Celiac.com 03/10/2018 - There's something so fun about summertime picnics; everyone is always so excited to whip up a batch of their famous gluten-free pasta salad or cornbread.  Whether you're bringing along the red and white checker tablecloth and wicker basket or simply using a towel and a canvas tote - there's always fun to be had at a picnic.  It may be nothing fancier than a peanut butter and jelly sandwich but you're still likely to have a fabulous time with good friends and tasty food.

After 30 years of picnics, I've seen just about every dish – the potato salad, the Jell-O mold and the deviled eggs.  But no matter how faithful you are to your picnic favorites I'll bet you'll find a few tasty options below to keep your taste buds happy this picnic season.  Here are a few of my tasty gluten-free favorites to bring along to my summertime picnic soirees.

Fresh Mozzarella and Balsamic Peaches: Toss together 4 sliced peaches, 12 mini balls of fresh mozzarella, 2 tsp. balsamic vinegar, 1 small red onion, 2 Tbsp. rosemary, 2 Tbsp. olive oil, 1 tsp. lemon juice, sea salt and pepper.  

Beet Salad Pitas: Peel beets and grate them in a food processor; add ½ cup pistachios, 1 Tbsp. orange zest, 2 Tbsp. orange juice, 2 Tbsp. olive oil, 1 cup Greek plain yogurt and ½ tsp. fresh parsley stuffed into gluten-free pitas.

Avocado Hummus and Fruit Skewers: Combine 2 ripe avocados, 1 cup black beans, ½ cup cilantro, 1 cup corn, 1 pint cherry tomatoes, sea salt, pepper, 1 Tbsp. fresh lemon juice, 1/3 tsp. chili powder and ¼ tsp. cumin in a food processor; pulse until smooth.  Serve with fresh fruit skewers of apples, pineapple and jicama chunks.

Curried Deviled Eggs: Hard boil a dozen eggs.  Slice each egg in half, remove yolks. Combine yolks with Greek plain yogurt, curry powder, Dijon mustard, lime juice, sea salt, white pepper, cilantro, red onion and diced apple; mix well.  Place a Tablespoon of mixture into each egg white half and serve.
Sweet Potato Pesto Turkey Wraps: Combine 4 baked sweet potatoes, 8 Tbsp. olive oil, sea salt and pepper, 2 ½ cups fresh parsley, ½ cup pine nuts, 1/3 cup walnuts, 1 clove garlic, 1 tsp. lemon juice, ½ tsp. lemon zest in a food processor; pulse until smooth.  Spread atop organic slices of turkey and roll up.

Peanut Edemame: Toss together 1 cup cooked edemame, 1 Tbsp. smooth peanut butter, 1 tsp. honey, 2 tsp. warm water, 1 tsp. sesame seeds; gently toss to combine.
Sunshine Tea with Fresh Mint: Combine 4 cups of boiling water, 4 green tea bags, 1 freshly sliced lemon and 1/3 cup fresh mint leaves in a large pitcher. Set in the sun for 8 hours. Serve over ice.

Bon appétit!

Celiac.com 12/29/2017 - Do you remember the moment when you were diagnosed with celiac disease or gluten sensitivity? Most people I talk to have it etched in their memory. After all, the information is life transforming. Yet, I doubt if most of us understood the enormity of the information until time passed and we had the opportunity to actually fully understand what it meant besides the gluten free diet (GFD).

Along with having to learn that gluten is everywhere, we also learn that having to eat differently is, to put it mildly, upsetting. In fact, the psychological impact of living with celiac disease or gluten sensitivity usually involves depression and anxiety. There are other emotional responses as well; these include grief and, for some, trauma (depending upon how long it took for a diagnosis and how sick the person became).

Celiac disease or gluten sensitivity is such a difficult illness to live with because of the social and cultural fallout we are forced to deal with as a result of having to be on the gluten-free diet. We quickly learn how difficult it is to negotiate the world having to live on the gluten-free diet.

Let's start with how much food is involved in normal social situations: a family gathering, a party, going out to eat for any meal, a wedding, and for kids of all ages, school, camp, etc. Until it happens to you, it is very difficult to comprehend the enormity of the change and its limiting impact. Change is something people do not like, even if that change is good. And we most certainly do not like to change the way we eat. Just talk to anyone who has ever been on a diet. Unfortunately for those of us with celiac disease or gluten sensitivity, the diet is not optional. And, it's hard; so hard in fact that some people cheat. And ultimately, they pay.

Culturally, food is hugely important. Food is almost always involved in every occasion that involves spending time with people, dating, any rites of passage including bridal showers, baby showers, weddings, and birthday parties. And there are the holiday gatherings. Every single time you are invited to attend one of these events, you have to stop and think about whether it's worth it to attend. If you go you will either have to eat before you go, take your own food or ask the hostess to make special arrangements. You not only feel like a burden upon those in your social and family circles, but you find yourself stressed out by the mere prospect.

And the social consequences are enormous. The very people life you have always relied upon for support, begin to drift. You find yourself shocked and saddened by the reactions and behavior of family and friends who you never suspected of being unable to handle change in you. It's hard not to take personally, but their reaction is not about you. They most likely react this way because your life is now too restrictive for them. Just like you, they want to be able to go wherever they want to eat, serve whatever they want to serve and not have to think about it twice. But unlike you, they still can. And this inevitably leads to conflict. Then your feelings get hurt and they are frustrated and you simply stop getting together as often because, in the end, it's just easier.

I believe that is why people with this disease enjoy socializing with others who are also living on the gluten-free diet. We are trying to avoid the social isolation, loneliness, and shame. We want to forget our fear of the unknown, feeling like we no longer fit in, as if we are lost, or in denial and maybe needing more information. In a nutshell, we feel crazy. Because we cannot do something most people can do: eat normally. These feelings are only a portion of what I have learned about people who are forced to live on the gluten-free diet experience. Parents of children impacted with celiac disease or gluten sensitivity share these feelings as well.

In the end, you need to give yourself time to fully understand the gluten-free diet, and in order to keep yourself safe, become vigilant to all of the hidden places gluten can hide. We do know that those who stay on the gluten-free diet and avoid gluten as much as possible feel better emotionally much more quickly than those who do not. I cannot underestimate the need to consult a good dietician. You need to find others living on the gluten-free diet; they can often be found through local support groups. Some of us might find it helpful to talk with a therapist who is familiar with celiac disease, gluten sensitivity or chronic illness in general.

Lastly, you also need to remind yourself that you cannot change how your body reacts to gluten. And you cannot change other people. What you can change is your perception and attempt to understand that while we may require a different diet to stay safe and healthy, those who do not have our diagnoses do not. Our experience of life, then, is changed. We have had change forced upon us. Our friends and family have not. The only thing different to them is that we are telling them we can't eat the way we used to. I think the sooner we accept these facts, the sooner those around us will as well.

