Celiac.com 03/01/2016 - Did you know that even products all scientists agree to be safe may not be because when researchers experiment in a contained laboratory, they find the product to be safe...and we believe them don't we? The reality is, several of those products, like quinoa and buckwheat can often be cross-contaminated because they are processed and packaged in plants that also process regular wheat. If you visit one of these facilities and see the flour dust everywhere you will notice workers in white coats and masks to prevent dust inhalation. The employees look like they are walking around in astronaut suits, and it becomes clear that anything else processed in that plant could be contaminated with wheat.

Whenever you have the choice to pick foods that come from facilities that are 100% dedicated gluten-free you should take it. Some foods, like Pamela's and Bob's Red Mill actually test their products twice for gluten. King Arthur Gluten Free Flour say that they test and re-test their entire line of gluten-free products, and have an on-line chat with the baker's hot line: 855-371-2253. Namaste Foods also have their gluten-free foods made in a dedicated facility that is free of gluten, wheat, soy, corn, potato, peanuts, tree nuts, dairy and casein. 1-2-3 Gluten-Free Products state "Made in a dedicated allergen-free facility (NO gluten, wheat, dairy, casein, peanuts, tree nuts, eggs and soy)." Don't just check whether an item is gluten or wheat-free, check whether it is made in a dedicated facility.

It makes sense that companies that manufacture their products in a dedicated facility may price their products a little higher, and the cost will likely be passed on to the consumer. Pro-Cert indicates that while the expense to produce products under these dedicated protocols offers little versatility from year to year, because it is a closed loop system, but consumers shouldn't expect huge spikes in the price that never come down and only go up. I dream of the day when all gluten-free products will be made in dedicated facilities!

Dedicated Facilities that Produce Gluten-free Oats

Montana Mills
Gluten-free purity protocol confirmed July 17, 2015. Oats are planted only on fields that have grown gluten-free grains for four years. Pure gluten-free seeds are planted. Fields are hand-rogued (You do know what roguing is don't you? Another grain flies in on the wind, or is trampled under foot from another field. Fairly easy to spot in the field of ripened wheat the farmers in my husband's family tell me.) to eliminate possible contamination. The grower is responsible for roguing, but is inspected by a Montana Mills inspector prior to harvest to ensure roguing was thorough and the fields are clean. Oats are transported in certified clean dedicated equipment to a dedicated facility. Redundant Elisa R5 testing is conducted before and after processing. Since 2012 Montana Mills uses the Elisa G12 approved testing.

Avenin Foods
Current gluten-free purity protocol confirmed July 21, 2015. They use only pedigree seeds. Growers attend workshops to learn requirements for gluten-free oats. Fields used to grow gluten-free are required to follow a specified crop rotation protocol. The fields are surrounded by isolated strips. All machinery and equipment is either cleaned or dedicated. All oats are processed in a dedicated gluten-free facility. Oats are tested using R5 Elisa 5 methadology.

Ice Cream Slip Up

I became very ill two weeks ago upon purchasing a soft ice cream, in a bowl of course, from a new store near our home. I should have realized that Wadden System Frozen Treats (www.icecreamflavors.com) coming from one machine but making over 20 flavors of ice cream, came from a flavor syrup that was added to the plain vanilla in the machine and that is how they got the flavored colors of ice cream. It contained wheat, and being a bit of a pig over ice cream I ordered a medium.

The nausea came first, then the diarrhea. Within twenty-four hours my scalp was covered in dermatitis herpetiformis lesions, water filled blisters that beg to be itched, and when you comply the burning in your scalp and thighs makes you so miserable you wished you had never even thought of ice cream! I went back of course, and I e-mailed the Wadden Company and suggested they notify the franchise people of what the bottles of flavorings contain. This did not help my illness or itching though, but we learn, oh goodness I hope I learn!

If a food allergen isn't labeled with all the proper food allergens and makes its
way into the store shelves, the food may be subject to a recall according to FALCPA (Food Allergen Labeling and Consumer Protection Act of 2004) requirements, and you can report such foods. "Get the Facts", the USDA, U.S. Department of Agriculture, list the new allergen labeling laws that include the top eight food allergens.

Double Check these Foods

Imitation Sea Foods, such as imitation crab meat, imitation bacon bits, licorice, flavored coffees and teas, processed foods, some chocolates and bars, salad dressings, hot dogs, sausages, deli-meats, sauces, marinades, seasonings, and soy sauce.

Medications
Do what I did, take the form provided by the National Celiac Association for Pharmacists to your pharmacy and tell them you are either a celiac or gluten sensitive and ask them to find out if your medications contain gluten.

Gluten-Free Oats

The Gluten Free Watchdog supports the use of gluten-free oats by the celiac disease community that are produced under a purity protocol. At this time we do not support the use of regular oats that are cleaned at the "end" of production via mechanical and/or optical sorting to be "gluten free". Before we can support the use of oats "cleaned" in this manner to be gluten-free we must be provided with thorough testing data. We can then compare this data to the thorough testing data provided to us for oats grown under a purity protocol."

The Gluten Free Watchdog, who work very hard to keep pushing companies with regards to the safety of oats, had a meeting with General Mills in July to discuss gluten-free Cheerios. Those involved with testing of the oats in Cheerios—Medallion Labs were also present. Marshall Gluten Free Milling and Pro-Cert, (Michael Marshall, President and CEO of Marshall Gluten Free Milling (www.glutenfreemilling.com) sent the Gluten Free Watchdog a letter indicating that they knew it was time to make a difference in a segment of the marketplace that needs some help. What does Marshall Gluten Free Milling do? They are the world's first company that provides ingredients to manufacturers that are produced on third party Certified Gluten Free FARMS by Pro-Cert a worldwide leader in third party organic certification.

It is a program that closely mirrors organic certification. Each farm must be free from gluten-containing products for two full years and on the third year of production the crops can be marketed. No gluten-containing product can be stored, handled, transported or conveyed with any infrastructure or equipment on the farm. Marshall gluten-free Milling Staff then control the dedicated trucking to a gluten-free only certified cleaning facility where the product is cleaned and sized to maximize quality. The oats are then shipped in a dedicated gluten-free truck to a third party certified gluten-free mill (GFCO, Pro-Cert, etc.). So the mill, cleaner and farm are all certified. The crops available right now on this program are organic oats and flax. Interest has spread to non-organic producers as well. They are expanding their offerings to lentils, peas and possibly quinoa. They need a sustainable crop rotation for the producers in the program. Primarily right now the focus of their ingredient marketing is oats as this is where the 3rd party certification of the farm is most crucial to developing a sustainable gluten-free crop rotation.

