Celiac.com 11/01/2016 - Homeopathy has been around for quite some time. You even see it in drug stores these days. Here are some basics behind homeopathy.

1. Certain substances that create a reaction in a healthy person can cure a sick person with the same symptoms.
2. Unlike conventional medicine, homeopathy is considered more effective when the substance is diluted and shaken and is considered more effective each time this dilution and shaken process is done. This also makes it much safer as there is so little of the active ingredient actually in the homeopathy.
3. It is tailored to each person depending on their health record, physical symptoms, emotional state, etc. Not just a one size fits all approach.

One point that is great about homeopathy as opposed to "regular" medicine is the side effects are next to nothing.  The dosages are so small and contain so little of the active ingredient that the worst thing to happen would be that no beneficial effect occurs.

If your child is celiac, then you have probably had plenty of issues with ingredients in medications as well as sensitivities with substances in them that aren’t even gluten. I have run into many kids who are celiac who cannot handle all sorts of other substances due to their gut. The good thing about homeopathic preparations is that many of them are gluten-free. I actually have never come across one with gluten so far. This makes it very easy to find remedies that your celiac child can handle. No strange ingredients that are made in a laboratory either.

I specifically use chamomile and arnica for my son when he is teething. There is a combination of specific ones for teething but the individual dosages always work best for my toddler. I see a large difference in his overall attitude and pain level when I administer these two. 

Of course there is always a place for standard medicine but I try to avoid drugs when I can.  Especially with my damaged gut from being misdiagnosed for 17 years! This allows the body to learn and adapt to properly fighting germs so there is less of a chance in getting sick the next time a bug is being passed around. Plus, have you read some of the warning labels on these drugs that doctors recommend? Pretty scary, horrible side effects! Worse than the sickness you are treating.

Give homeopathy a try and see if it gives you, your celiac child or your family any comfort.

Celiac.com 10/25/2016 - The 504 Plan stems from Section 504 of the Rehabilitation Act of 1973. This section prevents discrimination against public school students in grades kindergarten through 12 because of disabilities. A 504 plan is meant to "remove barriers" to learning by providing a specific outline on how to make accommodations or modifications on a student-by-student basis.

The Rehabilitation Act of 1973 applies to all institutions receiving federal financial assistance, such as public schools. Under this law, public schools must provide a free, appropriate public education and not discriminate against disabled students. This law acknowledges that the disability may not require special education services, but a plan is needed to ensure the student receives an appropriate education accommodating the disability within the classroom. This law must accommodate a special diet, including the gluten-free diet for children with celiac disease.

The decision to enroll in the 504 plan is entirely up to you as a parent or guardian. Some parents find that informal discussions and accommodations have been sufficient for having the child's needs met at school. However, having a formal 504 plan in place is valuable, especially as teachers and staffing may change. The 504 plan guarantees by law that your child's needs are met throughout their school career and not just in certain classrooms. You can choose to utilize your 504 plan accommodations any time, and having them in place before you need them can save important time and resources. It can be helpful if your child develops symptoms from gluten exposure, or if you are having trouble with consistent accountability.

How to Start Your 504 Plan

• First you need to contact your child's school. The 504 plan team should include:
• Primary classroom teacher
• School counselor or psychologist
• School nurse
• Director of food services
• 504 plan coordinator

You will also need a doctor's note to show that your child has been formally diagnosed with celiac disease or non-celiac gluten sensitivity (gluten sensitivity). This note should outline the accommodations required to maintain your child's health, enabling him or her to have equal access to public education. Having a 504 plan in place will also make it much easier to apply for disability accommodation in college.

What Information is Included in a 504 Plan?

Generally you'll need to provide information about your child's diagnosis and needs including:

• Year of diagnosis
• Amount of time on a gluten-free diet
• Details on why a 504 plan is needed (including how a restricted diet affects a major life activity)
• Child's developmental level and needs (are they self-reliant in managing the diet? do they need strict supervision? Etc.)

A 504 PLAN will specifically outline all of the details of how our child's celiac disease needs to be managed in the classroom. For example you and the 503 plan team can develop an action plan for:

• Navigating school lunches
• Snacks
• Birthday Parties
• Art Classes
• Field Trips
• Holiday Parties

I wish that this 504 Plan was available when my son attended school! Do not forget to check your school's ruling on peanut butter. A lot of schools will not allow lunches to contain peanut butter because of severe peanut allergies, and we need to be respectful of other food allergies as we sort through the maze of gluten-free lunch packing.

