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    Scott Adams

    McDonald's - A Safe Place for Celiacs to Eat According to the Gluten Intolerance Group

    Celiac.com 02/27/2006 - Gluten Intolerance Group (GIG) applauds McDonald’s for providing proof that their French fries are safe for persons with celiac disease and gluten intolerances, states Cynthia Kupper, RD, Executive Director of GIG. Kupper, who has worked with large corporate chain restaurants for many years to provide gluten-free menu options, states McDonald’s took the best action possible by having the fries tested by one of the leading independent laboratories in food allergens. McDonald’s has provided the reassurance those persons with celiac disease need, to feel confident they can eat the fries without getting sick.

    Outback Steak House was the first large restaurant chain Kupper worked with to develop gluten-free menus. “We definitely made some new friends!” stated Thomas C. Kempsey, Director of Culinary for Cheeseburger in Paradise, speaking of the gluten-free menu Kupper helped the chain launch in February. Cameron Mitchell’s Fish Market, Bone Fish Grill, Carrabba’s, Bugaboo Creek, and many others have worked with GIG to develop gluten-free menus. The program has been very successful for restaurants involved with GIG’s outreach project, states Kupper. The patrons are happy and the restaurants see a growing number of loyal customers.

    GIG promotes safe and healthy dining through education of restaurants and consumers. Many restaurants have developed gluten-free menu options. Some individual restaurants are part of a program GIG will soon manage called the Gluten-Free Restaurant Awareness Program (www.glutenfreerestaurants.org). Both this program and GIG’s corporate program have strict guidelines for inclusion. Many restaurants have the potential to meet the needs of persons with food sensitivities, however not all are willing to take the extra steps necessary to do so.

    Many people with celiac disease are afraid to eat away from home for fear of getting sick according to research. To know that restaurants offer gluten-free choices, verified by trusted sources is a big deal for these people. For people who travel, places like McDonalds and Outback become their safety nets and they will not eat anywhere else, states Kupper. Parents want their children to have options like other kids, so McDonald’s is a perfect fast food choice. Not all fast food restaurants use dedicated fryers and some use fries that are treated with wheat flour – an absolute ‘must avoid’ for celiacs.

    Unlike other acute allergies, such as peanut allergies, celiac disease is a chronic condition that can cause damage to the intestines, malabsorption and malnutrition by eating gluten (proteins found in wheat, rye, barley and hybrids of these grains). Celiac disease is a life-long disease that can be diagnosed at any age. The only treatment for the disease is the strict avoidance of gluten. Celiac disease affects nearly 3 million people in the US and 1:250 people worldwide, yet it is the most misdiagnosed common disorder today.

    The Gluten Intolerance Group, based in Seattle WA, is a national nonprofit organization providing support and education to persons with gluten intolerances in order to live healthy lives. GIG is the leading national organization for gluten intolerances with a dietitian on staff daily to work with consumers. Gluten Intolerance Group (GIG) works with restaurants to offer gluten-free dining options for persons with celiac disease.


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    If you look at McDonald's ingredients for their French fries you see this:

    French Fries:

    Potatoes, vegetable oil (partially hydrogenated soybean oil, natural beef flavor (wheat and milk derivatives)*, *CONTAINS: WHEAT AND MILK (Natural beef flavor contains hydrolyzed wheat and hydrolyzed milk as starting ingredients.)

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    Please note that just because something contains wheat it does not mean that it cannot be gluten-free. Yes, that is correct, items that contain wheat can be gluten-free. In Europe this is generally understood and more information about this is in the related links above--see the Codex Alimetarius and Wheat Starch link. In the USA the law will soon become that is something contains less than 20ppm of gluten, it is gluten-free, which, as I understand it, is the case with McDonald's French fries.

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    Very nice article, my son has celiac disease and we get him French fries at McDonald's all the time. We also special request a hamburger patty with no bun, no condiments - sometimes they get it wrong and we have to re-order but he can eat the freshly made hamburger patty's at McDonald's. What helps is that we tell them of his condition.

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    I was told twice by a clerk at McDonalds that the fries were safe. I ate them and became very sick for two days. After that, I asked the owner to check for wheat and he said there is wheat listed in the fries and hash browns. On another note, I ate at Five Guys. They use a divided section on the grill for buns and another for burgers. They also cut the potatoes on site and add nothing and cook nothing else in fry oil. Go Five Guys.