Michael Marshall was asked about General Mills announcing that five varieties of Cheerios were to be labeled gluten-free. The company is using regular oats cleaned at the "end" of production via mechanical separation. According to General Mills there are not enough oats grown under a purity protocol to produce Cheerios. He was asked, based on his industry experience, did he feel that mechanical/optical sorting was sufficient to ensure the gluten-free status of oats. He stated that General Mills was a trusted brand who value their name, and have done their homework on the process. But he also stated that mechanical and optical sorting equipment has been used for quality control for years as well as for food safety precautions. It is not new idea, has come a long way, but he thinks that even General Mills would have to agree it does not reduce the risk to zero. Michael Marshall is concerned about the dust control system used by General Mills. In his opinion, contaminated conventional low cost oats in gluten-free foods is risky.

After Tricia Thompson of the Gluten Free Watchdog asked if his program guaranteed 100% pure gluten-free oats? He said, "Generally speaking, there are always going to be anomalies." However if you look at the protocols in our program there are standard operating procedures in place. These procedures include: Planting seeds that are verified pure. Using only gluten-free planting equipment. Using buffer strips around the field – At harvest, the crop within the buffer strip cannot be binned with the gluten-free product—this protects the gluten-free crop from outside contamination. Strip testing every load that comes off the field before it is binned. Sending a representing sample from every bin to the lab for testing using the R5ELISA R7001 assay (testing prior to the crop being shipped to the mill. Testing at the mill before the crop is unloaded. The bottom line being they are testing at various steps to find gluten through the entire production of the crop to mitigate or eliminate the risk of contamination before it even gets to the mill. Once at the mill hi-tech sorting or mechanical separation will be for quality versus the only fail-safe measure to assure removal of gluten. The farm will be required to be certified gluten-free by Pro-Cert. They have 25,000 acres of both organic and conventional farmland under the certification program that will be available for the market this October. There are farmers lining up to get on the program and they have not even marketed it yet. It is a big market to supply and I believe we can all benefit.

Of course they want to follow safety guidelines! The celiac population is big business and I thank the Gluten Free Watchdog for working to develop a safety protocol for oats and working hard to obtain purity so that we can safely eat food without getting sick. But I know there will be a price to be paid for purity and safety, and it has to be passed on to the consumer, and I think there should be more tax breaks for the celiac population. AND, that is another place that the Gluten Free Watchdog and FALCPA (Food Allergen Labeling and Consumer Protection Act of 2004) can help us with keeping the costs down. No-one should have to be penalized out of their pocketbook for having a gluten sensitivity or severe gluten allergy.

My goodness, in Great Britain tax breaks are considerable for anyone who has diabetes, celiac disease or many notable food allergies. They do not decide that you have to use a certain medication, a generic brand, because the brand prescribed by your doctor is not listed under Pharmacare like they do in British Columbia, and, in Great Britain, as soon as a woman becomes pregnant she receives free vitamins for her unborn baby and all costs during her pregnancy are covered by their Medical Insurance Coverage. Dental, glasses, and money for diapers and a clothing allowance for the first three months of the babies life are paid for. We in the United States and Canada are so far behind Europe and the Great Britain in our health coverage. I think as a celiac and somone who has multiple allergies that require severe diets, some assistance and tax adjustments should be available more than the paltry difficult to monitor cost adjustment program that is in place today in our two countries! I know, my "Bandwagon", but one you should get on board too, and so should the NFCA.

Celiac.com 02/23/2016 - Rather than enjoying the youth of my 20's, some of the 'best years of my life,' I suffered from over a decade of chronic illness—everything from Lyme disease to C-diff colitis to hypothyroidism and chronic systemic candida. It started with severe leg swelling and chronic pain on a daily basis. By mid-afternoon, I carried what felt like bricks of water in my legs. On top of that, I was plagued by horrible digestive issues that left me feeling sick, lethargic and just plain gross. This was what I suffered with before I started my journey of detox, which led me to feeling younger and more energetic than I had felt since I was a kid.

During my decade of chronic illness, on a daily basis I focused on eating clean and detoxing my body by eating lots of fresh, organic foods such as fresh herbs, raw nuts, seeds and tons of veggies that helped support my thyroid, gut and liver function and to support the removal of toxins in my body. When you're trying to detox, organic salads filled with fresh, whole ingredients are always a good idea!

'Eating Clean' is all about adding in whole, organic fresh foods to your lifestyle and feeling good about what you are putting into your body. It's not about feeling deprived or going on a diet. Wellness is more than just calories, it's nourishment for your body to keep you healthy and strong. At this point in my life, I can honestly say that after reading almost every detox and medical book, seeing over 500 doctors including an entire week at Mayo Clinic, I've learned that the answers were within me the whole time. I had to be my own doctor and put the missing pieces together. My doctors could only do so much and they didn't communicate with each other, plus they didn't understand anything outside of their specialized field, which left me feeling hopeless and lost.

Whether you're suffering from chronic illness or just the occasional headache or bloated belly, I hope to inspire you to be your own doctor and realize that wellness starts with what's on your plate. Start tossing out the processed foods in your fridge and pantry today, add in beautiful, fresh foods and I promise you'll feel better just looking at the beautiful colors and tasting their amazing flavors. Get creative, go out and pick up a bunch of fresh herbs and start adding them to your meals—you will be amazed at how much flavor they can add to your them without having to add refined, unhealthy oils or other processed ingredients.

This is a fun recipe to pack in a mason jar with a lid and take to work for lunch, or you can toss it all together and serve it in a big bowl for a quick weeknight for dinner. I love to cook quinoa in large batches on Sunday nights for myself and my clients, so that I always have it ready in my fridge to add to quick salads for lunch, stir-fry's for dinner, and even warmed up on the stove top for breakfast with almond milk and cinnamon.

Simple Honey Sunflower Quinoa Bowl

Serves 4

Ingredients:

• ½ cup quinoa
• 2 medium yellow summer squash or zucchini, thinly sliced or diced
• 1/3 cup thinly sliced jicama or peeled apple
• 2 tsp. finely chopped fresh basil, plus more if desired
• 2 Tbsp. sunflower seeds
• Juice of 2 medium lemons
• ½ tsp. honey
• 2-3 Tbsp. extra-virgin olive oil
• Sea salt and pepper, to taste
• Pinch crushed red pepper flakes, optional

Directions:
Cook quinoa according to package directions. Remove from heat; fluff with a fork, cover and set aside.

Meanwhile, steam squash in a steamer basket over medium heat for about 5-7 minutes or until tender. Add to quinoa mixture and toss to combine. Add jicama, basil and sunflower seeds; toss again.

In a small bowl, whisk lemon juice, honey, olive oil, sea salt and pepper. Drizzle over quinoa mixture and toss to combine. Season to taste and transfer mixture to a sealed container and place in the lunchbox with a spoon and napkin.

Amie Valpone, founder of TheHealthyApple.com, wrote her first cookbook, over 200 recipes free of gluten, dairy, soy, eggs, corn, sugar, peanuts and processed foods, Eating Clean: Detox, Fight Inflammation, Reset Your Body & Get to the Root Cause of Illness, which is available for pre-order now on Amazon.com.