If you have a picky eater or a child who needs to gain weight after their diagnosis, nutritional shakes, power bars and calorie powders can pack a punch. Make sure they are labeled gluten-free. Consult with a registered dietitian to help with your child's meal plan. When you find a winning combo, send enough with your child to share. That will show your child's peers that gluten-free food is not "weird" and your child will have the opportunity to feel part of the group.

Recently, the U.S. Department of Agriculture (USDA) mandated that food service workers who manage and handle meals would need to complete education and training requirements in order to maintain their positions. The requirement to maintain professional standards education, which is required by the Healthy, Hunger-Free Kids Act, went into effect on July 1, 2015. Completion of the GREAT Schools program helps school nutrition professionals meet this requirement. You can remind your child's school that completing the GREAT Schools training program does benefit both your child and the cafeteria staff in maintaining the necessary education to work in school food service

Additional Resources:

• Open Original Shared Link
• Open Original Shared Link
• Open Original Shared Link

Celiac.com 10/20/2016 - Whether you are an adult or a child, you could have attention deficit hyperactivity disorder (ADHD), autism or even Asperger's Syndrome. If you do not have enough symptom improvements with the traditional treatments, then why not consider an alternative therapy? What about a gluten-free diet? There are so many statistics that show the connection between these mental conditions and celiac disease.

Now, in order to help the symptoms, eating a gluten-free and casein-free (Gluten-free Casein-free) diet might actually help. There is evidence of a correlation between ADHD and celiac disease. It is actually fairly strong. Children and adults with undiagnosed celiac disease, seem to have a higher risk than the general population. Once they started a gluten-free diet, the patients or their parents, reported significant improvements in overall behavior and functioning.

As for individuals with autism, they might have a food allergy or high sensitivity to foods containing gluten or casein. Eating a Gluten-free Casein-free diet, might help to reduce symptoms and improve speech, social and cognitive behaviors.
Children with autism, according to theory, process peptides and proteins in food items that contain casein and gluten differently. The difference within processing, may exacerbate autistic symptoms.

Lastly, children with Asperger's Syndrome, can actually have leaky gut syndrome as well. Treating with a gluten free diet could help ease certain symptoms, such as nonsense talk, obsessions, poor coordination, staring off into space and even social difficulties. Then, consider even going one step further and trying an elimination diet. This is an easy method of figuring out what foods your child is truly reacting to.

So, as you can see, these three conditions might actually have more improvements with just simple dietary changes. Having less challenges and being able to focus and interact with less difficulty won't be just a dream, but could be a real possibility for your child.

References:

1. Open Original Shared Link 
2. http://www.thesavvyceliac.com/2011/03/12/research-is-food-the-culprit-in-adhd/
3. Open Original Shared Link
4. Open Original Shared Link 

Celiac.com 10/18/2016 - Vitamin K was discovered in 1929 and named for the German word koagulation with Herrick Dam and Edward A. Doisy receiving the Nobel Prize for their research in 1943. But Vitamin K is a multi-functional nutrient.

Vitamin K1 or phyloquinone is found in green leafy vegetables like spinach and used by the liver for blood coagulation within 10 hours.

Vitamin K2 or menaquinone (referred to as MK-4 through MK-10) comes from natto (fermented soybeans), organ meats, egg yolks, and raw milk cheeses. It circulates throughout the body over a 24 hour period and is synthesized in the human gut by microbiota according to the Annual Review of Nutrition 2009. Aging and antibiotic use weakens the body's ability to produce K2 so supplementation needs to be considered.

The Rotterdam Study in the Journal of Nutrition 2004 brought into focus the role of K2 as an inhibitor of calcification in the arteries and the major contributor to bone rebuilding osteocalcin- NOT calcium supplementation that many health professionals had recommend. The study reports K2 resulted in 50 percent reduction in arterial calcification, 50 percent reduction in cardiovascular deaths, and 25 percent reduction in all cause mortality. K1 had no effect on cardiovascular health.

