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Tracy Grabowski

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About Tracy Grabowski

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  1. Celiac.com 11/28/2016 - The title of my article might seem a little shocking to most of the celiac community. Why wouldn't I want restaurants to offer high quality, safe meals to those who suffer from celiac disease or from non-celiac gluten intolerance so they could also enjoy dining out with their family and friends like everyone else? It's not that I don't want restaurants to offer gluten-free options: I do. But, I want them to be high quality, high integrity, and offered by a properly trained and knowledgeable staff. Otherwise, I truly don't think your establishment should bother offering gluten-free options to your diners and guests. The truth is that genuinely gluten-free dishes should be more than just replacing a bun, or using a corn or rice version of pasta in your dishes. Claiming to be "gluten-free" or "celiac-friendly" needs to go much further than just claiming such or simply swapping a product for your gluten-free diner. Without the benefit of training and education, many restaurants are not going to take into account any cross-contamination factors such as where the food is prepared, or who has touched it (and what did they touch last?) or where the plate was prepped and cleaned. It doesn't consider the air-borne flour coating almost every surface of a bakery or kitchen, and, it certainly doesn't involve investigating ingredients in the finished dishes for "hidden" sources of wheat, rye, or barley whose derivatives (such as malt or "flavorings") might be lurking around the kitchen and in prepared foods. There are so many sources of cross-contamination that are simply not explored, or may not even be known by a dining establishment. Unless a typical restaurant or bakery staff is well-versed and knowledgeable in what to look for, the questions to ask, and the proper procedures that will ensure a safe dining experience for gluten-free guests, and until all of the sources of cross contamination are explored and eliminated, it is highly doubtful that a gluten-free dish is truly gluten-free at all. With the FDA's recent updates to the gluten-free standard, restaurants, bakeries and dining establishments need to start following suit. Anyone offering a gluten-free meal should be aware that not only are their customers expecting adherence to the 20ppm of gluten (or less) standard that has been accepted as the standard for certifying something is gluten-free, but that the FDA expects their dining establishment to live up to that standard. As with any product that comes to market with a claim, restaurant menus are subject to abide by the same guidelines. For instance, if you claim something is "reduced fat", then it better, by all means, be reduced fat from the original version of the same dish. The same principal applies to gluten-free dishes with the standards taking full affect in the summer months of 2014. If your restaurant claims it is gluten-free, then it better be gluten-free, and not just "assumed" gluten-free. Living in blissful ignorance can not be an option for restaurants or for any establishment offering gluten-free products. As with any other food allergy or intolerance (FAI) there can be dire consequences for not adhering to procedures for safe preparation and service of food. Not to mention the damage that can be done to an establishment's reputation should the word get out that their integrity or food knowledge is questionable. Personally, I believe restaurants have a lot to gain in terms of offering gluten-free meals, or menu options in their establishment. I believe that restaurants who establish—and enforce- gluten-free procedures to eliminate cross contamination, accidental exposure, and provide training to their staff can benefit greatly in terms of business growth and satisfied repeat guests and their referrals from gluten-free diners to both gluten-free dieters and "traditional" diners alike. Gluten-free diners, just like all diners, place a great deal of faith and trust in people who prepare their meals at restaurants, diners, bakeries and cafes. With this great measure of trust being established at the first encounter with a restaurant guest, it pays to educate everyone from host/hostess to head chef on the proper way to handle gluten-free meals, and for that matter, all FAI's. That is why I recommend that until you are completely certain that your food is gluten-free, and that your staff is in complete compliance with your establishment's gluten-free policy, it is probably better that your establishment NOT offer gluten-free menu options. Those with gluten intolerance and celiac disease would appreciate your honesty and your integrity in doing so. The good news is that we'll be willing to become your dinner guests when you can honestly say that your kitchen staff, servers, management team, and even your host or hostess are educated, trained, and 100% on-board with providing a safe gluten-free experience for all of us. Trust and integrity go a long, long way for those of us with special dietary needs.
