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    Most Gluten-free Products Fall Short on Nutrition


    Jefferson Adams

    Celiac.com 08/28/2015 - Perhaps unsurprisingly, a study of over 3,200 supermarket products finds gluten-free foods aren't a healthier choice than their non gluten-free counterparts.

    Photo: CC--Whatsername?If you have celiac disease, or gluten sensitivity, gluten-free foods are necessary and beneficial, but the new study suggests that, nutritionally speaking, there's no evidence that they're any healthier than their gluten-containing counterparts.

    The research looked at 3,200 food products on Australian grocery shelves, and found little or no nutritional difference between regular foods and comparable gluten-free items. Now, that doesn't make gluten-free products unhealthy, just no better than their gluten-containing equivalents.

    But if you are not celiac or gluten-sensitive, then you're probably spending more money to get the same nutrition, and not getting any health benefits. Strangely, plenty of people seem to believe that sugary treats such as cakes are 'healthier' if they are gluten-free.

    The study compared supermarket products in 10 categories: bread, breakfast cereal, dry pasta, cereal bars, cakes, sweet biscuits, ice cream, potato chips, processed meats, and candies.

    The study team assessed foods using the Australian Government's Health Star Rating, which rates food by nutritional value. The rating system awards one star to the foods with the least nutritional value, and five stars to those with the most.

    Basically, when they crunched the numbers using the Health Star Rating, the team found no significant difference between the ratings of gluten-free foods and their regular alternatives.

    For me, though, the real takeaway is that there's a good amount of processed food out their, gluten-free or not, and you're likely healthier eating fresh, whole foods than anything processed.

    Or, alternatively, it takes a bit of effort to maintain a healthy diet, whether you are gluten-free or not. Share your thoughts below.

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    I don't see the relevance of comparing nutritional value between gluten-free and regular food. To focus on health, you avoid junk foods like potato chips, whether or not they are gluten-free. To avoid the side effects of gluten, including bloating, even for those who do not have celiac, you eat gluten-free. The two have nothing to do with each other.

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    "Most gluten free food" includes all fruits and veggies, meats and fish, all, dairy products, beans, potatoes nuts and seeds. Anything processed is going to be somewhat short on the nutrition we need to be our healthiest, whether gluten-free or not, but the most nutritious foods are still gluten free and they are still the vast majority of the foods out there.

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    Guest Ed Epifani

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    Thank you., thank you! gluten-free food made from finely ground grains, especially baked goods ,are not nutritionally dense. They have a very low ANDI score, meaning few nutrients for the amount of calories. I love them, but they are my special occasion "junk food". Weddings, birthdays, funerals. It would be my own if I ate them all the time.

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    I never buy what I consider junk food, anyway. The idea of stuffing my face with overly sweet empty calories never did appeal - even before celiac. Potato chips are an occasional treat, and processed boxes of food can never give me the flavor and texture that I get from freshly made food. BUT I am grateful that if I do need a substitute I know I have some choices. Perhaps the greatest strength of this article is that all packaged food needs to be more nutritionally acceptable.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided health and medical content for Sharecare.com.

    Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book Dangerous Grains by James Braly, MD and Ron Hoggan, MA.

