Celiac.com 12/23/2016 - Before my dog Amber's health started to fall apart, I had observed friends and family members on their gluten free journeys without ever considering this could be a solution for me. Years of periodic juice fasting, vegan and vegetarian diets, and then finally a GMO-free, semi-vegetarian lifestyle, had never led me to consider complete and total gluten free eating, until Amber.

At nine years old she began to have a chronic yeast and skin infection and she stunk. Her stools became bloody, she was fat, her walking was slow and labored, and the vet said that if we didn't find out what was wrong with her soon she'd be dead within a year. He referred me to a woman in Eugene, OR who worked with animals and might know what I could do.

The woman told me to immediately change her diet from dog food that contained grains, to gluten-free. She said that most retrievers and labs will carry on as if healthy for years with no issue, and then suddenly begin to fall apart when they reach senior ages. Their bodies can no longer tolerate gluten at that point, and a bundle of symptoms will appear.

We began shopping at Animal Crackers, a store in town that sells a variety of high quality animal foods. Amber began eating gluten-free Orijen dog food, and within three months her skin lesions and yeast infection had healed. Also, all stink was gone, her stools were normal, and she was suddenly bounding around the park with puppy energy again. No doubt a dietary change had healed her.

Soon afterward, at 47 years old, I suddenly decided to not eat anything with gluten in it. It wasn't even a plan or necessity, it was just like, one day I found myself buying gluten-free muffins and trying them. For some unexplainable reason I stuck to no gluten for a while, and by day three I noticed I was feeling happier.

A lack of longing for traditional bread surprised me, because I love baking, and eating homemade bread. To omit my beloved goodies seemed extreme, and I was always of the opinion that organic and GMO-free wheat and gluten was sufficient unto itself, if one didn't have celiac disease.

Yet here I was, day four and feeling fantastic. Actually, I wasn't sure what changes were occurring. I felt lighter, with an absence of discontent in my body. I experienced frequent bursts of 'anti-depression', akin to joyful energy rushes, which I never related to hyperactive sensations. Sleep became easy and relaxing. I would awaken with recharged emotional and physical well being. I began to crave junk food less, my stomach flattened, and all jitters went away. I found myself patiently standing in long lines, an unfamiliar feeling to me, and my mind cleared up, pleasurably.

After about two weeks of observing these lovely 'feel-good' transformations, I discovered a divine intervention had occurred with bladder control. Years of frustration and concern, even discussions with a doctor about surgical intervention, had led me to believe that I was cursed with a life long issue of urinary stress incontinence. Yet, now I was noticing that a gluten-free change had all but dissolved my problem!

Even as a 'wheat bellied' child I'd had incontinence issues, and this only exacerbated after two natural child births. Months of yoga, kegal exercises, and daily trampoline jumping helped some, but it never entirely went away. With a gluten-free dietary change, bloating and mild incontinence are now absent. This calm, non jittery, focused, new me, experimented ever so cautiously with jogging around the block, and nothing happened!

About a month into it, I decided to eat a wheat bun with a hamburger, just to see if I would feel any different. After a couple hours, my mind went to dull and foggy mode, my body felt a little heavier and 'full', and what must have been a chronic urinary tract inflammation for years, returned again to nag at me. Minor leakage reared it's bothersome head again, but only for as long as it took to get gluten out of my system. The difference was like going from "Ah!" to "blah."

A surprising factor in my gluten-free experience is that I've always been a healthy and happy person. I never seriously considered taking beloved gluten filled foods out of my diet, because I love those foods and never got sick eating them, OR so I thought. Aches and pains I figured were genetic curses, and part of my natural aging.

Oh how wrong I was! After a year of gluten-free living, every organ in my body approves of this change, including bowels and nervous system. Best of all, I've experienced a seeming miraculous, non surgical intervention, with hardly any effort. And there's more to my story:

Before gluten-free my cholesterol was high. I'd tried diet and natural supplements to no avail, and finally went on a statin medication to control it. It remained high and challenging until I changed my diet to gluten-free. With virtually no decrease in my fat intake, this life style change has brought the cholesterol level down. My latest labs shows normal levels, and once I accomplish a goal of eating more vegetables (than all these darn delicious gluten-free baked goods), and staying on a clean, low fat diet, I will explore going off cholesterol medication, once and for all.

I continue to get caught up in all the numerous gluten-free pizza crust, pastry and bread recipes available. My salad creations are sorely neglected and I know this is my next challenge. But I won't beat myself up too much for enjoying this new exploration of 'all foods gluten free', (including beer- I recommend Omission).

As for ever going backward, I have zero desire whatsoever, to return to a gluten filled lifestyle. I LOVE the way I feel now. When tempted by gluten-filled foods, I think of how I can now jog as long as I want to, with no leakage, for the first time in over twenty years. And I remember how surgery is out of the picture when it was once in my future, which is fantastic! I'm aware now that the source of my incontinence was a chronic, low level inflammation caused by gluten. The inflammation attacked various organs and areas all over my body, especially the bladder and urinary tract. Gluten even effected my cholesterol level in negative ways. So no way to that whole wheat bread, because I feel terrific now and I want to stay this way.

Celiac.com 12/27/2016 - For many years, nutritionists, doctors and the media declared a low-fat diet as an effective method of losing weight, lowering the level of so-called "bad cholesterol", and preventing health problems. We have since seen that it is not only fat intake but also the type of fat we eat is of paramount importance. So-called "bad fats" increase the level of LDL cholesterol and increase the risk of certain diseases, in contrast to the good fats that protect the heart and promote general health. Good fats, such as the ubiquitously advertised omega -3 are essential to physical and emotional wellness.

Dietary health is becoming increasingly important to the consumer whose awareness is growing and will continue to grow. It is therefore important that in the face of these facts the wise producer will not only follow the trends set by the consumer but will try to get ahead of these shifts so he will be prepared when the new client asks for products suggested by these new insights.

Walking through the store, it is easy to see health-oriented products displayed on the shelves, as well as customers looking for these products. When it comes to fats, the client is offered non-fat ice cream, low fat candies, cookies and cakes.

While the number of low-fat products is growing, paradoxically increasing levels of obesity are also on the rise in our society. Thus, it becomes clear that low fat products and diets are not effective in the fight against obesity.

Contrary to what has been widely proclaimed, fat is not always a negative factor in maintaining good health and a slim figure. Saturated fats and trans fats are unhealthy for humans. However, initially, all groups fats were considered the cause of the adverse consequences listed in the beginning paragraph. As it turned out, there are fats such as monounsaturated fat, polyunsaturated fat and omega-3 fatty acids that have the opposite effect. In fact, healthy fats play a huge role, affecting not only the appearance of the silhouette but also, human well-being and mental agility throughout life. For example, they are necessary for the proper development of a child's brain.

This article is not a waiver for eating fat but suggests minimizing the consumption of those fats that negatively affect humans.

To better understand these concepts about fats we should explain the way fats are grouped. In addition to the simplest categories of fat according to whether they come from animals or plants, they can be divided by the presence of bonds between carbon atoms in the chain and so on:

• unsaturated fatty acids containing a hydrocarbon chain having a double bond , are present in large quantities in plants. At room temperature they are usually liquids.
• monounsaturated fats - one unsaturated bond
• polyunsaturated fats - many unsaturated bonds
• saturated fats contain fatty acids having a hydrocarbon chain with only single bonds

Trans fats are characterized by a specific molecular shape. They are found in natural animal fats, milk, and other dairy products. In larger quantities of solids they are present in vegetable fats such as margarine. Trans fats are normally fat particles that have been deformed by a process called hydrogenation . During this process, liquid vegetable oils are heated and combined with hydrogen gas . Partial hydrogenation of vegetable oils makes them more stable and less prone to loss of freshness, which is very good for food manufacturers, but not necessarily for the health of consumers.