Dennis Goodman, M.D. in Vitamin K2- The Missing Nutrient for Heart and Bone Disease describes why most western diets are deficient in K2. Dietary awareness of Vitamin K has focused on anti-clotting since warfarin was approved as a medicine (in 1948 it was launched by the Germans as rat poisoning) and President Eisenhower was administered warfarin following his heart attack. Little attention was paid to any other nutritional importance this essential fat-soluble vitamin could provide.

Menaquinones (K2 or MK) are rapidly depleted without dietary intake of natto or animal sources needed for repletion which results in bone health issues, especially in menopause. Without it, the body does not use calcium and Vitamin D3 to activate osteoblasts to rebuild bone. Menaquinones cause cells to produce a protein called osteocalcin which incorporates the calcium into the bone. Without it, calcium moves into the artery wall and soft tissues of the body leading to hardening of the arteries and osteoporosis.

The benefit of K2 is not new research. In 1997 Shearer presented the roles of vitamins D and K in bone health and osteoporosis prevention in the Proceedings of Nutrition Society. The Osteoporosis International meeting in New Zealand 2013 re-emphasized this nutrient's importance proclaiming the best treatment for osteoporosis is achieving a strong peak bone mass before 30 years old and increasing Vitamin K2 food sources in the diet throughout life.

The richest food source of K2 is the Japanese fermented soybean natto, which is produced with Bacillus natto, a bacterium that converts K1 to MK-7. Fermented cheeses like Swiss and Jarlsberg contain Mk-8 and Mk-9 which can be converted to K2 at a 20 to 40 percent lower rate than from natto, but more appealing to the western taste buds. Grass-fed beef and egg yolks are the most common source of K2 in the American diet.

For those who have not acquired a taste for fermented soybeans or natto, my nutrition mentor, Adelle Davis, had it right when she recommended eating liver once a week. Celiacs need to be sure that their diets include ample red meats, eggs and fermented cheeses or yogurt or else dietary supplementation with Vitamin K2 (MK-4) is recommended. Without it, bones can become soft tissues and arteries "turn to stone" or calcified.

A Chart of Vitamin K levels in Foods can provide insight into food choices for menaquinone compared to Vitamin K1. It was adapted from Schurgers et al. Nutritional intake of vitamins K1 (phylloquinone) and K2 (menaquinone) in the Netherlands. J Nutr. Environ. Med. 1999.

The American Heart Association and many medical professionals who advocated no organ meats or red meat and egg yolks, deprived Americans of primary sources of Vitamin K2 which is essential for bone and cardiovascular health.

Celiac.com 10/12/2016 - How early can you diagnose celiac disease? This is a most challenging question for everyone: children, parents, pediatricians, gastroenterologists and many other health professionals. This is because, like so many other diseases, celiac disease is a progressive condition that slowly creeps up on you. In addition, there is disagreement about what constitutes a definitive diagnosis of celiac disease. What if the small bowel biopsy result is at odds to the blood test results?

It is my opinion that the fundamental diagnostic requirements for celiac disease remain unresolved. This makes early diagnosis problematic!

Do you keep waiting (whilst suffering from symptoms) for classic gut damage to be visible in a bowel biopsy before adopting a gluten-free diet? Or do you recognize the early onset of celiac disease and go gluten-free prior to this gut damage occurring? Will you be accused of "masking" celiac disease if you are an early gluten-free adopter?

Currently, most guideline protocols require a definitive diagnosis of celiac disease by demonstrating small bowel tissue damage. This is achieved by performing and upper gastrointestinal endoscopy, taking a tissue biopsy of the mucous lining of the small bowel, and then showing specific tissue damage (villus atrophy) under the microscope: this is the small bowel biopsy procedure.

However there is significant controversy about the accuracy and necessity of a small bowel biopsy test. We will have a close look at the difficulties and shortcomings of these tests. But first, let's look at these diagnostic problems in relation to Francesca.

Meet Francesca who is highly at risk of celiac disease
So how early could we diagnose Francesca's celiac disease? She has just turned 3-years-old. Her mother has celiac disease, diagnosed over 10 years ago. So mum bought Francesca for my opinion because she had started to have some loose bowel motions (runny poops), although sometimes she did have hard bowel motions, which were difficult to pass. She also had a big distended tummy, was getting more cranky, and a bit more tired. Because of mother's celiac disease, Francesca was already consuming a smaller amount of gluten, although she was eating at least one slice of normal wheat gluten bread each day. Her mother's question was: "Has Francesca now developed celiac disease?" This problem confronts me most days in the Clinic.

