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    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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    Scott Adams
    Am J Health-Syst Pharm 58(05):396-401, 2001
    Celiac.com 04/12/2001 - Patients with celiac disease must eliminate all gluten from their diets, including any that might be present in the pharmaceutical or nutritional products that they consume. Researchers Sister Jeanne Patricia Crowe and Nancy Patin Falini designed a study to identify pharmaceutical companies whose policy is to manufacture only gluten-free products, and to determine the accuracy of product information held by companies whose products might contain gluten. The accuracy of this information is crucial for the effective treatment of patients with celiac disease.
    The researchers mailed 172 surveys to pharmaceutical companies listed in the 1998 Physicians Desk Reference and the 1998 generics supplement to Pharmacy Times, and made follow up telephone calls to companies that did not respond. The survey was strictly designed to determine the companies’ policies with regard to the use of gluten in their products, and if they use gluten, to determine their knowledge with regard to its content in their products.
    Almost all of the 100 companies that responded to the surveys (52 surveys, 26 letters and 22 oral responses were received) warned that they could not guarantee the possibility that minute amounts of gluten contaminants existed in the raw materials for their inactive ingredients. Many also warned that their products were gluten-free at the time of the survey, but their suppliers of raw materials for their inactive ingredients could change at any time without notice, and this could affect the gluten-free status of their products.
    Out of all those who responded, only five had a policy of producing gluten-free products, and could guarantee the gluten-free status of their products. Another group of respondents did not refer to their products as gluten free but stated that they added no ingredients derived from wheat, oats, rye, barley, or spelt. Many companies responded with legal disclaimers stating that although they believed that their products did not contain gluten, they neither certified their gluten-free status nor tested them for gluten. Some said that they could not make this guarantee because of the uncertainty with their suppliers of raw materials. Some said that their responses concerning ingredients were only as current as the date of correspondence.
    Currently few medications are labeled “gluten-free,” and labeling medications as such would be a great help to those on gluten-free diets. With most products a patient, pharmacist or doctor must periodically contact the manufacturer to determine the continuing gluten-free status of the product. This process is time consuming and costly for all involved. A reliable means of determining the gluten-free status of medications and nutritional products is badly needed, and is essential to the health of people on gluten-free diets.

    Jefferson Adams
    Celiac.com 11/25/2016 - First of all, if you are using methamphetamine, gluten is probably the least of your worries. Seriously.
    But what about rumors and articles circulating that suggest that meth contains gluten, and that said gluten might make an already dangerous drug much word for people with celiac disease or gluten intolerance? Is there really gluten in meth? The short answer is no, gluten in meth is not a thing. Meth does not contain gluten.
    To the best of our knowledge this latest bit of misinformation comes from an article published in the ThatOregonLife.com, and constitutes an attempt at humor.
    According to the article, "Health experts have today warned that meth found on the streets of Portland has tested positive for gluten, a protein composite normally found in several types of grains, including wheat, spelt, rye, and barley." The article goes on to say that a group called Action on Gluten is working to eliminate gluten from meth within a year.
    According to the article, the group's spokesperson, Simon Krueger explained that "Gluten is not only dangerous, but also highly addictive. When added to meth, an otherwise fairly safe drug, the consequences can be deadly." 
    What some readers may fail to notice, however, is that the article appears in the magazine's "Satire" section, and is undoubtedly tongue in cheek. The article appears alongside other obviously satirical articles, such as one claiming that President-elect Donald Trump has recently announced his plans to build a marijuana-themed hotel in notorious hippy enclave of Eugene, Oregon.
    So, anyone who actually believes meth contains gluten can credit their misconception ThatOregonLife.com.
    Once again, as a public service announcement. People should absolutely not use meth, but meth certainly does not contain gluten.