Monounsaturated and polyunsaturated fats are known to be "good" fats, and are thought to have a positive effect on heart health, cholesterol levels and general health.

Saturated fats and trans fats are presented as "bad" fats because they increase the risk of disease and increase cholesterol levels.

With so many different sources of fat in the diet, and increasing consumer awareness of these fats, customers will strive to reduce consumption of those ingredients that have a negative impact on their health. Thus, they will limit the intake of trans fats and saturated fats by the avoidance of products containing them.

What is the impact of these facts on the behavior of the confectionery industry?
Firms engaged in the production of confectionery fats have, for several years, been developing technologies and offering products with reduced trans and saturated fat content. Manufacturers are trying to limit the hydrogenation of oils and fats and produce other methods for processing fats and taking advantage of properties of existing fats. Many of those technologies are still being developed.

In accordance with Article 30 REGULATION OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL (EU) No 1169/2011 of 25 October 2011 on the provision of information to consumers about food, which will take effect from 13 December 2014, the mandatory nutrition declaration shall include the following elements:

• a) energy value and
• the amounts of fat, saturates, carbohydrates, sugars, protein and salt.

Therefore, please note that in future, European producers will have to adapt their labels to comply with the new laws. Consumers will have easier access to information on the composition of fatty products in foods, which can have a significant impact on their choices at the time of purchase.

If you look for information on healthy eating in the basic knowledge base of general consumer... on the internet, you can find tips such as:

• Limit your intake of saturated fat to less than 10 % of calories
• Limit trans fats to 1% of calories
• The main source of trans fats in the diet is baked goods and snacks such as cookies, crackers , cakes , muffins, pizza dough , some types of bread and hamburger buns

This shows how important the selection and appropriate control of fats is for confectionery production. Moreover, the producer is required to maintain a constant and reproducible quality of raw materials that can affect the final product, avoiding any unexpected ingredients. Growing consumer awareness can be seen today when shoppers pay much more attention to the labels and what is written on them. Increasingly, this is a decisive factor in their choice of whether to buy a particular product.

On the other hand, the desired taste of food imparted by those elements that are not always the healthiest for people offers another perspective on confectionery food. We should keep in mind that when eating so-called sweets, we do not do it to be healthier and more beautiful. The most common motive is pleasure. If we were to look at food only from a chemical point of view, just the chemical names and function of substances that emit the aroma of coffee would stagger the average person. But what would coffee be like without its aroma? A truly conscientious consumer knows these facts.

Again, it all comes down to common sense and moderation. Those who are able to be moderate are those who do not have to fear. But you cannot disregard the information flowing from the world of science. If we are able to produce safer food for people, we should go in this direction.

Celiac.com 12/21/2016 - I have previously criticized the use of a single blind test protocol for a gluten-free diet. In past issues of The Journal of Gluten Sensitivity I have also been critical of some double blind research protocols for investigating dietary variables for a variety of reasons not relevant to the current topic. However, there are good reasons that the double blind protocol continues to be favored, especially among medical researchers. Single blind testing is where the research subjects are not aware of the intervention being used whereas, in a double blind test, both the subjects and the researchers are kept in the dark about the intervention until the end of the trial. Sometimes that requires the use of placebos. In other protocols, it involves masking the intervention.

The primary merit of double blind, over single blind tests is that the former eliminates something called "confirmation bias". Single blind testing was first developed because patients' and other experimental subjects' expectations were thought to skew results. Under some circumstances, this problem is called a placebo effect. We can see the placebo effect in action when research subjects are split into two groups. One group is given the medical treatment or drug being investigated, while the other group is given a placebo. This placebo may be a sugar pill or some other substance or treatment that should have no significant or measurable medical impact on the subject. The placebo is given to subjects/patients as if it could provide medicinal properties. Because the patient expects to feel better with this placebo intervention, some subjects do start feeling better. That's the placebo effect. Single blind testing does reduce this problem.

Especially for drug treatments, blinding subjects does make sense. However, another confounding variable was soon recognized as arising from single blind tests. It turns out that, in addition to patients' reporting health benefits from sugar pills and other placebos, the physicians and other scientists were skewing the results in another fashion. This is where confirmation bias comes in. The term identifies a situation where researchers miss signs of a problem with gluten. (A fascinating book titled The Structure of Scientific Revolutions (1962), by Thomas Kuhn provides detailed explanations of this phenomenon in his descriptions of several experiments that clearly show this tendency.) To some extent we all have a tendency to confirm our expectations in what we see. This confirmation bias can have an impact on research results in two ways. First, it can lead researchers who are interacting with the test subjects to communicate, either through body language, or verbal "slips" to indicate that they expect a given patient to improve following the intervention or drug being investigated, leading to more of the placebo effect. It can also lead researchers to interpret their results in ways that confirm what they expected to see, rather than in a more objective light.

Placebo effect and confirmation bias can be nullified in a double blind study when researchers subtract the portion of the placebo group who are feeling better on the placebo from the number who report feeling better in the experimental group. (The experimental group is the group that was given the actual drug or medical treatment under investigation.) This simple arithmetic eliminates the number of people in the experimental group who were likely to report feeling better even though they were only given the placebo. The remaining number of experimental subjects who report feeling better after the medical intervention are thought to reflect the number of people who actually experience a benefit induced by the treatment.

My concern with physicians running single blind tests on patients who believe that they feel healthier on a gluten-free diet is that the physician is likely to see what she/he expects to see (confirmation bias). So skeptical physicians who would request that their patients do a gluten challenge in the form of a single blind test are most likely to see what they expect to see. This may be why more than 95% of people with celiac disease remain undiagnosed in the USA. Confirmation bias seems to afflict many physicians practicing in the USA. Judging from my years of exchanging correspondence with gluten sensitive people from all over the world, similar dynamics seem to be at work, to varying degrees, in many other countries as well.

A protocol that requires the patient to undergo a gluten challenge in a single blind test format is offensive in its implications. It denies the limitations of the very physicians who would be charged with conducting these tests, making observations, and treating patients accordingly. I sincerely believe that physicians are intelligent, hard-working individuals who have pursued a career that is dedicated to helping people. I also believe that they are equally fallible in their judgments and pre-conceived notions about others, especially when it comes to dietary interventions. If physicians cannot accept the observations of their patients, why should their patients be willing to accept their physicians' observations and conclusions? Who has more at stake in this relationship? And who is in a better position to observe even very subtle responses to gluten ingestion?

As a culture, we seem to have lost track of why we consult physicians. Although we are all subject to confirmation bias, most of us are not seeking insulting instructions that disparage our honesty, integrity and reliability. When I visit my family physician, I want her to act as my guide to the science she is familiar with, and render the best guidance she can offer based on her expertise and paying careful attention to what I report. If my problem is beyond her knowledge or experience, I expect to be referred to a specialist in my area of concern.

