Archive for the ‘Gluten free’ Category

 


garret-children-tested-for-celiac-disease

This post answers the common question - When is the best time to introduce gluten to a child's diet when celiac disease runs in the family?

Question:

Hi John,

I was wondering if you have any information about when to introduce a baby to gluten if there is a gluten intolerance in the family. I work with babies with special needs and I am seeing a growing need for some accurate information on this. I am sure you are not surprised.

I know that some research seems to be indicating a good time to try a small amount of gluten is between 4-6 months. It seems that older research said older than 6 months. Do you have any knowledge on this subject? I am very curious but hate to share inaccurate information.

I have found some information on the internet, but wanted another opinion.

Thanks for any help you may be able to offer...... Alisa W. Celi-ACT Support Group

Alisa Weeks Early Interventionist Tennessee Early Intervention System

Answer:

Hi Alisa,

Regarding when to introduce children to gluten is a difficult question. There was a study that "showed" introduction at between 4 and 6 months had some benefit, but this study was poorly performed and subsequently shown to be in error.

Really, there is no proper time to introduce gluten to prevent the development of active celiac disease. Every person is different and even siblings can exhibit different symptoms. 1st degree relatives have about an 11% chance of having celiac disease, so there is an increased chance that the child will have it. (As an aside, my sister with celiac disease has two boys, 2 1/2 and 1. She won't let either touch it because she doesn't want to risk it.)

If the parents of an infant or young child with familial risk to celiac disease decide to risk exposure to gluten, Cleo Libonati advises not introducing gluten before the age of three.

Why three?

Children do not reliably produce antibodies before the age of three which means antibody testing could be inconclusive and misleading if symptoms arise. Suppose the child does not develop the classic presentation of diarrhea but instead atypical symptoms that mimic other disorders. The symptoms could be dismissed altogether and not considered as presentations of celiac disease.

Harm could then occur unnoticed such as development of defective tooth enamel in unerupted permanent teeth (in the gums) or neurological disorders such as epilepsy that would show up later, with or without poor growth and development. Brain development is rapid in the first year particularly so that mental, social and behavioral skills could be adversely affected.

If celiac disease testing is performed in a young child, the following should be carefully considered before determining whether a negative result is truly negative.

• Children under the age of 2 years do not produce tissue transglutaminase (tTG) antibodies, therefore the best time to begin measuring antibodies is after children reach age 2 to 3 years.

• In clinical practice tTG lacks the reported sensitivity. Specificity is reported between 95% and 99% in adults, falling to 73% in children at the recommended cut-off value of 20 IU.3 tTG is reported to be less reliable in early stage celiac disease without villous atrophy, the elderly, children under 3 years of age, smokers and advanced celiac disease.

• In screening relatives of patients with celiac disease, evidence showing discordance in testing suggests that both tTG and EMA should be used to avoid false negative results.

• EMA is reported less reliable in early stage celiac disease without villous atrophy, the elderly, children under 3 years of age, smokers and advanced celiac disease.

• EMA positivity with normal biopsy was found to be a very early predictor for later overt celiac disease, and necessitates further follow-up, especially if the child is AGA-positive and there is a family history of celiac disease.

• A substantial proportion of patients with true celiac disease are EMA negative.

• AGA testing had 100% sensitivity for diagnosis in children less than 18 years of age with iron deficiency anemia compared to EMA sensitivity of 81.8% in the same study.

In any case, the mother must watch the child for symptoms of nutrient deficiencies after the introduction of dietary gluten - whenever (if) she starts him or her. Children under the age of two seem to present with classic signs of failure to thrive, diarrhea, however, after that age atypical symptoms become predominant. Use Recognizing Celiac Disease to identify changes in behavior, growth, skin, hair, eyes, intelligence - anything at all - because that age period is a critical time in growth and development of the body and the mind.

Here are two videos about a child who presented with atypical symptoms at age 3 months, whose mother knew she had celiac disease but was told her children could not have it because it was so rare…and even if they did, she would recognize it because the kids would have the same symptoms she did: diarrhea, weight loss, and fatigue. Her son had neurological symptoms only, disturbing schizophrenic-like episodes and you will see it was a miracle that he was diagnosed at all. You may recognize his symptoms in other children you know who you never suspected of having celiac disease. These videos are a real eye-opener and exactly why people need Recognizing Celiac Disease – so they can determine whether symptoms are related to celiac disease and the causes when they are. It is very likely that many children are being affected just as this little boy was...it is far less likely that the events that led to his diagnosis will happen for them.