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    With celiac disease, it's hard enough having to be careful that you're not eating something with gluten...wheat is listed as an ingredient, so don't eat it! Who knows how much you can eat until you feel the damage to your intestines...If you have a cut, you bleed. When it scabs over, you're not bleeding anymore, but you're not healed. You might not feel the damage because it's such a small amount, but I wouldn't risk it!

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    Guest Andrew Schorr

    Posted

    15 year old daughter just designated a "celiac suspect", helpful info for us, looking to connect her with other teenagers? Suggestions? In Seattle area.

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    Guest Carolyn Ribeiro

    Posted

    OK, so the french fries are ok for us. Who just wants to eat french fries? I contacted McDonalds when I first got diagnosed and they said that their grilled chicken was not gluten free. If they want to pat themselves on the back, how about gluten free grilled chicken so we can have a decent meal like a grilled chicken salad?

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    If it contains 20 ppm of gluten, then it is not gluten free, whether it is the law or not. If it contains gluten, it causes damage, whether you have "symptoms" or not.

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    Agreed, Ms. Ribeiro. Gluten-free french fries? What do they want, a medal? This article should have bashed "Burger Doodle", as i call it, instead of proclaiming it to be a "safe place to eat".

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    If it contains 20 ppm of gluten, then it is not gluten free, whether it is the law or not. If it contains gluten, it causes damage, whether you have "symptoms" or not.

    Becca, I understand gluten causes damage. But I'm unaware of a food chemistry procedure that can reliably detect less than 20ppm gluten. Demanding a level better than current technology can deliver would make it impossible to have a useful law related to gluten free labeling.

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    I was told twice by a clerk at McDonalds that the fries were safe. I ate them and became very sick for two days. After that, I asked the owner to check for wheat and he said there is wheat listed in the fries and hash browns. On another note, I ate at Five Guys. They use a divided section on the grill for buns and another for burgers. They also cut the potatoes on site and add nothing and cook nothing else in fry oil. Go Five Guys.

    Please note the incidences of contamination to the McDonald's fries by the chicken nuggets sitting next door that accidentally fall into the fries when the deep fryer basket is dumped!!! I have observed this frequently!!

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    The content in the fries is WHEAT not Wheat Starch and even then the wheat (or wheat starch) is not guaranteed to be within the Codex Standard of less than <20ppm.

     

    If they don't clearly advertise that the fries are gluten-free (no gluten or at least 20ppm or less) then it should not be deemed safe.

     

    The article does not explain where or how Cynthia Kupper from the GIG got her information about the fries being gluten-free. It would be great for that information to be posted for us to read, for example, the ELISA test results from the fries.

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  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

  • Related Articles

    Scott Adams
    The following list was taken from the Fall, 1996 Celiac Disease Foundation Newsletter.
    Anemia IBS Psychological stress, nerves, imagination Diarrhea IBD Diabetes Spastic Colon Ulcers Virus (Viral Gastroenteritis) Chronic Fatigue Syndrome Weight-loss Allergies Amoeba, Parasites, Infection Gallbladder Disease Thyroid Disease Cancer, Lymphoma, Digestive Colitis Cystic Fibrosis Lactose Intolerance Reflux Data from an on-going Celiac Disease Foundation study of 600 Biopsy-proven celiacs.

