For millions of Americans who avoid gluten, due to celiac disease or gluten sensitivity, eating out can be a constant challenge. Having easy access to a safe, tasty, low-cost gluten-free sandwich is like the Holy Grail for some of those folks. For many, being able to grab a gluten-free Subway sandwich would be a major step toward vanquishing the challenges of eating gluten-free.

Subway understands that being gluten-free "…really cuts down on fast-casual dining options, particularly sandwiches,” said Michele Shelley, Subway board member and owner.

Many people were excited to read about Subway's early testing of gluten-free products in selected areas. Many were equally excited to hear about Subway's commitment to getting their gluten-free sandwich offerings right, from start to finish.

For example, Subway’s wheat-free sandwich rolls and brownies are produced in a dedicated gluten-free facility and are individually packaged. Subway staffers are trained to prevent cross-contamination during the sandwich-making process.

Moreover, a single employee will prepare a gluten-free sandwich order from start to finish. Other features to Subway's gluten-free process include single-use knives and eliminating contact between traditional sandwich rolls and other ingredients including meat, cheese and vegetables.

Oregon is one of a handful of states where Subway first tested gluten-free products in selected areas. The current statewide roll out in Oregon comes after a successful test in Bend and Portland, Subway restaurants, and seems to signal Subway's desire to offer gluten-free menus to diners.

“Subway is known for being a leader in healthy fare, and we are excited to embrace these gluten-free menu items for those who can benefit from them,” Shelley told reporters.

Source:

• Open Original Shared Link

A number of breweries have been labeling certain of their barley-brewed beers as 'low gluten." The breweries have contended that the brewing process eliminates or reduces the gluten content in beer to levels that make it acceptable for people with sensitivity to gluten.

Perhaps unsurprisingly, a recent study of sixty commercial beers has debunked the idea that the beer brewing process eliminates gluten or reduces it to levels insignificant for people with celiac disease or gluten-intolerance.

Beers tested in a new study, including some brands labeled "low-gluten," contain hordein, the form of gluten found in barley, at levels that could trigger symptoms in patients with celiac disease, according to researchers.

You can find the full study to address this controversy over the gluten content of beer in ACS' Journal of Proteome Research.

In their article, Michelle Colgrave and colleagues explain that celiac disease affects over than 2 million people worldwide.

They explain that their study faced an initial challenge because  detecting gluten in malted products using existing tests was difficult, as the tests were largely inaccurate. So the scientists developed a highly accurate new test for hordein, the gluten component in barley-based beers.

As many expected, their analysis of 60 commercial beers found that eight labeled "gluten-free" did not contain gluten. All eight of the commercial beers labeled 'gluten-free' were, in fact, gluten-free.

But most regular, commercial beers had significant levels of gluten. Most alarming was that discovery that the two beers labeled as "low-gluten" each contained about as much gluten as a regular beer.

With the market for gluten-free products continuing to expand rapidly, it is no surprise that products may slip onto the market which are targeted at people with celiac disease or gluten-intolerance, but which actually contain levels of gluten that are unacceptable and potentially harmful to people who are sensitive to the proteins.

The problem is partly compounded by a lack of consistent standards for what constitutes "gluten-free," or what levels best address the needs of people with celiac disease and gluten-intolerance.

That leaves the burden for making decisions about what products are safe or not safe largely up to consumers, who must rely on a loose patchwork of manufacturers and product certification organizations that are, hopefully, knowledgeable, scientific and reliable. When science is hazy, room exists for spurious.

The lesson here is that commercial gluten-free beers seem to be genuinely gluten-free, and safe for people with celiac disease and gluten-intolerance, while anything labeled 'low gluten' is potentially bad news.

Source:

• Open Original Shared Link

The woman's daughter, Chelsea McGarry already has a long list of challenges — Down syndrome, autism, early onset Alzheimer's disease, diabetes, and celiac disease, among other conditions.

The problem is that Chelsea turns 19 in December, at which point her responsibility for her care transfers from Ministry of Children and Family to Community Living B.C., the government agency that provides services to adults with developmental disabilities.

Shelley McGarry says she's been battling for months with Community Living B.C. According to McGarry, Community Living B.C. has refused to approve the a plan for Chelsea. Moreover, the agency has threatened to reduce the minimal care Chelsea now receives, McGarry says.

