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  • Jefferson Adams
    Jefferson Adams
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    Subway Stores in Oregon First to Offer Gluten-Free Options Statewide

    Celiac.com 03/09/2012 - Subway stores in Oregon are in the process of rolling out gluten-free sandwich buns and gluten-free brownies as regular menu items statewide, according to Subway spokesperson Cathie Ericson.

    Photo: CC--zyphbearFor millions of Americans who avoid gluten, due to celiac disease or gluten sensitivity, eating out can be a constant challenge. Having easy access to a safe, tasty, low-cost gluten-free sandwich is like the Holy Grail for some of those folks. For many, being able to grab a gluten-free Subway sandwich would be a major step toward vanquishing the challenges of eating gluten-free.

    Subway understands that being gluten-free "…really cuts down on fast-casual dining options, particularly sandwiches,” said Michele Shelley, Subway board member and owner.

    Many people were excited to read about Subway's early testing of gluten-free products in selected areas. Many were equally excited to hear about Subway's commitment to getting their gluten-free sandwich offerings right, from start to finish.

    For example, Subway’s wheat-free sandwich rolls and brownies are produced in a dedicated gluten-free facility and are individually packaged. Subway staffers are trained to prevent cross-contamination during the sandwich-making process.

    Moreover, a single employee will prepare a gluten-free sandwich order from start to finish. Other features to Subway's gluten-free process include single-use knives and eliminating contact between traditional sandwich rolls and other ingredients including meat, cheese and vegetables.

    Oregon is one of a handful of states where Subway first tested gluten-free products in selected areas. The current statewide roll out in Oregon comes after a successful test in Bend and Portland, Subway restaurants, and seems to signal Subway's desire to offer gluten-free menus to diners.

    “Subway is known for being a leader in healthy fare, and we are excited to embrace these gluten-free menu items for those who can benefit from them,” Shelley told reporters.

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    I understand that they are taking, what seem to be, great precautions to avoid cross-contamination. However, as a former Subway worker myself (prior to Celiac diagnosis)...I know that there are plastic tops that go over the stainless steel of the counters, where the bread is slid across for sandwich-making. This is obviously a porous material, which would not be completely rid of its gluten by just wiping it down. Though the bread is placed on deli paper and slid across, it's going to come into contact with the plastic counter top. Also, there are bread crumbs EVERYWHERE. I can't even imagine how valid a quick wipe-down of them would be before a gluten free sandwich is made. Props to Subway for their effort, but this entire idea sounds dangerous!

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    Great effort. But, I too, am very skeptical that it could ever be safe. There is no way they could share ingredients and not contaminate with the gloves touching the standard bread, and then someone else grabbing the same ingredients....just wouldn't work. May be possible if 2 separate kitchen/serving areas could exist. Could be a huge success if done right!

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    They should do this in Florida! I have to admit I would try one if they showed up here, but I agree with the fear. I know the workers are very apathetic and don't understand the importance of not even a little crumb. I just don't think a teenager at minimum wage is going to be as careful as someone at a fancy resturant would be who bend over backwards for you. However, I do eat salads at my subway, actually I want one today, and it is a risk, I ask them sometimes to change their gloves but I hate asking cause they give me that look as if it a big deal to change their gloves! I think its a good idea, I just think some workers really don't care or understand.

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    I am 68 years old and was diagnosed with celiac two years ago after eating a subway sandwich. I still have some problems [weight loss/220 lbs to 140 lbs now] but if Subway offers gluten free sandwiches in Florida, I'll try them...

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    It would be awesome to be able to go to Subway and enjoy a gluten-free sub but like the rest of you, I have my doubts. There is no way that wheat crumbs do not end up in the containers of lettuce, tomatos, onion etc. etc.

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    This article too is years old, and we never had gluten free anything at Subway. These out of date links should be removed or updated.

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    This article too is years old, and we never had gluten free anything at Subway. These out of date links should be removed or updated.

    You can still get gluten-free rolls at Subway in Oregon.