    Scott Adams
    This article originally appeared in the Summer 2004 edition of Celiac.coms Scott-Free Newsletter.
    Celiac.com 10/27/2004 - I recently decided to have my DNA and that of my son screened for the genetic markers, also known as HLA alleles, which make celiac disease possible. Both my mother and I have long since been diagnosed with the disease, so I naturally worry that my son Spencer may also end up with it at some point in his life. Even though he has been mostly symptom-free for his entire life—all three and a half years of it—last year I subjected him to serological screening after he had a several week bout with diarrhea. We were happy to discover that he did not have it, but I still knew that such tests could not rule the disease out of his future. Even so, it was nice to learn that he did not have the active disease, although a blood draw at two years of age was not exactly a pleasant experience for him—or for his parents! I swore then that I would try to avoid any unnecessary blood draws in the future, even though I knew that it might still be necessary from time to time—unless he somehow did not inherit the genetic markers for it—the idea of which led me to my decision to have Spencers DNA screened for celiac disease.
    After mentioning my plans for the DNA screening at a family dinner, my brother also grew interested, as he too has had unexplained symptoms and a recent negative celiac disease antibody panel and biopsy. He too felt that it would be nice to find out once and for all if this was something that he was going to have to worry about in the future. He also pointed out to me that genetic screening had the potential to save him money over the long haul, since the test is only necessary once in a lifetime. Periodic antibody screening for the disease can prove to be quite expensive, and a negative DNA test would effectively rule out the necessity of any future testing. After we finished our dinner that evening I sat down with my brother and we reviewed several offerings on the Internet by companies who provide genetic services for celiac disease, and were particularly impressed by one of them—Kimball Genetics, located in Denver, Colorado, as their DNA collection method did not require a blood draw and instead employed a simple and painless cheek cell collection using a swab.
    The next day I telephoned Kimball Genetics and was connected with a very knowledgeable genetic counselor. After a discussion with her about my familys history I decided to order three celiac disease genetic tests, one each for my son, my brother, and myself. I requested three cheek cell collection kits to be sent to my home, where the samples would be collected and sent back to Kimball Genetics for testing. For individuals the cost of a kit is 10% off of $325, or $292.50 per test, and they offer a 20% family discount for testing additional family members, which brings the per test price down to $260. Kimball Genetics also offers assistance with billing your health insurance company, which can often result in the recovery of all or part of the costs incurred for the tests. This includes detailed help with the forms, insurance CPT codes for the procedure, as well as obtaining the ICD9 codes, which are the diagnostic and symptom codes that come from your doctor. At this point I realized that to get reimbursed for the tests a person should first make an appointment with their doctor, and ideally this appointment should take place before actually ordering a test kit. This will ensure that you and your doctor are on the same page regarding the importance and necessity of the genetic tests.
    The cheek cell collection kits arrived in the mail within a couple of days, and I phoned my brother to arrange a "DNA collection party" at my house. On collection day we opened the kits to find enclosed two brushes for sample collection, a Test Request Form, a consent form, medical literature regarding Kimball Genetics DNA screening test for celiac disease, and detailed instructions that outlined how to properly collect and mail the samples. The kits also included a stamped return envelope that was pre-addressed to their laboratory. The Test Request Form included an area where one could enter their credit card information, and this form along with the consent form and a check or card information were required to be sent along with the sample in the return envelope.
    The medical literature included with the kits comprised of a three page document titled "Celiac Disease DNA Test." The following two sections, which I found to be particularly helpful, are reproduced below from this document, which is also available on their Web site www.kimballgenetics.com:
    Indications for Celiac Disease DNA Testing:
    Clinical diagnosis of celiac disease. Negative or equivocal antibody results (antiendomysial, tissue transglutaminase, or antigliadin) or intestinal biopsy results in an individual with symptoms of celiac disease. Relatives of individuals with celiac disease. Individuals with iron-deficient anemia. Individuals with dermatitis herpetiformis. Adults with diarrhea, abdominal pain and distention, recurrent aphthous stomatitis (canker sores), osteoporosis, infertility, multiple miscarriages, anxiety, and/or depression. Children with abdominal pain, diarrhea, abdominal distention, failure to thrive, short stature, delayed puberty, irritability, attention-deficit disorder and/or poor school performance. Children with Type I diabetes. Our Celiac Disease DNA Test Service Provides:
    PCR analysis for DQ2 alleles (DQA1*0501, DQA1*0505, and DQB1*0201/*0202) and DQ8 allele (DQB1*0302). Detailed reports with genetic interpretation, recommendations, and education. Free genetic counseling for physicians, patients, and families. Free shipping. The sample collection went very smoothly for each of us, and Spencer found it to be slightly more annoying than having to brush his teeth. We each rinsed our mouths out with water beforehand, and then rolled one brush at a time 20 times over the entire inside surface area of one check, and then did the same on the other cheek with the second brush. We let the samples dry for 30 minutes, and then put everything in their respective packages and envelopes along with the filled out paper work. Our final step was to put them out for the Mail Carrier to pick up. Their literature promised a 3-4 day turn around, and sure enough, both my brother and I got a call from someone at Kimball Genetics several days later who needed our doctors fax numbers, which we had forgotten to include on the paperwork. Once they had this information, a call to our doctors was all that was necessary to have our doctors forward the results directly to us by fax, and we also received the original reports by mail. Amazingly the Celiac Disease DNA Test at Kimball Genetics takes just one business day from the day the lab receives the sample (if it arrives by noon) to reporting of results.
    I have to admit that besides hoping that my son did not inherit the genetic makeup that makes celiac disease possible—as the results were printing out from my fax machine—I still held out the very slight hope that they had not found the markers in my genetic sample, and that my whole diagnosis was some sort of big mistake. This hope was quickly crushed as the report indicated that I was in fact part of an elite genetic group—one that carries both markers for celiac disease: DQ2 and DQ8—which I later discovered meant that I inherited genetic traits for celiac disease from both of my parents, rather than just from my mother, which was my original assumption. My father is no longer alive, but after discussing his results with my mother we decided that it is possible that he also had undiagnosed celiac disease, and it is interesting to note that he had diabetes.
    I couldnt help but think that my results make me something like a "Super Celiac," although the genetic counselor at Kimball Genetics reassured me that having both markers for it doesnt necessarily mean that the disease will present itself any differently. Spencer turned out to be positive for DQ2, and my brother found out that he too tested positive for both DQ2 and DQ8. On the down side their results indicate that they will need to watch out for any future signs of the disease for the rest of their lives, and probably get screened for it from time to time. On the up side there is still only a small chance that either will ever develop the disease, and at least we will know to watch for its symptoms in the future, which likely would lead to a quick diagnosis and treatment should one of them ever get it.
    Ultimately anyone who decides to undergo genetic screening must be comfortable with the results—positive or negative. I advocate testing because I believe in the saying that knowledge is power, and that it is better to know than not to know—especially when it comes to your health. Unlike other testing methods, genetic screening for celiac disease has the amazing potential to reveal whether someone has been misdiagnosed with the disease, even though the odds for such a scenario are small. It also can confirm a diagnosis, or let relatives of celiacs know that they do or dont need to worry about it in the future. My mother felt vindicated by our results, as they indicated that she wasnt the only person who passed celiac genes to her children—my father did too. Who knows, your genetic results may even have the potential to elevate your celiac status, as it did in my case, to that of—Super Celiac!