"It just turns my stomach to think of taking this public," she said. "But I don't know where else or what else to do."

Independent provincial politician Bob Simpson and B.C. Representative for Children and Youth Mary Ellen Turpel-Lafond both say Chelsea's case is a classic example of Community Living B.C.'s failure to work with families and find solutions. Instead, they say, the agency is worsening the McGarrys' situation.

"This is a young woman whose life is in crisis," said Turpel-Lafond, who has been pushing Chelsea's cause since her family since Ausgust 2011, when they asked him to advocate on her behalf. Turpel-Lafond says that Community Living B.C.'s efforts have been lacking so far.

"I've written, I've met with the head of CLBC, I've done just about everything I can," she says. "I've said to them very clearly, 'This is a case that needs a review by you, she added'"

Simpson represents Chelsea and her family in the provincial legislature. He says that the family has followed all of the government's rules.

Shelley McGarry has thoroughly documented Chelsea's fragile medical conditions. She developed a plan with the local non-profit society, also known as a micro-board. McGarry arranged for Chelsea to receive home care for about $340,000 a year. That amount is far less than the CLBC's plan to put Chelsea in a care home capable of managing her complex needs.

Simpson called the plan that the McGarry's have offered the CLBC a 'very reasonable and appropriate plan.'

However reasonable that plan may be, the CLBC has refused to approve it. Worse still, their proposed alternatives would either be unsafe, or cost up to three times what it would to keep Chelsea at home, Simpson said.

Simpson says that he suspects the CLBC is punishing Shelley McGarry for her vocal and tireless advocacy on Chelsea's behalf. Simpson adds that he also suspects  that officials, as he says they have done in other recent cases, have lost sight of Chelsea as a person.

Both Social Development Minister Stephanie Cadieux and Community Living B.C. have declined to comment on specific cases. However, Cadieux said in an interview that she is aware of the file, and that she has appointed a new client support team, which she hopes can resolve the matter.

"I agree that it needs attention," Cadieux said, adding that the new team includes a number of "high-ranking officials" from the Ministry of Social Development, and the Ministry of Children and Family Development.

Source:

• Open Original Shared Link
  

Go to many schools today, and you may hear terms like 'gluten-free,' 'celiac-friendly,' or 'allergen-free' thrown around liberally with more common standbys like 'kosher,' 'organic,' 'vegetarian,' and 'vegan.'

Students are "becoming more sophisticated customers," says Joe Wojtowicz, general manager of Sodexo, Inc.'s Crossroads dining room at Concordia University Chicago in River Forest. These days, it's common for staff to field questions about food options before students even arrive on campus, especially questions about celiac disease, gluten-intolerance, food allergies and vegetarian preferences.

For these students, access to accurate nutritional information is all the more important given their need to avoid foods that trigger allergies, Wojtowicz says. "All our menus are on the Web, and they click through an item to learn the nutritional content," he adds. "And we make sure we label our offerings if they contain nuts." These benefits extend to students with celiac disease and gluten intolerance, as well.

Overall, more students are requesting foods that are more nutritious and healthful than in the past, says Travis Orman, senior director of dining services with Chartwells Educational Dining Services at Elmhurst College in Elmhurst, which serves up to 3,200 meals a day. Students are also demanding more options. That means a change in even the most basic offerings.

For example, many colleges are finding that students enjoy ethnic specialities. Orman says authentic Mexican is a favorite on his campus. "We honed in on the authentic cuisine and developed 8 to 10 options where the flavors just burst in your mouth. We launched Serranos Mexican Grill in September, and it's been very well received." Offerings include a burrito bowl taco, taco salad and barbacoa, a beef slow braised in garlic, lime, chiles and spices, then shredded, Orman says.

Many college students prefer meat-free options, says Wojtowicz, so Crossroads always offers at least two to four vegetarian menu options, including cheese pizzas, grilled cheese sandwiches and cheese quesadillas. Other items, such as grilled Provencal vegetable sandwich or black bean and cheese quesadilla also appear.

At CUC, Wojtowicz has responded to a growing interest in Mediterranean dishes with items like paella, spanakopita, Spanish tapas and other regional favorites.

Some schools are taking food offerings to the next level by serving vegetables grown in local community gardens. North Central College in Naperville is among schools that has turned to harvesting a community garden to supply a portion of the produce for its dining operation.