You are not crazy. The way you have felt since the day all of this began for you is perfectly normal. Yes, some people have serious depression in addition to celiac disease and gluten sensitivity. This requires treatment in addition to the gluten free diet. For some, the depression and anxiety are alleviated over time because of the gluten-free diet and subsequent healing. In the end, this is a difficult but doable road and you are in good company.

Celiac.com 12/21/2017 - After a lot of trial and error we celiacs learn, often the hard way, to eliminate foods that are poisonous to our bodies. Sadly, we often forget about what "goes onto" our skin. Since the skin is the living outer layer of our bodies it absorbs not only water and oils, it also absorbs cosmetics that can be poisonous to our celiac bodies, most specifically those of us afflicted with dermatitis herpetiformis (often called celiac disease of the Skin). Men, before you set this article aside, thinking it's only for women and you are exempt, please read on. One of 133 Americans has a wheat-related allergy according to CNN.com. We have a tendency not to group toothpaste and lip-glosses with cosmetics, and we usually ignore vitamins and medications when researching celiac disease and dermatitis herpetiformis. We forget to ask our hairdresser what products they are using and whether they contain wheat or gluten, and glibly apply night creams (to absorb into our skin as we sleep) and mud packs that promise similar benefits.

Inquiring into the gluten content of cosmetics, I contacted more than twenty leading companies, then I waited. I was discouraged, particularly by the blatant rudeness of some of the responses I received. Meanwhile, I had to learn whether gluten could be absorbed through the skin.

Some websites answered that question with a direct "no". Even some physicians responded saying "no". However, since the skin is the largest living organ in the body and it does absorb various oils and emollients, listing gluten-containing components of medicinal and non-medicinal ingredients allows consumers with celiac disease (celiac disease) or wheat allergies to make informed choices when purchasing and/or consuming natural health products. It enables them to avoid gluten in quantities that may trigger adverse reactions.

There are numerous articles on dermatitis herpetiformis and celiac disease making claims so contradictory that it is no wonder we are confused. And I'm not talking about accidental ingestion of gluten. Some such articles claim that trace amounts of gluten One article insists that the skin is not going to absorb gluten, even though our skin is a living organism that can absorb suntan lotions, trans-dermal drugs, etc. It is so susceptible to absorption that when you place a slice of onion in your sock you will taste it in your mouth the following day. How can these websites make such contrary claims? The skin absorbs flavors as well as creams containing gluten.

On the other hand, "Glutino" had an article on record, written on September 14, 2010, regarding "Hidden Gluten in Health and Beauty Products". It states that if you apply hand lotion that contains gluten and then prepare food you are exposing yourself to accidental ingestion and your food to cross contamination. They suggest a site called: naturallydahling.com, a site that lists gluten-containing ingredients commonly used in cosmetics.

Research proving the full extent of how much your skin absorbs is still unavailable, but to those who believe that "what goes on, goes in", the cosmetic industry is full of unknowns. The size of gluten molecules suggests that they may not be able to pass through the skin, but chemicals and technology designed to enhance skin absorption are already present, if not prevalent, in the cosmetic industry. These chemicals are potentially dangerous and often go untested for negative health effects, yet are widespread in lotions, antiperspirants, perfumes and the "Great Mother Market" anti-wrinkle cosmetics.

Since the cosmetic industry is self-regulated it is more important than ever to carefully read labels and use natural or organic products whenever possible. If you find yourself reacting to a particular cosmetic, it is possible that you may have an increased sensitivity to gluten, an allergy or even dermatitis herpetiformis.

But wait a minute! Aren't we told that gluten cannot pass through the skin? I suffered terribly from the use of an "Anti-Frizz" product for my hair that caused a massive outbreak of dermatitis herpetiformis. I should have read the label all the way down to the end. I would have found, in very small print, "wheat germ oil". When researching for this article, I wrote to the company and mentioned my problems with their product. I received an apology and a sample of their "new and improved" "Frizz-Ease" product. They obviously do not know their own products and the fancy names they use are as confusing to them as they are to me. The "new and improved" product contained Avena Sativa, the Latin name for OAT.

I was also told that I likely just had "hives" on the back of my scalp, as oats are still somewhat controversial. Some research suggests that oats in themselves are gluten free, but that they are virtually always contaminated with other grains during cultivation, harvest, distribution or processing. Recent research indicates that a protein naturally found in oats (avenin) contains peptide sequences closely resembling some peptides from wheat gluten. The oat peptides caused mucosal inflammation in significant numbers of celiac disease sufferers. Some examination results show that even oats that are not contaminated with wheat particles may be dangerous.

Again, I was told not to introduce oats into my diet, or use oatmeal as a facial mask until I had been free of a dermatitis herpetaformis outbreak for at least a year. Thus far I have not been able to get relief for that long. It seems the celiac or those who suffer from dermatitis herpetiformis {and let's face it, most people suffering from dermatitis herpetaformis have celiac disease} have to apply the rule of "caveat emptor" - Let the buyer beware.

Tolerance to gluten varies among individuals with celiac disease and there are limited clinical scientific data on a threshold for the amount of gluten required to initiate or maintain an immunological reaction in celiac disease patients. "Therefore there is no clear consensus on a safe gluten threshold level." The Dermatologist I see at The University of British Columbia Hospital has told me to tell people in restaurants that gluten is poison to my system and I can become very ill from ingesting gluten. They are a little more careful before telling me a dish is gluten free, and hopefully through education the cosmetic industry is going to improve its testing and cease glibly stating things as "fact" when they simply do not know.

Industries that produce over-the-counter medications and vitamin supplement, especially those that may contain gluten as a binding agent, should also be scrutinized. We have come a long way, but large challenges are still ahead. One of our biggest challenges is reading the labels on these products. One almost needs to carry a magnifying glass when shopping.

Cosmetics, which include hair products, soaps, perfumes and toothpastes also run us into problems, often big, "itchy" problems. The male celiac/dermatitis herpetaformis experience can also include outbreaks from any product that comes into contact with the skin and particularly those that "stay" on the hair or skin. Who would have known that sun tan lotions could contain wheat germ oil? It is difficult enough to eliminate words such as "triticum vulgare" the Latin name of wheat or "wheat germ" containing ingredients!

In preparation for this article, I contacted the following companies:
Avon, Clairol, Clarins, Clinique, Coty, Covergirl, Estee Lauder, Garnier, John Frieda, John Paul Mitchell, L'Oreal, Mabelline, Marcelle, Neutrogena, Olay, Pantene, Revlon, and companies that go under general all-encompassing headings such as "Life Brand". This can be a daunting task, and "gluten free" and "wheat free" are not the same thing.