I usually consult her, on a collaborative level, when she has some relevant expertise that will compliment my own expertise. I can not foresee a set of circumstances in which I would allow her to conduct a single blind trial on me. I do not accept the premise that she is less susceptible to her confirmation bias than I am to the placebo effect. Thus, my expectation of my physician is that we work together to solve any health problems that arise. I must say that both my current physician, whom I have been seeing for the last five years, and my previous physician who worked with me for the previous eleven years, have consistently exceeded my expectations. In both cases, they seem very happy that I am trying to take responsibility for my own health care and that I consider their advice to be a resource rather than the final word in the matter. I'm very grateful for these relationships, as they, and the gluten-free, dairy-free, diet, along with reduced soy and refined sugar consumption, have helped me achieve a much better state of health than I previously considered possible.

Celiac.com 12/20/2016 - I know of many people with celiac disease who dread traveling. They even cringe at eating out in restaurants. One person actually said it on the Web: "I have celiac disease, and I was sick of being poisoned in restaurants, even after asking for gluten-free food." It can also be disastrous to spend even one week in a foreign country where there is a language barrier. Part of the problem? Point your finger at yourself. Many of us do not prepare ahead and travel with our diet in mind.

According to Wm. K. Warren, Medical Research Center for Celiac Disease in San Diego, celiac disease is twice as common as Crohn's disease, ulcerative colitis and cystic fibrosis. The website Open Original Shared Link has named Pennsylvania as the most celiac-friendly destination in the world. Wow!

Eating out can be difficult for several reasons. We do not yet have a global definition for gluten-free. It does not exist in the restaurant world. Most restaurants buy in bulk, such as a 12" x 6" can of tomato sauce, a gallon of sweet and sour sauce, and huge bags of fries, which more and more are being tossed in pure flour prior to frying. I have heard that McDonald's is now offering items that do not have gluten in the ingredients to allow for the possibility of inadvertent cross contamination. Their famous fries are made gluten-free in a separate fryer. Hamburger patties and many breakfast items are also gluten-free. Early breakfast at McDonald's before you "hit the road" with a packed car in which your children are belted in.

This sounds like a travel brochure for New Zealand, but Celiac.com states that traveling in New Zealand is a pure pleasure for the celiac. Gluten awareness is widespread, there are gluten-free food options virtually everywhere you go, and product labeling for allergens and gluten is typical. Those of you planning a Disneyland holiday this year will be pleased to note that Disney is earning major kudos from people with celiac disease, gluten intolerance and other food allergies. They claim that for more than a decade Disney has worked to provide information and options to guests with food allergies.

I read a negative blog about gluten-free dining in Maui, and have one to add myself. I would suggest calling ahead; I would suggest not dining at the peak busy periods. Our waiter did not know what celiac disease was, and I did not have my information sheet with me in those years. (I have grown up since then!) The waiter was told twice about gluten; it was described to him. When the meal arrived at our table 3/4 hour later, my husband asked him again if there was any flour used in the making of the dish, and had he checked with the chef? Slight hesitation, hopped on one foot indicating he was busy I assume. He said the meal was "okay". I was up all night ill in someone else's home. We called the next day to do some late sleuth work, only to find out that the waiter had not checked with the cook and just ‘assumed' the meal was safe to eat.

I now travel with a small file containing our "SAFE TO EAT" and "UNSAFE FOODS", or as my husband calls them, "SAFE" and "SORRY". I have laminated my own list. I carry a home-made typed sheet about celiac disease, not going into our reactions in a big way, but telling people that ingesting gluten, that means rolled oats too, can make me very ill. Celiac disease is a most difficult disease to diagnose, and equally difficult to explain "quickly" to a host or hostess, or restaurant waiter.

Statistics are not standing still. Coeliac disease (celiac = Western)< (Coeliac = Great Britain, in the United Kingdom is the leading charity (Coeliac UK), and affects 1% of the children in the United Kingdom. All major grocery stores have a large gluten-free section. The last time I visited my family I made a pig of myself eating cream buns and pie, all with the International Logo, and though food is more expensive in the UK, the gluten-free food was not as expensive as it is here. We made gluten-free restaurant cards with the explanation regarding the disease on the back.

This year, when we traveled to the Grand Sirenis Mayan (all inclusive) in Mexico I did not have to keep saying, "NO FARINA". (To the person filling the heated trays, I was "nuts".) After so many years of traveling to all inclusive hotels in Mexico, this year the light bulb went on. My husband wrote out an information sheet about celiac disease and our "Safe and Sorry" list and went on the World Wide Wonderful Web and had it translated into Spanish. We were able to advise the assistant manager right away upon registration. No-one at the registration desk had heard of celiac disease, so that was my education class for them. But I received exceptional service. Every restaurant we booked for supper had the information sheets faxed to them by the registration desk ahead of time and we just had to mention our name, they went down their list to check it off, and they saw the Spanish note attached. During the entire two weeks I was not sick from ingesting gluten and I did not have one dermatitis herpetiformis lesion. I thought I had one but it turned out to be a bug bite!

HINT: Some hotels that provide a free breakfast buffet means you will probably have access to a toaster. Several companies now manufacture heavy-duty reusable toaster bags that let you toast gluten-free bread in the hotel toaster without fear of cross contamination. Toaster bag brand names include the following:
...Toast it Reusable Toaster Bags ... Toastabags ... Kitchen Craft Non-Stick Reusable Toaster Bags. Bring sealed bags of gluten-free cereal, and add milk and fruit from the restaurant. Bring your own rice cakes or granola bars, and ask the restaurant for cheese, fruit or for individual servings of cream cheese. You can consider faxing a note to the restaurant staff in advance to help explain the gluten-free diet. Many restaurants are more than willing to adapt their menu items to suit your needs, but these things have to be done ahead and require a bit of thought. Celiac disease is virtually unheard of in some parts of eastern Asia, so a written description in the local language will be very important.

"WEB: Travel and holidays Coeliac UK" state they have information leaflets for more than 35 countries, with translations that can be used in many others. These detailed, useful phrases will help you while out and about as well as with local cuisine, applicable allergen labeling and contact details for local coeliac societies. In the UK local organizations can sometimes provide lists of hotels/restaurants and shops that supply gluten-free foods, as well as their gluten-free food list.

Some celiac association chapters actually provide a "Pocket Dictionary" that they claim is the most reliable resource available for information on what's safe for people living with celiac disease. The books are updated regularly. Check at a chapter near you and see if they provide these celiac dictionaries; I am certainly going to check ours out!

They advertise Spain as being the celiac's paradise. Most of the products are labeled with gluten-free symbols, and their labeling system for gluten-free is quite different from any other labeling, for example "sugar free".

Brazilians are not used to the term celiac. Almost all have heard about gluten because it is law there. All the processed foods and drinks are labeled with either "contains gluten" or "does not contain gluten". That would be wonderful, rather than reading all the ingredients, almost putting the item in your grocery buggy until you read at the very bottom of the box the wording, "may contain traces of gluten". How can they measure a trace, and which box has a bigger trace than another? Even food made in a machine that uses gluten has to be avoided if you want to stay healthy.