The North Central College Community Garden is now in its second year, and benefits from the efforts of nearby residents, who tend their own plots of land. Because of that support, those gardens "produce some of the fresh vegetables and fruits used in the college's salad bar and deli bar," says director of residence life Kevin McCarthy. The school then labels those items at the dining hall so that students know they are choosing sustainable options grown at the Community Garden.

Source:

• Open Original Shared Link
  

Celiac.com 01/23/2012 - After their diagnosis, celiac patients are put on the gluten-free diet, which is the only treatment option currently available. The diet requires total elimination of gluten, a protein found in wheat, barley, and rye, which when ingested causes an autoimmune reaction in celiacs which results in damage to the absorptive finger-like projections that line the small intestine, which are called villi. As diligent as celiacs can be, avoiding gluten can be a challenge, and slip-ups can happen, especially when eating out. In my research, I've come across gluten-digesting enzymes as a new medical treatment option for later down the line and have shared this good news with the gluten-free community. However, gluten-digesting enzymes are already available over the counter to help celiacs and gluten-sensitive people with managing their gluten-free diet. Dr. Nan Kathryn Fuchs, who helped to formulate the Advanced Bionutritionals product, Gluten Sensitivity Formula, shares some information regarding these enzymes and clears up a couple of misconceptions regarding their use.

Furthermore, not all enzyme formulas containing DPP-IV are the same in terms of strength. Dr. Fuchs had her supplement creators formulate a gluten-digesting enzyme that was stronger than the other ones available on the market. The result was Gluten Sensitivity Formula. In her pamphlet, "How to Tell If You're Gluten Sensitive.And What to Do About It If You Are," Dr. Fuchs offers advice on how to take the supplement.

Dr. Fuchs emphasizes that Gluten Sensitivity Formula isn't intended to replace a gluten-free diet; it is, however, designed to reduce or get rid of a reaction to "small amounts" of what would presumably be unintentionally ingested gluten, such as one may encounter at a restaurant or a dinner party due to cross-contamination. She also recommends taking one or two capsules of the formula "as insurance" before eating meals that might possibly be contaminated with gluten.

Dr. Fuchs also clears up a myth regarding hydrocholoric acid (HCl), which has been believed to counteract digestive enzymes; this misconception has led to the incorrect advice that one shouldn't take hydrochloric acid and enzymes together. Hydrochloric acid is taken, according to Dr. Fuchs, in order to help with digesting proteins and minerals, for example calcium and iron. She says the supplement is more common among people over the age of 50. In fact, enzymes can only cancel out the benefits of hydrochloric if they alter the pH of the stomach by neutralizing its acids. Dr. Fuchs says that while animal-based enzymes can accomplish this, they are usually formulated with a protective coating or in a form that will prevent this from occurring. What's more, many enzymes, especially gluten-digesting ones, are made from plants. "So you can take them with HCl," Dr. Fuchs says.

According to Dr. Fuchs, taking gluten-digesting enzymes "can make the difference between being successful on a gluten-free diet and failing." When used correctly, it can help alleviate the symptoms of a reaction caused by accidental gluten ingestion or prevent the reaction from occurring. As a celiac myself, I can say that inadvertent gluten ingestion is still a challenge I face on the gluten-free diet, even though I've been on the diet for years. Dr. Fuch's Gluten Sensitivity Formula is thus a welcome product that will make the lives of the gluten-free community a lot easier.

Resources:

• Fuchs, Nan Kathryn, PhD. "How to Tell If You're Gluten Sensitive.And What to Do About It If You Are." Advanced Bionutritionals, 2010.
• "Digest This: Enzymes Can Help Your Food Intolerance." Living Without: August/September 2010.
• Food Reactions: Food Intolerance http://www.foodreactions.org/intolerance/index.html

Celiac.com 01/20/2012 - Candi Smithson says her 2-year-old son, Preston, has severe allergies that present him from eating certain breads and dairy items, among other things. Celiac disease prevents Preston from eating anything containing gluten, a protein found in wheat, rye and barley.

Preston also is allergic to certain milk proteins, making things like butter and other dairy products hazardous to his health.