  • Related Articles

    Sayer Ji
    Approximately 70% of all American calories come from a combination of the following four foods: wheat, dairy, soy and corn - assuming, that is, we exclude calories from sugar.
    Were it true that these four foods were health promoting, whole-wheat-bread-munching, soy-milk-guzzling, cheese-nibbling, corn-chip having Americans would probably be experiencing exemplary health among the world's nations. To the contrary, despite the massive amount of calories ingested from these purported "health foods," we are perhaps the most malnourished and sickest people on the planet today. The average American adult is on 12 prescribed medications, demonstrating just how diseased, or for that matter, brainwashed and manipulated, we are.
    How could this be? After all, doesn't the USDA Food Pyramid emphasize whole grains like wheat above all other food categories, and isn’t dairy so indispensible to our health that it is afforded a category all of its own? 
    Unfortunately these “authoritative” recommendations go  much further in serving the special interests of the industries that produce these commodities than in serving the biological needs of those who are told it would be beneficial to consume them.  After all, grains themselves have only been consumed for 500 generations – that is, only since the transition out of the Paleolithic into the Neolithic era approximately 10,000 years ago.  Since the advent of homo sapiens 2.5 million years ago our bodies have survived on a hunter and gatherer diet, where foods were consumed in whole form, and raw!  Corn, Soy and Cow's Milk have only just been introduced into our diet, and therefore are “experimental” food sources which given the presence of toxic lectins, endocrine disruptors, anti-nutrients, enzyme inhibitors, indigestible gluey proteins, etc, don’t appear to make much biological sense to consume in large quantities - and perhaps, as is my belief, given their deleterious effects on health, they should not be consumed at all.
    Even if our belief system doesn’t allow for the concept of evolution, or that our present existence is borne on vast stretches of biological time, we need only consider the undeniable fact that these four “health foods” are also sources for industrial adhesives, in order to see how big a problem they present.
    For one, wheat flour is used to make glues for book binding and wall-papering, as well as being the key ingredient for paper mache mortar. Sticky soy protein has replaced the need for formaldehyde based adhesives for making plywood, and is used to make plastic, composite and many other things you probably wouldn’t consider eating. The whitish protein known as casein in cow's milk is the active ingredient in Elmer's glue and has been used for paint since ancient times. Finally, corn gluten is used as a glue to hold cardboard boxes together. Eating glue doesn't sound too appetizing does it?  Indeed, when you consider what these sticky glycoproteins will do to the delicate microvilli inside our intestines, a scenario, nightmarish in proportions, unfolds. 
    All nutrients are absorbed in the intestine through the microvilli. These finger-like projections from off the surface of the intestine amplify the surface area of absorption in the intestine to the area the size of a tennis court. When coated with undigested or partially digested glue (glycoproteins), not only is the absorption of nutrients reduced leading to malabsorption and consequently malnourishment, but the villi themselves become damaged/dessicated/ inflammed and begin to undergo atrophy - at times even breaking off.  The damage to the intestinal membrane caused by these glues ultimately leads to perforation of the one cell thick intestinal wall, often leading to "leaky gut syndrome": a condition where undigested proteins and plant toxins called lectins enter the bloodstream wreaking havoc on the immune system. A massive amount of research (which is given little to no attention both in the mass media and allopathic medicine) indicates that diseases as varied as fibromyalgia, diabetes, autism, cancer, arthritis, crohn's, chronic fatigue, artheroscerosis, and many others, are directly influenced by the immune mediated responses wheat, dairy, soy and corn can provoke.
    Of all four suspect foods Wheat, whose omnipresence in the S.A.D or Standard American Diet indicates something of an obsession, may be the primary culprit.  According to Clinical Pathologist Carolyn Pierini the wheat lectin called "gliadin" is known to to participate in activating NF kappa beta proteins which are involved in every acute and chronic inflammatory disorder including neurodegenerative disease, inflammatory bowel disease, infectious and autoimmune diseases.
    In support of this indictment of Wheat’s credibility as a “health food,” Glucosamine – the blockbuster supplement for arthritis and joint problems – has been shown to bind to and deactivate the lectin in wheat that causes inflammation. It may just turn out to be true that millions of Americans who are finding relief with Glucosamine would benefit more directly from removing the wheat (and related allergens) from their diets rather than popping a multitude of natural and synthetic pills to cancel one of Wheat’s main toxic actions. Not only would they be freed up from taking supplements like Glucosamine, but many would also be able to avoid taking dangerous Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like Tylenol, Aspirin and Ibuprofen, which are known to cause tens of thousands of cases of liver damage, internal hemorrhaging and stomach bleeding each and every year.
    One might wonder:  “How is it that if America's favorite sources of calories: Wheat and Dairy, are so obviously pro-inflammatory, immunosuppressive, and generally toxic, why would anyone eat them?”  ANSWER: They are powerful forms of socially sanctioned self-medication.
    Wheat and Dairy contain gliadorphin and gluten exorphins, and casomorphin, respectively.  These partially digested proteins known as peptides act on the opioid receptors in the brain, generating a temporary euphoria or analgesic effect that has been clinically documented and measured in great detail.  The Institute of Pharmacology and Toxicology in Magdeburg, Germany has shown that a Casein (cow's milk protein) derivative has 1000 times greater antinociceptive activity (pain inhibition) than morphine. Not only do these morphine like substances create a painkilling "high," but they can invoke serious addictive/obsessive behavior, learning disabilities, autism, inability to focus, and other serious physical and mental handicaps. 
    As the glues destroy the delicate surface of our intestines, we for the life of us can't understand why we are so drawn to consume these "comfort foods", heaping "drug soaked" helping after helping.  Many of us struggle to shake ourselves out of our wheat and dairy induced stupor with stimulants like coffee, caffeinated soda and chocolate, creating a viscous “self-medicating” cycle of sedation and stimulation.
    As if this were not enough, Wheat, Dairy, and Soy also happen to have some of the highest naturally occurring concentrations of Glutamic Acid, which is the natural equivalent of monosodium glutamate. This excitotoxin gives these foods great "flavor" (or what the Japanese call umami) but can cause the neurons to fire to the point of death.  It is no wonder that with all these drug-like qualities most Americans consume wheat and dairy in each and every meal of their day, for each and every day of their lives.
    Whether you now believe that removing Wheat, Dairy, Soy and Corn from your diet is a good idea, or still need convincing, it doesn’t hurt to take the “elimination diet” challenge. The real test is to eliminate these suspect foods for at least 2 weeks, see how you feel, and then if you aren’t feeling like you have made significant improvements in your health, reintroduce them and see what happens.  Trust in your feelings, listen to your body, and you will move closer to what is healthy for you.
    This article owes much of its content and insight to the work of John Symes whose ground-breaking research on the dangers of wheat, dairy, corn and soy have been a great eye opener to me, and a continual source of inspiration in my goal of educating myself and others.