  2. Celiac.com 08/09/2016 - Is athletic improvement, after beginning a gluten-free diet, a sign that the athlete had gluten intolerance or celiac disease? Or, could it simply be a benefit of following a gluten-free diet? The real cause of the gluten-free athlete's improved athletic performance may be harder to uncover than you think. Could the serious athlete's diet, free from gliadin and glutenin (the two protein groups found in wheat, barley, rye and triticale which create what we collectively label as "gluten"), cause improved physical output? Or, is it possible that these high-performing machines we call athletes may have had an undiscovered intolerance to the gluten substance before they ever discovered the diet? The "cause and effect" here may be hard to define; or, quite possibly, impossible. Most data now supports that as many as 10% of people may have negative reactions, or an intolerance to, the gluten found in wheat, barley and rye products and by-products(1). However, most people may not even realize they have symptoms, and like many of us, chalk them up to numerous other issues: I worked out too much. I have a sensitive stomach. I ate something bad. It's too hot out to digest properly… and, of course, the list goes on. If a marathon runner, soccer player, football player, Olympic athlete, or anyone else who trains recreationally, semi-professionally, or professionally, were to have some level of intolerance and remove gluten from their diet, it is very likely they would see a marked improvement in their performance. This boost in athleticism could be credited to a number of factors including increased and improved absorption of vital nutrients such as iron, calcium, and vitamin D as well as secondary nutrients such as B12, copper, folate, magnesium, niacin, riboflavin and zinc. Athletic improvement can also be attributed to better overall awareness and tracking of what is being consumed. (This better management and awareness generally leads most athletes to eat cleaner, less refined and less processed foods as a result.) On the flip side, the reverse is also true: Athletes might be seeing better performance results… even if they are not intolerant to gluten or have celiac disease. The improved performance may, in fact, be a product of increased protein intake (which tends to happen when processed carbohydrates are removed from the diet), better overall decision-making (like choosing whole foods or "clean" foods in order to avoid gluten), as well as higher natural fiber intake (from beans, vegetables, and whole grains such as quinoa, rice, and even amaranth) which aid the body's systems and digestion. The foods that performance and endurance athletes eat on a strict gluten-free diet are less likely to have been processed, and therefore low in salt, low in chemicals, and anti-inflammatory. (Thus, making it easier to train harder, faster, and longer.) As you can see, it's a real "what came first.. chicken or the egg" dilemma. Both groups, both gluten intolerant and non-intolerant athletes could be showing improvement on a gluten-free diet. So how do you know if the athlete has an intolerance that led to the improvement? In a landmark study, conducted by the University of Chicago Celiac Disease Center(2), it was estimated that 60% of children and 41% of adults who were diagnosed with celiac disease were asymptomatic when they received their diagnosis. Yes, asymptomatic. That means they didn't have any clue that they were negatively, medically, affected by gluten. One can only imagine in highly-maintained, otherwise "fit" populations, such as athletes who are striving for peak health, aimed at peak performance, these sample numbers might be even higher. These numbers seem to imply that it is very likely that athletes who see an increase in athletic performance may, indeed, be suffering from either celiac disease or non-celiac gluten intolerance symptoms…that they didn't even know they had. However, that being said, it might be next to impossible to render a celiac diagnosis without subjecting the athlete to a rash of testing which will include the request that they, once again, consume gluten. (Try telling an athlete who is performing better than ever to change their ways. It's not likely to happen, especially during peak season.) Adding to the difficulty in diagnosis of gluten sensitivity is the lack of a verified blood or stool marker. The closest factor that can be studied to determine gluten sensitivity is the AGA-IgG antibodies. (Antibodies the body from exposure to "foreign" substances. AGA stands for antigliadin antibodies, which are antibodies produced by the body in response to contact with gliadin, a part of the gluten molecule. IgG stands for immunoglobulin G, which are generalized antibody molecules(3)) While it is true that about 40% of people with proven gluten sensitivity have elevated AGA-IgG, it is also true that about 15-25% of healthy individuals also have elevated AGA-IgG. Therefore, about 60% of gluten sensitive people do not have elevated AGA-IgG (making the test not sensitive enough); and about 20% of "normal", or non-gluten sensitive people have elevated AGA-IgG for no apparent reason (making the test not specific enough(4)). In either case, many high-level athletes are finding comfort and elevated performance in a gluten-free diet. In The Gluten-Free Edge: A Nutrition and Training Guide for Peak Athletic Performance and an Active Gluten-Free Life (Bronsky, McLean Jory, Yoder Begley, Published by The Experiment, December 2012) there are several real-life gluten-free athletes who are discussed. They also provide insight into the "fuel" these athletes use instead of typical carbohydrates found in wheat-based pastas and products. There are also several websites dedicated to the insights, training methods, and nutrition of athletes that also promote the gluten-free diet to promote enhanced performance, better recovery, and increased stamina as a result of stabilized blood sugars (reducing the hypoglycemic effect of intense exercise) as well as decreased inflammation, and leaner muscle. Sources: National Institutes of Health, Univ. of Chicago Celiac Disease Center, May 7, 2013. A multi-center study on the sero-prevalence of celiac disease in the United States among both at risk and not at risk groups. Fasano et. al., Archives of Internal Medicine. February 2003. Celiac Disease Center at Columbia University. http://www.cumc.columbia.edu February 14, 2011. Detection of secretory IgA antibodies against gliadin and human tissue transglutaminase in stool to screen for coeliac disease in children: validation study (Published 26 January 2006) BMJ 2006;332:213