Part 1 - Celiac Disease Manifesting as a Mental Aberration in a Baby

Part 2 - Celiac Disease Manifesting as a Mental Aberration in a Baby

References:

Cleo J. Libonati. Recognizing Celiac Disease, Fort Washington, PA, USA: GFW Publishing, 2007. www.recognizingceliacdisease.com

Abrams JA, Diamond B, Rotterdam H, Green PH. Seronegative celiac disease: increased prevalence with lesser degrees of villous atrophy. Dig Dis Sci. Apr 2004;49(4):546-50.

Lurz E, Scheidegger U, Spalinger J, Schöni M, Schibli S. Clinical presentation of celiac disease and the diagnosic accuracy of serologic markers in children. Eur J Pediatr. Oct 2008. Epub.

Donaldson MR, Book LS, Leiferman KM, Zone JJ, Neuhausen SL. Strongly positive tissue transglutaminase antibodies are assodciated with Marsh 3 histopathology in adult and pediatric celiac disease. J Clin Gastroenterol. Mar 2008:42(3):256-60.

Donaldson MR, Firth SD, Wimpee H, et al. Correlation of duodenal histology with tissue transglutaminase and endomysial antibody levels in pediatric celiac diasese. Clin Gastroenterol Hepatol. May 2007;5(5):567-73.

Esteve M, Rosinach M, Fernández-Bañares F, et al. Spectrum of gluten-sensitive enteropathy in first degree relatives of patients with celiac disease: clinical relevance of lymphocytic enteritis. Gut. Dec 2006;55(12):1739-45.

Sanders DS, Hurlstone DP, McAlindon ME, et al. Antibody negative celiac disease presenting in elderly people – an easily missed diagnosis. BMJ. Apr 2005; 330(7494):775-776.

Utiyama SR, Nass FR, Kotze LM, Nisihara RM, Ambrosio AR, Messias-Reason IT. Serological screening of relatives of celiac disease patients: antiendomysium antibodies, anti-tissue transglutaminase antibodies or both? Arq Gastroenterol. Apr-Jun 2007;44(2):156-61.

Boger CP, Thomas PW, Nicholas DS, Surgenor SL, Snook JA. Determinants of endomysial antibody status in untreated celiac disease. Eur J Gastroenterol Hepatol. Oct 2007; 19(10):890-5.

Grodzinsky E, Fälth-Magnusson K, Högberg L, Jansson G, Laurin P, Stenhammar L. IgA endomysium antibodies – an early predictor for celiac disease in children without villous atrophy. Acta paediatr. Jul 2008;97(7):972-6.

Shah VH, Rotterdam H, Kotler DP, Fasano A, Green PH. All that scallops is not celiac disease. Gastrointest Endosc. Jun 2000;51(6):717-20.


starbucks-gluten-free-cake

(UPDATE: Starbucks no longer carries the Valencia Orange Cake.)

Starbucks Corp. will begin selling its first gluten-free pastry in its U.S. stores next month in response to requests from its customers.

The pastry, called Valencia Orange Cake, will be made with seven ingredients which are all 100 percent gluten-free, the company said. The cake will be sold in individually wrapped packages for $2.25 each and will be available beginning May 5.

Starbucks said it wanted to offer its gluten-free customers more choices.

"I think one of the things we learned right from the get-go from our gluten-free customers is they can't eat away from home very easily," said Adrienne Knapp, a product manager in the food category at Starbucks. "A cake is actually really hard to find for someone that's a gluten-free consumer."

Gluten is a protein common in rye, wheat, barley and other grains. More than 3 million Americans are thought to suffer from a condition called celiac disease, which is associated with intolerance to gluten. Even more people claim they are sensitive to wheat and other gluten-filled grains.

Starbucks said it has received numerous requests from its customers for gluten-free foods on its mystarbucksidea.com Web site. The site allows customers to submit ideas for how to improve the company, its drinks and its food.

Source: http://www.forbes.com/feeds/ap/2009/04/17/ap6305750.html

rice_chex

General Mills Announcement 3/31/09

"Thank you for contacting General Mills regarding gluten in Corn Chex cereal. General Mills is reformulating the following Big G Cereals to gluten free status:

· Corn Chex · Honey Nut Chex · Strawberry Chex · Chocolate Chex · Cinnamon Chex

As was the case with Gluten Free Rice Chex, the barley malt ingredient was removed and replaced with another ingredient. Production has begun, so you may start seeing the gluten free formulas on store shelves now. All 5 products should be widely available across the U.S. by June 1, 2009. As with all reformulated products, both products may be on store shelves at the same time so please read labels/packaging carefully, examining the product packaging to ensure that the cereal inside the box is in fact the new, gluten free product. Look for "NOW GLUTEN FREE" or "GLUTEN FREE" on the front/side/back panels.