    Scott Adams
    If you would like to learn more about celiac disease genetic testing, or read about my personal experience with Kimball Genetics, be sure to read the following two related articles:
    Your DNA Results Indicate: Super Celiac! By Scott Adams Understanding the Genetics of Gluten Sensitivity by Dr. Scot Lewey Celiac.com 11/29/2006 - Kimball Genetics, Inc. announces its participation this week at the XII International Celiac Disease Symposium in New York City and its support of the Celiac Disease Center at Columbia University. Kimball Genetics has a strong commitment to celiac disease education and genetic testing for this common, chronic, autoimmune disorder. Celiac disease affects approximately 1% of the U.S. population but is highly underdiagnosed, with less than 10% of cases currently detected. In genetically susceptible individuals with the specific markers HLA-DQ2 and HLA-DQ8, ingestion of gluten-containing grains causes inflammation of the small intestine and leads to malabsorption. Symptoms may be gastrointestinal and/or a wide range of other multi-systemic manifestations such as iron-deficiency anemia, chronic fatigue, osteoporosis, dermatitis herpetiformis, and attention-deficit/hyperactivity disorder. Early diagnosis and lifelong treatment with a gluten-free diet is critical to relieve inflammation and symptoms and to reduce the risk for development of secondary autoimmune disorders such as type 1 diabetes. Silent celiac disease, involving inflammation without symptoms, is also important to detect and treat.
    Kimball Genetics offers the Celiac Disease DNA Test, a genetic test with increasingly recognized importance in the diagnostic work-up of celiac disease. The test is valuable because it excludes the diagnosis of celiac disease in patients with a negative result, detects family members at risk for the disorder, and is accurate even when the patient is on a gluten-free diet. Both antibody testing and small bowel biopsy require going off a gluten-free diet to gain reliable results if the patient initiated the diet before diagnosis.
    Kimball Genetics is the only laboratory presently offering celiac disease DNA testing on cheek cell specimens with results available in one day. Dr. Peter Green of the Celiac Disease Center at Columbia University says "Cheek cell testing at Kimball Genetics is convenient and tremendously popular with my patients since it eliminates the need for blood draw. The one-day turnaround time and expert genetic counseling provided with Kimballs service are much appreciated." The Celiac Disease Foundation also recommends Kimball Genetics Celiac Disease DNA test due to these unique features of its service.
    In concurrence with the National Institute of Healths "Celiac Disease Campaign for Health Care Providers and Public," Kimball Genetics, Inc. conducts ongoing educational efforts including presentations to gastroenterologists, family practitioners, nautropaths, chiropractors, and nutritionists, and assists national celiac support groups. Dr. Annette Taylor and genetic counselors from Kimball have written an in depth review about celiac disease, co-authored by Dr. Peter Green, soon to be published in GeneReviews online. In addition, Kimball Genetics is collaborating with Drs. Xavier Castellanos and Dominick Auciello from New York University Child Study Center and Dr. Peter Green from Columbia University on an exciting new research study to determine the incidence of celiac disease in children with attention-deficit/hyperactivity disorder (ADHD) or learning disabilities.
    About Kimball Genetics, Inc.
    Founded in 1994 by Annette K. Taylor, M.S., Ph.D., Kimball Genetics is a national DNA diagnostic laboratory specializing in testing for common genetic disorders that are preventable or can be treated. Known for its unparalleled turnaround time and distinctive focus on genetic counseling and education, the company has a major focus on celiac disease and is at the forefront of education and testing for this disorder. Other major areas of testing currently include inherited hypercoagulability, hemochromatosis, cystic fibrosis, and fragile X syndrome. Soon Kimball will be expanding into pharmocogenomic testing which allows for the personal customization of drug therapy.