  3. Celiac.com 02/11/2014 - Looks like the gluten-free market will see growth again in 2014, at least, according to a survey conducted as part of the Market LOHAS MamboTrack Annual Natural & Organic Consumer Study, and funded by FreeBird Chicken and Plainville Farms Turkey, both part of the HAIN Corporation (Nasdaq: HAIN). Interestingly, the survey was not dedicated to gluten-free dieters, but to "health conscious" consumers. In the survey, at least seven out of ten said that they frequently purchased products labeled gluten-free, and at least four in ten stated they planned on purchasing more gluten-free products in the coming year. The survey they conducted also predicted more "farm-to-table" product requests, and an emphasis on natural farming techniques. How This Affects Gluten-free Consumers As the gluten-free lifestyle becomes more mainstream rather than niche, there will likely be an influx of products and services available to gluten-free consumers across the entire U.S., versus just in the trendier and more health-conscious West Coast and East Coast areas. Gluten-free items will eventually be making their way into smaller local grocers and hometown markets as both the demand from health conscious consumers and newly diagnosed celiac disease and Non-Celiac Gluten Intolerance sufferers continues. Grocery store shoppers will increasingly see gluten-free sections or aisles, or an increase in boxes and cans marked "Gluten-Free." One can only assume that the demand will not only increase availability, even in smaller gluten-free markets such as the "Bread Basket States" and the Midwest, but will also allow prices on gluten-free products will also level out. With the cost of gluten-free products being so much higher (sometimes as much as 30% more) than their traditional counterparts, this is a great thing for celiac patients and those with gluten intolerance. On the flip-side, though, there may also be a down-side to the increased availability of gluten-free products: the loss of nutritional quality at the expense of providing lower prices and meeting higher demands. The biggest fear is that no longer will these "gluten-free products" offer healthy alternatives, but rather, just non-gluten-containing versions of already nutritionally unstable foods. Most Americans are attracted to convenience foods, or "pre-boxed" or "pre-made" foods because of their affordability and quick preparation times that fit busy-lifestyles perfectly. Major food industry manufacturers of course know this applies to newly diagnosed Celiac and gluten-intolerant individuals as mush as it does to "average" consumers. And, so, many more "convenience foods" and "snack-type foods" are sure to appear in the coming months. As more major food industry players get involved in processing gluten-free foods, the gluten-free dieter will be given the opportunity to purchase MORE VARIETY, but not necessarily HEALTHIER or MORE NUTRITIONAL VARIEITIES of products. Instead, as of late, gluten-free consumers are seeing more "overly-processed" food options enter into the marketplace; which, by all means are gluten-free, but may be pretty scant when it comes to actual nutritional value. A white powdered prepackaged donut is still a donut, regardless of whether or not it is processed with gluten-free flour blends or is made with "traditional" white flour. In other words, a gluten-free donut is really no healthier than a non-gluten-free donut in terms of nutritional value. This is especially true if the manufacturer uses starches with relatively low-nutritional-value because they also happen to be "inexpensive" to produce food with. (Thus, still increasing their bottom line profits even if they appear to lower the price of gluten-free foods on the shelf.) Before the mass production of gluten-free products, one would have had to adjust their entire diet. (No donuts or traditional cakes and MSG- containing canned and frozen meals.) Therefore, those who became healthier from the diet became so by avoiding gluten AND by the necessity to make wiser food choices all together like fruits, veggies, nuts, seeds, homemade food and "small batch" gluten-free products made with high quality ingredients and sense of responsibility and concern for the gluten-free consumer’s response to their product as well as their health and well-being. This advent and introduction of new products and cheaper products by big industry (the pastas, breads, mixes, and myriad of ready-to-eat canned and frozen gluten-free options from big-box suppliers) might actually make it more complicated for consumers in the long run. While there are definite differences, there may be some parallels in the emergence of "gluten-free products" with the emergence of "sugar-free products" manufactured for the rising diabetic market. In 1980, 5.8 million people were diagnosed with diabetes (Source: CDC). No coincidence that this is the same time period that sugar substitutes and "sugar-free" versions really began to swarm the market. What might appear on the surface to be a "healthier" option to someone who is suffering from diabetes (or gluten intolerance) might later prove to be just a slick bandaid-type-solution to a much-deeper nutritional issue. In conclusion, while the expanding market promises new products and more availability, it is always wise to read labels carefully, eat whole, natural foods, and to educate yourself on nutrition and gluten intolerances whenever possible so that you can make informed decisions on your health instead of taking your cues from brands and advertisers.