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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 "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Lionel Mugema
    Celiac.com 06/17/2009 - He stands aloof and watches absent-mindedly as the other children queue up for the food. He remembers his mother’s stern warning and the hunger pangs worsen. He knows the even a morsel of the delicious mouth-watering cake will surely make him ill. Meet Mike, he was born with celiac disease.
    Mike’s parents are well-off and highly educated. According to his mother, Mrs. Kintu, shortly after his birth Mike started showing signs and his parents immediately took him to a European hospital for a check-up.  The doctors did an endoscopic exam and Mike was diagnosed with celiac disease. Mike had to stick to a gluten free diet for the rest of his life. Mike’s life was spared.
    Had Mike been born in a poor family, Mike would have eventually lost his life to celiac disease, just like the increasingly shocking numbers of African infants between the very minor age of 6 months and 4 years that die every year—particularly in the East-African region. The acute lack of awareness and subtle ignorance about the disease leads the devastated parents to think that sorcery or envious neighbors robbed them of their little ones.
    Mike is alive today and maintains a particularly sparse diet and survives on such food as vegetables, rice, beans, potatoes, small quantities of red meat, and fresh fruits. Granted, this may seem like a rather healthy and outright fulfilling diet for an adult, however, as fate would have it, Mike is also lactose-intolerant. Essentially, this means that, in lay-man’s language, Mike is allergic to milk in its natural form and all its by-products.
    Celiac disease is a permanent inflammatory disease of the small intestine triggered by the ingestion of gluten-containing cereals in genetically predisposed individuals. It is a lifelong autoimmune intestinal disorder. Damage to the mucosal surface of the small intestine is caused by an immunologically toxic reaction to the ingestion of gluten and interferes with the absorption of nutrients. Celiac disease is unique in that a specific food component, gluten, has been identified as the trigger. Gluten is the common name for the offending proteins in specific cereal grains that are harmful to persons with celiac disease. These proteins are found in all forms of wheat (including durum, semolina, spelt, kamut, einkorn, and faro), and related grains such as rye and barley must also be eliminated.
    Celiac disease was first described in the second century AD by Aretaeus of Cappadocia, a contemporary of the Roman physician Galen, who used the Greek word “koeliakos”, which means “suffering of the bowels”. However, only in 1888 AD did Samuel Gee of St. Bartholomew’s Hospital give the classical clinical description of celiac disease.
    The cause of celiac disease, also known as celiac sprue, or gluten sensitive enteropathy (GSE), is unknown. Celiac disease occurs in 5-15% of the offspring and siblings of a person with celiac disease. In 70% of identical twin pairs, both twins have the disease. It is strongly suggested that family members be tested, even if asymptomatic. Family members who have an autoimmune disease are at a 25% increased risk of having celiac disease.
    Celiac disease displays itself with the following symptoms:

    Recurring bloating, gas, or abdominal pain Chronic diarrhea or constipation or both Bone or joint pain Behavior changes/depression/irritability Vitamin K Deficiency Fatigue, weakness or lack of energy Delayed growth or onset of puberty Failure to thrive (in infants) Missed menstrual periods Infertility in male & female Spontaneous miscarriages Canker sores inside the mouth Tooth discoloration or loss of enamel
    And many others (to see a complete list go to the Celiac Disease Symptoms page).In any case, there is little or no research on this disease in East Africa. The principal ideals behind this article are the commencement of an awareness program, with particular emphasis on celiac disease and any other diseases that are not generally known about in the region. It is important that these are brought to the light and addressed duly by the concerned parties. There is also an urgent need to formally address the problem especially to those that can not possibly afford treatment and are generally ignorant. I am in the process of establishing an awareness campaign concurrently with a patients’ association for celiac disease in East Africa. The association is still in its infant stages and I am appealing for support and any form of assistance.  The name of my association is: Creating Celiac Disease Awareness in Africa.
    Author's Note: The names of the characters in this article have been changed for privacy reasons.