    Leszek Jaszczak
    Celiac.com 04/15/2017 - Raw materials used by breweries include barley. A characteristic feature of this grain is the presence of gluten proteins which also includes hordein. This group of proteins are the trigger of celiac disease symptoms [Darewicz, Dziuba, Jaszczak: "Celiakia – aspekty molekularne, technologiczne, dietetyczne." PrzemysÅ‚ Spożywczy, styczeÅ„, 2011] . This issue raises the need to seek new methods of brewing that allow for the elimination of gluten proteins from the beer [swora E., Stankowiak-Kulpa H., Mazur M. 2009. Dieta bezglutenowa w chorobie trzewnej. Nowiny Lekarskie 78, 5-6, 324-329]. The biggest problem for coeliac patients is to identify permitted foods. Food manufacturers know about the above problem and are offering new products for people with celiac disease. [CichaÅ„ska B.A., 2009. Problemy z rozróżnianiem żywnoÅ›ci bezglutenowej. Pediatria WspóÅ‚czesna. Gastroenterologia, Hepatologia i Å»ywienie Dziecka 2009, 11, 3, 117-122.] The market offers access to a gluten-free beer. Beer of this type can be prepared in one of two ways, either by using materials that do not contain gluten or by removing gluten during the production of beer. Such products are, however, expensive. Traditional market beers are not tested for gluten content, which may differ from one brand to the next.
    Barley, hops, yeast and water are the basic raw materials for conventional beer production. Gluten in beer is only in the barley or wheat, from which malt is produced. During malting, barley is subjected to the processes of soaking, germination and drying. At that time, amylolytic and proteolytic enzyme activity increases and grain composition is undergoing changes. Knowledge about the migration through various stages of beer production and the final level of these proteins or their "toxic" fractions is crucial to ensuring customers about the safety of the beverage they will consume. Therefore, it is important to conduct research to better understand the role and the amount of unwanted hordein and/or wheat prolamin in the production of beer. Malt has become a subject of research because of its harmful potential for patients with celiac disease.
    In a study conducted by Czech scientists different species of barley, malt and beer were analyzed. Beers analyzed for gluten content were characterized by very different gluten contents. The level of gluten in raw cereals ranges from 18-68 g/kg. After comparing the different types of beers, in terms of the gluten concentration, the results were as follows:
    non-alcoholic beer
    Raw seed contained 50.4 ± 1.8 g per kg of gluten and comparing to it malt 68 ± 4 g per kg of gluten. Higher levels of gluten in malt have been confirmed in studies on other types of barley and other crops derived from a corresponding malt from which they were produced under similar conditions.
    Malt barley grains are subjected to extraction during mashing. Gluten content was examined during the entire production process. The amount of protein decreases during the production process due to precipitation of proteins in the fermentation mash, at the adsorption stage, and during beer stabilization. Researchers say that the gluten content in beer is about three times lower than in the raw barley grain. The gluten content changes at each stage of the beer production as is shown below:
    malt> sweet wort> wort after chop adding > beer> stabilized beer.
    Most of the proteins in the sharps (milled barley) are extracted which is a remnant of the filtration process in the mash tun (the vessel where the wort is boiled). Only a small part of the gluten goes to sweet wort – 1.75%. A slight decrease was recorded after the boiling process with the addition of hops -1.7%. During the fermentation process the pH decreases, this causes the precipitation of the polypeptides and their adsorption on the surface of yeast cells. Only 0.21% of the initial gluten content remains in the beer. After the filtration process beer is subjected to colloidal stabilization with PVPP - polyvinylpolypyrrolidone and silico gel (kiesegel) and then they are removed. This process results in lowering gluten content to less than 0.11% of the initial gluten content of barley [immunochemical determination of gluten in Malts and Beers, Food Additives and Contaminants; TFAC-2005-365.R1, 29-Mar-2006; Dostálek, Pavel; Institute of Chemical Technology, Prague, Department of Fermentation and Bioengineering Chemistry].