Celiac.com 02/16/2016 - About two years ago, as a result of two comprehensive review articles written by research scientists, Anthony Samsel and Stephanie Seneff, the term "glyphosates" made media headlines.

Based on more than 200 citations, their reviews concluded that long term exposure to glyphosates via ingestion (in food and water) and/or inhalation seems to parallel the incidence and clinical features of celiac disease and may contribute to a number of diseases including autism, cancer, Parkinson's Disease, Alzheimer's Disease, infertility, depression, inflammatory bowel disease, Multiple Sclerosis, cancer, allergies, eosinophilic esophagitis (EOE), obesity, and kidney disorders.

In case you don't already know, glyphosate (an organophosphate) is the active chemical ingredient in Monsanto's trademarked herbicide called RoundUp, which in the last 15 or more years has become very popular and is used throughout the world. It is largely used in "no-till non-organic production systems" as a desiccant (drying agent) for many genetically engineered (GE) food crops, especially those considered "RoundUp Ready" such as corn, soy, canola, cotton, sugar beets and alfalfa. RoundUp Ready foods are genetically engineered to resist being killed by RoundUp.

While wheat is not a genetically engineered food crop, RoundUP is used on all non-organic wheat crops to produce a greater yield and reduce any rye grass weeds. The glyphosates in the RoundUp kill weeds by disrupting the shikimate pathway in the plant.

I once used RoundUp to kill some weeds in my yard thinking that it was safe and nontoxic. It was thought then that humans and animals could not be affected by this weed-killing herbicide because humans and animals don't possess the shikimate pathway, only plants and bacteria do.

That was until Samsel and Seneff set me straight. The bacteria in the human gut, which outnumbers the cells in our body, do have shikimate pathways. Glyphosates suppress the enzyme necessary for the shikimate pathway to produce aromatic amino acids such as tyrosine, tryptophan and phenylalanine. This happens in plant cells, too, where reduced levels of other amino acids have been discovered including serine, glycine and methionine.

What does this mean for we humans? These amino acids are precursors to neurotransmitters (found in the gut and in the brain). Tryptophan alone is necessary for the production of serotonin, "the happy hormone." An impaired supply of serotonin frequently found in celiac disease causes depression. Impaired serotonin receptors in the gut sets the stage for inflammatory bowel disease.

So besides blocking the shikimate pathway for the production of nutrients in foods, glyphosates seem to reduce the overall bioavailability of nutrients in the foods we eat. I have been a regular advocate for taking a daily multi vitamin and mineral, contending that the food we eat may lose nutrients from farm to table. Low and behold, Samsel and Seniff's review substantiated my contention. They cite two studies, which showed multiple mineral depletions in soybean crops treated with glyphosates. The depleted nutrients in the soybeans mirrored those frequently found in celiac disease, including cobalamin (B12), iron, molybdenum, selenium and sulfur. The authors hypothesize that the association between celiac disease and autoimmune hypothyroid disease may be due to a selenium deficiency.

Samsel and Seniff suspect that chelation in the gut due to glyphosate ingestion may further account for deficiencies in cobalt, molybdenum and iron in these foods. This confirms yet another contention of mine that a single nutrient can indeed disrupt a whole system. The chelation of cobalamin in the gut is suspected to contribute to neurodegeneration and heart disease; the synergistic dynamic of molybdenum deficiency altering the body's supply of sulfate can have the consequence of cancer, anemia and insulin resistance. The authors purport that glyphosates disruption of the sulfur transport in the body is "the most important consequence of glyphosate's insidious slow erosion of health."

The health of the human intestinal tract is affected by glyphosate ingestion and inhalation. Citing a study on the effects of glyphosates on predatory fish, Samsel and Seneff's review showed that glyphosates cause damage to the intestinal mucosal folds and microvilli similar to what is seen in celiac disease. Beneficial gut bacteria are killed, allowing the pathogenic (disease-causing) bacteria to proliferate, producing a state of bacterial dysbiosis (microbial imbalance). With reductions in the beneficial Bifidobacteria and Lactobacillus bacteria, the breakdown of both gluten and phytase are impaired, leading to the inability to digest gluten. The pathogenic bacteria such as E. Coli and C. Difficile can lead to kidney failure and inflammation. These authors argue that other digestive pathologies, such as pancreatitis, fatty liver disease and EOE are due to impaired CYP function in the liver. Could there also be a link between the high rates of small intestinal bacterial overgrowth (SIBO) and gut dysbiosis caused by glyphosate disruption of these enzymes?

Glyphosates disruption of CYP enzymes in the liver occurs with celiac disease. These enzymes are involved in detoxification of xenobiotics (foreign chemical substances), so theoretically a reduction of CYP enzymes slows detoxification. Vitamin D3 and cholesterol synthesis and regulation of retinoic acid are also a part of the CYP enzyme system. It has puzzled me at times, that some of my patients do not respond to high dose vitamin D supplementation. The concept that glyphosates effect on CYP enzyme inhibition results in inadequate vitamin D activation in the liver could be a mystery solved. CYP enzymes are also important in bile acid production, gallbladder and pancreatic function. Samsel and Seneff hypothesize that glyphosate "disrupts the transport of sulfate from the gut to the liver and pancreas", resulting in bile acid insufficiency and gall bladder disease. Excess retinoic acid as a result of glyphosate exposure is similarly found in celiac disease and has been linked to reproductive disorders.

How can we avoid glyphosate exposure? The obvious answer is not to use this herbicide to kill weeds in your yard. In the best interest of health, eat organic foods as much as possible, avoid the "the dirty 15" and genetically engineered foods. Check out your local farmer's market and buy from certified organic farmers. Eat animal products fed with non- genetically engineered foods. If you eat wheat, choose organic wheat. Glyphosates cannot be washed off of food, and there is yet no known way of detoxifying glyphosates from the body. The authors suggest eat garlic or soak in an Epsom salts bath to ensure adequate sulfur intake. Sea salt is a natural way to include minerals in your diet along with eating vegetables.

Maria Larkin, M.Ed, RDN/LD owns Better Gut Better Health, LLC, a nutrition counseling practice in Durham and Portsmouth, NH. She is a registered dietitian and functional medicine provider, specializing in gastrointestinal concerns, food allergies and sensitivities. Website: www.bettergutbetterhealth.com.

References:

• Samsel, A. and Seneff, S. Glyphosate's Suppression of Cytochrome P450 Enzymes and Amino Acid Biosynthesis by the Gut Microbiome: Pathways to Modern Diseases. Entropy, 2013: 15 (4): 1416-1463.
• Samsel, A. and Seneff, S. Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance. Interdisciplinary Toxicology, 2013: 6 (4): 159-184.

Celiac.com 02/09/2016 - The top 8 food allergies in Canada are eggs, milk, peanuts, tree nuts, seafood, sesame, soy and wheat. If you have a food allergy and feel limited by it, it's a good idea to explore plant-based options. Plants offer so many benefits—they alkalize your body, reduce inflammation, beef up your vitamin, mineral, phytonutrient, antioxidant and fiber intake, and much more!

