is taking special care to make their new gluten-free waffles "delicious and wholesome," and to avoid the pitfall of gluten-free products which "…sometimes sacrifice taste and texture compared with their original versions," said AnneMarie Suarez-Davis, vice-president of marketing and innovation for Kellogg’s Frozen Foods.
    For more information, check out Kelloggs.com.
     

  • Recent Articles

    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.
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    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

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics

    Jefferson Adams
    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.
    A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain.
    For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. 
    They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage.
    The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development.
    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.