    Jefferson Adams
    Celiac.com 11/03/2008 - Blood testing for radioimmunoassay (RIA) tissue transglutaminase auto-antibodies (tTG-Abs) has proven to be a sensitive test for celiac disease follow-up. Recent studies have shown that RIA can accurately detect tTG-Abs in human saliva. However, not much is known about reliability of this method for monitoring the progress of celiac disease over time in patients who are attempting to follow a gluten-free diet.
    A team of researchers recently set out to assess salivary RIA tTG-Abs in celiac children on gluten-free diet. The research team included doctors M. Bonamico, R. Nenna, R.P.L. Luparia, C. Perricone, M. Montuori, F. Lucantoni, A. Castronovo, S. Mura; A. Turchetti, P. Strappini, and C. Tiberti.
    The team evaluated blood and saliva samples taken from 109 children at the time of their diagnosis for celiac disease. The first group included 71 females, with an average age of 9.4 years. A second group included 58 people who were following a gluten-free diet. The second group was broken into two subgroups: group 2a with 36 patients assessed at 3-6 months; and group 2b with 34 patients at 9 months or more (group 2b).
    The research team also included two control groups matched for age and sex. Group 3 included 89 gastroenterological patients, while group 4 included 49 healthy subjects. The team used RIA to detect tTG-Abs in saliva and blood, and compared the results against two other established tests: serum tTG-Abs ELISA and IgA anti-endomysium antibodies (EMA).
    The team detected salivary RIA tTG-Abs in 94.5% of patients from group 1, 66.7% of celiac patients from group 2a, and 50.0% from 2b. They detected blood RIA tTG-Abs in 98.2% of patients from group 1, 72.2% of celiac patients from group 2a, and 50.0% from 2b. The longer patients were on a gluten-free diet, the more the tTG-Abs decreased. The research team also found a correlation between saliva and serum levels (r = 0.75, P = 0.0001). A celiac disease follow-up showed comparable salivary and serum RIA sensitivities, and higher levels for EMA and ELISA methods.
    The research team concluded that it is possible to measure salivary tTG-Abs with a high level of accuracy; both at initial diagnosis for celiac disease, and also while patients are following a gluten-free diet.
    This discovery means that doctors treating people with celiac disease might soon be able to use a simple saliva test to monitor the progress of their patients’ gluten-free diets. Such a development might take remove much of the guesswork for celiacs who are trying to follow a gluten-free diet, and would be particularly useful for patients who might be asymptomatic, or who are at risk for celiac-associated conditions.
    Aliment Pharmacol Ther.  2008; 28(3): 364-370.


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