    The researchers used three methods to test the gluten content of beer. Their results differ from each other. Results show that to accurately estimate the amount of proteins and peptides dangerous to people with celiac disease, we must first develop a good methodology for the analysis. This will give the exact content of these harmful substances and provide real security to customers. If we use the method demonstrating the largest gluten protein content, only 30% of the samples were safe for patients. According to the authors there is no safe beer brewed from barley or wheat if we accept that the maximum tolerable daily intake of gluten is 10 mg. The law of the European Commission says that gluten-free food must contain less than 20 mg. per kg. Proteins present in the beers are removed during production through product stability and are hydrolysed by proteolytic enzymes present in the various stages of production. Partially hydrolyzed prolamines contained in beer are still "toxic peptides"- short protein fragments containing from a few to several amino acid residues. These fragments, rich in proline, trigger a series of reactions from the immune system, leading to celiac disease [Commission Regulation (European Communities) No 41/2009 of 20 January 2009, the Official Journal of the European Union, 21.1.2009, L 16 / 3].
    The most obvious method for the production of gluten-free beer is to use only gluten-free raw materials. In the production of such a beer a lot of attention must be paid to remove unwanted components from the beer. Technologists involved in the production of beer specialize in the removal of proteins from beer and controlling their levels, as they can reduce colloidal stability of the beer flavor. Removing or reducing the amount of these proteins may be a way to achieve our goal.
    Confounding factors in the production of gluten-free beer can be:
    Selection of barley varieties with a low content of protein and the corresponding enzymatic apparatus; Mashing process modified by deeper proteolysis, similar methods are used in the manufacture of gluten-free bread searching for enzymes capable of degrading specific proteins and peptides; Methods of striving for maximum distribution and precipitation of proteins with the use of adsorbents; The use of proteolytic enzymes in the production and stabilization of fermentation, such as amyloglucosidase is used to improve fermentation or β-glucanase to reduce viscosity. The enzyme used in the end may be proline endopeptidase; Implementation of the adsorbent during the stabilization phase of beer to remove residual proteins and peptides. Conventional materials can be used, if the genetically modified seeds will be devoid of genes responsible for the production of gliadin. However, such seeds are not yet available and the use of transgenic food additives is prohibited in many countries.
    Modification of the enzymes to reduce the gluten content can be achieved in two ways. Genetically modified yeast capable of expressing specific enzymes capable of degrading the protein can be used, or adding the enzyme - transglutaminase - directly during the production can also be done. These methods each have their own advantages, because with the right methodology a beer can be produced without loss of its natural taste.
    Another method of manufacture of gluten-free beer is the use of cereals rich in carbohydrates that do not contain gluten. These include amaranth, buckwheat, quinoa, sorghum, millet, corn, and rice.
    We can also add raw materials, the lack of native amylolytic enzymes must be compensated by the addition of external enzymes. However, this is a factor which increases costs. Colorants and flavorings also have to be added [Celiac Disease, Beer and Brewing, Michael J. Lewis, Emeritus Professor of Brewing Science Department of Food Science and Technology, University of California Davis].
    Gluten-free raw materials
    Cereals that are not taxonomically close to wheat, barley and rye are safe for people with celiac disease. Potential sources of gluten-free beer include: sorghum, corn, brown rice, millet, teff, buckwheat, and amaranth. At present, one of the best gluten-free beer production methods is to use gluten-free raw materials and avoid any cross-contamination. Gluten-free beer production technology is not a new technology. Some African tribes have produced beer based on sorghum and corn for 20 years. It turns out that buckwheat has a large potential for the production of gluten-free beer. Even unhulled seeds can be used. Husks can be used as the filtering material in the filter vat. The resulting malt is characterized by a taste reminiscent of toffee with a slightly nutty flavor.
    One of the major problems with buckwheat beer production is very low enzyme activity. It is several times lower than in barley enzymes. In addition, the high content of polysaccharides increases the viscosity of the solution. However, through rheological tests scientists have developed optimal methods in pilot studies and demonstrated that it is possible to produce a gluten-free beer with buckwheat. [brewing New technologies, CW Bamforth Published by Woodhead Publishing Limited, Abington Hall, Abington, Cambridge CB1 6AH, England, First published 2006, Woodhead Publishing Limited and CRC Press LLC ß 2006, Woodhead Publishing Limited].