And if you think that plant-based foods lack protein to get you going and keep you satisfied, guess again! Certain plant-based foods contain all of the essential amino acids we need and can completely replace animal protein.

Here are four choices that are high in protein and loaded with additional nutrients. Enjoy each one in their whole form in a variety of ways—they are also available in flour form for baking!

Amaranth

Amaranth—a gluten-free grain that is high in fiber, manganese, magnesium and calcium—is a complete protein, containing all of the essential amino acids. It actually has more protein than quinoa, gram for gram—one cup of raw amaranth contains 28.1 grams of protein. Another benefit is that it can lower hypertension and cholesterol. Amaranth can be enjoyed as breakfast porridge, in muffins or as a side dish.

Buckwheat Groats

Buckwheat is the seed of a fruit in the rhubarb and sorrel family. Another complete protein that does not contain wheat or gluten despite its very misleading name, buckwheat is a great source of folate and zinc, which have both been shown to support fertility/virility in women and men. Both of these nutrients are also excellent for our immune system. Buckwheat is a good source of fiber and magnesium. It can be enjoyed for pancakes, as porridge or a side dish replacement to rice. One cup of raw buckwheat contains 22.5 grams of protein.

Quinoa

Quinoa functions like rice. Like amaranth and buckwheat, quinoa is also a complete protein. And like buckwheat, quinoa is technically not a true grain or member of the grass family either. Referred to as a "chenopod," quinoa is related to species such as beetroots, spinach and tumbleweeds. In addition to protein, quinoa contains many nutrients, including fiber, manganese, magnesium, phosphorus, folate, iron and zinc. Quinoa can be served in its whole form as a main or side dish, and quinoa flour is great in baked goods. One cup of raw quinoa contains 24 grams of protein.

Teff

Good things come in small packages! Last but not least, teff is the smallest grain in the world. Teff contains many amino acids and is high in protein—it just isn't a complete protein. It contains an excellent source of calcium, magnesium, zinc and iron, which are all important for immune function. Teff can be eaten as a hot cereal and is also available as tortilla wraps. One cup of raw teff contains 25.7 grams of protein.

Celiac.com 02/02/2016 - Thanksgiving dinner is one of the culinary highlights of the year. Family and friends join together to share a blessed moment when they give thanks for each other and for homes, jobs, and the opportunity to live comfortable lives. We may give thanks for peace, decent weather, surviving illness, or just making it through another day.

This is all done around the celebration of a food feast. Food is of central importance to social bonding and sharing a sense of community. As we all eat from the same platters and serve from the same bowls, there is a one-ness, a unity between us. But for folks who have celiac or who can't eat gluten, there is a sense of exclusion when relegated to a "separate but equal" dining system.

People who have no problem eating anything and everything often fail to consider how hard it is for people who need to be super-careful about what they consume. When they have gone to great expense to buy festive foods, and after they've expended significant time planning the perfect plates, it is understandable that they get frustrated when others won't eat what they've prepared. What they may not remember is that there is a big difference between "won't" and "can't". Will-not implies a preference—and in food-terms it means wrinkling up your nose over something that doesn't strike your fancy. Can-not implies the hard truth that if one eats something, they could get sick. Won't is a choice—can't occurs when there is no choice. So when people do not eat a festive food, is it because they can't or won't? The usual default is to assume won't. But for people who are gluten-free, the answer is can't.

Going gluten-free at Thanksgiving can be tough because it's so keenly associated with memories. Some of them are sensory, like remembering the smells of fresh-baked pumpkin pie or roasted turkey wafting out of the oven. Others are emotional, such as laughing with grandma while kneading bread that they family will soon lunge to smother with melting butter, or chopping up onions, celery, and chestnuts for dressing with Aunt Molly. For folks who once weren't gluten-free, certain foods evoke desire. We all have emotional trigger-foods. What's yours? One year we were invited to a colleague's Thanksgiving dinner and the hostess asked everyone, "What is the one food that if you don't have it for Thanksgiving, you would feel sad about?" It was a thoughtful question. After we all confessed she then told us that was the item we were to bring.

When you're going to a pot-luck type of Thanksgiving dinner where everyone is bringing something, it's dietary roulette for someone with celiac. It's gambling at its finest. What are the chances that you can eat a dish? Does the cook appear conscientious and trustworthy or make you ask "am I feeling lucky?" enough to try that dish? Eating in collective settings lowers the risk of getting glutened when everyone knows you've got dietary issues and they're openly attentive to them. The risk is greater when you're with people you don't know well, or those who aren't as careful as they seem. Culinary posers prevail during the holidays. Some stop at the deli and put the food into their own bowls and cover them with aluminum foil to make it appear they made it themselves (I know—I have in fact done this). We have no idea what's really in the food because we didn't make it ourselves. Others lie about the dish's ingredients. They may innocently fib because they don't know what's safe and what's not for someone who has to go gluten-free—or they could tell only partial truth, like I did long ago about whether I put cream in a pumpkin soup when someone was lactose intolerant. Back then, I wrongly assumed that if they didn't know, they couldn't tell, so they wouldn't put up a fuss and then I wouldn't get embarrassed. I didn't know then what I know now. Even well-intended people may screw up when it comes to telling the truth, the whole truth, and nothing but the truth about what's in food or how it was prepared.

Preparing a gluten-free Thanksgiving dinner that is absolutely safe and delicious for everyone to eat is easy. Here's a menu and recipes that will help you to create a meal that everyone is thankful for! It focuses on foods of the season, especially apples and the family of squashes. It is inclusive and delicious, and will give everyone one less thing to worry about as we instead focus on gratitude.

A Gluten-Free Thanksgiving Dinner Menu

Appetizer
When folks are milling around before a meal, it's nice to put out appetizers that they can nibble on. Usually these are very sharable, so making sure they are safe for someone with celiac is essential. So don't put out anything that could lead to cross-contamination. Here is our favorite tried-and-true appy:
Artichoke Dip

This is so easy and delicious as not to be believed!

Ingredients:
2 -3 cans of artichokes, cut into small pieces
1 red pepper, diced
Swiss, Cheddar, Parmesan, Muenster, and other cheeses of your liking
Salt, pepper, onion flakes
gluten-free crackers

Directions:
Spray a low casserole dish. In a bowl, mix in the cut artichokes, pepper, and pieces of cheeses. Add in the spices; only a little salt and more pepper, as the cheeses are usually salty and the artichokes could have been processed with some. Probably there will be salt on the crackers, so you don't want to kill this dish with it. Pour in the mixture into the casserole and heat until bubbly. Serve with only gluten free crackers or veggie sticks. . Part of the fun is dipping in a bowl together, so make sure if people double-dip that everyone is safe!
Option: some people like to add spinach or cream cheese to their dip. It's not my way, but the popularity of spinach-artichoke dips conveys that it may be right for you!
Soup
Soup is warm, comforting, and sets the stage for what's to come. Here are two recipes from which you can choose that are sure to whet the whistle of people for dishes to come!
Apple Kale Soup
Apples are abundant in autumn, and I created this dish in desperation to use foods that I had in the fridge on a day when the chill started to go through my bones. As a child I didn't understand kale, but now know it's a flexible, healthy and friendly vegetable.