    Tina Turbin
    Prices of Gluten-Free versus Regular Foods - What to Do?
    Celiac.com 10/17/2012 - This article originally appeared in the Winter 2012 edition of Celiac.com's Journal of Gluten-Sensitivity.
    It’s estimated that of the 3 million Americans with celiac disease, an autoimmune disease triggered by exposure to gluten-a protein component of wheat, barley, and rye-only 3% have been diagnosed. The good news for celiac patients who have been diagnosed is that the treatment for their condition is simple and doesn’t require the ingestion of drugs--a gluten-free diet. Unfortunately, celiac patients must deal with several challenges in maintaining a diet free of gluten, specifically the expenses involved. Compared with “regular” gluten-containing foods, gluten-free alternatives are more expensive. In fact, a study has indicated that gluten-free foods cost more than double their gluten-containing counterparts.
    In a study by the Dalhousie Medical School at Dalhousie University in Halifax, Nova Scotia, prices were compared between food products labeled as “gluten-free” with comparable gluten-containing food products at two large-sized chain grocery stores. Unit prices of the food items in dollars per 100 grams were calculated for this purpose. According to the study, all the 56 gluten-free products were more expensive than their corresponding products. The average unit price for gluten-free products was found to be $1.71, compared with $0.61 for the gluten-containing products. This means that gluten-free products were 242% more expensive than gluten-containing items.
    Fortunately, celiac patients can receive tax deductions for certain expenses related with their gluten-free diet. To receive these benefits, celiacs must provide a doctor’s note confirming their celiac diagnosis and save their receipts for all their gluten-free foods and other products they purchase. The difference between the prices of gluten-free items compared to those of regular items is tax-deductible. Products that don’t have a gluten-containing counterpart, such as xanthan gum and sorghum flour, are totally tax-deductible. Shipping costs for online orders of gluten-free items are also tax-deductible. In order to file your claim, you should fill out a 1049 schedule A for medical deductions. For more information, contact a qualified accountant.
    There are other ways to avoid spending loads of money on gluten-free foods. For instance, stay away from gluten-free processed and “junk” foods such as snack foods and desserts made with refined carbohydrates and sugar and lacking nutrients. Not only will you save money, but you’ll safeguard your health. I recommend making meals comprised of nutritious, naturally gluten-free whole foods at home such as fruits, vegetables, dairy products, poultry, fish, meats, nuts and seeds, and eggs. These foods are packed with vital nutrients and don’t carry any additional costs. Make sure that no gluten has been added to such foods and they are safe from cross-contamination.
    Another way to save money is to make your own gluten-free mixes yourself, such as the ones I recommend on my gluten-free website. Instead of buying expensive commercial gluten-free baking mixes, you can create your own gluten-free flour mixes for a variety of foods such as pancakes, pizza, rolls, and muffins and store them conveniently in your refrigerator or freezer. I also recommend purchasing gluten-free ingredients in bulk online, as many websites offer great deals. These are just a few of the ways to save money on the gluten-free diet.
    It is unfortunate that gluten-free foods are more expensive than “regular” food items, especially to such an extraordinary degree, however savvy gluten-free dieters can through tax deductions and smart shopping choices cut down on their expenses. Perhaps in the future we will see a decrease in gluten-free food pricing, but one thing is for sure-we should consider ourselves lucky that we have found an answer to our health problems. Even if the gluten-free diet is expensive, at least it’s the road to greater health and quality of life.