Some of the things that I learned in this rather massive undertaking include the rule of "Pac Man". Companies are sometimes taken over by bigger companies and when this occurs their rules change. A company that at one time did not test on animals or use machines that were cleaned prior to using products claiming to be gluten free are now glibly adopting the "new bigger and better". I was shocked to find out that some of the containers from the smaller company were still being used after these PAC MAN take-overs, to save on manufacturing costs.

And, remember, once several ingredients are combined the "organic" ingredient probably ceases to be "organic". Some women (and men, you are not exempt here) expect to pay a higher price for a luxury brand assuming that the gorgeous bottle of eye cream sold at Saks for $60.00 is going to work better than the $1.99 tube on the clearance rack of a local store. Just ensure the product has not reached its "sell by" date because it may all be psychological. What you have to concern yourself about, as a celiac patient or a person with dermatitis herpetiformis, is whether there is gluten or wheat in that product.

Before you splurge on an expensive product take the time to compare it to a similar product from one of their sister brands. Usually an online store (like Drugstore.com) will list the ingredients. Or you can check on a site like "Makeup Alley" which is a great resource, offering numerous reviews and you can ask questions of the extremely knowledgeable posters on this message board.

Another great resource is a large paperback book, titled "Do not go to the Drugstore Without Me" written by Paula Begoin. When I purchased the books in 2001 it was in its 5th Edition. NB: This is not a book specifically for celiac disease or dermatitis herpetiformis, but it was in this book that I found out about "Glutamic Acid". It is derived from wheat gluten and is an amino acid that can have water binding properties for the skin. It also explains glycerylesters that form a vast group of ingredients that are a mixture of fatty acids, sugars, and non-volatile alcohols. These fats and oils are used in cosmetics as emollients and lubricants as well as binding and thickening agents. At the back of this book is a list of the companies that do not test on animals and those that do, but again, the PAC MAN Rule applies.

I purchased the book for myself, my daughter, and daughter-in-law, specifically because when my daughter was in her twenties she seemed to think she simply must buy her shampoo from the hairdresser because only $45.00 shampoo was good enough for her hair. It was a big eye opener when she moved out of home and had to purchase it herself!

I believe that the more we know about beauty products and the beauty industry the wiser our purchases will be. Consider, for instance, the cost of research and development for say, L'Oreal who develop formulas that can be used in Garnier Shampoos ($3.99) and Kerastase shampoo ($29.99) It doesn't take long to realize that it is a good idea to compare products at different ends of the price scale. Sometimes, two products from two different brands will have the same patent number. The difference is in the non-active ingredients, which give it a unique texture, scent and/or color.

Also, it is wise to photo-copy, and even apply plastic covering to lists of "safe" beauty products, just as it is wise to keep a copy of "safe" and "unsafe" foods on hand when you go shopping. When you cannot even pronounce some of the words used in foods and beauty products how can you be expected to remember what is safe to apply to your hair and skin?

I received a very nice letter from Teresa Menna, Manager at L'Oreal in Quebec who told me that L'Oreal has abolished gluten in the composition of L'Oreal products. However, on reading more literature I find that Garnier is a mass market cosmetic brand of L'Oreal, and L'Oreal is part of the Group P&G. P&G stands for Proctor and Gamble and P&G Beauty brands can be found on the site:_ http://pgbeautygroomingscience.com/product.php {The Company Garnier Laboratories was started in 1906 and acquired by L'Oreal in the 1970's}. I was unaware prior to researching this article that L'Oreal owned Kerastase, or that L'Oreal had purchased the MAC Cosmetic line, or that the KAO Brands Company owns Ban, Biore, Jergens and John Frieda.

Here are some of the ingredients you might find in cosmetics that could indicate wheat or gluten:

• Avena Sativa {Latin name of oat, or "oat" term containing ingredients
• Hordeum distichon {Latin name of barley, or "barley" term containing ingredients}
• Hydrolyzed malt extract
• Hydrolyzed wheat protein
• Hydrolyzed vegetable protein
• Wheat germ
• Vitamin E
• Cyclodextrin
• Barley extract
• Fermented grain extract
• Oat (Avena sativa)
• Samino peptide complex
• Secale Cereale (Latin name of rye, or "rye" term containing ingredients)
• Stearyldimoniumhydroxypropyl
• Phytosphingosine extract
• Triticum vulgare {Latin name of wheat, or "wheat" term containing ingredients}
• Dextrin
• Dextrin palmitate
• Maltodextrin
• Sodium C8-16 Isoalkylsuccinyl Wheat Protein Sulfonate
• Yeast extract
• Anything with wheat in the name

Thoughts:
Some cute person gave the warning to ensure your lipstick is gluten free even if you don't have any skin issues. You could swallow some lipstick and get gluten in your system!

Another person adds at the bottom of their e-mail to be sure to check guidelines regularly because company policies can change yearly and the list is only to be considered as "guidelines" and make-up ingredients can change each time a company changes or the scientists within that company decide to add to or delete certain products. {Makes you feel very safe as a celiac/dermatitis herpetaformis person doesn't it?}

Another e-mailer suggested that mascara labeled as a "thickening agent" should be fearfully evaluated by the celiac/dermatitis herpetaformis person because the thickening agent is often "flour" and can sometimes cause eyelashes to fall out! Who knew?
Noted on one e-mail, ‘So-called luxury brands can be laden with synthetic ingredients that do not cost more than their not so luxurious counterparts.

True natural products that do perform, and there are a few such brands on the market, are authentic natural products that actually deliver what they promise and they truly do cost more to make because raw ingredients are much higher in cost. In fact, the cost is significantly higher when pure high grade ingredients are used.

Letter received: " We have compiled a list of gluten free beauty products available on sephora.com. These products do not contain any wheat, rye or barley derivatives, and they were made in gluten-free laboratories so there is no chance of cross-contamination. But since you cannot be too careful, discontinue use of any product that triggers an attack."

Letter received from Clairol:- "Gluten is a protein found in wheat, rye and barley. Although it is not added directly to our product, it may be present in fragrances. Due to the difficulty of tracing the source ingredients for the variety of fragrances used in manufacturing our products, we cannot provide specific levels of gluten content for any of our fragrance blends. Be aware that even products labeled "unscented" will still contain masking scent, therefore they may potentially contain gluten."

Advertisement: World's Top Ten Cosmetic Companies : "Beauty begins on the inside, check out our post on ‘The Top Five Foods for Amazing Skin'" - Posted by The Greenster Team

"I finally got up the nerve to go through my own (their) personal care products and look them up on "SKIN DEEP" and was very disappointed. The Company that makes my mascara (L'Oreal) tests on animals as does the company that makes my eyeliner (Covergirl) and my under eye concealer (Made by Physician's Formula) contains parabens" THE GREENSTER TEAM creates great articles, list the top ten cosmetic companies, what portion of the world's market they share and their hazard range.