    As the diagnostic methods for identifying celiac disease improve every year and more and more people are diagnosed with coeliac disease, the demand for this kind of drink will continue to grow. In addition, new types of beer can attract people who are interested in trying new tastes and making alternative choices.

    Jefferson Adams
    Celiac.com 09/14/2017 - Is your water hip? Is your water cool? Is your water gluten-free? Does it say so on the label? Does it matter?
    Gluten-free has become such a marketing buzzword that the words "gluten-free" are now appearing on all kinds of things that most certainly gluten-free, such as, yes, bottled water.
    Would you be more likely to buy water labeled "gluten-free?" Would you feel safer? More nourished?
    If the bottled water craze wasn't enough in itself, there is now the added marketing factor that turns plain, clean, pure bottled water into "premium" water that is not only gluten- and GMO-free, but also certified kosher and organic.
    Never mind that not a single drop in these bottle contains anything but plain water. Plain water, of course, is gluten-free, GMO-free, very much organic, and likely perfectly fine for kosher Jews.
    Basically, labels should help people make informed decisions, not confuse them with useless marketing information.
    Putting "gluten-free" labels on water likely doesn't help consumers make better decisions about the water they buy, it may just confuse people into believing (wrongly) that some water has, or might have, gluten in it; which is seriously unlikely.
    So, in our world, where the catchphrase seems to be caveat emptor, or, buyer beware, it falls on us as consumers to be informed and to resist the empty marketing promises made by products like "gluten-free" water. What's next, a label that says: Guaranteed Wet!?
    Got any good stories about confusing or useless "gluten-free" labels on products that clearly don't need them? Share them below.

  • Recent Articles

    Jefferson Adams
    Celiac.com 07/21/2018 - These easy-to-make tortilla wraps make a great addition to your lunchtime menu. Simply grab your favorite gluten-free tortillas, a bit of cream cheese, some charred fresh sweet corn, creamy avocado and ripe summer tomato. Add a bit of sliced roast beef and some mayonnaise and hot sauce, and you’re in business. And it's all ready in about half an hour. If you cook the corn the night before, they can be ready in just a few minutes.
    Ingredients:
    12 ounces thinly sliced cooked beef, sliced 6 burrito-sized gluten-free tortillas 1 ripe medium avocado, diced 1 large tomato, diced ½ medium red onion, thinly sliced ¼ cup mayonnaise 2 ears sweet corn, husks and silk removed 1 teaspoon olive oil ¾ cup soft cream cheese spread 1-2 teaspoons gluten-free hot sauce of choice Sprouted pea greens, as desired fresh salsa, as desired Directions:
    Heat grill to medium-hot. 
    Brush corn with olive oil. 
    In a small dish, blend mayonnaise and hot sauce. Adjust mixture, and add fresh salsa, as desired.
    Grill corn for 8 to 12 minutes, turning as it browns and lowering heat as needed until corn is tender and charred in some places. 
    Cool slightly; cut kernels from cobs.
    Spread 2 tablespoons cream cheese on one side of each tortilla to within ½-inch of edge; arrange beef slices to cover.
    Spread beef with mayonnaise hot sauce mixture as desired.
    Place a bit of grilled corn kernels, avocado, tomato and red onion in a 3-inch strip along one edge of each tortilla. 
    Fold ends and roll into a burrito shape, and serve. I like to add sweet, crunchy pea greens for some extra crunch and nutrition.