    Kristen Campbell
    Celiac.com 11/10/2008 - Dietary shifts in recent years towards more organic food choices and low carb diets have forever-altered the food pyramid—the grocery world is changing in response to our health concerns.  Now there is a new trend in the food world: the gluten-free diet.  According to Nielson reports, the gluten free sector of the grocery world grew 20% between June of 2007 and 2008.

     
    With unarguable growth in this new direction, the word is spreading about conditions such as celiac disease and gluten intolerance.  But is gluten-free just the latest diet fad, belittling the severity of these diseases, or is it a trend in the right direction for the millions of Americans who are still undiagnosed?

     
    One of the greatest fears surrounding the growth of the gluten-free trend is that people may indulge the diet for faddish reasons, discounting the severity of conditions such as celiac disease and gluten intolerance.

     
    Celiac is an autoimmune disease that affects at least 1 in 133 Americans. When gluten is consumed, antibodies in the small intestines attack the gluten, damaging the intestinal lining and villi, small hair-like structures which extract nutrients from the food.  Without treatment, the body is rendered unable to absorb the proper nutrients from dietary food, leaving patients vulnerable to an entire host of serious, life-threatening diseases.  The prescribed treatment for celiac disease is an adherence to a completely gluten-free diet for the rest of the patient’s life.  Left undiagnosed and untreated, celiac disease can cause serious conditions such as cancer, osteoporosis and infertility.

     
    Celiac disease is very serious, and it should not be discounted.  Far more common, and often as severe, however, is gluten intolerance.  Gluten intolerance can range in levels of severity, wreaking the same havoc on the body that celiac disease does, or in some cases simply causing gastrointestinal discomforts.  The key here is that gluten intolerance can in fact be as damaging to the body as celiac disease, and gluten intolerance is suspected to affect as many as 30% of Americans  (SOURCE: The Gluten Connection).

     
    With every new trend comes controversy, but ultimately, the growth in interest in a gluten free diet will mean more research, more diagnoses and more food options.  Doctors often have a hard time diagnosing gluten intolerance and celiac disease, because of the broad range of symptoms and their lack of exposures to these diseases.  Patients often receive their diagnosis only after digging deeper, looking further than one or two doctors for the correct answer.

     
    More coverage on these conditions, means more people with undiagnosed gluten intolerance or celiac disease will find their answer, and get the diagnoses they need.  People with gluten sensitivities are often very outgoing about them, and many write articles, post on forums, or start blogs.  One thing is for sure, the more people who get diagnosed, the more the word will spread.

     
    Perhaps just as dietary trends or fads have taught us that carb-centric, processed food diets may not be the answer for optimal health, so too will the gluten free-movement correct our country’s addiction to the wheat-based diet.  Many argue that our diets should have never contained gluten to begin with, and today it is added to nearly all processed foods ranging from soups and sauces to seasonings and condiments.  The gluten-free diet may just be the latest trend for some people, but for many of us it is our only path to good health—and for this reason the gluten-free diet is here to stay.