How should I investigate and manage her illness?

• What blood tests should I request?
• How do I interpret her results?
• Should I organize a small bowel biopsy?
• Do we look for early evidence of gluten problems, or do we wait for end stage celiac damage?
• Should she go on a gluten-free diet now?
• Should we be concerned about "masking" celiac disease?

Francesca's blood tests show:

1. She does carry the HLA gene DQ2: this makes her a likely candidate for developing celiac disease.
2. The tissue-damage antibodies were normal: the tTG (tissue Trans-Glutaminase) levels were low normal, but the IgG-DGP (Diamidated Gliadin Peptide) levels were borderline (18 units, with a normal range 0-20). Her EMA (Endomesial Antibody) was negative: the borderline DGP is very suspicious and evidence of early celiac disease.
3. IgG-AGA (Anti-Gliadin-Antibody) level was moderately raised: showing that she has developed an immune response to gluten.
4. She has not had an endoscopy: with her tissue damage antibodies at low levels, the likelihood of abnormal tissue histology is very low.

My opinion
In my opinion, this child is at extreme risk of developing celiac disease. I would like to see her on a strict gluten zero. However, it is now up to her parents to decide whether they will wait until she actually develops gut damage, or do something now to prevent her getting a serious disease.

What would you do if she were your child? Well her parents decided to place her gluten-free and they saw a big change for the better in just a few weeks. Her bowels become normal, her energy levels improved and she is now a happy girl.

So what is her diagnosis? I call her early celiac disease. Others would say she has non-celiac gluten-sensitivity. Some would claim that I am unwarranted to suggest a gluten-free diet until she has a positive biopsy and they accuse me of "masking" celiac disease by treating her symptoms.

Why let Francesca unnecessarily suffer whilst waiting for her to get progressively sicker until we can get a tissue diagnosis?

Written in the spirit of cooperation and knowledge sharing. You can read many more patient stories in my book "Gluten-Related Disorder: Sick? Tired? Grumpy?" (Open Original Shared Link).

Celiac.com 10/10/2016 - Omega-3 fatty acids are an important part of our diet. These key players help with brain function, are good for your heart, improve cholesterol and provide numerous other benefits. Salmon tastes delicious alone but why not dress it up a tad and enjoy a bit of change? I always love to work with gluten-free spices and add new and unique flavors to my gluten-free recipes.

My maple salmon recipe is the perfect amount of sweet along with all the spices playing perfectly with one’s palate. Remember when purchasing salmon, ensure each piece is a similar thickness for consistent cooking. Most grocery stores will have precut pieces all ready to go. As a side note, this sauce pairs well with other proteins like chicken.

Ingredients

• 8 6 oz. salmon fillets
• 1 lemon, cut into wedges
• 4 teaspoons extra virgin olive oil
• â…› teaspoon nutmeg
• â…› teaspoon cinnamon
• 2 tablespoons garlic powder
• ¾ teaspoon salt
• 1 tablespoon onion powder
• â…› teaspoon black pepper
• ¼ cup gluten-free soy sauce
• ¼ to ½ cup grade-B maple syrup

Directions:

1. Rinse and dry salmon fillets.
2. Rub each with a lemon wedge.
3. Brush 2 teaspoons of oil onto the fleshy side of the salmon (to help seasoning adhere).
4. In a bowl, mix nutmeg, cinnamon, garlic powder, salt, onion powder and black pepper. Sprinkle each filet with spice mix. Let sit covered in fridge for 1 hour.
5. Heat skillet and coat bottom with 2 teaspoons of oil.
6. When oil is hot, place salmon in skillet, flesh side down, and cook over high heat for about 4 minutes or until brown. Turn over and cook for an additional 4 minutes.
7. In a saucepan, mix together soy sauce and maple syrup over medium heat until sauce is thick enough to coat the back of a spoon (about 7 to 10 minutes).
8. Drizzle sauce over salmon fillets and serve.
9. Enjoy!

Celiac.com 10/06/2016 - You do not need to be celiac to need to stay away from gluten. Wheat isn't just harmful to celiac or gluten-sensitive individuals. Did you know that just one slice of wheat bread raises one's blood sugar higher than 3 teaspoons of table sugar? That is equivalent to 12 grams of sugar! Talk about diabetes waiting to happen!