Smithson claims that the local pizza Hut in Muskogee, Oklahoma discriminated against her by asking her and her son to leave the restaurant. Smithson told reporters that she was in Muskogee as part of a home-schooling group to see replicas of the Niña and Pinta ships, which had been cruising the Arkansas River in recent weeks. Smithson, another parent and four children, including Preston, stopped at Pizza Hut to have lunch.

Smithson told reporters from NewsOk.com that, before going into Pizza Hut, she had first stopped at McDonald's to get Preston a hamburger without the bun, and some french fries, which is safe for Preston to eat.

She brought that food with her into Pizza Hut, where she planned to order pizza for the other kids. But before the group could place an order, Smithson said a waitress told her that she could not be in the store with the McDonald's items.

Smithson told reporters that she explained the situation, but that the waitress remained unmoved.

“I explained why I was bringing in the food, but she said it didn't matter,” Smithson said. Smithson then asked to speak to the manager. She says that the manager, who was reportedly unavailable for comment, was also unsympathetic to the situation.

According to Smithson, the manager basically said, "We can't have this food in here, so we're going to have to ask you to leave,'” Smithson said. “I was really shocked ... we bring food into restaurants all the time, and this has never happened before.”

Smithson told reporters that Pizza Hut had no signs indicating a no-outside-food policy, and added that the restaurant lost out on five paying customers by demanding the hamburger and fries be discarded.

Indeed, a Pizza Hut official, who spoke to reporters on the condition he remain unnamed, says he knows of no company policies that would prevent paying customers from eating outside food in a Pizza Hut restaurant.

According to reporters, calls to Pizza Hut's corporate offices seeking comment on this story went unreturned.

Smithson says the actions of the Pizza Hut manager violated her son's rights as a person living with a disability. She claims food allergies that interfere with “major life activities” are considered disabilities.

Marca Bristo, who helped craft the original Americans with Disabilities Act during the late 1980s, agrees with Smithson. Bristo served as chairman of the National Council on Disability, a position she was appointed to by former President Bill Clinton.

Bristo said the Americans with Disabilities Act, enacted in 1990, was amended in 2008 to broaden what are considered “major life activities.” She said the changes were necessary because “the courts had narrowed the definition of the law” up to that point.

Eating is listed as major life activity in the amended act, which went into effect Jan. 1, 2009.

When asked about Candi Smithson's ordeal, Birsto said, “I do think she is right to challenge this." There are some ambiguities in the law, but, basically, Bristo says, "…if a food allergy affects life activities, it's got to be considered a disability and should fall under the act.”

Still, Smithson insists she's not looking for money. “I just want the policies changed,” she told reporters. “That way, when he gets older, he won't have to deal with things like this.”

Has anything like this happened to you or anyone you know?  Should restaurants be flexible when paying customers need to bring in outside food for reasons concerning allergies or food sensitivities? Let us know your thoughts.

The story was originally reported by Open Original Shared Link.

Source:

• Open Original Shared Link
  

Celiac.com 01/05/2012 - I was disappointed to read this opinion article in The Atlantic (titled: Open Original Shared Link) when there are three U.S. studies demonstrating that about half of overweight and obese children and/or adults with newly diagnosed celiac disease lose weight following institution of a gluten free diet (GFD) (2,3,4). Some of these researchers make statements such as “The GFD has a beneficial effect upon the BMI [body mass index] of overweight children with celiac disease” after following 27 children who, at diagnosis, were overweight or obese (2). Similarly, Cheng et al reported that “A GFD had a beneficial impact on BMI, underweight patients gained weight and overweight/obese patients lost weight” (3).  Murray et al report that only 30% of their obese patients with celiac lost weight after six months of following a gluten free diet (4). 

There isn’t much ambiguity in any of these three studies conducted by three separate groups of reputable medical scientists and published in the peer reviewed medical and scientific literature. Clearly, the gluten free diet is an effective weight loss tool for some of the individuals investigated. Yet Fontenot asserts that “there is no evidence that gluten-free foods promote weight loss….” (1). Exactly what evidence does she want?   

She goes on to say that “The only condition that necessitates a gluten free diet is celiac disease” (1). Yet she previously states, when discussing several other conditions that have been connected with gluten that “the research shows mixed results” (1). Surely the “mixed results” suggests that there is evidence that at least some cases benefit from a gluten free diet.

Neither does the notion of ‘necessity’ apply to celiac disease. A person with celiac disase can consume gluten. They may place their health at risk by so doing, but that applies equally to those individuals with other conditions that have been shown to benefit from a gluten free diet. So the distinction she makes is, at best, one of degree.