Letter received from Mabelline:- "Please find below most ingredients containing gluten (wheat and other grains). We invite you to take this list and compare it to our ingredient listings every time you buy a new product. When in doubt, do not hesitate to do your own research or contact your doctor." {Caveat Emptor}

REMEMBER:- The truth is that there is no such thing as gluten free. The FDA has proposed a less than 20 ppm gluten -free standard in 2006. That was its first attempt to define the term gluten free, but the agency has yet to finalize it. The USDA is awaiting the FDA's decision before moving ahead.

STILL WAITING. With the number of products making unregulated gluten free claims on the rise, the marketplace can be scary for consumers with gluten sensitivity and wheat allergies. Why hasn't the FDA finalized its 2006 definition of gluten free? As part of sweeping legislation known s FALCPA the Food Allergen Labelling and Consumer Protection Act of 2004, Congress ordered the FDA to define and permit the voluntary use of the term gluten free on the labeling of foods by August 2008. As directed, the FDA issued proposed gluten-free regulations on schedule but seems to have failed to follow through with a final ruling. There has been no explanation for the delay. Since the Cosmetic Industry is a self-regulating body it seems {appears, is assumed} that we the consumers are on our own as far as researching what goes on our skin and in our hair, because some of the letters I have received leave it to the celiac or dermatitis herpetiformis sufferer to research their own products.

Even a letter from Avon states:- "Although Avon sells quality products, there is always possibility of contamination during manufacturing or changes/substitutions of ingredients. As with everything related to celiac disease, dermatitis herpetiformis and gluten Intolerance, products, ingredients and preparation may change over time. Your reactions to a specific product, ingredient may be different from the reactions of others. Like eating at a restaurant, you have to make a choice whether to consume/use a product. The list is meant to be a "guide" and does not guarantee that a product is 100% free of gluten. Dacia Lehman, Avon and GIG assume no responsibility for its use and any resulting liability or consequential damages is denied."

LETTER: - Proctor and Gamble "The WHMIS rating is designed to rate raw materials and not formulated products such as ours. Nor are our consumer products required to be labeled under the Occupational Safety and Health Administration (OSHA) Hazard Communication Standard. Thus labelling of our products with WHMIS ratings or any other hazard rating should not be required by any state health and safety regulatory agencies." That letter is signed by Asela for the Pantene Team.

LETTER:- May 2, 2012 - xyz@ca.loreal.com - "We have received your message and we will get back to you as soon as possible.

Web Sites:

• Gluten-free Lifestyle: glutenfree-lifestyle.com (Gives gluten free products by type and by company) i.e.: deodorants, face & body wash, make-up, suntan lotion, toothpaste, moisturizer, lotion, shampoo & conditioner, shave cream, gels, after shave, laundry products, cleaners, soap, etc.
• Beauty Industry: Who Owns What?
• Glutino - Hidden Gluten in Health Products - Glutino & Gluten Free Pantry

Blogs:

• www.gluten-free-cosmetic-counter.org
• Beauty Blogging Junkie
• Ebates Shopping Blog
• In The Makeup
• Lipstick Powder n'Paint
• Shop With a Vengeance
• Smarter Beauty Blog
• The Beauty Brains
• Sephora
• Sephora's iGoogle Beauty Portal

References:

• Codex Standard for Foods for Special Dietary Use for Persons Intolerant to Gluten. Codex STAN 118 - 1979 ROME
• Government of Canada 2008 - Regulations Amending the Food and Drug Regulations (1220-
• Enhanced Labeling for Food Allergen and Gluten Sources and Added Sulphites)
• Health Canada 2007 - celiac disease and the Safety of Oats
• Labeling of Natural Health Products Containing Gluten - Health Canada Notice 2010

Celiac.com 12/01/2017 - Celiac disease is a genetically determined disorder in which affected individuals show an intolerance to ingested gluten (Food Safety Authority of Ireland [FSAI]). It is an inheritable, life-long disease and is characterized by an inflammatory reaction to dietary gluten in the human small intestine. The special feature of the disease is a flattening of intestinal villi along with crypt hypertrophy. As a result, it leads to significant loss of absorptive surface area and resulting malabsorption of nutrients, vitamins and minerals. Untreated celiac disease may be found in the context of symptoms like: anemia, bone diseases, infertility, neurological problems, cancer and other complications due to persistent inflammation and micronutrient deficiencies. Approximately 1% of the United States population has the disease, which is similar to its frequency in the United Kingdom. Only about 10% of affected individuals have been diagnosed thus far [Kagnoff MF (2007) Celiac disease: pathogenesis of a model immunogenetic disease. J Clin Invest 117: 41–49].

At present, the only suitable treatment is strict, life-long exclusion of gluten from the patient's diet. Although a large fraction of patients who attempt to follow such a diet still exhibit signs or symptoms of active disease, there is no available supplementary therapy for such conditions [Ehren J, Morón B, Martin E, Bethune MT, Gray GM, et al. (2009) A Food-Grade Enzyme Preparation with Modest Gluten Detoxification Properties. PLoS ONE 4(7): e6313. doi:10.1371/journal.pone.0006313].

Gluten is defined as a protein fraction from wheat, rye, barley, oats or crossbred varieties and derivatives thereof. Some persons are intolerant to this group of proteins that are insoluble in water and 0,5 M sodium chloride solution [Commission Regulation (EC) No 41/2009 concerning the composition and labeling of foodstuffs suitable for people intolerant to gluten. Official Journal L 16/09 21 January 2009].

To address this problem, the food industry is developing new products for people affected by celiac disease. These new foods are very helpful in diversifying the celiac diet. More available products will increase nutrient consumption, including fiber and minerals, which are often lacking in restrictive diets.

Production of gluten free products involves the fulfillment of specific requirements. These products must be free of gluten, which is present in most components of confectionery production. Labeling of the final product is subject to the European Community Commission Regulation No 41/2009 of 20 January 2009, which sets conditions that must be fulfilled by manufacturers. The composition and labeling of foodstuffs suitable for people who are intolerant to gluten is divided into two categories of products according to the nutritional purpose: Gluten free for people intolerant to gluten, and very low gluten content [Wojtasik. A, Daniewski W., Kunachowicz H., 2010. Ocena wybranych produktów spożywczych w aspekcie możliwoÅ›ci ich stosowania w diecie bezglutenowej. Bromat. Chem. Toksykol., XLIII, 2010, 3, str. 362-371].