I would have thought that Italy would be a difficult place to find gluten-free foods. It is the land of pasta after all. But on the website (gluten-free holidays, trips and vacations) some of the happiest holidays by writers have been spent in Italy. Switzerland is famous for it's delicious cakes and breads, but traditional Swiss food is very celiac-friendly and their core national foods are often naturally gluten-free. Don't forget your note cards, and translate them into German and Swiss-German Traveling and living gluten-free in Australia, they say there is nothing else like it for a coeliac traveler. "This country is a haven for coeliac's and their traveling buddies alike. (glutenfreeholidays, tripsandvacations)

AIRLINES: Not only have they changed their luggage weight allowance they have also changed their short flight meal rules. Under six hours flying time, they do not provide specialty meals, like gluten-free, diabetic, vegetarian or kosher. This was a big surprise to us when flying to Mexico, and a surprise to our travel agent also. Check with the airlines regarding their dietary restrictions. This may not be the case with ALL airlines, but for sardine can flying with your knees on your chest, they think the celiac does not need to eat for six hours.

If they do not provide special diets you are well within your rights to purchase or take a gluten-free meal onto the plane. It anyone queries what is in the bag, you can explain you are a celiac who becomes hungry in less than six hours. Since they have vetoed peanuts as a nutritious snack on airlines and substituted with pretzels that means the non-celiac partner gets double treats and you go hungry. Make sure you have emergency snacks to fall back on in case of delays or cancellations. If you are planning a cottage or camping holiday the same rules apply. I hope you have a card in your wallet indicating you are a celiac, and if you have dermatitis herpetiformis that should be listed too.

The Web site: "Open Original Shared Link" has a holiday cookbook you can download. It is their free first ever e-cookbook featuring the top 10 gluten-free recipes from some of their recipe contests.

If you are traveling by car, of course, you will travel with a cooler and ice packs to prevent food spoilage. When we go to visit family in England we purchase one of the reasonable styrofoam coolers at the first grocery store we see, along with some ice packs. Sainsbury's offers a deluxe shopping experience; if they do not have the celiac food you want there then you do not need it. Great Britain also has Costco Stores that carry gluten-free food.

I found that the Web Site:" Open Original Shared Link" offered a wealth of information. You can click away all day, reading the posts and blogs, laughing and agreeing with the suffering celiac who became sick at her own wedding. It was good to know that all packaged foods in the EU (The European Common Market) countries are covered by the same food labeling legislation as in the UK. Manufacturers must list all deliberate ingredients in the ingredients list, regardless of the amount used. Manufacturers must name the particular grain, for example, wheat, rye, barley or oats or some will use the word gluten as well. Specific information for each country is given where possible in the individual travel sheets you can obtain at this site.

I know that for many celiac people a holiday is synonymous with relaxing with a glass of wine, a whiskey and tonic, or a bottle of beer, but after reading on Celiac.com it has given me confidence to tell you to be very careful. Sick on holidays and don't know why? Been drinking? I know you want to blame it on something else; you are like me and the malt in colas. Oh how I loved that drink, but my gut did not, and I was a fool deceiving myself that it was something else causing my bloated crampy stomach. I cannot take malt in any form, nor can I ingest MSG; it could be cross-contamination, but the angst and pain I experience are not worth the risk. Anytime you drink away from home, like on holidays, you are at risk for exposure because non-celiacs simply do not understand how we're affected. Every single one of us have been poisoned by cross-contamination, most of us multiple times.

Reactions can be triggered by poor manufacturing practices that don't include segregation of malicious gluten bits. Some products are different because of the way they were aged (ex: wooden barrels). A lot of people state, "I understand the science behind alcohol being gluten-free but I still have a reaction to any that are distilled from grains." At first I thought my reactions may have been psychosomatic. Maybe It's just because I am questioning the validity of truly being gluten-free. Not too long ago I had a very serious reaction and did research on the drink I had. Indeed it was a wheat/barley vodka. I believe for most people it may be fine, however, I have always been super sensitive and am continually reminded that I must be careful."

Then we come to the beer lovers, whose hot day holiday experience includes a cold beer in hand. Unfortunately a lot of beer drinkers settle for beers brewed with buckwheat or sorghum that are combined with lower concentrations of barley malts, as are the most common brewing practices. The demands of beer-lovers with celiac disease are finally gaining the attention of craft brewers throughout the world. Most of these brewers have been researching the chemical and physical features of celiac disease, and have formulated their products with 100% gluten-free ingredients and processes that ensure purity of product. They point out that some filtering processes used by brewing companies render gluten undetectable in "low-gluten" beer; however, unless a beer is totally gluten-free, there is no assurance that it is safe for celiacs.

The most common substitutions for gluten-rich grains are : buckwheat and sorghum, rice, maize, corn, and sunflower, amaranth, flax, millet, quinoa, teff, wild rice, soybean, ragi, and rape. Sorghum and buckwheat are the most common ones used in Western gluten-free beer. This Web site lists the approved gluten-free beers and the ones that have been recalled as well. There is also a "Contact Information for Gluten-Free Beer listing of Web Sites." It is rather lengthy and you will need to photocopy the information and take it with you while traveling on holiday. This site was updated on January 23, 2010, so it is already three years old, and I am sure there are lots of other gluten-free beers around. Don't risk your health by grabbing the first beer on the table at a social outing or restaurant and keeping your fingers crossed; it will not work!

I'm sorry if I am ruining your holiday, but drinking does not necessarily equate to a good holiday and is one drink worth destroying the villi in your gut leaving yourself open to a multitude of connective tissue disorders? You only get one body in this life. Take care of it!

Celiac.com 12/14/2016 - Just when you think you've heard everything, something brand new enters the arena. When it comes to non-dietary sources of gluten, I think of things such as lipstick (it's not a food but we still eat some of it), Play-Doh (also not a food but if you've ever seen children playing with it, you'll note that some ingestion occurs), and some cosmetic items like body lotions and shampoos. The skin does ‘ingest' what you put on it and we've definitely seen negative reactions from topical application of gluten-containing ingredients. But prior to becoming acquainted with a recent published paper in Clinical Pediatrics, my list of non-dietary sources of gluten would likely have ended there.

This brand new study entitled "An orthodontic retainer preventing remission in celiac disease" gives it all away in the title… or does it?

Yes, it turns out that the specialized plastic used by manufacturers of retainers contains gluten. And the gluten can get mobilized into the body of the person utilizing the retainer. The story cited by the researchers involved a 9 year old child with celiac disease. She complained of abdominal pain and was diagnosed via blood and biopsy as having celiac. Upon implementing a gluten-free diet, the young girl's physical complaints persisted and her lab findings also showed an active form of the disease.

Brilliantly, someone thought to suspect her retainer, which contained a plasticized methacrylate polymer. It turns out that gluten is a common additive to plastics. And despite the idea that a hard plastic would be stable, it turns out that nothing could be further from the truth.

After discontinuing use of her retainer, not only did her symptoms resolve, but so too did her blood and biopsy findings become normal.

I did a little digging and this specific form of plastic is used in more than just retainers. It's found in dentures, white dental fillings, hard lenses for the eye in the treatment of cataracts, hard and some soft contact lenses, as a bone cement in orthopedic surgery, in cosmetic surgery as fillers, and more.

The history behind the use of this plastic is rather interesting. It turns out that during World War II pilots flew in planes that had side windows made from this particular type of plastic (abbreviation PMMA). When they were shot at, splinters from the windows lodged in the pilots eyes. Unlike glass splinters that did create problems, the plastic caused no rejection by the eyes. This human tissue compatibility was then used for cataracts, contact lenses, etc.

If you know of someone who continues to be ill despite a strict gluten-free diet, looking into non-dietary forms of gluten may yield the answer to their problem.