I am very diligent in reading over even the gluten–free ingredients of products to ensure they are indeed gluten-free. I decided to start grabbing items off of the shelf to read the other listed ingredients as well. Wow, was I surprised! Sugar, high fructose corn syrup, corn syrup, fructose etc.! Sweetener and especially sugar are added to so many things; it is really horrible. No wonder Americans are addicted to it. We have many new diagnoses and physical disorders stemming from the standard American Diet, the "improper diet", not to mention a rapid rise in obesity statistics and diagnosed diabetes.

Americans love bread, gluten-free or not. Go to a restaurant and what is the first thing brought to the table? Bread! Can you imagine being brought some cut up cucumbers and celery instead? Now THAT would be a nice change! I often ask for this by the way and suggest you do as well.

Kids products are the worst! To give a tiny or growing body with a rapidly developing brain that needs proper nutrition all that junk, additives and unhealthy ingredient are a crime. If your child has been having trouble focusing in school, I highly advise you to look at the ingredients list of the food and snacks he or she eats and check out the children's menu at a restaurant. Gluten-free foods as well.

You may not have any issues with gluten and wheat type bread but it is harming your body in one way or another and I strongly advise you to stay away from it and keep your family off of it too. I also highly suggest you start being diligent and read your gluten-free product's ingredients list. Going gluten-free is the first step as a diagnosed celiac or one who is gluten intolerant, but getting healthier or staying healthy is of utmost importance to a long and healthy lifestyle. Your body's future is in your hands.

Celiac.com 10/04/2016 - Several years ago, Dr. Levinovitz contacted me by telephone, asking if he could interview me then, and in subsequent calls, for a book he was writing about gluten consumption. Assuming he, as an academic employed by a university, had an open mind, I was happy to share my own anti-gluten paradigm and the sources of my angst about these harmful foods. Dr. Levinovitz mentioned that he was involved in religious studies, but since I had earned my doctorate in the field of Education, I didn't feel any particular concern about answering his questions or his qualifications to write about gluten. As the interviews proceeded (he called back for further information and/or clarification at least once more but I think it was twice) I was most anxious to help with his project as I see gluten as a food source that fosters a great deal of illness. Because he used a poor, static laden Internet phone (VOIP) for these interviews, I missed much of what he was saying, but when I got the gist of his questions, I did my best to answer as fully and honestly as I could.

However, when I mentioned that several of my former students had benefitted academically from excluding gluten from their diets, he wanted their names and contact information. That is when I began to feel uneasy. I told him that I would get back to him with that information if my former students were willing to be interviewed. After some thought, I decided that I would not expose these people to Dr. Levinovitz's questions without their prior permission and without a clear understanding of what he was trying to accomplish. He was quite forthcoming when I asked for some specifics about his book project. He said that he planned to attack the whole gluten-free "fad". He said that he saw it as silly and unscientific. Please remember that I'm paraphrasing something that was said several years ago, over a poor telephone connection, so I am open to correction on the specific words he used, although his meaning was crystal clear.

I realized that he was determined to undermine much of the work I had done to sound the alarm about the human health hazards posed by gluten consumption. I speculated aloud that he had used the VOIP to make it more difficult for me to detect his duplicity when not telling me what his book project was about during that first call when he asked to interview me. I ended the call and did not respond to the two phone messages he subsequently left for me. He hadn't lied. He just hadn't told the whole truth. He claims, in his book, that exaggeration or distortion is a lie when it comes to science (p. 18). What is it when the distortion is aimed at getting an interview? Is that a lie too? I don't know.

On the other hand, readers of his book will not suffer any confusion about its author's bias. The title gives adequate forewarning. He begins with the anti-MSG movement, which he describes in detail, beginning in 1968 and extending to a 2013 edition of a reference book where MSG is exonerated as a harmful additive, except in "rare" cases. The implication is clear. Americans condemned and avoided this Japanese flavor enhance for a period of 45 years without what Dr. Levinovitz considers to be good reason. Perhaps some Americans continue to avoid MSG. Dr. Levinovitz says that "Today, food allergy experts believe the overwhelming majority of reactions to MSG are psychological, not physiological." (1 p. 4) I saw this type of statement repeatedly when reading his book. Dr. Levinovitz makes sweeping generalizations for experts in "food allergy" and other such specialist practitioners without any apparent desire to provide a source for these statements of opinion. If his approach is correct, my training has me suffering under the faulty illusion that citing sources is a very important part of science.