    Jefferson Adams
    Can You Guess the Most Common Misdiagnoses for Celiac Disease?
    Celiac.com 05/22/2015 - The fact that celiac disease is commonly misdiagnosed will come as little surprise to anyone who's ever gone through what can often be a long, circuitous process of getting diagnosed. Celiac symptoms can be vague, and can mirror symptoms of numerous other conditions.
    Even though celiac awareness is improving, and blood screens are becoming more common, misdiagnosis remains common for people who are eventually diagnosed with celiac disease.
    Can you guess the most common misdiagnoses that doctors make for patients with celiac disease?
    The most common misdiagnoses include:
    Irritable bowel syndrome: People with celiac disease are often told that they have irritable dowel syndrome when they actually have celiac disease. In fact, IBS is the most common misdiagnosis for people with celiac disease. Inflammatory bowel disease: Coming in a close second to IBS, inflammatory bowel disease is another common misdiagnosis for people who actually have celiac disease. Gastro-esophageal reflux disease: People with GERD don't have any higher rates of celiac disease than the rest of the population. However, to be fair, a pretty high percentage of newly diagnosed celiac patients have reflux and/or esophageal dysmotility; which might explain the high prevalence of reflux symptoms in celiac disease patients, and the common misdiagnosis of GERD. Ulcers: Ulcers are often wrongly suspected, well before celiac disease is finally diagnosed. Viral gastroenteritis: Another very common thing doctors suspect long before they suspect celiac disease, is viral gastroenteritis. Chronic fatigue syndrome: Fatigue is a common complaint of many people with celiac disease, so maybe it's understandable why many people with celiac disease find themselves with a misdiagnosis of chronic fatigue, rather than an accurate diagnosis of celiac disease. Allergies: Many people find themselves wrongly diagnosed with environmental allergies long before they are diagnosed with celiac disease. Parasitic infection: Celiac disease symptoms can mirror symptoms of certain gut parasites, which is one reason that many people with celiac disease find themselves being checked for parasites long before they get checked for celiac disease. Gallbladder disease: Celiac disease symptoms can mirror symptoms of gallbladder disease, which is why many people who actually have celiac disease find themselves diagnosed with gallbladder problems. Colitis: Another common culprit for misdiagnosis is colitis, which shares many symptoms with celiac disease. Cystic fibrosis: Many people don't realize that in a number of cases, the symptoms of celiac disease can lead doctors to suspect cystic fibrosis, rather than celiac disease, thus prolonging diagnosis, treatment and recovery. Psychological dysfunction: In many cases, celiac disease symptoms can be so hard to pin down that doctors find themselves wondering if the symptoms aren't really in the patient's head. In their quest for diagnosis, many people with celiac disease have been referred to a psychologist, rather than evaluated for celiac disease. Lactose intolerance: Lactose intolerance is a common misdiagnosis in celiac patients, because the mucosal damage from gluten leaves them unable to digest lactose-containing products. In addition to being frustrating and painful, misdiagnosis of celiac disease is a big deal because, left unaddressed, the damage done by the disease continues unabated, and can snowball into further health and wellness problems.
    Have you, or anyone you know, suffered through misdiagnosis before being diagnosed with celiac disease? Share your story in our comments section.
    Source:
    US Pharmacist. 2014;39(12):44-48. 

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    Hi Wade, You areright, there are lots of little gotchas out there in the gluten-filled world.  That's why it is easier/safer to stick with whole foods at the beginning of the gluten-free diet.  The list of ingredients on an apple or an orange or a steak is usually real short.  So you can get out of the grocery store quicker by eating whole foods like those.  Plain frozen veggies or canned are usually safe too.  And fresh produce as long as you give it a quick rinse.
    Why....why would your doctor not follow the standard of care for testing celiac disease?  I think you need to think about  finding another doctor.  If you are in the US, you can “walk” into a lab and order the test and pay cash: https://labtestsonline.org/tests/celiac-disease-antibody-tests No, your result does not significantly lower your odds of getting a celiac disease diagnosis.  She ordered the LEAST commonly used test, especially since she only ordered that one alone.  I think she thinks you do not have celiac disease, but that you may have a gluten sensitivity.  But that is wrong!  There is no test for gluten sensitivity.  http://www.cureceliacdisease.org/screening/ https://www.mayocliniclabs.com/it-mmfiles/Celiac_Disease_Diagnostic_Testing_Algorithm.pdf https://celiac.org/about-celiac-disease/screening-and-diagnosis/screening/ https://www.verywellhealth.com/celiac-disease-blood-tests-562694 https://www.niddk.nih.gov/health-information/diagnostic-tests/celiac-disease-health-care-professionals I am not a doctor though.  Perhaps, you can ask her why she did not order the complete panel or at least the screening tests most often ordered for celiac disease. Know that some celiacs are asymptomatic (no symptoms) Some just have one symptom.  Some have classic symptoms.  I presented with only anemia and no GI symptoms with only a positive on the DGP IgA.    I hope this helps.  
    Got the result today, and it is indeed the IgG only, and it is "negative" with a result of: <10.0 Units I have sent a message to my doctor requesting that she at least also order the TTG IGA test. However, I'm assuming that this result does at least significantly lower the likelihood that I have celiac? This is all just a shot in the dark anyhow... but after 8 years of unsatisfactorily diagnosed mystery joint pain, I don't want to only half-explore an option and then abandon it without a reasonably definitive result.
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