Selected paragraphs of these labeling rules are quoted below:

• Foodstuffs for people intolerant to gluten, consisting of or containing one or more ingredients made from wheat, rye, barley, oats or their crossbred varieties which have been especially processed to reduce gluten, shall not contain a level of gluten exceeding 100 mg/kg in the food as sold to the final consumer.
• The labeling, advertising and presentation of the products referred to in paragraph 1 shall bear the term ‘very low gluten'. They may bear the term ‘gluten-free' if the gluten content does not exceed 20 mg/kg in the food as sold to the final consumer.
• Oats contained in foodstuffs for people intolerant to gluten must have been specially produced, prepared and/or processed in a way to avoid contamination by wheat, rye, barley, or their crossbred varieties and the gluten content of such oats must not exceed 20 mg/kg.
• Foodstuffs for people intolerant to gluten, consisting of or containing one or more ingredients which substitute wheat, rye, barley, oats or their crossbred varieties shall not contain a level of gluten exceeding 20 mg/kg in the food as sold to the final consumer. The labeling, presentation and advertising of those products shall bear the term ‘gluten-free'.
• Where foodstuffs for people intolerant to gluten contain both ingredients which substitute wheat, rye, barley, oats or their crossbred varieties and ingredients made from wheat, rye, barley, oats or their crossbred varieties which have been especially processed to reduce gluten, paragraphs 1, 2, and 3 shall apply and paragraph 4 shall not apply.
• The terms ‘very low gluten' or ‘gluten-free' referred to in paragraphs 2 and 4 shall appear in proximity to the name under which the food is sold.

To achieve gluten content as described above, special conditions in work environment must be instituted. Preparation of high quality products that are safe for people affected by celiac disease, the production process must be controlled not only at the production plant. Origin, breeding, harvesting, storage and transport of ingredients must be also taken into account. The best way to ensure the customer about the safety of a given product is to implement a specially designed quality management plan from the very first step of production.

In order for products to be gluten-free or reduced in gluten when they reach the consumer, the gluten-free quality of the product must prevail at every stage of production. Cross contamination is the process by which a reduced-gluten or gluten-free product loses that status. It has come into contact with something that is not gluten-free. Cross contamination may happen during primary production, harvesting and storage of grain, during the manufacture of gluten-free or reduced gluten food in the same plant where gluten-containing food is produced. Cross contamination may also occur as a result of poor re-work, incorrect formulation, product carry-over due to use of common equipment, clean-up or sanitation, poor equipment design, human error or the presence of gluten products near exposed product lines. Potential risks, preventative measures and critical control points need to be identified in the handling of ‘gluten-free' or ‘very low gluten' products. (Deibel, Kurt, Tom Trautman, Tom DeBoom, William H. Sveum, George Dunaif, Virginia N. Scott, and Dane T. Bernard. 1997. A Comprehensive Approach to Reducing the Risk of Allergens in Food. Journal of Food Protection. Vol. 60, No. 4: 436-441)

Raw Materials Origin
To minimize risk, producers of raw ingredients have to implement appropriate control practices during crop production, harvesting and storage. Plants should originate from certified seeds which guarantees a high level of species purity. Cleaning of sowing machines is also important because seeds from the previous planting can contaminate new crops. The same rule applies to equipment used for harvesting and transportation. Storage areas should be thoroughly cleaned before filling with new crops. Every magazine should be identifiable and people responsible for crop delivery must be informed and instructed to maintain a gluten free workplace. Producers should produce representative samples for laboratory analysis to verify their product's "gluten free" status. Even on the first level of food production, which is plant growing, training and supervision of employees and producers is critical for maintaining the non gluten status of raw materials. Good training of all staff working at these first stages will help to avoid potential sources of food allergens. This type of training should increase awareness about food allergens and the consequences of unintentional consumption by allergic persons. Workers should be encouraged to report any suspected breaches of protocol to their supervisors and suggest possible improvements [Australian Food and Grocery Council, Food Industry Guide to Allergen Management and Labelling - 2007 Revised Edition].

Transport
Suppliers of raw materials are obligated to have good allergen management practices to minimize the risk of cross contact between raw materials. Suppliers should provide information identifying any products that contain allergens, the origins of allergenic materials, or those that are likely to cross contamination with allergens. Vendor audits are recommended to verify and explore potential contact with allergenic substances [Australian Food and Grocery Council, Food Industry Guide to Allergen Management and Labelling - 2007 Revised Edition].

Storage
Manufacturing plants should be designed to accommodate all aspects of the quality control and allergen management plan,. Storage of raw materials should prevent mixing allergens with non allergenic ingredients. To meet this condition, allergenic materials should be kept at separate facilities, or when this is impossible, all raw materials should be covered to avoid allergenic dust contamination. Clear and visible labeling of containers and all equipment should also be implemented. Tools and equipment used for different materials must also be kept separate [Guidance Note No. 24 Legislation on ‘Gluten-free' Foods and Avoidance of Cross-contamination during Manufacture of ‘Gluten-free' or ‘Very Low Gluten' Products Published by: Food Safety Authority of Ireland 2010, ISBN 1-904465-71-4].

Production
To minimize the risk of unintentional contamination of products good manufacturing practices – the Good Manufacturing Practice (GMP) and Hazard Analysis and Critical Control Points (HACCP) plan must note all specific conditions. The production plan should be designed to avoid production of allergenic and non allergenic foods during the same shift. If this is impossible, non allergenic products should be produced first to avoid contamination from dust. Ingredients containing gluten should be identified by color-coded containers or stickers. Ingredients containing gluten must be added at the end of the shift after gluten free products are completed and removed. Rework containing gluten should be reused into the same products. Appropriate employee training and labeling for rework can also help to minimize the risk of cross contamination through human error. The possibility of contamination can easily be minimized by using dedicated equipment for the gluten free products. When it is impossible to have a separate building, the use of special barriers is necessary. The use of separate space and separate containers for all materials (as above) is recommended for gluten free production. In such conditions ventilation and dust flow must be well controlled. Dust flow in the plant has a potential to carry over allergens from separate spaces of facilities. [Guidance Note No. 24 Legislation on ‘Gluten-free' Foods and Avoidance of Cross-contamination during Manufacture of ‘Gluten-free' or ‘Very Low Gluten' Products Published by: Food Safety Authority of Ireland 2010, ISBN 1-904465-71-4].