I hope you found this informative. If you have any questions feel free to contact me. If you need assistance with your health, consider contacting us for a free health analysis – 408-733-0400. We are a destination clinic and treat patients from across the country and internationally. You don't need to live local to us to receive assistance. We're here to help!

To your good health!

Reference:

• Clinical Pediatrics. 2013 Nov; 52(11):1034-7. doi: 10.1177/0009922813506254. An orthodontic retainer preventing remission in celiac disease. Memon Z, Baker SS, Khan A, Hashmi H, Gelfond D.

Celiac.com 12/13/2016 - Cookie exchanges are fun social occasions but let's resolve to make cookies healthier next year. They don't need to be 7 layer high fat, high sugar indulgences that contribute to many chronic diseases like diabetes, high blood pressure, cardiovascular damage and dementia. Yes, high sugar is now identified as a major contributor to dementia and even has its own classification called Type 3 diabetes. As the levels of obesity and diabetes continue to generate headlines, emphasis on reducing sugar will continue to make news. Stevia now has a global market over $300 million as a sugar substitute but it continues to lag behind other sugar substitutes in the U.S. Stevia leaf has been valued for centuries throughout South America for its sweetening properties. It is about time Americans started using a healthier sugar substitute that the Japanese have enjoyed for decades.

Using sugar substitutes like stevia, erythritol and xylitol can modify calories without sacrificing taste. These sweetening agents are better choices than the other sugar substitutes used in sugar-free foods.

Whole grain gluten-free flours like hemp and quinoa provide more protein, fiber, calcium and iron than whole wheat so gluten-free cookies are healthier than conventional choices. These flours impart a nutty taste to delight any appetite. Quinoa is the Andean cereal that originated in the Ecuador, Bolivia, Columbia and Peru region of South America. Quinoa and hemp are both becoming increasingly popular throughout the United States and are available in most health food stores. What was once considered "peasant food" now sells for a higher price per pound than chicken! Quinoa flakes are easy to use in cookies, yogurt or soups for added protein and nutrients.

Butter and coconut oil add the most calories to each cookie. Don't pay any attention to all those negative comments about saturated fat content of butter and coconut oil. There is no science to demonstrate they are unhealthy. Coconut oil is made unhealthy when hydrogen is added to the oil to make non-dairy cream or whipped toppings. Theron Randolph, M.D. described it best when he stated "analytical dietetics" (what can be assessed by a machine) is not "biological dietetics" (how food is used in your body).

Many recipes and commercially baked products contain xanthan gum to make the dough more sticky. This recipe does not use of xanthan gum because it is derived from the fungus, xanthomonas campestris (the black mold on broccoli, cauliflower or leafy greens). This fungus is grown on corn, wheat, dairy or soy to produce the powder. Since no studies have been done about sensitivities to xanthan gum produced from these foods, anyone with sensitivities to these foods should limit or avoid products that do not state the source for the production of xanthan gum. Remember, it is a thickening agent that can be present in many foods like salad dressings, ice cream, egg substitute products, etc. As a thickener, xanthan gum is a very effective laxative

This one basic cookie recipe can provide lots of variety for health snacks throughout the coming year. Cookies can provide a quick snack so numerous options mean healthy eating for everyone.

Chocolate Chip Quinoa Cookies

Ingredients:

• 1/4 cup coconut oil
• 1/2 cup butter or margarine
• 3/4 cup Xylitol sweetener or 3 tablespoons stevia- erythritol sweetener
• 2 eggs
• 3/4 cup brown rice flour or hemp flour
• 3/4 cup coconut flour
• 1/4 teaspoon salt
• 1 1/2 teaspoon baking soda
• 1/2 cup quinoa flakes or hemp hearts
• 1 cup (6 oz) chocolate baking chips
• 2 tablespoons water

Directions:
Cream together coconut oil, butter, sweetener and eggs. Add rest of the ingredients and mix thoroughly. Drop by teaspoons onto lightly oiled baking sheet. Press down and bake in 350 degree oven 10-12 minutes, or until browned. Makes 3 dozen.

To make Oatmeal Spice Cookies: add 1 teaspoon ground cinnamon, 1/4 teaspoon ground nutmeg and 1/8 teaspoon ground cloves instead of chocolate chips.

To make Hemp Raisin Cookies: add 1/2 cup raisins instead of chocolate chips and use hemp flour

To make Peanut Butter Cookies: add 1 cup peanut butter to creamed mixture. Top with chocolate chip, if desired.

Calories per cookie: 158; Protein: 3 g; Carbohydrates: 16 g; Fat: 8 g, Sodium: 69 mg.

Celiac.com 12/08/2016 - New gluten-free information continually appears on the scene through journals like this one and others. It helps direct many towards a more robust life. Millions of people however are left in the shadows, confused and frustrated because they have low health literacy; lacking the ability to access, understand, and process health information and services. As would be expected, their healthcare decisions can then be faulty, leading to potentially harmful consequences and the delayed diagnoses which we see so commonly with celiac disease and gluten sensitivity.

Over 90 million adults in the U.S. struggle with low health literacy. Nearly 9 out of 10 adults lack the skills to manage their health and prevent disease according to the U.S. Dept. of Health and Human Services. In rural areas, the rate is even higher due to an older, poorer, and less educated population who are more likely to suffer from chronic health conditions.

A substantial part of the population therefore remains under-served and is unaware that a change in their food choices can dramatically improve their health. And we can't help them by talking louder, or by explaining things in longer, lovelier sentences, or by repeating the same message over and over. We can start communicating with those with low health literacy by using simple-English (plain language), in short sentences. We can then advance their new understanding by finding another way to repeat the same thought; through video, by using well-conceived illustrations, audio, and/or simplified charts and graphs.

The problem is substantial. I've decided to be part of the solution. I've therefore produced Gordon's Simple-English Gluten-free Glossary and placed it on Amazon as an e-publication. I've set up a blog, Open Original Shared Link, so we can discuss words, phrases and definitions. As an e-publication, the glossary is accessible to most and affordable by all at 99 cents.

This is a place to start. The gluten-free community has arrived late on the healthcare scene; but we can lead the rest of the world in this important area of healthcare communication.

Check out the glossary. Refer to it. Participate in its expansion. Recommend it to others.

Celiac.com 12/06/2016 - Neurological problems are a very common effect of gluten intolerance. Whether you have celiac disease or gluten sensitivity, there is research showing that gluten can cause nervous system problems in affected individuals.

What kind of problems? When it comes to the nervous system, symptoms run the gamut from depression to schizophrenia, from migraines to brain fog, and from seizures to numbness and pain.

I want to share more information with you about a particular type of nervous system ailment called peripheral neuropathy. The name basically means damage to the nerves of the extremities (arms and legs) that typically manifests in numbness and pins and needles-type pain that all of us have experienced at one time or another if we sat on our feet too long or fell asleep in a weird position and had a hand ‘go to sleep'. While these latter type incidents are normal, having such symptoms occur when no pressure is being put on the nerve is abnormal.

Not only is it uncomfortable to have such sensations, but when truly numb, accidents from tripping or burning oneself can occur due to not having adequate sensation.

I think it is interesting to note that the most common occurrence of peripheral neuropathy is seen in type I diabetes, an autoimmune disease. Celiac is also an autoimmune disease and according to the University of Chicago's Center for Peripheral Neuropathy, 10% of those diagnosed with celiac disease have a neurological problem, and peripheral neuropathy is quite common.

