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    The Coach's Top 23 Tips for Eating Gluten Free on a Budget


    Kim Hopkins

    1. Plan your meals:  It sounds simple, but it’s one that is often ignored.  Sit down before you do your weekly grocery run.  Know what you are going to make for each meal including snacks.  Find out what’s on sale before you make your weekly meal plan.  Stick to the list when you shop!
    2. Develop a file of dependable, go to gluten-free recipes.  My people report that, when they are short on time, that’s when they are likely to make extravagant purchases.  Take the thinking and guess work out of meal planning by looking through your file.  You can even write down the estimated cost of the meal.
    3. Eat foods that are naturally gluten free found at the regular grocery store.  Corn tortillas are cheap and have many uses, including for sandwich wraps.  Beans are a nutrient-rich starch substitute, as are lentils.
    4. Eat whole foods.  Whether you are gluten-free or not, it is healthier not to eat packaged, processed foods.  Just because a product is marked gluten free doesn’t mean it’s good for you.  Processed gluten-free products often lack nutrients.  Limit these to a couple times per week or less.
    5. Eat foods that are in season.  This means they had to travel less far to reach your grocery store, therefore they will be cheaper.
    6. Grow your own.  Learn how to can and/or jar the extras.  Live in a cool climate?  Some veggies can be started inside.
    7. Make a soup.  Soups are filling, and they are a great way to use up items in the fridge.
    8. Eat more vegetarian and vegan meals.  Eliminating meat from two dinners per week will save you quite a bit of money.
    9. Eat breakfast for dinner.  Make a frittata – cook 3 strips of bacon in a skillet.  Set aside and drain off most of the fat.  Add diced onions.  Cook for 5 minutes.  Add diced red pepper.  Cook another 5 minutes.  Add a package of thawed, drained frozen spinach.  Salt and pepper to taste.  Add bacon back in.  Beat 5 eggs and pour them all over the filling.  Top with cheese and bake at 350 for 8 – 12 minutes, or until the eggs are set.  Serves 2 – 3.
    10. Get creative.  For thickening sauces or gravy, substitute equal amounts of cornstarch for flour.  Mashed potato flakes also make a great, inexpensive thickener and binder in place of breadcrumbs. Xanthan gum is used in many gluten-free recipes to serve as the “glue” to hold the product together; use 2 tsp. unflavored gelatin to replace 1tsp. xanthum gum in some recipes such as cookies. Cornmeal or crushed potato chips can be substituted when a recipe calls for a coating or crunchy topping.
    11. Buy in bulk.  Once you found something you like, save big by buying in a large quantity.  The Gluten-Free Mall  has bulk discounts and many other ways to save you money. See their "Shop Smart & Save Money!" section on the top-right corner of their site.
    12. Create or join a bulk buying group.  Ask around at your local support group, or link up with local folks online.  If you like the same products buy a bulk order and split it.
    13. Cook ahead and freeze meals in individual or family-size servings.  If you are not someone that cooks and you are watching your budget, it makes sense to learn.
    14. Invest in a good vacuum food sealer.  This will help keep leftovers fresh for longer = less waste.
    15. Bake 1-2 times per month.  Things like Pizza crusts, bread, and pie crusts will freeze well if wrapped properly.
    16. Make gluten-free cookie dough from scratch and freeze in a roll.  Cut and bake what you need.  This will curb your desire to buy an expensive mix.
    17. Start a gluten-free dinner swap (like a holiday cookie swap).  Get a few families to cook up a large quantity of gluten-free meals and swap them for variety!
    18. Join a food co-op.  Co-ops are groups who use their purchasing power to get lower prices.
    19. Make your own blend of gluten-free flours ahead of time and store in an air tight container.
    20. To prevent contamination, purchase extra appliances (like a toaster) from Craig’s List or Goodwill.
    21. Track your purchases.  Seeing it in black and white can be very revealing.
    22. Consult with your employer’s human resources department.  Do they offer a flexible spending account (FSA) benefit?  These accounts hold your money pre-tax for medical purchases.  If so, will the FSA recognize gluten free food (and related shipping charges)?  Get it in writing!  If your employer doesn’t offer this benefit, ask them to look into it.  This will save you about 30%.
    23. If you are not using an FSA and you spend a lot of money on medical expenses, consult with your accountant.  Are a portion of your gluten-free food purchases tax deductible?  Shipping charges often can be reimbursed from this account, as can mileage to and from specialty stores.

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    Substituting guar gum for xanthan gum is another money-saver.

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    Guest barbara

    Posted

    Thanks for all the interesting information. I'm always looking for new news that has to do with Celiac.

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    Guest Maureen Anderson

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    Thank you for all the useful information I just found out I have this disease and I am very overwhelmed.