Packing and labeling are also important elements in preventing cross contamination. Packing equipment may also be a source of contamination. The packaging machines and material should be checked for any allergens, e.g. foil coated with releasing agents derived from wheat flour. Appropriate labeling should be use to inform customers who are affected by coeliac disease. Correct labeling should reflect actual and real composition of the product. Labels must also fulfill legislative requirements. To facilitate recognition of gluten free products, labeling must be clear and readable. EU legislation regarding food labeling imposes an obligation to provide true and clear information about ingredients. Alerts to all allergenic ingredients, starch source (plant from witch starch originates) and gluten content are required. The manufacturer is obligated to ensure readability of the above information. Directive 2003/13/EC of 10 February 2003 posted in the Official Journal of the European Union requires that food manufacturers should place notification on labels of any of the fourteen groups of potential allergens responsible for more than 90% of allergic reactions if they have been used as food ingredients (including alcoholic drinks), regardless of the allergen content. The list of allergenic ingredients is constantly being updated. Also, the components derived from allergenic substances must be listed as potential allergens [ Czarniecka-Skubina E., Janicki A. 2009. Znakowani produktów żywnoÅ›ciowych. Informacje żywieniowe i zdrowotne. PrzemysÅ‚ Spożywczy, StyczeÅ„, 34-36; Commission Directive 2003/13/EC of 10 February 2003 amending Directive 96/5/EC on processed cereal-based foods and baby foods for infants and young children. Official Journal of the European Union L 41/33, 14.2.2003]

Codex Alimentarius has proposed the introduction of the following descriptions in the vicinity of the product name. If the product comes from natural raw materials that do not contain gluten, it is described as "gluten free by nature," or "product may be used in gluten-free diet" [Hoffmann M., JÄ™drzejczyk H. 2007. Å»ywność bezglutenowa – legislacja i aspekty technologiczne jej produkcji. PostÄ™py Techniki Przetwórstwa Spożywczego, 1, 67-69]. Products low in gluten, are marked with the inscription: "very low gluten foods", "low gluten foods", or gluten-reduced foods [Wojtasik. A, Kunachowicz H., Daniewski W. 2008. Aktualne wymagania dla produktów bezglutenowych w Å›wietle ustaleÅ„ kodeksu żywnoÅ›ciowego. Bromat. Chem. Toksykol., XLI, 2008, 3, str. 229-233; Darewicz M., Jaszczak L.; „Oznakowanie produktów stosowanych w diecie osób chorych na celiakiÄ™", PrzeglÄ…d Piekarski i Cukierniczy, march, 2012.].

Training
Employee awareness at all levels of production, beginning with plant growing to finished preparation of proper labels is necessary throughout the gluten free production chain. Everybody must be informed about the consequences of gluten consumption by coeliac patients. Staff who are employed from time to time must be also well trained. Implementation of control procedures and proper documentation will be very helpful in maintaining control. Documentation of the training of every new employee needs to be prepared and maintained. All working stuff and implemented methods must be supervised all the time [Guidance Note No. 24 Legislation on ‘Gluten-free' Foods and Avoidance of Cross-contamination during Manufacture of ‘Gluten-free' or ‘Very Low Gluten' Products Published by: Food Safety Authority of Ireland 2010, ISBN 1-904465-71-4].

By taking into account all aspects mentioned above and striving to make continuous improvements, manufactures are able to produce safe, high quality gluten free products. The human factor is one of the most important elements in this process because only human mistakes can lead to contamination and only good training and awareness at every stage of production stage can produce the best possible product. Implementation of quality management systems like HACCP or GMP assures customers of food quality and safety, while also allowing the producer to lower production costs related to potential human mistakes. However, nothing will really change the fact that all of the factors described above must be implemented in everyday production, ensuring that they are not simply ideas on the piece of paper. Implementation is the key.

Celiac.com 11/25/2017 - We have long known that gluten intolerance, both celiac disease and gluten sensitivity, are highly associated with neurological symptoms. Migraines, ataxia (unstable gait), seizures, schizophrenia – the list is long. But a recent research study just published last month sheds some new light on exactly what the mechanism may be. Understanding why these debilitating symptoms occur as a result of a gluten intolerance will, hopefully, go a long way toward increased awareness among the lay public and clinicians alike. It is certainly true that too many millions of Americans suffer the effects of a gluten intolerance unknowingly. They only know that they feel unhealthy but have no idea that gluten is the culprit.

The digestive tract is sometimes called the second brain. Some say that is because it is second in importance to the brain. After all, if the food that is consumed doesn't turn into fuel that can effectively feed the 10 trillion cells in the body, those cells will be unable to perform their job and keep the body healthy. In fact, poor digestion is absolutely linked to poor health and increased onset of degenerative disease.

This article in Current Pain and Headache Reports looks at another possibility for naming the digestive tract the second brain, and it simply stems from anatomy. The digestive tract actually has a ‘mind of its own'; more correctly, it has a nervous system of its own, called the enteric nervous system. ‘Enteric' simply means having to do with the intestine. This nervous system, according to research, is very similar to the brain housed in the head in that it is bathed in similar chemicals (called neurotransmitters – which, interestingly enough, are mostly produced in the gut!). It sends and receives impulses and records experiences and is influenced by emotions. Some proof of the latter: Have you ever been nervous and had diarrhea?

This particular study stated that experiencing ‘adverse events' created a state of hypervigilance (a state of being overly responsive - not a good thing) in the nervous system which was associated with migraines and IBS. Such ‘hypervigilance' was previously only associated with the central nervous system – the one attached to the brain in the head. This group of researchers suggests that the initiation of hypervigilance may very likely lie in the enteric nervous system also.

What this means is that if the small intestine is genetically sensitive to gluten and gluten is ingested, it could set off a nervous system response that could create disabling diseases, such as migraines and IBS, but likely others as well.

The take-away message is that it is truly critical to diagnose gluten intolerance as soon as possible. Once that hurdle is surmounted it then needs to be followed with a program of nutrition, lifestyle and diet that will ensure healing of the small intestine and a ‘calming' of the hypervigilant nervous system. You may sometimes hear this referred to as healing a leaky gut.

Here at HealthNOW we often see this clinically in patients who seem intolerant to many different foods and can't seem to enjoy stable improvement of their symptoms, even after they eliminate gluten from their diet. The reason for this insufficient improvement is that a comprehensive follow-up program is missing – a program that addresses what we call the Secondary Effects of Gluten. This entails evaluating for any other food sensitivities, cross reactive foods, a tendency towards autoimmune disease, the presence of any infectious organisms, healing the leaky gut, balancing the probiotic population, and more.

While increasing awareness of the presence of gluten intolerance is absolutely critical, neglecting the secondary effects, as mentioned above, can result in long-term ill health that is truly preventable.
Have you experienced such symptoms? Have you removed gluten but are only partially healthier? I'd love to hear from you.

To your good health.