Taking it a step further, we know that gluten creates a leaky gut and we know that a leaky gut is associated with autoimmune disease, through several wonderful studies brought to us by Dr. Alessio Fasano and his team. Therefore, seeing a connection between gluten and peripheral neuropathy is not unexpected based on research.

Further, despite a dearth, or scarcity, of research on gluten sensitivity, doctors currently engaged in such research cite peripheral neuropathy as one of the most common symptoms associated with gluten sensitivity. In fact neurological symptoms are frequently associated with gluten sensitivity before any digestive symptoms ever develop. And in some cases, the nervous system disorders are present with no digestive disturbances. A lack of any digestive symptoms is perhaps one of many reasons why these individuals' gluten sensitivity is missed by their doctors.

When it comes to comparing gluten sensitivity to celiac disease, according to Dr Fasano, 30% of the patients he diagnoses with gluten sensitivity suffer a neurological ailment, a much higher percentage than that associated with celiac disease.

How Do You Know if You Have Peripheral Neuropathy?
The symptoms of peripheral neuropathy are numbness, a feeling of hot/cold or a pins and needles feeling that tends to start at the ends of your body's long nerves, meaning your feet and hands, before moving upwards. The symptoms can be in legs and/or arms, right side and/or left.

Certainly, considering that type 1 diabetes is the most common cause of peripheral neuropathy, with an estimated 50% suffering some type of nerve damage, that would be the first thing to rule out.

What Should You Do?
If you have these symptoms and your doctor has ruled out diabetes and any other obvious sources of the problem (including any drugs you may be taking that create neuropathy as side effects), you may fit into the category of "idiopathic neuropathy". This means that you have the problem but the reason is unknown. Or is it?

Let's look at the result of a study where researchers worked with more than 200 individuals with neuropathy, 140 of whom fell within the ‘idiopathic' category. These smart doctors tested those 140 people for antibodies to gluten, specifically utilizing the anti-gliadin antibody test – AGA-IgA and AGA-IgG. This blood test is a general blood test that is not specific to celiac disease or gluten sensitivity, but shows that the body's immune system is reacting negatively to these proteins in gluten called gliadin.

Of those tested, 34% were positive to one or both tests, compared to 12% of the general population. Interestingly, a full 9% of those tested in the ‘idiopathic' group actually had celiac disease, compared to 1% of the general population. And perhaps even more interesting, 80% of that same idiopathic group had the genes for celiac disease, either HLA-DQ2 or HLA-DQ8. 80%!! In the normal population that number is about 40%.

Our takeaway message is that peripheral neuropathy has a rather high correlation to immune reaction to gluten – be it celiac disease or gluten sensitivity. Therefore anyone you know who suffers with such symptoms absolutely should be checked for gluten intolerance. Regaining one's strength and correcting nervous system abnormalities is well worth the change in diet when gluten is the cause. Such cases have been described in the literature where the only treatment that led to success was a gluten-free diet.

So many diseases and symptoms can be prevented and reversed by discovering their true underlying root cause and for many of those ailments it is gluten that is the culprit.
Don't continue suffering nor let you friends and family members suffer. Find out why the symptom is there rather than just masking it with a drug.
If you need assistance, consider calling us for a free health analysis – call 408-733-0400. Our destination clinic treats patients from across the country and internationally. You don't need to live local to us to receive assistance. We are here to help!
To your good health,

References:

• Hadjivassiliou M. et al. Neuropathy associated with gluten sensitivity. Journal of Neurology, Neurosurgery, and Psychiatry. 2006 Nov;77(11):1262-6.
• Rigamonti A. et al. Celiac disease presenting with motor neuropathy: effect of gluten-free diet. Muscle & Nerve. 2007 May;35(5):675-7.
• University of Chicago Center for Peripheral Neuropathy. Types of Peripheral Neuropathy - Inflammatory - Celiac Disease.

This article originally appeared in the Winter 2014 issue of Journal of Gluten Sensitivity.

Celiac.com 04/30/2014 - Dr. Catassi and colleagues reported, in the September of 2013 issue of Nutrients, that during the previous 21 months for every ten reports about celiac disease, there was one report of non-celiac gluten sensitivity (1).  They plotted the publication ratio over the last 60+ years, showing that there has been a steady increase of reports on non-celiac gluten sensitivity in the medical literature that has grown proportionally faster than the number of reports about celiac disease, and most of us are aware of the rapid growth made by the celiac literature during that same period. By implication, we may reasonably assume that this reflects a growing interest among physicians and other health care workers.  Catassi and colleagues mention the first meeting of an expert panel in London during 2011, and report on discussions from the December, 2012 meeting of experts in Munich, addressing a wide range of illnesses thought to have some connection with gluten ingestion (1, 2).  An approximately concurrent report by Mooney et al ( including Sanders, one of the above-mentioned experts) (3)  attempts to clarify and extend some of the information from the Catassi et al report, as well as contradicting it on the issue of IgG anti-gliadin antibodies as a potential biomarker for non-celiac gluten sensitivity (1).   This growing trend of interest in non-celiac gluten sensitivity, along with the publications specifically cited here, offer enormous affirmation of the Journal of Gluten Sensitivity and its editorial staff, and we are loathe to criticize it in any way.

Oats
However,  in the same report, Catassi and colleagues repeatedly decry the “lack of biomarkers” for non-celiac gluten sensitivity (1). In essence, they  are saying that there is no known laboratory test that will reliably identify this form of gluten sensitivity. Further, while they admit that they have “poor knowledge of the pathophysiology” of non-celiac gluten sensitivity, they seem to assume that oats may be safely eaten by individuals afflicted by this sensitivity. They appear to reflexively exclude oats from any further investigation, as a possible factor in non-celiac gluten sensitivity. Such assumptions appear to be bleeding over into their perceptions of non-celiac gluten sensitivity from their work with celiac disease.    

The IBS Connection
Catassi et al also cite one study that reports a rate of 28% of non-celiac gluten sensitivity among IBS patients, and a larger study that reports a rate of 30% of IBS patients who have wheat sensitivity, either with or without other food sensitivities.  This same group reports a prevalence of IBS in northern Europe of between 16%  and 25% of the population (1).  If we take their most conservative numbers,  estimating that IBS afflicts only 16% of the population, and that 28% of that group has  non-celiac gluten sensitivity, then about 4.48% of northern Europeans should have non-celiac gluten sensitivity. Catassi et al  say that the rate could well be above 1% (1). Some might suggest that this is a gross understatement that distorts the data rather than clarifying it. This, too, may reflect a preoccupation with lessons learned from celiac disease, rather than a de novo view of gluten sensitivity.  

They cite yet another study of a subset of IBS patients in which diarrhea was the predominant symptom, particularly among patients with genetic HLA DQ2 and DQ8 markers, which are associated with celiac disease.  These IBS patients showed compromised bowel barrier function when consuming gluten, presumably as a function of barrier permeability.  They go on to assert that the gluten free diet offers some measure of symptom relief even to those patients whose IBS may be partly or wholly driven by low-fermentable, poorly-absorbed, short-chain carbohydrates, as  gluten proteins may be included in this list of potentially problematic foods.  