For decades many highly regarded investigators have published test results clearly showing that a gluten free diet is beneficial in the conditions listed by Ms. Fontenot, as well as many other ailments. These range from autism (5,6,7)  to schizophrenia (8,9,10,11) to a variety of neurological (12,13,14) conditions to attention deficit disorder (15,16), to many other forms of autoimmunity (17,18,19), learning disabilities (20) and even to AIDS patients (21).

Ms. Fontenot even asserts that “A person with celiac disease has increased levels of certain autoantibodies circulating in their blood due to their intake of gluten”(1). Again, she overlooks seronegative celiac disease which is frequently seen in the context of IgA deficiency (22, 23, 24) and may be present in many other contexts. 

Opinion pieces are probably easier to write when ignoring relevant facts. In this case, the overwhelming body of personal bias that drives Ms. Fontenot’s article is offered in the absence of a single supporting research finding and only one other professional opinion which is offered by one of Ms. Fontenot’s colleagues. She certainly hasn’t let the facts get in the way of her story, but it is deeply disturbing to discover that The Atlantic has chosen to republish this unsupported rant.

Sources:

1. Open Original Shared Link
2. Reilly NR, Aguilar K, Hassid BG, Cheng J, Defelice AR, Kazlow P, Bhagat G, Green PH. Celiac disease in normal-weight and overweight children: clinical features and growth outcomes following a gluten-free diet. J Pediatr Gastroenterol Nutr. 2011 Nov;53(5):528-31.
3. Cheng J, Brar PS, Lee AR, Green PH. Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol. 2010 Apr;44(4):267-71.
4. Murray JA, Watson T, Clearman B, Mitros F. Effect of a gluten-free diet on gastrointestinal symptoms in celiac disease. Am J Clin Nutr. 2004 Apr;79(4):669-73.
5. Whiteley P, Haracopos D, Knivsberg AM, Reichelt KL, Parlar S, Jacobsen J, Seim A, Pedersen L, Schondel M, Shattock P. The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutr Neurosci. 2010 Apr;13(2):87-100.
6. Reichelt KL, Knivsberg AM. The possibility and probability of a gut-to-brain connection in autism. Ann Clin Psychiatry. 2009 Oct-Dec;21(4):205-11.
7. 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.
8. Cascella NG, Kryszak D, Bhatti B, Gregory P, Kelly DL, Mc Evoy JP, Fasano A, Eaton WW. Prevalence of celiac disease and gluten sensitivity in the United States clinical antipsychotic trials of intervention effectiveness study population. Schizophr Bull. 2011 Jan;37(1):94-100.
9. De Santis A, Addolorato G, Romito A, Caputo S, Giordano A, Gambassi G, Taranto C, Manna R, Gasbarrini G. Schizophrenic symptoms and SPECT abnormalities in a coeliac patient: regression after a gluten-free diet. J Intern Med. 1997 Nov;242(5):421-3.
10. Dohan FC, Grasberger JC, Lowell FM, Johnston HT Jr, Arbegast AW. Relapsed schizophrenics: more rapid improvement on a milk- and cereal-free diet. Br J Psychiatry. 1969 May;115(522):595-6..
11.  Singh MM, Kay SR. Wheat gluten as a pathogenic factor in schizophrenia. Science. 1976 Jan 30;191(4225):401-2.
12. Hadjivassiliou M, Kandler RH, Chattopadhyay AK, Davies-Jones AG, Jarratt JA, Sanders DS, Sharrack B, Grünewald RA. Dietary treatment of gluten neuropathy. Muscle Nerve. 2006 Dec;34(6):762-6.
13. Hadjivassiliou M, Rao DG, Wharton SB, Sanders DS, Grünewald RA, Davies-Jones AG.Sensory ganglionopathy due to gluten sensitivity. Neurology. 2010 Sep 14;75(11):1003-8.
14. Turner MR, Chohan G, Quaghebeur G, Greenhall RC, Hadjivassiliou M, Talbot K. A case of celiac disease mimicking amyotrophic lateral sclerosis. Nat Clin Pract Neurol. 2007 Oct;3(10):581-4.
15. Niederhofer H, Pittschieler K. A preliminary investigation of ADHD symptoms in persons with celiac disease. J Atten Disord. 2006 Nov;10(2):200-4.
16. Zelnik N, Pacht A, Obeid R, Lerner A. Range of neurologic disorders in patients with celiac disease. Pediatrics. 2004 Jun;113(6):1672-6.
17. Rodrigo L, Hernández-Lahoz C, Fuentes D, Alvarez N, López-Vázquez A, González S. Prevalence of celiac disease in multiple sclerosis. BMC Neurol. 2011 Mar 7;11:31.
18. Malalasekera V, Cameron F, Grixti E, Thomas MC. Potential reno-protective effects of a gluten-free diet in type 1 diabetes. Diabetologia. 2009 May;52(5):798-800. Epub 2009 Feb 14.
19. Iuorio R, Mercuri V, Barbarulo F, D'Amico T, Mecca N, Bassotti G, Pietrobono D, Gargiulo P, Picarelli A. Prevalence of celiac disease in patients with autoimmune thyroiditis. Minerva Endocrinol. 2007 Dec;32(4):239-43.
20. Open Original Shared Link
21. Quiñones-Galvan A, Lifshitz-Guinzberg A, Ruíz-Arguelles GJ. Gluten-free diet for AIDS-associated enteropathy. Ann Intern Med. 1990 Nov 15;113(10):806-7
22. Evans KE, Leeds JS, Sanders DS. Be vigilant for patients with coeliac disease. Practitioner. 2009 Oct;253(1722):19-22, 2.
23. Mozo L, Gómez J, Escanlar E, Bousoño C, Gutiérrez C. Diagnostic Value of Anti-Deamidated Gliadin Peptide Igg Antibodies for Celiac Disease in Children and Iga Deficient Patients. J Pediatr Gastroenterol Nutr. 2011 Dec 23.
24. Wang N, Shen N, Vyse TJ, Anand V, Gunnarson I, Sturfelt G, Rantapää-Dahlqvist S, Elvin K, Truedsson L, Andersson BA, Dahle C, Ortqvist E, Gregersen PK, Behrens TW, Hammarström L. Selective IgA deficiency in autoimmune diseases. Mol Med. 2011 Aug 4.