But "what," you may ask, "does MSG have to do with gluten?" Well, it seems that Dr. Levinovitz wants us to conclude that the anti-MSG fad is the same as the shift away from eating gluten grains. He also tells his readers a story about Horace Fletcher and his "theory of mastication," in which a low protein diet is consumed, chewing the food hundreds of times. This, according to Levinovitz, was what led Fletcher to make claims of weight loss and improved health. Levinovitz names several prominent individuals who followed Fletcher's prescription. Then, Dr. Levinovitz discusses epidemiology. Quoting an authority on the subject, who attributes the causal connection of lung cancer to smoking to this type of study. This authority also states that it is exceedingly difficult to establish "credible linkages" in these studies. There is a very good reason for that. Epidemiology may have pointed researchers at smoking as a candidate for causing lung cancer, but this kind of study cannot be used to establish causal relationships. That approach to dietary research is a major source of the many dietary misconceptions that Dr. Levinovitz decries.

Levinovitz fails to explain just what epidemiology is. It is the study of correlations. During my first year of university, in the 1960s, I was taught that "correlation ‰ causation". This means that simply because two things happen at the same time and place does not mean that they are linked in a causal relationship. For example, drowning deaths can be shown to rise and fall with ice cream sales, and victims of auto accidents usually wear white underwear. Does that mean that ice cream causes drowning deaths? Or that white underwear causes car accidents? Most of us recognize these as foolish claims. Yet that is the type of study that is at the very heart of the epidemiology or "science" that Dr. Levinovitz offers his readers under the heading of "What Real Experts Say about Gluten".

He claims that "..... after I reveal the myths and superstitions behind fears of gluten, fat, sugar, and salt, you will be less afraid of these vilified foods - and food in general." (1 p.22) He also says that: "..... exaggeration in science is nothing less than a lie" (1 p. 18).

Lest you begin to fear that Dr. Levinovitz becomes more timid as the book progresses, the first sub-heading in chapter two is "The Gluten Liars" (1 p. 23). He very briefly explains that there are about one percent of Americans, or about 3 million have celiac disease and only 17% have been diagnosed. Thus, 2 and 1/2 million Americans with active celiac disease are, as yet, undiagnosed.

He goes on to say that "a slightly larger number of Americans" have a condition called non celiac gluten sensitivity, but says that this malady or set of maladies is a "matter of considerable debate". Yet some of the world's foremost experts in gluten sensitivity research (2, 3) publishing in a wide array of journals, have estimated that between 0.5% and 6% of Americans have non celiac gluten sensitivity (2, 3). They define it as a condition in which the person's innate immune system reacts to gluten and causes symptoms similar to those seen in celiac disease. Although it defines a range, it is a number that could stretch to something north of 18 million individuals in the USA alone. Where I come from, that's more than just "a slightly larger number". As Dr. Levinovitz repeatedly admonishes, 'remember, in science, any exaggeration is a lie' (1 p 18).

But there's more. Levinovitz acknowledges celiac disease (he is unclear about the diagnostic criteria) and non celiac gluten sensitivity (NCGS) diagnosed on the basis of innate immune reactions to gluten, but he really is missing quite a few people who are gluten sensitive and would, and sometimes do, benefit from a gluten free diet. For instance, when IgG antibodies against gliadin are measured, they show that 10% to 12% of the population is mounting an identifiable, measurable immune reaction to gluten grains. However, these findings are non-specific, so they are not popular with doctrinaire writers such as Dr. Levinovitz. There is also a sub-group of people with schizophrenia who show an immune reaction to transglutaminase 6, another grain-related reaction that is also implicated in some brain disorders (3).

Dr. Levinovitz presents both Grain Brain by David Perlmutter, M.D., and Wheat Belly, by William Davis, M.D., as irresponsible and alarmist. He then claims that reading such books can "make people physically and mentally ill". That claim falls well short of the scientific standards set by these two anti-grain authors. Levinovitz apparently doesn't see any harm in his sensationalist rhetoric attacking these two physicians for writing within their areas of specialty, yet Dr. Levinovitz's field quite far removed from the laboratory. There is something terribly incongruent here. But what, exactly, does Levinovitz have to teach us about science?