In addition, the following Betty Crocker Gluten Free mixes will be available at approximately the same time:

Betty Crocker Gluten Free Brownie Mix Betty Crocker Gluten Free Chocolate Chip Cookie Mix Betty Crocker Gluten Free Devils Food Cake Mix Betty Crocker Gluten Free Yellow Cake Mix

It is our goal to help our consumers determine whether or not they can include our products in their diet when they are not labeled Gluten Free. To accurately accomplish this, we believe it is best to refer to the specific ingredients listed on each product package; and for this reason, we do not offer a gluten-free product list.

However, we do understand that ingredients can be confusing. We want you to be assured that if the ingredient label does not list wheat, barley, rye, oats or gluten containing ingredients sourced from these grains, then the product would be gluten-free. Sources of gluten are listed on the label even if the source of gluten is part of another ingredient (such as flavoring or spice). Because ingredients may vary from one package to another due to product reformulation, you should use the products ingredient label to provide you with current and accurate information."

Amy Peters, Consumer Services

John Libonati

Sams Club Raw Whole Chickens Are Gluten Free

April 6th, 2009 by John Libonati

sams_club_logo Sams Club raw whole chickens are gluten free. (Post below can be found at the gluten free weight watchers blog.)

I double checked the status of the raw whole chickens I buy. When I read the label yesterday it said the ingredients contain "chicken broth". I know a lot of broths have gluten so I shot an e-mail to Pilgrim's pride. Their website did have a listing of items that are gluten free but I did not see whole chickens.

It looks like they are GF (see below).

Kim

_____

From: Dreika Linwood [mailto:Dreika.Linwood@ pilgrimspride. com] Sent: Friday, April 03, 2009 1:17 PM Subject: RE: Other - Response Requested

Thank you for your email. Yes, our whole chickens are gluten free.

Dreika Linwood

Pilgrim's Pride Corporation

Consumer Relations Rep ll

903-434-7532 Direct

800-321-1470

John Libonati

Gluten Free Restaurants – Philadelphia

December 16th, 2008 by John Libonati

Celiac disease - Gluten Free friendly restaurants in Philadelphia (listed alphabetically)

Applebee’s Restaurant

http://www.applebees.com/

Applebee Dietary Inquiries 888-592-7753 You can call this number and someone will provide information on gluten free menu items. I have spoken with them while seated in the restaurant – though you could certainly call ahead of time.

Arpeggio

http://www.arpeggiobyob.com

542 Springhouse Village Center Springhouse, PA 19477 {GPS} 1101 BETHLEHEM PIKE OR SPRINGHOUSE VILLAGE CENTER 215-646-5055 Mediterranean BYOB. Per my GI doc, the owner is very in tune to the needs of celiac patients.

Boston Style Pizza 447 N Sumneytown Pike North Wales, PA (215) 699-3977 Has gluten-free pizza as well as a recently expanded gluten-free menu.

Carrabba's Italian Grill

http://carrabas.com/index.aspx

2575 Maryland Road Willow Grove, PA 19090 (215) 659-3950 Has a gluten-free menu

Charlie Brown’s Steakhouse 324 W. Swedesford Road Berwyn, PA 19312 (610)240-0997 www.charliebrowns.com/ Has a gluten free menu and location information online.

Chipotle www.chipoltle.com Plymouth Meeting Mall location Website has a gluten-free listing. Staff and management were very receptive to requests as well as the food being delicious and healthy.

Five Guys Burgers and Fries www.fiveguys.com Check website for local sites – coming soon to K of P mall. Great burgers and fries! Locations I visited were very gluten-friendly.

JB Dawson’s

http://jbdawsons.com/index.html

Has a gluten free menu available online as well as upon request at each location. This is a local chain with five outlets –one near Plymouth Meeting Mall. The corporate Director of Kitchen's is very Celiac aware as he has family member with Celiac.

Jules Thin Crust Pizza

http://www.julesthincrust.com/

Offers great gluten –free pizza and crusts to make your own. Locations in Doylestown and Newtown.

Legal Seafoods

http://www.legalseafoods.com/

King of Prussia Mall. Great food and great attention to gluten-free concerns. Gluten-free menu is available.

Morton’s Restaurant

http://www.mortons.com/

King of Prussia Mall location is actually working on an allergy menu for customers, though other locations have been very responsive to gluten-free requests. My waitress, Gina, was very well versed and great at offering gluten-free alternatives.

Outback Steakhouse

http://www.outbacksteakhouse.com/

Has a gluten free menu available online as well as upon request at each location.

Pasta Pomodoro

http://www.pastapomodoronj.com

Won 2007 NFCA Gluten-free cooking competition Voorhees NJ

PF Chang’s China Bistro

http://www.pfchangs.com/

Great Chinese food. They have a gluten-free menu available and are very responsive to concerns. Plymouth Meeting Mall location is now open.