    Christina Kantzavelos
    Celiac.com 07/20/2018 - During my Vipassana retreat, I wasn’t left with much to eat during breakfast, at least in terms of gluten free options. Even with gluten free bread, the toasters weren’t separated to prevent cross contamination. All of my other options were full of sugar (cereals, fruits), which I try to avoid, especially for breakfast. I had to come up with something that did not have sugar, was tasty, salty, and gave me some form of protein. After about four days of mixing and matching, I was finally able to come up with the strangest concoction, that may not look the prettiest, but sure tastes delicious. Actually, if you squint your eyes just enough, it tastes like buttery popcorn. I now can’t stop eating it as a snack at home, and would like to share it with others who are looking for a yummy nutritious snack. 
    Ingredients:
    4 Rice cakes ⅓ cup of Olive oil  Mineral salt ½ cup Nutritional Yeast ⅓ cup of Sunflower Seeds  Intriguing list, right?...
    Directions (1.5 Servings):
    Crunch up the rice into small bite size pieces.  Throw a liberal amount of nutritional yeast onto the pieces, until you see more yellow than white.  Add salt to taste. For my POTS brothers and sisters, throw it on (we need an excess amount of salt to maintain a healthy BP).  Add olive oil  Liberally sprinkle sunflower seeds. This is what adds the protein and crunch, so the more, the tastier.  Buen Provecho, y Buen Camino! 

    Jefferson Adams
    Celiac.com 07/19/2018 - Maintaining a gluten-free diet can be an on-going challenge, especially when you factor in all the hidden or obscure gluten that can trip you up. In many cases, foods that are naturally gluten-free end up contain added gluten. Sometimes this can slip by us, and that when the suffering begins. To avoid suffering needlessly, be sure to keep a sharp eye on labels, and beware of added or hidden gluten, even in food labeled gluten-free.  Use Celiac.com's SAFE Gluten-Free Food List and UNSAFE Gluten-free Food List as a guide.
    Also, beware of these common mistakes that can ruin your gluten-free diet. Watch out for:
    Watch out for naturally gluten-free foods like rice and soy, that use gluten-based ingredients in processing. For example, many rice and soy beverages are made using barley enzymes, which can cause immune reactions in people with celiac disease. Be careful of bad advice from food store employees, who may be misinformed themselves. For example, many folks mistakenly believe that wheat-based grains like spelt or kamut are safe for celiacs. Be careful when taking advice. Beware of cross-contamination between food store bins selling raw flours and grains, often via the food scoops. Be careful to avoid wheat-bread crumbs in butter, jams, toaster, counter surface, etc. Watch out for hidden gluten in prescription drugs. Ask your pharmacist for help about anything you’re not sure about, or suspect might contain unwanted gluten. Watch out for hidden gluten in lotions, conditioners, shampoos, deodorants, creams and cosmetics, (primarily for those with dermatitis herpetaformis). Be mindful of stamps, envelopes or other gummed labels, as these can often contain wheat paste. Use a sponge to moisten such surfaces. Be careful about hidden gluten in toothpaste and mouthwash. Be careful about common cereal ingredients, such as malt flavoring, or other non-gluten-free ingredient. Be extra careful when considering packaged mixes and sauces, including soy sauce, fish sauce, catsup, mustard, mayonnaise, etc., as many of these can contain wheat or wheat by-product in their manufacture. Be especially careful about gravy mixes, packets & canned soups. Even some brands of rice paper can contain gluten, so be careful. Lastly, watch out for foods like ice cream and yogurt, which are often gluten-free, but can also often contain added ingredients that can make them unsuitable for anyone on a gluten-free diet. Eating Out? If you eat out, consider that many restaurants use a shared grill or shared cooking oil for regular and gluten-free foods, so be careful. Also, watch for flour in otherwise gluten-free spices, as per above. Ask questions, and stay vigilant.

    Jefferson Adams
    Celiac.com 07/18/2018 - Despite many studies on immune development in children, there still isn’t much good data on how a mother’s diet during pregnancy and infancy influences a child’s immune development.  A team of researchers recently set out to assess whether changes in maternal or infant diet might influence the risk of allergies or autoimmune disease.