    Destiny Stone
    Gluten-Free Foods are Improving
    Celiac.com 05/10/2010 - Celiac is a genetic autoimmune disease which affects 1 in 100 people worldwide, making it one of the most common food intolerance's in the world. Celiac disease is triggered by the ingestion of gluten proteins, and for those sensitive to gluten, digestion of gluten grains results in an immunological response in the small intestine, destroying mature absorptive epithelial cells on the surface of the small intestine, and creating side effects ranging from severe illnesses, to no obvious symptoms what-so-ever. Regardless of your symptoms, if left untreated, celiac disease can be life-threatening.
    There is no medication to cure or alleviate celiac disease, and the only cure is complete gluten abstinence for life. Avoiding gluten, means avoiding wheat, rye and barley; which when entirely avoided can lead to recovery from celiac disease symptoms, and result in significant improvement of the intestinal mucosa and its absorptive functions.
    There is great controversy among most people who are gluten sensitive over the current market  for gluten-free products, especially breads and cereals. Most people who avoid gluten agree that gluten-free bread leaves much to be desired. Most gluten-free breads are dry, bland, and can only be tolerated when toasted and covered with lots of jam. However, Healthgrain, a European Union project  is working hard to strengthen the scientific formulas for a new generation of cereals and breads for those looking for healthy, tasty gluten-free options.
    New methods are being created  by Healthgrain, and conducted by the research team of Professor Elke Arendt, University College Cork, Ireland and the team of Professor Jan Delcour, KU Leuven, Belgium, to improve the overall quality of gluten-free products. One new method Healthgrain is exploring is the use of special Lactic acid bacteria. Lactic acid bacteria has innate properties such as anti fungal activity, which  has been shown to improve the quality and shelf-life of gluten-free breads.
    Texture is another big complaint most gluten-free people have when it comes to gluten-free products. Healthgrain has been experimenting with the effect different enzymes such as transglutaminase, glucose oxidase and protease play on the texture of gluten-free cereals. The enzymes showed that they in fact have an essential role in improving the construction of gluten-free bread, although the enzymes also showed varying reactions to the array of different gluten-free breads.
    Another technique introduced to improve  gluten-free products is something called, 'high pressure processing' (HP).  The impact of HP on the major polymers found in gluten-free flours, were also investigated by Healthgrain. The results of the impact of HP on gluten-free grains reveled that starch gelatinisation and protein network formation occurred at pressures greater than 350 MPa. However a weakening of protein structures  was discovered at lower pressures. Adding HP treated gluten-free batters to bread showed an improvement in volume and decreased staling with pressure less than 200 MPa.
    We live in a great time to be gluten-free and the scientific studies of the Healthgrain project offers more hope to gluten-free folks looking for more gluten-free products that don't taste gluten-free.
    Source:

    New Improved Gluten-Free Foods Developed for Patients with Celiac Disease  


    Dr. Ron Hoggan, Ed.D.
    Dr. Ron Hoggan Responds to The Atlantic's Article: A Gluten-Free Diet Reality Check
    Celiac.com 01/05/2012 - I was disappointed to read this opinion article in The Atlantic (titled: A Gluten-Free Diet Reality Check) when there are three U.S. studies demonstrating that about half of overweight and obese children and/or adults with newly diagnosed celiac disease lose weight following institution of a gluten free diet (GFD) (2,3,4). Some of these researchers make statements such as “The GFD has a beneficial effect upon the BMI [body mass index] of overweight children with celiac disease” after following 27 children who, at diagnosis, were overweight or obese (2). Similarly, Cheng et al reported that “A GFD had a beneficial impact on BMI, underweight patients gained weight and overweight/obese patients lost weight” (3).  Murray et al report that only 30% of their obese patients with celiac lost weight after six months of following a gluten free diet (4). 
    There isn’t much ambiguity in any of these three studies conducted by three separate groups of reputable medical scientists and published in the peer reviewed medical and scientific literature. Clearly, the gluten free diet is an effective weight loss tool for some of the individuals investigated. Yet Fontenot asserts that “there is no evidence that gluten-free foods promote weight loss….” (1). Exactly what evidence does she want?   
    She goes on to say that “The only condition that necessitates a gluten free diet is celiac disease” (1). Yet she previously states, when discussing several other conditions that have been connected with gluten that “the research shows mixed results” (1). Surely the “mixed results” suggests that there is evidence that at least some cases benefit from a gluten free diet.
    Neither does the notion of ‘necessity’ apply to celiac disease. A person with celiac disase can consume gluten. They may place their health at risk by so doing, but that applies equally to those individuals with other conditions that have been shown to benefit from a gluten free diet. So the distinction she makes is, at best, one of degree.
    For decades many highly regarded investigators have published test results clearly showing that a gluten free diet is beneficial in the conditions listed by Ms. Fontenot, as well as many other ailments. These range from autism (5,6,7)  to schizophrenia (8,9,10,11) to a variety of neurological (12,13,14) conditions to attention deficit disorder (15,16), to many other forms of autoimmunity (17,18,19), learning disabilities (20) and even to AIDS patients (21).
    Ms. Fontenot even asserts that “A person with celiac disease has increased levels of certain autoantibodies circulating in their blood due to their intake of gluten”(1). Again, she overlooks seronegative celiac disease which is frequently seen in the context of IgA deficiency (22, 23, 24) and may be present in many other contexts. 
    Opinion pieces are probably easier to write when ignoring relevant facts. In this case, the overwhelming body of personal bias that drives Ms. Fontenot’s article is offered in the absence of a single supporting research finding and only one other professional opinion which is offered by one of Ms. Fontenot’s colleagues. She certainly hasn’t let the facts get in the way of her story, but it is deeply disturbing to discover that The Atlantic has chosen to republish this unsupported rant.
    Sources:

    http://www.theatlantic.com/health/print/2012/01/a-gluten-free-diet-reality-check/250750/ Reilly NR, Aguilar K, Hassid BG, Cheng J, Defelice AR, Kazlow P, Bhagat G, Green PH. Celiac disease in normal-weight and overweight children: clinical features and growth outcomes following a gluten-free diet. J Pediatr Gastroenterol Nutr. 2011 Nov;53(5):528-31. Cheng J, Brar PS, Lee AR, Green PH. Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol. 2010 Apr;44(4):267-71. Murray JA, Watson T, Clearman B, Mitros F. Effect of a gluten-free diet on gastrointestinal symptoms in celiac disease. Am J Clin Nutr. 2004 Apr;79(4):669-73. Whiteley P, Haracopos D, Knivsberg AM, Reichelt KL, Parlar S, Jacobsen J, Seim A, Pedersen L, Schondel M, Shattock P. The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutr Neurosci. 2010 Apr;13(2):87-100. Reichelt KL, Knivsberg AM. The possibility and probability of a gut-to-brain connection in autism. Ann Clin Psychiatry. 2009 Oct-Dec;21(4):205-11. Knivsberg AM, Reichelt KL, Høien T, Nødland M. A randomised, controlled study of dietary intervention in autistic syndromes. Nutr Neurosci. 2002 Sep;5(4):251-61. Cascella NG, Kryszak D, Bhatti B, Gregory P, Kelly DL, Mc Evoy JP, Fasano A, Eaton WW. Prevalence of celiac disease and gluten sensitivity in the United States clinical antipsychotic trials of intervention effectiveness study population. Schizophr Bull. 2011 Jan;37(1):94-100. De Santis A, Addolorato G, Romito A, Caputo S, Giordano A, Gambassi G, Taranto C, Manna R, Gasbarrini G. Schizophrenic symptoms and SPECT abnormalities in a coeliac patient: regression after a gluten-free diet. J Intern Med. 1997 Nov;242(5):421-3. Dohan FC, Grasberger JC, Lowell FM, Johnston HT Jr, Arbegast AW. Relapsed schizophrenics: more rapid improvement on a milk- and cereal-free diet. Br J Psychiatry. 1969 May;115(522):595-6..  Singh MM, Kay SR. Wheat gluten as a pathogenic factor in schizophrenia. Science. 1976 Jan 30;191(4225):401-2. Hadjivassiliou M, Kandler RH, Chattopadhyay AK, Davies-Jones AG, Jarratt JA, Sanders DS, Sharrack B, Grünewald RA. Dietary treatment of gluten neuropathy. Muscle Nerve. 2006 Dec;34(6):762-6. Hadjivassiliou M, Rao DG, Wharton SB, Sanders DS, Grünewald RA, Davies-Jones AG.Sensory ganglionopathy due to gluten sensitivity. Neurology. 2010 Sep 14;75(11):1003-8. 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. Niederhofer H, Pittschieler K. A preliminary investigation of ADHD symptoms in persons with celiac disease. J Atten Disord. 2006 Nov;10(2):200-4. Zelnik N, Pacht A, Obeid R, Lerner A. Range of neurologic disorders in patients with celiac disease. Pediatrics. 2004 Jun;113(6):1672-6. Rodrigo L, Hernández-Lahoz C, Fuentes D, Alvarez N, López-Vázquez A, González S. Prevalence of celiac disease in multiple sclerosis. BMC Neurol. 2011 Mar 7;11:31. Malalasekera V, Cameron F, Grixti E, Thomas MC. Potential reno-protective effects of a gluten-free diet in type 1 diabetes. Diabetologia. 2009 May;52(5):798-800. Epub 2009 Feb 14. Iuorio R, Mercuri V, Barbarulo F, D'Amico T, Mecca N, Bassotti G, Pietrobono D, Gargiulo P, Picarelli A. Prevalence of celiac disease in patients with autoimmune thyroiditis. Minerva Endocrinol. 2007 Dec;32(4):239-43. http://www.timesonline.co.uk/tol/news/uk/article444290.ece Quiñones-Galvan A, Lifshitz-Guinzberg A, Ruíz-Arguelles GJ. Gluten-free diet for AIDS-associated enteropathy. Ann Intern Med. 1990 Nov 15;113(10):806-7 Evans KE, Leeds JS, Sanders DS. Be vigilant for patients with coeliac disease. Practitioner. 2009 Oct;253(1722):19-22, 2. Mozo L, Gómez J, Escanlar E, Bousoño C, Gutiérrez C. Diagnostic Value of Anti-Deamidated Gliadin Peptide Igg Antibodies for Celiac Disease in Children and Iga Deficient Patients. J Pediatr Gastroenterol Nutr. 2011 Dec 23. Wang N, Shen N, Vyse TJ, Anand V, Gunnarson I, Sturfelt G, Rantapää-Dahlqvist S, Elvin K, Truedsson L, Andersson BA, Dahle C, Ortqvist E, Gregersen PK, Behrens TW, Hammarström L. Selective IgA deficiency in autoimmune diseases. Mol Med. 2011 Aug 4.