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    If I might also suggest:

    #10 Another excellent gum-base/thickener is sweet or glutenous rice flour (NOT wheat gluten, just very sticky rice). I use this in place of xanthan gum in my bread flour- 6 lbs white or brown rice flour + 3 lbs potato starch + 1 lb each of Tapioca flour and Glutenous Rice flour. Makes 11 lbs.

     

    #20 A used toaster is very likely to already be contaminated with wheat gluten, and even cleaning it out by yourself you run the risk of getting sick. Better to buy a new, inexpensive one.

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  • Related Articles

    Dr. Ron Hoggan, Ed.D.
    This article appeared in the Autumn 2007 edition of Celiac.com's Scott-Free Newsletter.
    Celiac.com 03/10/2008 - Virtually every parent and every professional person who works with children wants to see them learn, grow, and achieve to the greatest extent of their potential.  The vast majority of these caregivers know that nutrition plays an enormous role in each child’s realizing their potential.  Unfortunately, that is where agreement ends.  There are almost as many perspectives on what constitutes a healthy diet as there are people on this planet.  Some claim that the healthiest diet is that of a vegetarian which almost invariably leads to a heavy reliance on grains and which is devoid of vitamin B12.  Others assert, based on cardiovascular disease being our number one killer that the best diet includes the smallest amount of fats.  They believe that fat consumption is related to blood cholesterol levels and that blood cholesterol levels are the best predictor of heart attacks.  Yet low cholesterol has been linked to increased cancer risk.  Still others argue for the health benefits conferred by a high protein diet.  They point out the importance of proteins in providing the building blocks for immune system function and the body’s maintenance and repair at the cellular level.  A small but growing faction points to the health benefits of a diet dominated by fats with little or no carbohydrate content.  Other diets target refined sugars and flours as problematic.  Added to this diversity, there is a plethora of dietary perspectives that advocate rigid proportions of fat, protein, and carbohydrates.  The proportions of each component vary according to the data that is given the most credence by the creators and advocates of each diet.  Many dietary rituals have grown up around cancer avoidance or therapy, weight loss strategies, treatments for cardiovascular disease or its avoidance, and autoimmune diseases.  Book, video tape, audio tape, menu guides, and other media sales are just a starting point.  Some advocates of specific dietary strategies are even selling special foods that comply with their recommendations.  The profit motive can be a powerful factor in creating bias.  Then there are the government sponsored healthy eating guides.  Of course, each paradigm assumes that one diet can be recommended for all people.  The USDA has recently devised recommendations that do make concessions to gender and stage-of-life (with separate recommendations for children, adults, and seniors) but even with these changes, the USDA provides a clear message advocating plenty of grains and little fat.  It is difficult to determine just how much these recommendations have been influenced by special interest lobbies.  Agricultural and food production corporations have made astronomical investments in current dietary practices and shaping new dietary trends.  Is it reasonable to expect them to be responsive to evolving research findings?  
    Those of us who have experienced the painful shock that we were ill, sometimes deathly ill, from grain proteins that come highly recommended by government food guides, have had to revise our views of healthy eating and reject such flawed guidance.  Gluten sensitivity and celiac disease often crop up in the context of what many health care professionals tout as a healthy diet.  Prior to my own diagnosis of celiac disease, I remember one physician recommending that I eat bran every morning to reverse some of the gastrointestinal problems I was having.  He would not believe that eating bran made me vomit.  There is a persistent sense that we should all know what constitutes a good diet.  Almost every one of us who have to avoid gluten knows that avoiding it is a healthy choice for us, irrespective of government or private sector recommendations for healthy eating.  We have learned not to trust these prescriptions filled with certitude and rigidity.  We have found new-found health in eating habits that are diametrically opposed to those recommendations.
     