Ingredients:

• 2-3 apples, peeled and sliced and diced
• 2/3 bag of fresh kale, or a hearty bunch cut into small pieces
• 1 purple onion, diced
• 1/3 pound of bacon (maple bacon is an especially good choice)
• 16 oz chicken broth (have another can handy if you want it)
• Salt, pepper
• Olive oil
• Plain nonfat yogurt

Directions:
Saute the onion and bacon in a little olive oil until they are brown and crispy. Add in a little broth, then the kale, which will shrink up immediately. Then add the apples in, along with the rest of the broth. Season with salt and pepper and let it simmer awhile on medium-low heat. I think a creamy looking soup is elegant, so I recommend spooning out the mixture into a food processor to make it smooth. Then return to the pan, adding more broth if you want. When that is done, add in the secret ingredient—plain yogurt. It will give it a creamy consistency and a little zing. You have to play with the amount of broth, yogurt and mixture to create a soup the consistency you like. It is an unusual soup that is tasty and sure to garner compliments.

Gluten-Free Pumpkin Squash Soup

In contrast to the previous soup recipe with is savory, this is a sweet soup recipe.

Ingredients:

• 2 cans pumpkin
• 1 small diced onion
• 1 medium butternut squash, cubed
• 3 cups chicken broth
• 1 teaspoon butter
• 2 tablespoons gluten-free flour or cornstarch
• 2 Tablespoon brown sugar
• 1 cup + half-and-half
• Salt, pepper, ginger, cinnamon to taste

Directions:
Saute the onions and squash in butter. Mash the squash when it is soft. Add to the chicken broth and simmer. Stir in the canned pumpkin. Mix gluten-free flour/cornstarch, butter, sugar, and spices. Fold in cream last. Heat but do not boil. You can garnish with a few slivered almonds if you want.

Salad

While my mama had many culinary talents, the salads she made weren't her specialty, to say the least. Her "green" salad consisted of iceberg lettuce with tomatoes thrown on top, or we might enjoy a Waldorf salad that had red-delicious apples cut up, some celery and pecans that she mixed with Miracle Whip. It took me years to understand that salads could be the best part of a meal. Here are substitutions for what mama didn't know about!

Diversity Salad

Salads are most enjoyable with they contain a mixture of ingredients. You are the artist in the kitchen and get to decide what ingredients in what proportions. Here are our suggestions of items to consider: Baby spinach, romaine lettuce, and spring greens are the base of the salad, but don't rely on this to be the biggest ingredient. Using plenty of other vegetables will make every bite an experience, each mouthful different than the bite before. Add liberal amounts of carrots, tomatoes, onions, cucumber, and peppers, cut in various shapes and types. We love radishes, celery, sprouts, broccoli, cauliflower, and fresh mushrooms, but not everyone agrees. Avocado, beets and asparagus are other vegetables that may be questionable; while we like them, not everyone does. We are sensitive to the palate of our guests and modify the salad ingredients to please them. Leafy vegetables like kale, arugula, cabbage, chicory, watercress can make a salad interesting. Likewise, using fresh basil, cilantro, parsley and other herbs create tastes that give each salad a different flavor. Do you like roasted red peppers? Artichoke hearts? Banana pepper slices tossed into a salad can be delightful if you like that kind of spiciness. Olive varieties are endless. We recommend putting out different types of dressings so people have choice. For examples of easy and delicious dressings, there is a list for you to consider in our book Going Gluten Free.

Waldorf Salad

This salad can be anything but boring!

The base:

• Toasted walnuts or pecans – toasting gives them a nice crunch that adds to the texture of the dish.
• Apples—I like flavorful crispy kinds, unpeeled so the color shines out. Red? Green? Combination? You choose! You also get to choose how to slice them. Hunks, thin slivers, slices—you're in charge. I rather like them slivered—they seem more delicate for an elegant meal.

Directions:

Celery—Cut it in slender shreds.

Seedless Grapes or Dried Cranberries—Historically, grapes were the ingredient selected in the original Waldorf Astoria recipe. You can certainly keep tradition and use them. I like grapes to eat but not as fond of them in salads, so I prefer dried cranberries. I live in New England and using them at this time of year seems right. The dried berries add another texture and bright color to the dish.

Optional: Some folks like to add thin sliced red or green peppers or even a few scallions.

Dressing
This is the make-or-break part of this salad. Mayonnaise is traditional, but today has been sidelined by the use plain yogurt or sour cream. Many people use a combination. I veer away from mayo in preference is a thinner, lighter dressing. Others add a tablespoon of fresh lemon juice mixed with a little honey. If you're into mustard, you may want to add a teaspoon, but no more or you will kill the dressing. It will need a little salt and pepper. Have handy some fresh mint leaves or parsley for garnish. Don't forget to serve it on some leafy lettuce. The lettuce bottom helps make the rest of the salad work even better!

Main Dishes

Turkey is by far the main dish at most Thanksgiving dinners. Every year, recipes seem to get more complex, like Turduckins or deep fried turkeys. Here is our recipe—it's simple, delicious, and healthy.

Roasted Turkey

Ingredients:

• Turkey
• Salt, pepper, paprika
• Butter
• Can of turkey/chicken broth

Directions:
Choose your turkey to your liking—some people like 20 pound birds with legs attached, others prefer a turkey breast and forgo the dark meat. Whatever you pick, you must decide whether to live the skin on or off. I always pull it off. It's an emotionally wrenching thing to do, but it's much healthier and makes for a tastier and prettier dish (in my opinion). I put the bird in a roasting pan that has some broth on the bottom. This keeps the bird moist as it cooks and it catches the natural juices and becomes the base for awesome gravy later on.

Then I butter the bird a bit to enhance flavor and to help the spices stick. Heavily salt, pepper and add paprika to the exterior of the bird. There are many different types of paprika and some are quite spicy, so judge accordingly. Paprika makes the bird brown beautifully. Put a lid or aluminum foil over the bird and bake at 425F degrees for an hour or several more, depending on the size of the bird. This will enable the bird to cook through (nothing worse than raw poultry!) and not over-brown on top. After it appears that the bird is done on the inside, then remove the foil/lid and let it brown on top. You can baste it with some of the broth to keep it moist. When the bird is golden brown, you can take it out and eat it steaming hot. Add some corn starch, salt and pepper to the broth, whisk over medium heat, and make gravy to go on mashed potatoes if you like. This is a simple recipe that is sure to please!

