Gluten free

In the past few weeks, I’ve had the chance to ponder the question “What is healthy food?” It seems that many of us have very different perceptions. Maybe that’s what stands in our way some times, we think healthy food and healthy eating is not obtainable.

It would be so much easier if my brain did not crave things like salty chips or sweet cookies but the reality is, it does. Maybe it’s a combination of many years of being bombarded with advertising to make me think I want it or maybe it’s as simple as it satisfies something in my head. I didn’t take enough psychology in college to answer that. I do know if it’s around me (like it is now as I write; you wouldn’t believe what is at the end of the table at my sister’s house) I’m less likely to eat well.

In my older years, I have realized that if I allow myself a little rather than denying myself entirely, I can balance the cravings with Read More »

Image source: BLTURLOCK.BLOGSPOT.COM

I am on a mission this year to get in shape and to become healthier. I’m doing this for several reasons but one in particular is that if I plan to become an RD I need to be healthy – no one, including myself wants to take advice about health and wellness from someone who is not healthy and practicing what they are preaching.

One of the biggest things that I have found is really being conscious of Read More »

For me, being happily gluten-free means eating many different kinds of foods—from meats to nuts—rather than just trying to replace bread products. This approach has sent me into the world of legumes, and I eat lots of beans. As a result, I’ve become more interested in the nutritional value of beans. More specifically, I began to wonder why beans are considered an “incomplete” protein.

I don’t know about you, but I’ve never really understood the term: incomplete protein. I know we have to “complete” the protein with other food, but what does that mean, and how are we supposed to do it?

Clearly, it was time to do some research, and here is what I learned. Read More »

Gluten reduced beer is brewed with water, malted barley, hops and yeast. Specialized enzymes used widely in the brewing industry are added to break down or hydrolyze the proteins in barley, including the gluten protein “hordein,” that causes adverse reactions in people with celiac disease. Read More »

Yes, you did just read that title correctly.

Kimye’s baby and the gluten-free diet have a few things in common. What are they you may ask? Well, here ya go:

It takes about 9 months to grow on you

Just like Kimye’s baby, the gluten-free diet isn’t second nature right when it’s sprung on you. At first you’re completely overwhelmed, thinking of how different life will be now, but you gradually get used to the idea of the whole thing. You get into a routine and oftentimes change your habits.

I’m sure motherhood is the same way (although I don’t want to find out for another 7-10 years). Read More »

Chef James Aptakin serves his delicious Hawaiian short rib sauce. Credits: A. Fothergill

The Fancy Food Show is put on by National Association for the Specialty Food Trade two times per year; a summer show in New York City and a winter show in San Francisco. With over 17,000 attendess and 80,000 products from 1300 vendors, it is a chance for retailers, restaurants and food service professionals to sample some of the best products on the market. For the vendors, it’s a way for them to connect with those people, in hopes of future sales. It’s also a good way to be “in the know” as new products come out.  Some vendors are already established and some are brand new, hoping to be picked up by small or large grocery stores. Either way, there is always something new.

Last year, there were more new gluten-free products. Whether it’s not quite the right venue or there are less new-comers, it was surprising there were not as many. Last year, gluten-free was a top trend. One reason might be in the labeling.

Some manufacturers are hestitant to call their products gluten-free because they worry about giving the right information to the public. One owner of a spice company said he doesn’t put gluten in any of his products but he can’t Read More »

If you eat gluten-free, you might think there aren’t a lot of choices for bread out there. A few years ago, I discovered Udi’s products and pretty much haven’t gone back since. The bread in particular was so much better than most of the other gluten-free bread that was being sold. Other brands more closely resembled cardboard than anything I would put turkey upon. My kids, at 6 and 4 years old, were able to make the change as well. I noticed though, my son would eat the meat and was very often not eating the bread. We tried toasting it and that really seemed to help. No more bread waste with the exception of a few crusts here and there.

Read More »

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.

It is that time of year. The time to bake and get ready for the upcoming holiday season. There are many places to get gluten-free baking products in Columbus, however, some are less expensive than the others.

Most successful gluten-free baking is done with a combination of flours instead of just 1 type of flour. There are many pre-mixed all-purpose gluten-free flour mixes out there, or you can mix your own.

Wal-mart on 23 (Lewis Center) has a nice selection of Bob’s Red Mill flours, including sorghum, as staple in many gluten-free flour mixes. Wal-mart also carries Ener-G flours (rice, tapioca & potato) for under $4. Read More »