Psychiatric Connections
Catassi and colleagues also explore schizophrenia and autism  where sub-groups of non-celiac gluten sensitivity have been identified. They report the findings of two studies of schizophrenic patients wherein no benefits were seen after gluten avoidance over the study periods of either 10 days (4) or 5 weeks of treating 8 chronic schizophrenic patients (5).  Catassi et al also mention the mildly positive results from a study of 14 weeks’ duration (6). However, beyond citing one paper authored by Dr. Curtis Dohan, identified as the earliest suggestion of a connection between gluten and schizophrenia, they do not mention the recommendations of Dohan and his colleagues, who called for a minimum study duration of at least six months and as much as a year on a gluten free, dairy free diet before the potential benefits of this diet can be observed in schizophrenic patients.  They also recommended treating newly diagnosed and newly relapsed schizophrenic patients with this diet as they had observed little positive response among the chronic schizophrenic subjects they studied (8, 9, 10, 11). Further,  Catassi et al completely fail to acknowledge the work by Zioudrou and colleagues (12) that identifies a possible source of urinary peptides seen both in many schizophrenics (13, 14) and many patients with autism (15). These peptides have, since their discovery, been recognized as psychoactive (12).  These insights are particularly important in these realms of mental illness and abnormal development, as they offer insights that may someday offer vastly more effective treatments than are currently available.  Again, celiac disease may be coloring the lens through which these experts are looking at non-celiac gluten sensitivity.   

Catassi and his colleagues go on to acknowledge that IgG class antibodies against gliadin, a sub-group of gluten proteins, as markers for increased intestinal permeability (1) but they fail to acknowledge this protein group as the missing “biomarker” of gluten sensitivity. They say:  “Non-celiac gluten sensitivity is currently a diagnosis of exclusion with the only positive diagnostic criterion being the clinical response to gluten withdrawal. Patients should have negative celiac serology, normal duodenal histology, and negative IgE-based tests” (1).  

IgG against gliadin offers a biomarker for 19.8% tp 23.5% of the population.  Yet serology is the most common approach to measuring IgG anti-gliadin, and others have made this connection, identifying IgG class anti-gliadin antibodies as “ a measure of the immune response to gliadin” (7). (Gliadin is a sub-group of gluten proteins.)  If  someone is mounting an immune response against gliadin, it is reasonable to say that they are gluten sensitive. So why would Catassi and colleagues back away from the data suggesting that non-celiac gluten sensitivity may afflict from 4.48% to as many as 7.5% of the northern European population, based only on those with diagnosed IBS?  Further, 12%  of healthy blood donors in the United Kingdom  have also been reported to show elevated levels of anti-gliadin antibodies (16).  Taken together, these suggest a rate of non-celiac gluten sensitivity, as identified by IgG class antibodies against gliadin among northern Europeans, of between 16.8% and 19.5%  of the general population.  

Dr. Sapone and her group have identified and reported on a group of non-celiac gluten sensitive patients (21) who present with what Dr. Sapone and her group have  elsewhere characterized as a function of the innate immune system and comprise between 6% and 7%  of the general population (22).  Only about half of these subjects show anti-gliadin antibodies but since they are not healthy blood donors or IBS patients, we may reasonably predict that between 22.8% and 26.5% of the population has non-celiac gluten sensitivity.  

And there are likely a lot more cases than are suggested by those numbers.   For instance, about 7% of patients with multiple sclerosis showed IgG class antibodies against gliadin (17),  while more than 20% of patients with Crohn’s disease, and 6.5% of patients with rheumatoid arthritis also showed elevated IgG antibodies against gliadin (18), and Samaroo et al found the same antibodies elevated in the sera of 5.6% of the schizophrenic  patients they studied (19).   And Hadjivassiliou’s group states “IgG antigliadin antibodies have a high sensitivity not only for patients with coeliac disease but also for those with minimal or no bowel damage where the principal target organ is the cerebellum or peripheral nervous system” (20).  

Cancer
Perhaps the most distressing part of the Catassi report is where it says “No major complication of NCGS has so far been described; especially autoimmune comorbidity , as observed in celiac disease, has not been reported so far.” In 2007, Anderson et al published a report in which people with non-celiac gluten sensitivity experienced: “ ..... the incidence of malignant neoplasms in patients with celiac disease (positive EMA test) was similar to that of the Northern Ireland population. However,  mortality from malignant neoplasms, NHL [non-Hodgkin’s lymphoma], and digestive system disorders was significantly increased in patients who were gluten sensitive with a negative EMA test” (7).  This same report states that it may be the first investigation of malignancy and mortality among non-celiac gluten sensitive patients (7) and they have found that cancer and increased mortality is higher among those who are gluten sensitive than among those with celiac disease.  

Why Not IgG Anti-gliadin as Biomarkers?
You may, like me, be wondering why the Catassi-led group retreated from the use of IgG antibodies against gliadin as a bio-marker for gluten sensitivity, when the consequences of ignoring it are made obvious by the Anderson et al study  mentioned in the previous paragraph, showing increased mortality rates in this group. This result may be due to physicians’ failure to recommend a gluten free diet, reflecting their skepticism regarding this marker.  The Catassi et al skepticism is especially puzzling when at least one of their own members (Sanders) had submitted a report for publication at about the same time, in which he and his colleagues assert a prevalence of non-celiac gluten sensitivity of 12%, among healthy blood donors, based on IgG anti-gliadin antibodies  (3).   We are also left wondering why these experts would ignore the recommendations and insights embodied in the large and earliest body of research connecting schizophrenia and gluten, authored by Curtis Dohan and his colleagues (8-14) while Catassi et al seem to give credence to the negative results reported by investigations lasting only ten days or five weeks?

I think that Catassi et al have answered this question, but before we discuss that, I’d like to point out that elite athletes have reported improved performance on a gluten free diet (23, 24). They were already performing at the very pinnacle of their sports, yet their experimenting with the gluten-free (and in one case, also a paleo-diet) led to enhanced performance.  That really is quite amazing.  And what about those with IgG AGA who have neurological or other autoimmune diseases?  Also, the girl that Kim and I wrote about in the last issue of this Journal is a perfect example of a patient with autoimmune diabetes, where celiac disease was ruled out, so she was told that she would have to inject insulin for the rest of her life. Yet all she needed was a gluten free diet and very insightful parents who were willing to press physicians to expand their thinking a little.

I must say that I am very pleased with Catassi et al’s stated recognition of extra-intestinal manifestations of non-celiac gluten sensitivity.  However, their approach is to call for further characterizing  the various groups that respond differently to gluten, based on grouping by specific illnesses. This may miss the larger picture.  Catassi et al acknowledge that “The vast majority of celiac experts initially reacted with a great deal of skepticism to the concept of NCGS existence and the fact that it was a separate entity from celiac disease” (1).  They go on to suggest that we are about at the same place that we were forty years ago with celiac disease.  Perhaps.  

As it stands, we have celiac disease and we have non-specific anti-gliadin antibodies that signal the lion’s share of cases of non-celiac gluten sensitivity, an increased risk for autoimmunity, a majority of a wide range of neurological diseases that are also more frequent among those with celiac disease, we also have many children with ADHD who recover on a gluten-free diet alone, we have a very large majority of children with learning disabilities who recover on a strict gluten-free diet, we have people who lose weight on a gluten-free diet, we have people who just think that they feel better on a gluten-free diet, and we have elite athletes who perform better on a gluten free diet.  We also have cases of non-celiac gluten sensitivity as characterized by Dr. Sapone et al, where the innate immune system is involved, and we only have anti-gliadin antibodies associated with about half of those individuals.   