Redstone American Grill www.redstonegrill.com Plymouth Meeting Mall Have spoken with Director of Culinary Operations from corp office. Gave me local chef’s name and email as well as a listing of gluten-free menu items.

John Libonati

Erewhon Organic Corn Flakes 11 oz. – Product Reviews

December 4th, 2008 by John Libonati

These light and crispy flakes are made with simple pure ingredients - organically grown corn and sea salt. And, Erewhon Corn Flakes are 100% natural, low in sodium, and low fat. Great taste and great nutrition! Allergy Alert: contains corn. Kosher.

Ingredients: Organic corn flour, sea salt.

Product does not contain: Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Peanuts

Nutrition Facts: Serving Size 1 1/4 cup Serving per container: 6

Amount per Serving: Calories 210, Total Fat 2.5g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 100mg, Total Carbohydrates 26g, Dietary Fiber 3g, Sugars 3g, Protein 2g, vitamin A 10%, vitamin C 2%, calcium 0%, iron 15%

Delicious organic cereal made from the actual whole grain of organic brown rice. After the rice has been carefully toasted, it is glazed with a subtle blend of honey and brown rice syrup that sparkles with sweetness. Then a delicious medley of strawberries, raspberries and blue berries is added. Kosher.

Ingredients: Organic whole grain brown rice, organic brown rice syrup, honey, freeze dried blueberries, freeze dried raspberries, freeze dried strawberries, sea salt, and natural flavor.

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Corn, Peanuts

Nutrition Facts: Serving Size 1 cup Serving per container: 9 Amount per Serving: Calories 120, Total Fat 0.5g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 100mg, Total Carbohydrates 27g, Dietary Fiber 1g, Sugars 6g, Protein 2g, vitamin A 0%, vitamin C 4%, calcium 0%, iron 2%

This chewy pizza crust is easy to make! Mix requires addition of oil, egg, cheese (optional) and liquid (milk or milk substitute) to make pizza dough, calzones, cracker bread, and more. Yeast free and made in a gluten-free environment.

Ingredients: Manoic (tapioca) flour, modified manoic starch (100% manoic), salt, minced herbs (basil, garlic, onioin, oregano, thyme).

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Corn, Peanuts

Nutrition Facts Serving Size 0.75 oz. Serving per container 10 Amount per Serving: Calories 70 Total Fat 0g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 190g, Total Carbohydrates 17g, Dietary Fiber 0g, Sugars 0g, Protein 0g, Vitamin A 0%, Vitamin C 0%, Calcium 0%, Iron 0%

John Libonati

Erewhon Rice Twice 10 oz. – Product Review

December 3rd, 2008 by John Libonati

Delicate crisps and tender puffs of organic brown rice gives you two distinct textures in this exceptional cereal. Rice is glazed with a blend of honey and brown rice syrup that sparkles with sweetness. Besides having great taste, Rice Twice is a fat free, low sodium food you can eat out-of-hand...just bag it for snacks at school, work, or on the road! "Only the purest, finest natural ingredients from the people who coined the term "natural foods."

Ingredients: Organic brown rice, brown rice syrup, honey, sea salt.

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Nuts, Corn, Peanuts

Nutrition Facts: Serving Size 3/4 cup Serving per container: 9 Amount per Serving: Calories 120, Total Fat 0g, Saturated Fat 0g, Trans Fat 0g, Cholesterol 0mg, Sodium 60mg, Total Carbohydrates 26g, Dietary Fiber 0g, Sugars 8g, Protein 2g, vitamin A 0%, vitamin C 0%, calcium 0%, iron 0%

One of a family of snacks. 100% organic chewy fruit and nut natural energy bar with creamy lemon, crunchy cashews, and anti-oxident goji berries. Deliciously satisfying. No added sugar. Not genetically engineered.

Allergy Alert: contains nuts. May contain trace amounts of dairy, peanuts, and soy.

Ingredients: Organic dates, organic roasted cashews, organic goji berries, organic lemon juice concentrate, organic vanilla.

Product does not contain:

Gluten, Wheat, Soy, Eggs, Dairy, Corn,

Nutrition Facts: Serving Size 1 bar (45g) Serving per container 1 Amount per Serving: Calories 160 Total Fat 6g, Saturated Fat 1g, Trans Fat 0g, Cholesterol 0mg, Sodium 5mg, Potassium 310mg, Total Carbohydrates 27g, Dietary Fiber 6g, Insoluble fiber 5g, Sugars 17g, Protein 4g, vitamin A 2%, vitamin C 0%, calcium 2%, iron 8% , selenium 4%, vitamin E 2%