Celiac.com 11/23/2017 - Many theories have been fielded about autism. Some research careers have been made by investigating autism, while other careers have been seriously damaged when that research threatened some sacred cows of allopathic medicine. Yet despite all of this active research exploring the world of autism, we continue to experience exponential increases in rates at which autism is diagnosed. And debate continues unabated regarding the causes and appropriate treatments. Part of this increasing trend is, doubtless, because we have gotten better at recognizing the various manifestations of this debilitating condition. However, the evidence indicates that there is a dramatic increase in the absolute incidence of autism. Although frightening, this trend may offer some insight into several of the factors that contribute to this condition. That is the crux of my argument here. Since most prior theories have been tested in isolation, as is the norm in medical investigations, measurement of changes induced by individual contributing factors may either be so mild as to escape notice, or may not have been sufficient to induce symptom mitigation. Similarly, if preconceived notions shape resistance to some of these hypotheses, we may miss the most salient characteristics of autism. I have therefore chosen to combine several findings to form a testable hypothesis. I'll let posterity and the reader be the judges of whether this speculation is worthy of further investigation.

We begin with Dr. Kalle Reichelt, who sought to understand autism and other psychiatric illnesses through the prism suggested by Dr. Curtis Dohan's work investigating schizophrenic patients. While Dohan et al reported positive results among schizophrenics from a gluten free, dairy free diet, Reichelt and his colleagues identified unique peptides in the urinary excretions from patients on the autistic spectrum and explored their possible connections with gluten and dairy proteins(1). A leaky gut appeared to be a precondition for autism. In 1996, D'Eufemia and others reported increased intestinal permeability in almost half of their autistic patients, using synthetic sugars that can be measured in the urine (2). Gardner has reported disturbed gastrointestinal function in autism.

Reichelt and Knivsberg have also published reports of improved social interaction and communication among some children with autism following institution of a gluten-free, casein-free diet (4). However, their investigations reveal that the diet must be consistent, strict, and long-lasting to allow the gradual dissipation of the psychoactive peptides from these foods. Others have reported that this dissipation process can take up to 12 months (5).

It is important to note that, while the work indicating that the symptoms of autism can often be mitigated by the strict, long-term avoidance of gluten and dairy, none of these investigators claimed that this diet can cure autism or even eliminates all of its symptoms. The diet simply helped children improve to the point where they could function better in school and society by mitigating their most severe and limiting symptoms (4). Many of these researchers postulate that improved integrity of the intestinal barrier and reduced ingestion of psychoactive peptides in the diet are a likely root of these improvements.

Against this backdrop of widespread recognition of gastrointestinal dysfunction, excessive intestinal permeability, and symptom mitigation through dietary restriction in many autistic children, Dr. Andrew Wakefield, along with 12 other researchers, published their discovery of a pattern of intestinal inflammation and compromised barrier function in 11 of 12 subjects with pervasive developmental disorders, including 9 children with autism.

Based on histories provided by parents, health visitors, and general practitioners, a pattern of behavioral/autistic symptom onset was seen within 14 days of combined vaccination for measles, mumps, and rubella. The average time to symptom onset was about 6 days. In the same report, Wakefield et al state "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described." Later on the same page, they state "If there is a causal link between measles, mumps, and rubella vaccine and this syndrome, a rising incidence might be anticipated after the introduction of this vaccine in the UK, in 1988." [my emphasis] Wakefield et al identify several reports connecting vaccine-strain measles virus with Crohn's disease and autoimmune hepatitis. They also hearken to earlier work that implicates inflamed or dysfunctional intestines in the behavior changes seen in some children. They point to other factors that suggest a genetic predisposition may also be a precondition of developing autism, along with markers of vitamin B12 deficiency (which many readers will recognize as a common finding in celiac disease and non-celiac gluten sensitivity). Clearly this group was not attacking the MMR vaccine or its importance to public health. Nonetheless, in the same issue of The Lancet, no less than six letters, written by a combined total of 21 authors, attacked Wakefield et al because of the impact that their findings might have on public health.

Over the ensuing months and years, Wakefield's methods were criticized and denigrated. One of the more emotional attacks alleged academic fraud on Wakefield's part (7). He has been vilified in the public and professional media as a brigand. Yet he and his research group were careful to avoid making any claims beyond having found a form of bowel disease (lymphoid hyperplasia) in 9 of their subjects, and non-specific colitis in 11 of their subjects, along with reporting the close temporal association of onset of behavioral symptoms and MMR vaccines as reported by parents, health visitors, and general practitioners. They would have been remiss had they failed to report this association. Further, there were 12 other researchers who put their names to this research. Surely we cannot suspect that all 13 of these professionals would risk their careers to perpetrate a fraud!
Meanwhile, as these attacks were ginning up, a research group at the University of Maryland reported that, in genetically susceptible individuals, a protein they dubbed "zonulin" can, when gluten is ingested, induce changes to intestinal permeability (8, 9). Does the gluten free, dairy free diet reduce excessive intestinal permeability? We know it does in people with celiac disease (8), but what impact would or could it have on children with the lymphoid hyperplasia and/or non-specific colitis identified by Wakefield et al? And does reduced zonulin production due to restriction of these foods explain the benefit experienced by many children with autism?

Perhaps these questions are also relevant to another area of autism research reflected by identification of specific strains of clostridium infection in autism, first postulated by Bolte (10). Dr. S. Finegold and his colleagues demonstrated that 8 of 10 children with late onset autism showed transient reductions of symptoms of autism in response to oral vancomycin which returned when vancomycin was withdrawn (11). This is an antibiotic that is usually used in cases of antibiotic-resistant infections. Because this group identified an unusually large number and variety of strains of clostridium in their autistic subjects, as compared with controls, and because many clostridium variants excrete neurotoxic substances, their use of vancomycin was given to target clostridium.

However, elements of Finegold's work and Wakefield's work may be taken to suggest some overlap. For instance, could the added clostridium load in autistic children contribute to the intestinal inflammation and permeability seen in Wakefield's report? Or could the MMR vaccinations produce conditions that are more hospitable to antibiotic resistant, neurotoxic strains of clostridia? Or could symptoms induced by MMR lead to administration of antibiotics that provide favorable conditions in the gut for proliferation of clostridium?

To further complicate this issue, Dr. Stephanie Seneff has identified vitamin D deficiency, and popular use of statin drugs, in combination with reduced dietary consumption of cholesterol and fats as possible factors in autism. She implicates these deficiencies as arising either in utero or in infancy and she specifically cites work demonstrating that cholesterol, fats, and vitamin D are important components of healthy immune function (14).

Putting it all together

The hypothesis embodied herein asserts that at some stage the autistic child has: some predisposition to autism; a multi-dimensionally compromised immune system; been exposed to multiple and uncommon strains of clostridium which lead to the colonization of the gut by these antibiotic-resistant bacteria; are suffering from some degree of vitamin D deficiency and are eating a diet that is deficient in fats and cholesterol. Further, as the child develops one or more of the symptoms or sequelae of clostridium colonization or other infection, antibiotics are administered to provide relief from these or other symptoms of infection, sometimes including chronic ear infections. Thus, the competing gut bacteria that might otherwise keep these strains of clostridia in check are wiped out, permitting broader proliferation of multiple strains of clostridia.