He wants us to listen to statements he attributes to several authorities. For instance, he quotes Dr. Stefano Guandalini, as an expert in nutrition, saying that the gluten free diet "is not a healthier diet for those who don't need it" p. 29 and later in the same paragraph, Guandalini is quoted as saying "these people are following a fad, essentially" but the reader is left wondering if Dr. Guandalini defined who does or does not need the diet? Such selected quotes can sometimes fail to accurately communicate the meaning of the speaker's comment.

When I conducted an Internet search for this statement along with Dr. Guandalini's name, I found an article from the New York Times in 2013. The statement appeared to be exactly the one Dr. Levinovitz attributed to Guandalini (p. 29). However, in the NYT article, Dr. Guandalini goes on to say "And that's my biased opinion." That small addition makes a huge difference to the meaning of Dr. Guandalini's statement. I had only read to page 29 of The Gluten Lie when I discovered this deception. And Dr. Levinovitz has the nerve to go around calling others liars? He deliberately withheld the part of Dr. Guandalini's statement that qualified it as his own bias.

Dr. Levinovitz is certainly teaching us something about gluten lies, but his lessons may not carry the message he wants to disseminate. Levinovitz mentions me in his acknowledgements. At the time of the interview, I told him repeatedly that I had earned a doctoral degree in Education, shortly after the publication of Dangerous Grains. Yet he represents me as having gone back to university to get a Master's degree. I had already accomplished that well before the time Dangerous Grains was published. I now wonder if he made this omission intentionally, especially given his other "oversights" outlined above.

He also mentions me at several points in his book. He does grant that undiagnosed celiac disease in connection with fibromyalgia, irritable bowel syndrome, diabetes, atopic eczema, and "other related conditions." p. 43 But he insists that only those with these conditions in the context of undiagnosed celiac disease will benefit from a gluten free diet. That's a pretty strong statement. It appears that Dr. Levinovitz has not experienced the challenges of getting appropriate testing for celiac disease, so he doesn't understand.

Perhaps he missed all the twists and turns that researchers have experienced on their way to choosing villous atrophy as the defining characteristic of celiac disease? He may not realize that the "gold standard" intestinal biopsy was a retrofit added to the diagnostic criteria for celiac disease to counter the widespread resistance to Dr. Dicke's claim that dietary gluten was the cause of celiac disease. Gastroenterologists simply wouldn't believe that gluten could cause celiac disease without some rigorous testing that ultimately excluded many of the folks who were previously diagnosable with this ailment, many of whom died from it. So the diagnostic criteria began with a constellation of gut symptoms, then it relied on an intestinal biopsy showing damage that was reversed by a gluten free diet. Now, those who have the same symptoms, which also respond to a gluten free diet, and who might previously been diagnosed with celiac disease, are now thought to have non-celiac gluten sensitivity.

The rude dismissal of Dr. Dickie's ideas by American gastroenterologists, signals a dynamic in science that was originally outlined by Thomas S. Kuhn, which Dr. Levinovitz seems to have overlooked. Kuhn's book, The Structure of Scientific Revolutions (7) outlines the process by which scientific revolutions take place. To oversimplify and paraphrase the process, it begins with scientists in that field ignoring the new idea. Then, as it gains credence, the scientists laugh at it. With gaining momentum, the new idea is vigorously opposed. Finally, once widespread acceptance has been gained, the scientists give the impression that they had known this all along.

Apparently, Elaine Gottshall wrote two books about gluten. I haven't read them. I have heard of them, and some folks swear by them. I don't know about the quality of information she provides. But I know that the information I provided in Dangerous Grains was accurate and it was mostly drawn from the peer reviewed medical and scientific literature, and supported by personal anecdotes from individuals on the celiac listserv. Further, every one of the more than 200 correlations between celiac disease and other ailments was drawn directly from the peer reviewed medical literature. Yet, Dr. Levinovitz lumps us together, saying that "Gottshall and Hoggan deserve our sympathy....." and in the next paragraph: "Sure, they distort the evidence and overstate the dangers of gluten. But is there any harm in that? You bet there is" (1 p. 48).