    The team included Vanessa Garcia-Larsen, Despo Ierodiakonou, Katharine Jarrold, Sergio Cunha,  Jennifer Chivinge, Zoe Robinson, Natalie Geoghegan, Alisha Ruparelia, Pooja Devani, Marialena Trivella, Jo Leonardi-Bee, and Robert J. Boyle.
    They are variously associated with the Department of Undiagnosed Celiac Disease More Common in Women and Girls International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America; the Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom; the Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom; the Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; the Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom; the Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom; and Stanford University in the USA.
    Team members searched MEDLINE, Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) for observational studies conducted between January 1946 and July 2013, and interventional studies conducted through December 2017, that evaluated the relationship between diet during pregnancy, lactation, or the first year of life, and future risk of allergic or autoimmune disease. 
    They then selected studies, extracted data, and assessed bias risk. They evaluated data using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). They found 260 original studies, covering 964,143 participants, of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies, covering 542,672 participants, of other maternal or infant dietary exposures, including 80 trials of 26 maternal, 32 infant, or 22 combined interventions. 
    They found a high bias risk in nearly half of the more than 250 milk feeding studies and in about one-quarter of studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with probiotics during late pregnancy and lactation may reduce risk of eczema. 44 cases per 1,000; 95% CI 20–64), and 6 trials, suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitization to egg. GRADE certainty of these findings was moderate. 
    The team found less evidence, and low GRADE certainty, for claims that breastfeeding reduces eczema risk during infancy, that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus, and that probiotics reduce risk of infants developing allergies to cow’s milk. 
    They found no evidence that dietary exposure to other factors, including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake, influence risk of allergic or autoimmune disease. 
    Overall, the team’s findings support a connection between the mother’s diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitization to food, respectively.
    Stay tuned for more on diet during pregnancy and its role in celiac disease.
    Source:
    PLoS Med. 2018 Feb; 15(2): e1002507. doi:  10.1371/journal.pmed.1002507

    Jefferson Adams
    Celiac.com 07/17/2018 - What can fat soluble vitamin levels in newly diagnosed children tell us about celiac disease? A team of researchers recently assessed fat soluble vitamin levels in children diagnosed with newly celiac disease to determine whether vitamin levels needed to be assessed routinely in these patients during diagnosis.
    The researchers evaluated the symptoms of celiac patients in a newly diagnosed pediatric group and evaluated their fat soluble vitamin levels and intestinal biopsies, and then compared their vitamin levels with those of a healthy control group.
    The research team included Yavuz Tokgöz, Semiha Terlemez and Aslıhan Karul. They are variously affiliated with the Department of Pediatric Gastroenterology, Hepatology and Nutrition, the Department of Pediatrics, and the Department of Biochemistry at Adnan Menderes University Medical Faculty in Aydın, Turkey.
    The team evaluated 27 female, 25 male celiac patients, and an evenly divided group of 50 healthy control subjects. Patients averaged 9 years, and weighed 16.2 kg. The most common symptom in celiac patients was growth retardation, which was seen in 61.5%, with  abdominal pain next at 51.9%, and diarrhea, seen in 11.5%. Histological examination showed nearly half of the patients at grade Marsh 3B. 
    Vitamin A and vitamin D levels for celiac patients were significantly lower than the control group. Vitamin A and vitamin D deficiencies were significantly more common compared to healthy subjects. Nearly all of the celiac patients showed vitamin D insufficiency, while nearly 62% showed vitamin D deficiency. Nearly 33% of celiac patients showed vitamin A deficiency. 
    The team saw no deficiencies in vitamin E or vitamin K1 among celiac patients. In the healthy control group, vitamin D deficiency was seen in 2 (4%) patients, vitamin D insufficiency was determined in 9 (18%) patients. The team found normal levels of all other vitamins in the healthy group.
    Children with newly diagnosed celiac disease showed significantly reduced levels of vitamin D and A. The team recommends screening of vitamin A and D levels during diagnosis of these patients.
    Source:
    BMC Pediatrics