Similarly, the MMR vaccine, which, by design, engages and taxes the immune system. In the immune system's weakened state resulting from vaccination and dietary opioids (13), increased numbers of unusual strains of clostridium, abnormal gut biome, cholesterol deficiency, vitamin D deficiency, and perhaps, other nutrient deficiencies, also reduces systemic surveillance for, and antibody combat with, the clostridia and/or remnants of MMR vaccine. The neurotoxic excreta from clostridia and MMR are released into the intestinal lumen and by zonulin's action to widen the junctions between epithelial cells, these toxins are thus given access to the bloodstream. By the same pathway, opioids, other psychoactive peptides from gluten and dairy, along with other undigested and partly digested proteins, which may be harmful, also reach the bloodstream. From there, they travel to the BBB where zonulin again opens gaps in this barrier and allows the clostridium-derived toxins, opioids, and other impurities access to the brain where they alter blood-flow patterns, damage neurological tissues, and perhaps do other damage that has not yet been recognized. Ultimately, this damage and dynamics lead to impeded social performance, intellectual performance, and sometimes, induce startlingly abnormal behaviors.

Although this picture appears bleak, and much of it simply reflects the several dietary miscues of the last and our current century, there are corrective steps that can sometimes improve these children's lives. Vitamin D, vitamin B12, and other supplements can be administered to address deficiencies. Because of the associated gut problems, sub-lingual vitamins, and exposure to sunlight without sun screen may both be good starting points. A strict, long-term gluten free, dairy free diet should also be on the menu, even if the whole family has to follow it to ensure that the autistic child does not rebel due to feeling deprived. High levels of cholesterol, saturated and mono-unsaturated fats should also comprise a large part of the diet. One or more courses of vancomycin may also be worth trying. In isolation, the benefits of antibiotics alone will likely be short-lived, as reported by Finegold, but in combination with these other strategies, may extend the benefits of this drug. New developments in antibiotics research may lead to isolation of protective substances from hens' egg shells that may provide more appropriate antibiotic relief and therefore benefit these children even more (15).

Most of the research, to date, has focused on one of these factors in isolation. However, if an immune system is compromised by any or all of cholesterol deficiency, vitamin D deficiency, vitamin B12 deficiency, dietary shortages of cholesterol and fats, lingering, chronic sequelae of MMR vaccination, opioids from gluten and/or dairy, and an unusual and wide variety of clostridia, then it seems unreasonable to expect to reverse this condition through implementing only one of the interventions suggested by the above. Each and all of these other components should be addressed when attempting to remediate autism. In the context of these dietary and lifestyle changes, appropriate antibiotics may lead to more permanent improvements for the autistic child. This would be the greatest gift that a physician, parent, or caretaker could give to these children. One may hope.

References:

1. Reichelt KL, Hole K, Hamberger A, Saelid G, Edminson PD, Braestrup CB, Lingjaerde O, Ledaal P, Orbeck H. Biologically active peptide-containing fractions in schizophrenia and childhood autism. Adv Biochem Psychopharmacol. 1981;28:627-43.
2. D'Eufemia P, Celli M, Finocchiaro R, Pacifico L, Viozzi L, Zaccagnini M, Cardi E, Giardini O. Abnormal intestinal permeability in children with autism. Acta Paediatr. 1996 Sep;85(9):1076-9.
3. Gardner MLG (1994) in Physiology of the gastrointestinal tract (Johnson LR : edit) Rave Press, NY pp 1795-1820
4. Knivsberg AM, Reichelt KL, Høien T, Nødland M. A randomised, controlled study of dietary intervention in autistic syndromes. Nutr Neurosci. 2002 Sep;5(4):251-61.
5. Paul, K., Henker, J., Todt, A., Eysold, R. (1985) Zoeliaki- Kranken Kindern in Abhaengigkeit von der Ernaehrung Seitschrift der Klinische Medizin 40; 707-709. as reported in Reichelt K (1990). The Effect of Gluten-Free Diet on Urinary Peptide Excretion and Clinical State in Schizophrenia. Journal of Orthomolecular Medicine. 5(4): 223-239.
6. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 2004 Mar 6;363(9411):750.
7. Flaherty DK. The vaccine-autism connection: a public health crisis caused by unethical medical practices and fraudulent science. Ann Pharmacother. 2011 Oct;45(10):1302-4. Epub 2011 Sep 13.
8. Fasano A, Not T, Wang W, Uzzau S, Berti I, Tommasini A, Goldblum SE. Zonulin, a newly discovered modulator of intestinal permeability, and its expression in coeliac disease. Lancet. 2000 Apr 29;355(9214):1518-9.
9. Clemente MG, De Virgiliis S, Kang JS, Macatagney R, Musu MP, Di Pierro MR, Drago S, Congia M, Fasano A. Early effects of gliadin on enterocyte intracellular signalling involved in intestinal barrier function. Gut. 2003 Feb;52(2):218-23.
10. Bolte ER. Autism and Clostridium tetani. Med Hypotheses. 1998 Aug;51(2):133-44.
11. Finegold SM, Molitoris D, Song Y, Liu C, Vaisanen ML, Bolte E, McTeague M, Sandler R, Wexler H, Marlowe EM, Collins MD, Lawson PA, Summanen P, Baysallar M, Tomzynski TJ, Read E, Johnson E, Rolfe R, Nasir P, Shah H, Haake DA, Manning P, Kaul A. Gastrointestinal microflora studies in late-onset autism. Clin Infect Dis. 2002 Sep 1;35(Suppl 1):S6-S16.
12. http://stephanie-on-health.blogspot.ca/2008/11/sunscreen-and-low-fat-diet-recipe-for.html 
13. Hoggan R. Considering wheat, rye, and barley proteins as aids to carcinogens. Med Hypotheses. 1997 Sep;49(3):285-8
14. Seneff S, Davidson R, Mascitelli L. Might cholesterol sulfate deficiency contribute to the development of autistic spectrum disorder? Med Hypotheses. 2012 Feb;78(2):213-7. Epub 2011 Nov 17.
15. Wellman-Labadie O, Lakshminarayanan R, Hinckeemail MT Antimicrobial properties of avian eggshell-specific C-type lectin-like proteins. FEBS Letters Volume 582, Issue 5 , Pages 699-704, 5 March 2008

Additional Resources:

• https://www.autismparentingmagazine.com/best-supplements-vitamins-autism/