When we see all these fractured pieces scattered about the landscape of gluten induced illness, it is highly likely that we are missing the larger vista that incorporates all of them. But we would have to let go of some sacred cows to see that larger picture. The first sacred cow we should abandon is the idea of celiac disease as a distinct and most important disease entity, and begin to think of gluten induced disease, or to use Rodney Ford’s term, “gluten syndrome”.   I think it is great that non-celiac gluten sensitivity is getting more recognition, but the current lens through which medical researchers view celiac disease and non-celiac gluten sensitivity may be clouded by their reductionist  paradigm.

The problem, as I see it, is that celiac disease has long been mischaracterized. When Dr. Dicke showed that the gluten free diet reversed celiac disease, few believed him.  He was laughed out of a world conference in New York City and vowed never to return to the USA.  When he and his colleagues searched for a ‘scientific’ way to validate the diet as an effective treatment for celiac disease, they  found intestinal villous atrophy, so the medical understanding of gluten induced illness has evolved, primarily, as an intestinal ailment characterized by villous atrophy.  

I think that Dr. Rodney Ford’s conception of celiac disease as a sub-group of intestinal and extra-intestinal ailments that first derive from gluten’s assault on neurological tissues (25) is better rooted in the facts, and much more likely to prove true.  Ford’s perspective may well provide a better tool for understanding gluten’s impact on human health - although it impugns major parts of more than seventy years of medical and scientific research into celiac disease. It may even suggest that we were looking in the wrong direction for much of the time. Ford postulates that gluten’s first insult is to neurological tissues. Those who are susceptible to celiac disease may go on to develop intestinal damage as a sequel to the neurological injury. Those who are not susceptible to celiac disease may go on to develop any of a number of gluten-related ailments, depending on their unique genetic makeup, experiences, and exposures (25).  Understandably, Rodney’s conception may be unpopular among some medical practitioners and researchers - but it sure fits the facts better than anything else I’ve seen.   

Sources:  

1. Catassi C, Bai JC, Bonaz B, Bouma G, Calabrò A, Carroccio A, Castillejo G, Ciacci C, Cristofori F, Dolinsek J, Francavilla R, Elli L, Green P, Holtmeier W, Koehler P, Koletzko S, Meinhold C, Sanders D, Schumann M, Schuppan D, Ullrich R, Vécsei A, Volta U, Zevallos V, Sapone A, Fasano  A. Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders. Nutrients 2013, 5, 3839-3853.
2. Open Original Shared Link
3. Mooney PD, Aziz I, Sanders DS. Non-celiac gluten sensitivity: clinical relevance and recommendations for future research. Neurogastroenterol Motil. 2013 Nov;25(11):864-71. doi: 10.1111/nmo.12216. Epub 2013 Aug 12.
4. Storms LH, Clopton JM, Wright C. Effects of gluten on schizophrenics. Arch Gen Psychiatry. 1982 Mar;39(3):323-7.
5. Potkin SG, Weinberger D, Kleinman J, Nasrallah H, Luchins D, Bigelow L, Linnoila M, Fischer SH, Bjornsson TD, Carman J, Gillin JC, Wyatt RJ. Wheat gluten  challenge in schizophrenic patients. Am J Psychiatry. 1981 Sep;138(9):1208-11.
6. Vlissides DN, Venulet A, Jenner FA.A double-blind gluten-free/gluten-load controlled trial in a secure ward population.Br J Psychiatry. 1986 Apr;148:447-52.
7. Anderson LA, McMillan SA, Watson RG, Monaghan P, Gavin AT, Fox C, Murray LJ. Malignancy and mortality in a population-based cohort of patients with coeliac disease or “gluten sensitivity”. World J Gastroenterol. 2007 Jan 7;13(1):146-51.
8. Dohan “Cereals and schizophrenia: data and hypothesis” Acta Psychiat Scand 1966; 42: 125-152
9. Dohan et. al. “Relapsed Schizophrenics: More Rapid Improvement on a Milk-and Cereal-free Diet” Brit J Psychiat 1969; 115: 595-596
10. Dohan et. al. “Is Schizophrenia Rare if Grain is Rare?” Biol Psychiat 1984; 19(3): 385-399
11. Dohan “Is celiac disease a clue to pathogenesis of schizophrenia?” Mental Hyg 1969; 53: 525-529
12. Zioudrou et. al. “Opioid peptides derived from food proteins. The exorphins” J Biol Chem 1979; 254:2446-2449
13. Dohan FC. Genetic hypothesis of idiopathic schizophrenia: its exorphin connection. Schizophr Bull. 1988;14(4):489-94.
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15. Reichelt KL, Tveiten D, Knivsberg AM, Brønstad G.Peptides’ role in autism with emphasis on exorphins.Microb Ecol Health Dis. 2012 Aug 24;23.
16. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A.Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.
17. Shor DB, Barzilai O, Ram M, Izhaky D, Porat-Katz BS, Chapman J, Blank M, Anaya JM, Shoenfeld Y. Gluten sensitivity in multiple sclerosis: experimental myth or clinical truth? Ann N Y Acad Sci. 2009 Sep;1173:343-9. doi: 10.1111/j.1749-6632.2009.04620.x.
18. Shor DB, Orbach H, Boaz M, Altman A, Anaya JM, Bizzaro N, Tincani A, Cervera R, Espinosa G, Stojanovich L, Rozman B, Bombardieri S, Vita SD, Damoiseaux J, Villalta D, Tonutti E, Tozzoli R, Barzilai O, Ram M, Blank M, Agmon-Levin N, Shoenfeld Y. Gastrointestinal-associated autoantibodies in different autoimmune diseases. Am J Clin Exp Immunol. 2012 May 25;1(1):49-55. Print 2012.
19. Samaroo D, Dickerson F, Kasarda DD, Green PH, Briani C, Yolken RH, Alaedini A. Novel immune response to gluten in individuals with schizophrenia. Schizophr Res. 2010 May;118(1-3):248-55. doi: 10.1016/j.schres.2009.08.009. Epub 2009 Sep 11.
20. Hadjivassiliou M, Grünewald RA, Davies-Jones G A B. Gluten sensitivity: a many headed hydra. Heightened responsiveness to gluten is not confined to the gut. BMJ. 1999 June 26; 318(7200): 1710–1711.
21. Sapone A, Lammers KM, Casolaro V, Cammarota M, Giuliano MT, De Rosa M, Stefanile R, Mazzarella G, Tolone C, Russo MI, Esposito P, Ferraraccio F, Cartenì M, Riegler G, de Magistris L, Fasano A. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med. 2011 Mar 9;9:23.
22. Sapone A, Lammers K M, Mazzarella G, Mikhailenko I, Cartenì M,  Casolaro V, Fasano A. Differential Mucosal IL-17 Expression in Two Gliadin-Induced Disorders: Gluten Sensitivity and the Autoimmune Enteropathy Celiac Disease. Int Arch Allergy Immunol. 2010 April; 152(1): 75–80. Published online 2009 November 24.
23. https://www.celiac.com/articles/23375/1/New-Djokovic-Book-Promotes-Gluten-free-Diet/Page1.html 
24. Open Original Shared Link
25. Ford RPK. The gluten syndrome: a neurological disease. Medical Hypotheses. 2009:73, 438-440