I was a vegetarian for two decades and know how awesome non-meat holiday dishes can be. Tofurky never quite worked for me. Here is one of our favorite dishes - but it's not safe for vegans because it contains both eggs and cheese. Sorry about that! We can't be all things to all people—but at least we are honestly transparent.

Holiday Cheesy-Nut Delight

Ingredients:

• 30 oz. cottage cheese
• 1 purple onion, diced
• 5 eggs
• 1 cup grated cheddar cheese
• 1 cup chopped walnuts
• 3-4 cups gluten-free corn flakes or rice krispies
• Butter

Directions:
Salt, pepper, A-1 sauce, optional dried minced onions or dried parsley

Saute the onion in butter until transparent and lovely. In a bowl, add cottage cheese, eggs, cheddar, walnuts, a tablespoon of A-1 sauce, and spices to your liking. Then stir in the cooked onions. Finally, add in the cereal. The mixture should be moist but not runny. Poor it into a greased pan—you can make them into a loaf, muffins, or cook in a casserole pan. The size of the pan you use determine how long you will cook this dish. It should take around a half-hour for most size pans. The dish will be firm and browned, but don't overcook it or it will be dry. It cuts nicely when cool. If you want to make it look even fancier, you can drizzle a bechemal sauce over it with parsley garnish. This is a family favorite, and we hope you will enjoy it too.
Chop 1 onion sauted in butter, add to mixture of eggs, cottage cheese, cheddar cheese, walnuts, salt, pepper, a T of A-1 and mix in 4 cups of gluten-free Corn Flakes. Baked in a greased pan at 350F degrees for an hour. Let sit 10 minutes uncovered before cutting.
Stuffing

What's Thanksgiving dinner without stuffing? Here's our version—tweak to your heart's content!

Gluten-Free Thanksgiving Stuffing

Ingredients:

• Leftover gluten free bread, any type, torn into small pieces
• Olive Oil
• Celery and Onion, cut into small pieces
• Chicken/turkey broth
• Salt, Pepper, Sage, Rosemary, Thyme, Parsley
• Butter
• Optional: Nuts (your choice), dried fruit (apricots, apples), sausage, or vegetables

Directions:
I gave up cooking the stuffing in the turkey ages ago. It turns out much better if you bake it in pan of its own. Saute until soft onion and celery in butter. Spray a cooking dish. In a bowl, mix the bread pieces, pour in the celery/onion mixture, add spices, and enough chicken broth to make it very moist. Add in whatever other ingredients you want. Personally, the simpler the better. Sometimes too much is overkill. Bake at 350 until it is firm with a light crust on top – then enjoy!

Vegetables

Let's face it—the sky's the limit when it comes to making amazing gluten-free vegetable dishes. I learned that color was important for a festive meal, so ours is white (potatoes), yellow (corn), orange (pumpkin), and red (cranberries or tomatoes in the salads). Instead doing green beans, broccoli, or asparagus—all that are awesome—we've given you a less familiar Brussel sprout recipe.

Mashed Potatoes
What could be easier? Scrape clean potatoes, cut them into hunks and toss them into boiling water until soft. Then mash. Add butter, milk, salt and pepper. Make more than you think you're going to need—they are going to disappear.

Baked Corn
Take 2 cans of gluten-free creamed corn, a can of whole kernel corn, drained, and mix them together in a bowl with 2-3 eggs, 1/3 cup corn starch, dried minced onion, salt and pepper and a smidge of butter. Pour into a greased casserole and bake until it is bubbly.

Bacony-Delicious Brussel Sprouts

Ingredients:

• Bacon
• Brussel sprouts
• Olive oil
• Salt/pepper
• Balsamic vinegar
• Parmesan cheese

Directions:
Cut the bacon into little pieces and fry them in olive oil. When brown, toss in the sprouts—slice the bigger ones. They will brown beautifully—you may want to put a lid on them for a few minutes to make sure they cook through and become soft. Then add salt, pepper, a tablespoon of balsamic vinegar and sprinkle with parm cheese. These are bound to be a hit!
Bread

I'll be honest with you—as a child I learned to bake some of the most fantastic yeast wheat bread imaginable. gluten-free bread has, by far, been the hardest thing for me to recreate with satisfaction. My solution? Don't try to do it in a way that recreates child memories. Find a new way. You may be pleased with the result.

Pumpkin Muffins

This is my own concoction. As you may recall from our cooking model described in our book, Going Gluten Free, I don't measure ingredients. I work with them in a zen method until they seem to be right. So I'll give you my recipe, with the recommendation that you tweak it as your intuition dictates!

Ingredients:

• 1 can pumpkin
• 1 1/2 c. gluten-free flour
• 1 c sugar
• ½ c. canola oil
• 2-3 eggs
• 1 tsp baking powder and 1 tsp baking soda
• Cinnamon
• Chocolate chips

Directions:
Mix all of the ingredients together in a bowl, then pour into greased muffin tins. Make sure the tins are gluten-free safe. We have a special pan that nothing else goes in, and recommend you do the same. It's better to spray the muffin cups instead of using papers—the muffins actually come out much prettier. They rise high and are beautiful and tasty. These are our autumn delights!
Fritters

Ingredients:

• 3 c. gluten-free flour
• ½ c. canola oil + oil for cooking
• 1-2 eggs
• 1 tsp baking powder
• Salt
• Optional ingredients: sliced scallions, cheese, herbs, or whatever pleases you!

Directions:
Mix the ingredients together in a bowl while the oil heats in a skillet. Drop a large spoonful of the batter into the oil, and flip when it browns. When both sides are golden, remove and add more fritter batter into the pan. Serve hot with butter. They satisfy the need for bread without having to feel dissatisfied with trying to make a loaf and expect it to be like traditional wheat bread. Maybe one day the recipes and products will be there for that, but not today. This is a satisfactory substitute, to be sure!

Dessert

Every meal needs to end with a food that ritually signifies the meal is over. By this time, bellies are usually full and dessert needs to be symbolic more than substantive. It should look pretty and taste sweet. Here is the quintessential Thanksgiving dessert.

Pumpkin Pie

This is the traditional dessert and so easy to make.

Gluten-Free Pie Crust:

• 1 can pumpkin
• 2/3 c. sugar
• 3 eggs
• 1 can evaporated milk
• Cinnamon, nutmeg
• Butter
• A tsp of corn starch

Directions:
The nice thing about making a gluten-free pumpkin pie for Thanksgiving dinner is that all the ingredients in the pie are naturally gluten-free, except for the pie crust. So follow the directions on the can for pie, or use the directions here. Mix all the ingredients in a bowl and then put into a gluten-free crust (your choice of frozen or homemade) and bake until it is firm and beautiful. Don't burn it! It will firm up as it sits for a few minutes. Top with ice cream or whip cream, and maybe a garnish of chocolate or glazed nuts. Serve with coffee or tea, and enjoy the closing conversation.