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    • Maureen and Cyclinglady, Of the foods you listed. . .. I would focus on the Chocolate. Chocolate has Tyramine in it and it could/can cause rashes that  might be confused for DH. Sometimes Tyramine get's confused for/in high sulfite foods as triggers. Here is a great overview article on this topic. http://www.chicagotribune.com/lifestyles/health/sc-red-wine-headache-health-0608-20160525-story.html you might also have trouble with headaches if it tyramine is causing you your trouble. People who have trouble Tyramine might also have trouble with consuming cheeses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738414/ As for the Milk causing/triggering your DH don't rule Adult onset dairy allergy. While rare it does occur in the literature/research when you search it out. I am including the research here in the hopes it might help you or someone else entitled "Adult onset of cow's milk protein allergy with small‐intestinal mucosal IgE mast cells" https://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.1996.tb04640.x It is generally thought most of grow out of a Milk Allergy at approx. 3 years old. But for some lucky one (I guess) we never do apparently.  (I speak for my friend on this board JMG).  He found out he was having trouble with dairy as an adult better never realized until about 6 months ago. With delayed onset allergies it is often hard to tell if it (allergen) is effecting us because we might not associate it with our dairy consumption because it might happen a day or two latter. See this WHFoods article about food allergens/sensitivies.  It is very long/exhaustive but it is very helpful if you have time to study it in more detail. http://www.whfoods.com/genpage.php?pfriendly=1&tname=faq&dbid=30 I will quote some key points for your information. Symptoms of Food Allergies "The most common symptoms for food allergies include vomiting, diarrhea, blood in stools, eczema, hives, skin rashes, wheezing and a runny nose. Symptoms can vary depending upon a number of variables including age, the type of allergen (antigen), and the amount of food consumed. It may be difficult to associate the symptoms of an allergic reaction to a particular food because the response time can be highly variable. For example, an allergic response to eating fish will usually occur within minutes after consumption in the form of a rash, hives or asthma or a combination of these symptoms. However, the symptoms of an allergic reaction to cow's milk may be delayed for 24 to 48 hours after consuming the milk; these symptoms may also be low-grade and last for several days. If this does not make diagnosis difficult enough, reactions to foods made from cow's milk may also vary depending on how it was produced and the portion of the milk to which you are allergic. Delayed allergic reactions to foods are difficult to identify without eliminating the food from your diet for at least several weeks and slowly reintroducing it while taking note of any physical, emotional or mental changes as it is being reintroduced." Here is their information on Tyramine's. Tyramine "Reactions to tyramine (an amino acid-like molecule) or phenylalanine (another amino acid-like molecule) can result from eating the following foods: Fermented cheeses Fermented Sausage Chocolate Sour Cream Red wine Avocado Beer Raspberries Yeast Picked Herring Symptoms of tyramine intolerance can include urticaria (hives), angioedema (localized swelling due to fluid retention), migraines, wheezing, and even asthma. In fact, some researchers suggest that as many as 20 percent of migraines are caused by food intolerance or allergy, and tyramine intolerance is one of the most common of these toxic food responses." Here is an old thread on tyramine and especially how it can trigger headaches. https://www.celiac.com/forums/topic/95457-headache-culprit-is-tyramine/ I would also suggest your research a low histamine food diet.  Rashes/hives etc. can be triggered my disregulaton of histamine in the body. The other thing in chocolate that might be causing your problems is Sulfites. Here is a website dedicated to a Sulftie allergy. http://www.allergy-details.com/sulfites/foods-contain-sulfites/ Chocolate bars are on their list of sulfite contaning foods but probably most noted in dried fruits and red wine. Knitty Kitty on this board knows alot about a sulfite allergy. I want to go back to the possible dairy allergy for a second as a possible trigger. . .because it has been established as connected to DH . . .it is just not well known. Here is current research (as I said earlier) most dairy allergies are studied in children but it does occur in approx. 10 pct of the GP unless your of Asian descent where it is much more common. https://www.ncbi.nlm.nih.gov/pubmed/29555204 quoting the new research from this year on children. "When CMP (Cow's Milk Protein) was re-introduced, anti-tTG increased, and returned to normal after the CMP was withdrawn again." and if adults can also (though rarely) it seem develop "Adult onset of cow's milk protein allergy with small‐intestinal mucosal IgE mast cells" (see research linked above) as the research shows  you should at least trial removing dairy from your diet if you haven't already and see if your DH doesn't come back when you re-introduce it. It just takes 15 or 20 years for medical doctor' to incorporate new research/thinking into clinical practice.  And note the research on this happening in adults is 20+ years old and as far I know doctor's . . . are not aware of this.  I know I wasn't until recently and I research things alot of to help myself and my friends. But I know you can't do what you don't know about.  So this is why I am trying to share what I learned so that other might be helped and this research might not  lay hidden another 20 years before doctor's and their Celiac/DH patients become aware of it. And if it helps you come back on the board and let us know so it can help others too! If it helps you it will/can help someone else! if they know it helped you then they will/can have hope it might help them too and why I share and research these things for others'. . . who don't know or don't have time to research this for themselves. I hope this is helpful but it is not medical advice. Good luck on your continued journey. I know this is a lot of information to digest at one time but I hope at least some of if it helpful and you at least have a better idea of what in your chocolate could be causing your DH (idiopathic) as the doctor's say (of an unknown cause mild) DH symptom's. Or at least it is not commonly known yet that Milk can also cause trigger (DH) in children and adults who have a Milk allergy undiagnosed. . .because we don't don't typically think  or associate it with adults like maybe we should if we are not of Asian descent. Maureen if this doesn't help you you might want to start a thread in the DH section of the forum. As always  2 Timothy 2: 7   “Consider what I say; and the Lord give thee understanding in all things” this included. Posterboy by the grace of God,
    • I hooe you can get some answers with your new GI doc.
    • Many of us deal with doctor issues and diagnosis, you got a really bad draw indeed. Most doctors dismiss Celiac as their is no money in the cure for them IE a gluten free diet and not medications.

      Keep up updated on your new doctor and testing, good to see you finally found one that listens and can help, I got through on doc #5 I think it was.
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