    Thus, many of us will have a very different view of conventional dietary wisdom.  For instance, Dr. Eve Roberts, a scientist at Toronto’s Hospital for Sick Children, was quoted on Monday, September 24th in the Victoria Times Colonist as saying: “I do not want children to grow up with liver disease because we forgot to tell them how to eat” (1).  I’m sure that same attitude abounds throughout the medical profession.  Unfortunately, despite the overwhelming consensus that children should not suffer such diet-induced illnesses, there is little agreement on exactly what we should be telling children (or adults for that matter) to help them avoid fatty liver disease.  The medical literature provides research reports of several contradictions on this point. 
    In fact, contradictions abound throughout the medical literature.  So how are we to choose a healthy diet? What can we teach our children about eating well? For those of us who are gluten sensitive or have celiac disease, gluten avoidance is a given.  For our children, the answer is less clear.  They will be at greater risk of having celiac disease or gluten sensitivity, but what should we teach them about these grains? Should they avoid gluten entirely? Should they eat normally until they become ill—perhaps risking permanent neurological damage or a deadly cancer? Should they be constantly vigilant with regular blood tests, endoscopies, or IgG allergy testing?
    Many of us have been told to “just eat a balanced diet”.  It sounds appealing, but it is so vague as to provide little meaningful direction.  What is a healthy diet and how do we judge if any special interest group is more interested in health than profits? Just how much can we trust information that has a price tag attached to it? Somebody is profiting.  Can they really provide objective guidance? These questions should form part of our search for information.  There is nothing wrong with making a profit or earning a living from providing dietary advice.  However, it is important to be aware of any possible conflicts of interest.  
    For these reasons, I have developed my own strategy for determining what advice and guidance I can provide to my children and grandchildren.  I acknowledge that this approach is limited by my own biases, my finite capacity for assimilating and synthesizing information, my incomplete familiarity with nutritional research, and my own personal experiences.  On the other hand, I don’t have to worry about being directly influenced by profiteering or lobby groups diverting me from my primary purpose.
    On that basis, I have proceeded to explore my own dietary program.  I have conducted some trial-and-error experiments on myself, and I have read as extensively as my part-time avocation of dietary investigation permits.  From this, I have learned to trust my own gut.  If something doesn’t feel right in my stomach, I avoid it.  I have also learned to trust my sense of smell.  If a food does not smell appetizing to me, I don’t eat it.  I suspect that this is a tool that evolution has provided us with to determine what is and is not safe to eat.  Those without it probably stopped contributing to the human gene pool.  I have learned that IgG allergy testing is an effective tool with which I can reduce the lengthy trial-and-error process necessary for identifying the majority of allergies.  I realize that this testing has its weaknesses, but so does almost every other form of medical testing.  I have come to accept that as long as human beings are involved, we will have imperfect testing, regardless of claims to the contrary.  Finally, although I try to read critically, I read medical and scientific research reports to stay abreast of new findings and gain a better understanding of this complex field.
    The tentative conclusions I have reached, pending new information, are as follows:

    Gluten grains probably aren’t very good for people.  They are highly allergenic affecting at least 10% of the general population, and perhaps as much as 40%  of the population.  These grains also contain opioids morphine-like substances that can be highly addictive and have a deleterious effect on our ability to resist cancer.  They also contain large quantities of starch that is converted very rapidly into sugars. The evidence suggests that refined sugars and starchy foods cause many of our problems with obesity, vision problems due to growth related distortions of the eyeball, type II diabetes, and hypoglycemia.  Dairy products probably aren’t very good for anyone either.  They are also highly allergenic and contain opioids similar to those found in gluten.  Further, about two thirds of the world’s adult populations are lactose intolerant.  They don’t retain enzymes for digesting milk sugars after childhood. I think it is wise to avoid processed foods where possible.  The more they’ve been processed, the further they are from the state in which we evolved eating them. I believe it is a good idea to avoid eating soy because it has been linked to neurological diseases and other health problems that I don’t want to develop. I avoid foods to which IgG blood testing has shown to cause an immune reaction in me. I try to avoid juices, as these are mostly sugar.  Those are the things I try to avoid.  On a more positive note, there are several specific strategies that I try to follow:
    I take supplements of vitamins and minerals which evidence has shown that I either absorb poorly or have been depleted from the soils in which my food is grown. I try to eat whole fruits and vegetables. I try to eat when I am hungry—not according somebody else’s idea of appropriate mealtimes. If I am ever diagnosed with cancer, I will follow a ketogenic diet.  That is a diet that is dominated by fats, includes about 30% protein, and includes no carbohydrates.  I have tried this diet for about a month.  I can’t say that I enjoy it very much, but I’d be happy to forego the pleasure of carbohydrates if my life is at stake.
    I’m very grateful to my wife who works very hard at finding tasty treats so I don’t have to feel isolated or deprived in social situations where food is consumed.
    I’m convinced that even a little exercise is a critical feature of a well balanced diet, but that belongs in another column.
    I realize that these strategies are often impractical and I don’t pretend to live up to all of them, except for gluten and dairy avoidance.  I also suspect that I would be better off if I ate organic fruits and vegetables along with range fed meat.  I also suspect that I should avoid any genetically modified food.  We really don’t know what’s in that stuff! I haven’t reached the point yet where I am sufficiently motivated to change my diet to that extent, although I do realize that it would probably be a good idea.  I am convinced that Dr. Barry Sears is onto something when he advocates specific proportions of each food type for optimal health and performance.  Unfortunately, my diet is already complex enough that without some specific and highly motivating reason, I’m just too busy or lazy to be bothered with measuring such things.  I just let my taste buds and availability (my wife only cooks one cake at a time) determine my portion sizes.This is the balanced diet I recommend.  I sorely doubt that my children or my grandchildren follow my advice, except when they visit during mealtimes.  However I am confident that such a diet, should they choose to accept it, will not cause them to self-destruct due to dietary disease.