This meal should leave everyone feeling satiated and satisfied. What most people are grateful for at Thanksgiving is to just sit together with loved ones and share good conversation, laughter, and connection. What they eat isn't nearly as important as eating together. But with a menu like this, everyone can eat together and feel treated to a gourmet meal fit for a king. And it's fun to show nonbelievers how scrumptious Going Gluten Free can be!

Celiac.com 01/26/2016 - One part of our natural protection from the microbes and toxins in our environment is the innate part of our immune systems. This includes everything from our skin, to the mucous we produce in various tissues which engulfs unwanted or harmful particles, isolating them and ultimately expelling them from the body in fecal matter and mucous, such as from our sinuses. While our immune systems have other components, it is the innate system that provides most of our protection from the world outside our bodies. The intestinal mucosa is very much a part of this system. Thus, since Hollon et al found that "Increased intestinal permeability after gliadin exposure occurs in all individuals" (1), there should be little doubt that humans are not well adapted to consuming these storage proteins from wheat, or gliadin's near relatives from rye and barley. Anyone eating these grains is opening a portal into their bloodstreams so toxins, microbes, along with undigested and partly digested proteins can enter their circulation. Without gliadin's impact, these various substances would probably not have entered the bloodstream and would have been wasted with feces.

Just as few of us would ever consider putting fecal matter on an open wound, neither would we knowingly introduce this same material into the bloodstream through the intestinal wall. Yet, that is the net effect of humans consuming gluten grains. We are giving microbes access to our circulation. These harmful substances may be destroyed by other parts of our immune systems. Or perhaps we will develop episodic or chronic inflammation, leading to vascular damage where plaques can accumulate to cause atherosclerosis. Or the inflammation may use up available serotonin and its precursor, tryptophan, leading to depression. Or this they may cause one of the many other forms of damage that can be induced by inflammation. Or perhaps these infectious agents will manifest in other ailments, the causes of which will often remain obscure, as they degrade our health. Just one example of this risk can be found in a recent report in which antibiotic resistant staph infections were detected in 13% of pasteurized milk samples, and in 75% of raw milk samples (2). The acid in our stomachs, another part of the innate immune system, may provide some protection against this hazard. 

On the other hand, microbes that have gained entrance into the circulation have also been implicated in some cases of arthritis, where the infectious agent binds to proteins in synovial fluid. Selective antibodies then target these complexes, causing damage to both the invader and the self tissues (3, 4).

Toxins, especially those from insecticides and other chemicals likely to be found in or on our food supply are also cause for concern. Although most cases of organophosphate insecticide poisoning were the result of suicide attempts, these substances are widely used on a variety of food crops, and can be very dangerous (5). After all, both herbicides and pesticides are designed to kill small organisms. Because of our size, we may require more of these substances to get the job done but we, too, are organisms.

One component of such substances is inorganic arsenic, which can also be found in natural rock deposits, some wood preservatives, rice, and sea foods, any or all of which can find its way to our bloodstreams (7) especially if we consume gluten grains. Of particular concern is that rice is often a staple of the gluten-free diet and it has been shown to have a strong affinity for inorganic arsenic, which "is a chronic, non-threshold carcinogen" (7). Thus, unlike smoking tobacco, even the smallest dose can result in cancer. Further, there are many areas of the United States where the groundwater is significantly contaminated with arsenic (8). Either drinking such water or excessive dietary reliance on rice grown in such a contaminated area can result in arsenic poisoning, as reported by Signes-Pastor et al (7) in a housewife in Saudi Arabia, who had celiac disease and relied heavily on rice. These authors first suspected dietary non-compliance until urine tests revealed an arsenic concentration at 46 times the highest value of the normal range (7). Her symptoms included: "progressive fatigue, profound watery diarrhea (12 times/d), palpitation, dry mouth, poor appetite, poor taste, sleeplessness, impaired concentration, and short-term memory" (7).

Proteins from outside our bodies are eschewed by our selective immune systems, identifying them as foreign, and mount an attack against these "aliens". So any undigested proteins from the foods we eat, if they arrive in our bloodstream, are going to result in the mobilization of antibodies aimed at the destruction of these proteins. This sounds like a process for developing an allergic response against common foods.

However, some proteins are worse than others. Gliadin, for instance, has long been recognized as harmful to many human cells (9). Humans also lack the necessary enzymes to fully digest it (10). Thus, after gliadin has caused increased zonulin production, leading to increased intestinal permeability, it can enter the bloodstream and travel to various tissues and organs where this undigested or partly digested family of proteins will induce one or more of their range of damaging impacts on the cells each molecule contacts. Dolfini et al have also reported that gliadin "induces an imbalance in the antioxidative mechanism of cells" (11) and it wreaks havoc on human cells by changing their shape, structure, and reducing their viability, as well as inhibiting enzyme production within the cell and/or inducing cell death (11).

Since some humans have been consuming these grains for more than 10,000 years, one might expect that we would have evolved a digestive tract that could neutralize this threat to our wellness. Unfortunately, the issue isn't that simple. Only a small segment of the human population started cultivating gluten grains so long ago. The early development of this agriculture was also very localized and episodic. It would begin in one area then, for some unknown reason, the fields would be abandoned after some period of time. Then it would (excuse the pun) crop up in another, nearby area of the Fertile Crescent (what is now parts of Iraq, Iran, Kuwait, Syria, Lebanon, Jordan, Palestine, Israel, and Egypt). The net result was that it took some time before cereal agriculture was a thriving concern. This may be explained by the illnesses that are reflected in the bones of those early farmers (11). Gluten grains appear to have taken a much greater toll on their health than it does on us now, so some adaptation has probably occurred. Nonetheless, once grain cultivation got a good start, it spread fairly quickly across Europe, arriving in England by about 5,000 years ago.

Populations living in environments that were not conducive to grain cultivation, either due to climate or soil conditions would wait much longer to incorporate gluten grains as a staple in their diets. Modern transportation systems were required to bring this crippling food to some doorsteps in Scandanavia, parts of Scotland and Ireland, and many other such environments throughout Europe. However, even in those halcyon days when the sun never set on the British Empire, Europeans really weren't the only people on the planet. They may have behaved as if they were, but that's an issue for another discussion. In the meantime, the bulk of the world's population had not eaten gluten grains until much more recently, when Europeans "shared" these grains almost everywhere they traveled. Most of the populations these Europeans met during their travels had also missed out on the many European plagues, including bubonic plague, smallpox, and typhoid fever, as well as the filthy living conditions that were common in Europe. These conditions had selected only those with the most vigorous immune systems to carry on as Europeans. When gifts such as smallpox-infected blankets were given to natives, these naive populations succumbed, in large numbers.

Further, only a small percentage of these naive populations who were very recently introduced to gluten were developing celiac disease. For instance, only about 5.6% of Saharawi children of Northern Africa had developed celiac disease when tested by Dr. Catassi and colleagues some 50 years or so after they had begun to eat gluten (12).