So what did I distort? What did I overstate? Does he base his refutation of our ideas on science? His evidence looks a lot less scientific to me. For instance, he claims that "rumors of illness can make you sick" (1 p.50). So it isn't much of a stretch for him to depict specialist physicians such as William Davis, MD, David Perlmutter, MD, and myself (not a physician) as purveyors of illness. Dr. Levinovitz's "science" is made up of the personal bias of Dr. Guandalini, as quoted in the New York Times, gossip from an endocrinologist, more personal opinions from scientists, consensus opinions, and even some opinion statements published in medical journals. For instance, he quotes Jennifer Thomas, a professor of psychology at Harvard Medical School as saying "There are no studies, but anecdotally we see this all the time". She is then quoted as saying "Of course most of my patients are reading these types of books and it definitely concerns me. People can't typically stick to these rigid diets" (1 p. 54). So, if there aren't any studies are we supposed to accept her pronouncements instead? And what harm do these rigid diets do if people can't stick to them?
Dr. Thomas does grant that "Eating disorders have been around, with or without these food fads, But I still believe that these diets can be a gateway to an eating disorder, and that they can help you maintain it" (1 p. 55). If there aren't any studies, what does she base this belief on? Isn't this the very heart of Levinovitz's argument? Doesn't he say that we should use science, not personal beliefs, to inform our views about diet?

Then Dr. Levinovitz attacks Dr. Robert Lustig, MD, an endocrinologist. Levinovitz quotes, in his chapter about sugar, gossip from another, nameless endocrinologist who calls Lustig "extreme and opinionated" (1 p.94). Perhaps he is. I don't know Dr. Lustig. However, I do know that Dr. Levinovitz has presented this gossip as "evidence" to further his attack on a group of not just physicians, but specialist physicians who have conducted studies and have done extensive work in their specialty fields. Levinovitz relies primarily on epidemiological studies (the ones that can be used to blame drowning on ice cream sales) expressions of personal bias, published opinion statements, and consensus opinions.

I believe that Dr. Levinovitz should attack any idea that he believes to be faulty. I believe that he is entitled to believe whatever he believes and shout it from the rooftops if he wishes. But I hope that his readers recognize that he needs more than personal opinions, gossip, sweeping generalizations, and the hyperbole he accuses others of wielding to effectively counter the work of dedicated people who have found answers for themselves and are trying to share them with others.

His attack on salt misses the more important point that we should be consuming sea salt, not just sodium chloride, to get the salt taste and the nutritional benefits of salt without the possible hazards of too much sodium for those who are sodium sensitive.

Are there other deceptions in The Gluten Lie? Perhaps. Is there anything of value here? I don't know. I think that we all need to take more responsibility for our own health. I don't know how most of us can do it through reading peer reviewed research articles. They are available but difficult to read without a strong educational background, especially in statistics. Dr. Levinovitz seems like a nice enough fellow except for his tendency to do exactly what he criticizes me and others for... hyperbolizing and twisting the facts to fit his own narrative. He may even have good intentions. It's hard to say. Although his omissions are misleading, I'm not sure whether he really means to mislead, or if his personal bias is so powerful that he is confused about the difference between gossip and evidence; the difference between opinion and data, and; the difference between epidemiology and the various other forms of research designs that can be brought to bear on questions about human nutrition. Whatever the source of his views on the gluten free diet, there doesn't seem to be much actual scientific insight there.

Sources:

1. Levinovitz A. The Gluten Lie And other myths about what you eat. Regan Arts, 65 Bleeker Street, NY, NY 2015.
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3. Lebwohl B, Ludvigsson JF, Green PH. Celiac disease and non-celiac gluten sensitivity. BMJ. 2015 Oct 5;351:h4347
4. Cascella NG, Santora D, Gregory P, Kelly DL, Fasano A, Eaton WW. increased prevalence of transglutaminase 6 antibodies in sera from schizophrenia patients. Schizophr Bull. 2013 Jul;39(4):867-71.
5. Leonard MM, Vasagar B. US perspective on gluten-related diseases. Clin Exp Gastroenterol. 2014 Jan 24;7:25-37.
6. Open Original Shared Link
7. Kuhn Thomas S. The Structu5re of Scientific Revolutions. University of Chicago. 1962.
8. Aziz I, Lewis NR, Hadjivassiliou M, et al. A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care. Eur J Gastroenterol Hepatol 2014;26:33-9.