  4. Celiac.com 02/03/2014 - It shouldn't be a surprise that there are celebrities who are jumping on the bandwagon of the "gluten-free" diet for no reason other than it seems to be a fashionable trend. I don't doubt that there are some celebrities who have actually found benefit and may sincerely suffer from Non-Celiac Gluten Intolerance, or worse, celiac disease. For the most part though, I am convinced they have decided to use the gluten-free diet as a method of avoiding pastas, breads, pizzas, and excess carbohydrates in order to lose weight. As we all know, adhering to a gluten-free diet is a mandatory thing for people with celiac disease or intolerance to gluten. It is a prescribed diet that helps those afflicted with the disease live a better quality of life, a healthier life, and therefore a more productive life. Thanks to the gluten-free diet's following by celebrities such as Miley Cyrus, Gwyneth Paltrow, and Victoria Beckham, it has also been linked to people who use it to simply "lose weight" and "look good." In fact, Miss Cyrus recently used the gluten-free diet as a defense when she was questioned as to whether her ultra-slim figure was actually the ill-effects of a possible eating disorder such as anorexia or bulimia (After all, if looking so thin that people assume you have an eating disorder doesn't mean that the gluten-free diet works on weight loss, then what does? Just another example of how Americans tend to look at nutrition for its face-value instead of health. But I digress…). There are definitely advantages to getting celebrity buy-in to the gluten-free-lifestyle. In fact, it is very possible that in a way, celebrities have shed light on the existence of such a thing called the "gluten-free diet" in a way the medical community just cannot. By association with a celebrity, the term "gluten-free" has made its way into common nomenclature found in groceries, restaurants, bakeries and even households. So, how can this be a bad thing for people who medically NEED to follow a gluten-free diet? Very simply, by a celebrity's choosing to promote the gluten-free diet as a weight-loss plan or weight maintenance program, they do harm by trivializing the importance of the lifestyle for so many Americans who suffer from celiac disease, Non-Celiac Gluten Intolerance, or even wheat allergies. When they promote it as a lifestyle CHOICE associated with the maintenance of their size zero frames, there is the great possibility that the general public will misinterpret the "diet" as a fad or trend much like Atkins, Sonoma, or any other diet-of-the-day. Therefore, the people you trust to prepare or serve your food (servers, chefs, bakers, or even friends and family) might be less apt to be overly cautious when preparing and serving your gluten-free meal. There is an inherent danger in leading the general public to believe that this is a diet of CHOICE and not necessity for so many… up to 6%... of the American population. It's not that most people aren't trying to provide gluten-free meals to those of us who require them--it's just that there is a danger that our servers, chefs, and friends become less concerned with trying to meet the completely gluten-free standard that someone who medically needs the diet is aiming to achieve. After all, it is very unlikely that someone who follows the diet to be on-trend with Miley or Gwyneth is ever going to call someone out on using malt flavoring in a dessert, or the wheat-laden seasoning blend used in a sauce--because it doesn't affect them in the same way. Then again…maybe they'll gain a pound overnight and they WILL call them out for using hidden gluten. We can only hope.
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