In face-to-face interviews, and via internet survey, researchers asked people about their knowledge of celiac disease and gluten sensitivity. They also asked people with celiac disease and gluten sensitivity about their dining habits, in addition to asking chefs about their levels of training and education.

In all, the researchers surveyed 861 persons from the general public. They found that 47% had heard of celiac disease, 67% had heard of gluten sensitivity, and 88% had heard about peanut allergy.

They surveyed 790 people with either celiac disease (82%, n=646), or gluten sensitivity (18% n=144).  The vast majority of respondents to the study were female, making up 83% of those with celiac disease, and 90% of those with gluten sensitivity.

Those with celiac disease and gluten sensitivity were older than the general public respondents, 57% of the patients were over 45 years of age compared with just 32% of the general public respondents (p< 0.0001).

The 200 chefs who were surveyed showed a much higher awareness of celiac disease, with 77% of chefs having heard about celiac disease compared to less than half of the general population. Interestingly, many more people in both groups had heard of gluten sensitivity, with 89% for chefs, and 67% for the general population, respectively.

Still, the chefs, like the general public, had a tendency to underestimate celiac disease was underestimated by both chefs (56%) and the general public (69%) while peanut allergy was overestimated by 55% of the general public and 60% of chefs.

People with celiac disease may not be surprised to learn that a large majority, 63% of the 790 following a gluten-free diet reported avoiding restaurants more, and eating take-out food much less often than the general public.

One important finding was that the level of training had a great deal of impact on a chef's knowledge of celiac disease. Overall, trained chefs were much more likely to be familiar with celiac disease compared with untrained chefs (83% vs. 52%)

Also, there was a direct connection between the average price of a meal and the likelihood that the chef was familiar with gluten-free concerns. The more expensive the restaurant, the more likely the chef was familiar with celiac disease and gluten-free concerns. Restaurants with an average check below $25 had a 64% rate of awareness, while the rate for restaurants with a check over $65 had a 94% awareness of gluten-free concerns (p<0.0001).

In general, the survey team was impressed by what they saw as a fairly high degree of awareness of gluten-related concerns. Interestingly, both trained and untrained chefs were more likely to have heard of gluten sensitivity than of celiac disease.