European "explorers" probably didn't really notice such illnesses among their grain-naive hosts. Nobody had the technology or the medical understanding to identify celiac disease or the many neurological ailments that gluten causes anyway. Many of us still deal with deep wells of medical ignorance, in the context of a very modern medical system, when it comes to our disease, so how could we expect anything more from those sea-faring Europeans of four or five centuries ago?

Perhaps those gluten derived opioids probably felt pretty good to people who tried gluten. Whatever the reason, the rest of the world seems to have adopted Europe's dietary choices, pursuing the "comfort" of gluten grains while developing myriad forms of autoimmune disease, neurological dysfunction, gastrointestinal complaint, and a variety of other ailments. And most of the people I encounter would rather deny the health risks than give up donuts, cake, pie, and toast (13).

Note: I'm proud to announce that I've been given the privilege of reviewing a new book that will be published early next year, under the Touchstone imprint, by Simon and Schuster. I will be writing about some interesting new insights this exciting book offers into the world of gluten sensitivity in the next issue of the Journal of Gluten Sensitivity.

Sources:

1. Hollon J, Puppa EL, Greenwald B, Goldberg E, Guerrerio A, Fasano A. Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity. Nutrients 2015, 7, 1565-1576.
2. Akindolire MA, Babalola OO, and Ateba CN. Detection of Antibiotic Resistant Staphylococcus aureus from Milk: A Public Health Implication. Int. J. Environ. Res. Public Health 2015, 12, 10254-10275.
3. Li S, Yu Y, Koehn celiac disease, Zhang Z, Su K. Galectins in the Pathogenesis of Rheumatoid Arthritis. J Clin Cell Immunol. 2013 Sep 30;4(5).
4. Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Br J Nutr. 2000 Mar;83(3):207-17.
5. Coskun R, Gundogan K, Sezgin GC, Topaloglu US, Hebbar G, Guven M, Sungur M. A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience. Niger J Clin Pract. 2015 Sep-Oct;18(5):644-50.
6. Hasanato RM, Almomen AM. Unusual presentation of arsenic poisoning in a case of celiac disease. Ann Saudi Med. 2015 Mar-Apr;35(2):165-7.
7. Signes-Pastor AJ, Carey M, Meharg AA. Inorganic arsenic in rice-based products for infants and young children. Food Chem. 2016 Jan 15;191:128-34.
8. United States Geological Survey. 2005. Arsenic in ground water in the United States. Open Original Shared Link Last Modified: Thursday, 17-Nov-2011
9. Hudson DA, Purdham DR, Cornell HJ, Rolles CJ. Non specific cytotoxicity of wheat gliadin components towards cultured human cells. Lancet 1976; 1: 339-341.
10. Kagnoff M. Private communication. 2005
11. Dolfini E, Elli L, Roncoroni L, Costa B, Colleoni MP, Lorusso V, Ramponi S,Braidotti P, Ferrero S, Falini ML, Bardella MT. Damaging effects of gliadin on three-dimensional cell culture model. World J Gastroenterol. 2005 Oct 14;11(38):5973-7.
12. Rätsch IM, Catassi C. Coeliac disease: a potentially treatable health problem of Saharawi refugee children. Bull World Health Organ. 2001;79(6):541-5.
13. Cordain L. Cereal grains: humanity's double-edged sword. World Rev Nutr Diet. 1999;84:19-73.

Celiac.com 01/20/2016 - I've got a sore tummy! So many children say they have tummy pain. I see them every day in my clinic. Is this attention seeking or actual pain?
 They often say: "I've got a sore tummy", or "My tummy's sore", or
 "Tummy hurt", or "I've an ache in my tummy" or "Why is my tummy sore?"

This is such a common complaint that mostly these symptoms are ignored or explained away as attention seeking. However, I have found that the majority of these children with so-called 'chronic abdominal pain' are affected by gluten sensitivity.

I've got a sore tummy?
Attention seeking or actual pain? In my experience, these children are in real pain. They need investigation and treatment. They need help for their tummy pains to go away. Yes, sometimes children do mix up the urge to do a poop with a pain (they feel uncomfortable before they do a poop), and it is gone when they poop. Some children mistake hunger as a pain. But most children with recurring "sore tummies" have a different pain. They are sore, in pain and really hurting. Can you imagine how they must feel when their pain is just ignored by their parents?

Should children be expected to put up with tummy pains?
Unfortunately, many health professionals and pediatricians are still living with teachings from the past. They refer to the writings of the 1960's. As 50 years ago it was believed that a child complaining about a tummy pain was being "bad" or "naughty". Their discomfort and pain was dismissed as "nothing serious" and told "they'll grow out of it" (the authors of these books were John Apsley "Child Development" and Professor Ronald Illingworth "The Development of the Infant and Young Child: Normal and Abnormal").

I totally disagree with them. Long ago when they wrote their books, they did not have any blood tests available to diagnose gluten-related disorders; nor did they have any knowledge about gluten or celiac disease; nor was the role of food allergy understood. Consequently, most common symptoms, including chronic tummy pains, were simply attributed to "the state of being a child"!

How many symptoms do you need to have? How severe do your symptoms have to be? How sick do you need to be? – before anyone will take your illness seriously? Why should we ignore a distressed child? Why should they be told "you will grow out of it"?

These children have real pains. These children warrant serious attention. These children need help and understanding for their symptoms. Some of these children have unrecognized gastric reflux symptoms; some have celiac disease; some have Helicobacter pylori infection; some have chronic constipation; some have food intolerances; and many have gluten sensitivity/ intolerance.

So what do I do in my clinic? Well I request gluten and celiac blood tests for ALL of these children who come and see me with tummy upset. To my surprise (I started this type of testing over 20 years ago), most of these sore-tummy-children have high levels of Anti-Gliadin-Antibody (AGA). When they strictly avoid gluten and go onto a gluten-zero diet—most get completely better. Their tummy pains go away, and often their parents report better mood and energy. Also better appetite and better eating.

For instance:
"Thanks for the blood results. A month ago, as soon as I got the first lot of blood results back, I took Mark off gluten all together (as you recommended). There has been a big improvement in him sleeping and he seems a lot happier. I haven't been giving him the reflux medication (Losec) for a good few weeks now: I had upped his dose to two pills a day but there was no improvement until I took him off gluten. So it must of been gluten upsetting his tummy. So at this stage we won't need a follow up appointment as with my family history we are pretty clued up with it all. Thanks for your help sorting Mark, it's greatly appreciated." Mum.

Please don't just ignore them—please test and treat them! Please do not dismiss what your child is telling you: you may be able to help them. They might have a gluten-related disorder. They are not "attention seeking" they are in actual pain.

See "The Gluten Syndrome" for more details. Also see Dr Rodney Ford's latest Kindle book: "Gluten-Related Disorder: Sick? Tired? Grumpy?" (Open Original Shared Link).