    Jefferson Adams
    Celiac.com 11/21/2013 - Gluten-free food manufacturer Against the Grain, of Brattelboro Vermont, has filed a trademark infringement lawsuit against a California company doing business as Against All Grain.
    Against The Grain Gourmet Foods has filed documents in the U.S. District Court for the District of Vermont asking the court to order Against All Grain to give up all claims to the name.
    The lawsuit, which was filed on Oct. 11, alleges the use of Against All Grain by the defendants "is likely to cause confusion, to cause mistake, or to deceive and therefore constitutes infringement of Plaintiff's federally registered trademark ..."
    In the court documents, attorneys for Against The Grain assert that the defendants are using a website and Facebook page and have published a cookbook of gluten-free recipes using their "Against All Grain" marks.
    The documents filed by Against The Grain further assert that Against All Grain's alleged infringements have devalued Against The Grain's brand and will confuse consumers, some of whom might assume there is a relationship between the two companies.
    Sound complicated? It is, a bit, and not just for the similarity of names. Want to read a detailed account?
    Check out this excellent article by Bob Audette for the Brattleboro Reformer, which does a great job of laying out the legal zigs and zags of this particular gluten-free name battle.

    Jefferson Adams
    Celiac.com 10/24/2014 - Here are ten recipes for make-at-home Halloween treats that are guaranteed to put smiles on the faces of your young ones, and help you to breath a sigh of gluten-free relief.
    The recipes are gluten-free, or easily modified to be gluten-free. Remember to double-check ingredients, such as caramel (I use Kraft caramels without any issues).
    Also, many of these recipes list ingredients that acre fat-free, sugar-free, low-fat, and/or low sugar. I always ignore such instructions and include full-fat, full-sugar alternatives, but prepare according to your own tastes.
    Top Ten Gluten-free Halloween Treats:
    Caramel Apples - http://www.realsimple.com/food-recipes/browse-all-recipes/caramel-apples Caramel Corn - http://www.foodnetwork.com/recipes/paula-deen/grandma-pauls-caramel-corn-recipe.html Roasted Pumpkin Seeds - http://www.tasteofhome.com/recipes/roasted-pumpkin-seeds Garlic Pumpkin Seeds - http://www.tasteofhome.com/recipes/garlic-pumpkin-seeds Strawberry Chocolate Ghosts - http://www.tasteofhome.com/recipes/strawberry-ghosts Butterscotch Pumpkin Mousse - http://www.tasteofhome.com/recipes/butterscotch-pumpkin-mousse Scary Halloween Apple Teeth Treats - http://allrecipes.com/Recipe/Halloween-Fruit-Apple-Teeth-Treats/Detail.aspx?evt19=1 Spooky Halloween Brain Dip - http://allrecipes.com/Recipe/Halloween-Brain-Dip/Detail.aspx?evt19=1 Two-Layer Halloween Fudge - http://www.crazyforcrust.com/2013/10/halloween-fudge/ Ghoulish Deviled Eyeballs - http://allrecipes.com/Recipe/Halloween-Eye-of-Newt/Detail.aspx?evt19=1  

    Jefferson Adams
    Celiac.com 05/13/2015 - In addition to being a common ingredient in many commercial food products, gluten is also used in numerous medications, supplements, and vitamins, often as an inert ingredient known as an excipient.
    Because chronic gluten-related inflammation and damage impairs absorption of nutrients, and likely causes malabsorption of oral medications, it is extremely important for people with celiac disease to review the nutrition labels of all foods and beverages, as well as the package inserts (PI) for information about gluten content.
    Most oral medications depend on absorption through the small intestine via passive diffusion. GI-tract damage may shift this diffusion process into systemic circulation, which can result in increased or decreased absorption, depending on the drug molecules.
    Since drug molecules have varying and unique chemical properties, it is hard to determine the exact means of drug absorption in celiac patients, and also hard to determine the impact of celiac disease on drug absorption.
    Based on their molecular properties, researchers suspect the absorption of a number of drugs is impaired by gluten sensitivity.
    These drugs include: acetaminophen, aspirin, indomethacin, levothyroxine, prednisolone, propranolol, and certain antibiotics.
    For these reasons, it is important for doctors to monitor serum drug levels for medications with narrow therapeutic indexes in people with celiac disease. If you have celiac disease, please let your doctor know before you take these drugs.
    Source:
    US Pharmacist. 2014;39(12):44-48.

  • Recent Articles

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    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.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. 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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    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    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