Most people with celiac disease avoid restaurants, and eat out the home far less often than the general public. Still, many do eat out, and they do so by making sure they get their needs met.

The simple take away is that chefs are generally pretty aware of gluten-intolerance and celiac disease, and that chefs with better training and higher-end restaurants are more likely to deliver a gluten-free dining experience.

As always, communication goes a long way toward ensuring a pleasant and successful restaurant experience for anyone with celiac disease. Knowing your needs, sharing your concerns, and asking your server and/or chef about their gluten-free options and preparation methods can go a long way toward a smooth gluten-free dining experience.

Source:

• Open Original Shared Link

Celiac.com 12/09/2011 - Gluten in lip, facial or other body products may be a threat to people with celiac disease, according to a new study.

A research team from George Washington University evaluated products from the top ten American cosmetics companies. They found a troubling lack of information about product ingredients. Only two of the ten companies featured clear, detailed ingredients, and none of the companies offered products that were gluten-free.

The study findings were revealed at the annual scientific meeting of the American College of Gastroenterology in Washington, D.C.

The results are worrisome, because cosmetics that contain gluten can "result in an exacerbation of celiac disease," said researcher Dr. Pia Prakash. "This study revealed that information about the ingredients, including the potential gluten content, in cosmetics is not readily available."

A number of smaller cosmetic companies produce gluten-free alternatives, said Prakash, who added that larger companies should take steps to inform consumers
with gluten sensitivity whether their products are safe for those individuals.

The study came about partly because doctors had seen a 28-year-old woman with celiac disease who suffered a worsening of symptoms, including gastrointestinal complications and a skin rash, after she used a "natural" body lotion.

The doctors and the woman had a hard time trying to figure out if the lotion contained gluten. However, Prakash said, "…once she stopped using the body lotion her symptoms resolved."

Such cases highlight the huge challenge faced by people with celiac disease in trying to determine if their cosmetic products contain gluten.

Because the results of the study were presented at a medical meeting, the data and conclusions should be considered preliminary until peer-reviewed and published in a medical journal.

Source:

• http://www.newsday.com/news/health/gluten-in-cosmetics-threaten-those-with-celiac-disease-1.3288992

A leading dietitian claims that people who avoid foods to which they are not allergic may have problems if they attempt to reintroduce those foods later on in life. Dietitian Arlene Normand says that banning food for those without allergies is not healthy, and could lead to later health complications. Normand specifically claims that that banning foods for the whole family, just because a family member has allergies to those foods, may leave one at risk for developing sensitivities when those foods are reintroduced later.

"You should not avoid any food because you can sensitize the body to that food," she said. "This could lead to an intolerance when you reintroduce the food. She cites wheat as another example, saying that people who "take wheat and gluten out of their diet suffer from bloating when they reintroduce bread." However, a number of prominent voice in the medical community strongly disagree with Normand.

Many allergy specialists say there is no evidence to support that claim. Royal Prince Alfred Hospital allergy specialist Dr Robert Loblay flatly disputed Normand's claim. "There is no evidence to suggest that avoiding a food can predispose an individual to an intolerance," he Loblay. While he supported high risk allergy families eliminating foods such as gluten, milk or nuts, he said it can be difficult to enforce a total ban.

For example, Dr Loblay says that it's fine to ban gluten for convenience when someone in the family has celiac disease. However, he says, there's no sound evidence that other people in the family should avoid eating foods containing gluten, or that they will suffer once they reintroduce it into their own diets. Alyson Kakakios of The Children's Hospital Westmead agrees that it's fine for families to place blanket bans on foods for the sake of one family member.

"If one child has a cow's milk allergy, parents are in a bit of a dilemma about whether they should have cheese, yoghurt and cow's milk in the house because the risk is that the child will mistakenly drink or eat some," she said. "But that risk has to be counterbalanced against removing or excluding whole food groups from the other children and family members who are not allergic." So, what's the verdict on blanket bans of allergens for the whole family?

Of course, everyone should weigh their own personal factors into the mix, but the current scientific thinking says that such bans are optional, and that there will likely be no increased risk of allergy if or when a banned food is reintroduced to someone who is merely avoiding the food, but not allergic to it to begin with.

One exception on overall bans might be in those cases where allergies can be life-threatening. Exposure to certain allergens, such as nuts, can have severe consequences for people who are allergic, and an outright family ban might be easy and provide a great amount of relief all around. Anaphylaxis Australia president Maria Said agrees, saying "I would encourage parents to remove the allergen from the house if it is something that can be easily removed. It's much less stressful if you don't have the fear of your child having an anaphylactic fit."

Otherwise, don't worry. Ban or don't ban depending on your family needs. Just make sure you're replacing any nutrients you might be losing out on by avoiding the banned foods. There is currently no solid scientific evidence to suggest that people who avoid foods would have any problems if they ate those foods many years later.

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The company also announced plans to mail a follow-up warning about the recipe to print subscribers.

The recipe for Orange-Honey Sweet Rolls included wheat germ and yeast, some brands of which contain gluten. The recipe appeared on Page 18 of the magazine.

Publix's swift and decisive action to correct the mistake shows a strong level of commitment to gluten-free consumers.

The letter to print subscribers said that "the recipe for Orange-Honey Sweet Rolls, which appears on page 18, calls for the use of gluten-free flour as an ingredient; however, the complete recipe was not intended to be gluten-free. In fact, the recipe includes ingredients which contain gluten, therefore, it is not suitable for those with celiac disease or gluten intolerance."

Publix operates 1,039 stores in the Southeast, including GreenWise Markets in Palm Beach Gardens and Boca Raton, Florida.

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In fact, a number of supplements currently on the market claim to do just that: to break down gluten after it has been consumed.

Are these claims accurate? Are these products in any way helpful for people following a gluten-free diet? Finally, do these supplements offer a safe alternative to a gluten-free diet for people who suffer from celiac disease and/or gluten-sensitivity?

For example, GlutenEase, made by Enzymedica Inc., contains a blend of enzymes, including amylase, glucoamylase and dipeptidyl peptidase-4 (DDP-IV) — that are intended to "digest both gluten and casein, a protein found in milk," according to the company.

The website for GlutenEase says that the supplement can "support" people who have trouble digesting gluten. However, and most importantly, the site says that GlutenEase is "not formulated" for people with celiac disease.

Gluten Defense, made by Enzymatic Therapy Inc., contains a similar blend of enzymes that includes DDP-IV, lactase and amylase.

The site for Gluten Defense says the product is "specifically formulated to defend against hidden gluten" that can cause gas, bloating and indigestion.

But what does that mean? Does that mean that taking the supplement might offer people with celiac disease some extra protection against accidental gluten contamination? That seems doubtful, and unproven from a scientific standpoint.

Unlike GlutenEase, Gluten Defense offers no specific disclaimer for people with celiac disease. There is also no claim that the product is safe, or in any way formulated for people with celiac disease.

Dave Barton, whose title is "Director of Education" for Enzymedica, claims that many people who say they have celiac disease see improvement when taking product, and that some even manage to begin eating wheat again.

However, Barton is quick to warn consumers that there's "no way to guarantee that it would break down 100% of gluten proteins."

But that's the problem isn't it? It would need to break down nearly all of the gluten proteins in order for those proteins to not cause damage to the person with celiac disease.

The fact is that these enzyme supplements may break down a few molecules of gluten protein, but no supplement exists that will make it safe for people with celiac disease to eat gluten again.

According to Dr. Stefano Guandalini, professor of pediatrics and director of the University of Chicago Celiac Disease Center, "[t]he amount of gluten that these would be able to digest is ridiculously low. For people with celiac disease, these are something to completely avoid."

Dr. Peter Green, director of the Columbia University's Celiac Disease Center, agrees that current enzyme supplements would digest only a small percentage of gluten molecules.

However, Green adds, the basic concept is sound. Pharmaceutical companies are spending hundreds of millions of dollars to create an enzyme-based drug that would permit people with celiac disease to consume gluten. However, Green points out, the companies wouldn't be spending that money if a successful over-the-counter alternative already existed.

Bottom line: Enzymes currently claiming to help break down gluten protein will not permit people with celiac disease to safely consume products made with wheat, rye or barley. Any benefit these enzymes may provide for people with celiac disease is strictly theoretical, and likely minimal at best.

A completely gluten-free diet is currently the only proven treatment for celiac disease. Talk with your doctor before making any changes to your gluten-free diet for celiac disease treatment.

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