4 Signs You Should Get Tested For Gluten Sensitivity

Did your doctors ask you serious questions about your health? Were they really attentive to you? It might have happened when you realized there was something wrong with your health, however, doctors remained calm and ignored some of your symptoms. This research is meant to help you identify the symptoms of gluten sensitivity if any.

Gluten sensitivity is an intolerance to gluten or wheat. Gluten is a protein, which is found in barley, wheat, and rye. Pasta, cereal, and bread contain wheat. Wheat is, also, found in soups and salad dressings too. Barley often appears in beer and in food that contain malt. Rye is commonly found in rye beer, rye bread, and some cereals.

Keeping reading these symptoms of non -celiac gluten sensitivity you might figure out, whether they appeal to you:

Brain Fog, or mental fatigue

Brain fog is a state of a human’s health when an individual is unable to think clearly. Being in this state, you might be unable to read, make conclusions, write, listen attentively to the details. That happens due to the fact that antibodies to the gluten, which might be present in your brain, are activated resulting in a brain fog.

Therefore, if you have such symptoms, it would be better to consult a therapist.

Fatigue

Fatigue is when you often feel exhausted with no serious reason. For example, you may sleep for 11 hours and still feel as if you were drugged. Gluten can provoke feelings of tiredness and sluggishness. If excluded, patients claim that they began to wake up 5.45 am without the alarm.

So, possibly, if you have difficulty waking up in the morning, this is a sign for you to take your health state into consideration.

Depression

Depression is accompanied by feelings of hopelessness, low energy, lack of desire to work, insomnia, appetite changes, anger, and more. Depression is a concern, which sometimes obliges patients to use medications. Nevertheless, the causes of depression were not completely studied. The recent research revealed that if gluten is excluded from the diet, depression might completely disappear.

Low immunity

If you often get sick, this is a sign to visit a doctor. The founder of Gluten Free School, Jennifer Fugo, stated that the first sign of her intolerance to gluten was a depressed level of IgA in her blood (IgA are antibodies, which exist in tears, saliva, and gastrointestinal tract). She got this result making the adrenal test, just before she got the idea that there might have been something wrong with her. A depressed level of IgA means that your organism is unable to defend itself enough.

Consequently, if you become ill too often, please, consult a therapist.

When to visit a doctor?

Before you diagnose yourself, it would be better to visit a therapist, if you noticed any of these signs of gluten sensitivity. The gastroenterologist or allergists might tell you to have tests first to define what might be wrong. They will precisely discuss your history in order to prescribe the diagnosis, of course, if they are professionals.

How to identify a good doctor?

A proper specialist should ask you these questions, so be prepared:

-What is your genetic ancestry?

-Have you had a vitamin D3 test? Do you know if you were low? (optimum ranges are 65-85 ng/dl)

-Has anyone in your family complained of digestive problems, such as your mother, father, or grandmother?

-Have you been hospitalized and placed on long course steroids or antibiotics?

-Have you had gastric surgery?

-Do you have a family history of colon cancer?

-Do you have any rashes or psoriasis that never resolve?

So, what not to eat?

Even if your doctor diagnosed you with a gluten sensitivity, there is no reason to panic. Just exclude these ingredients from your diet: barley, bulgur, cereal binding, couscous, durum, einkorn, emmer, filler, farro, graham flour, kamut, malt, malt extract, malt flavouring, malt syrup, oat brans, oats, oat syrup, rye, semolina, spelt, triticale, wheat, wheat bran, wheat germ, wheat starch, hydrolyzed plant or vegetable protein (HPP/HVP), seasonings, flavourings, soy sauce, ketchup, barbeque sauce, commercial lunch meats, starch, modified food starch, dextrin, maltodextrin, medications.

Caution:

– It’s important not to begin the gluten-free diet before you visit a doctor because the results of the tests might be incorrect.

– Don’t leave this issue unsolved for too long since it might have complications, especially in children.

Remember that there are 83% of  Americans, who remained undiagnosed with gluten sensitivity. So, if you want to keep your health, it would be much better for you to check it and visit a doctor.

If you did not notice any of these symptoms, lucky you are, but if your friends or relatives have them, it’s your responsibility to clarify this data to them. Once you know this information, you might even save someone’s life by suggesting them a piece of advice.

gluten-free-food-guide

References

Karr, Tammera J. “Understanding Wheat & Gluten Issues In Today’s Clients”. Annals Of Psychotherapy, 2013, pp. 53-56.

KIND Bars & Granola Gluten-Free Review

Sure, nutrition bars can be part of a healthy diet, but most have tons of added sugar, unhealthy carbohydrates, and extra calories – not to mention additives and preservatives, which can cause digestive issues.Screen shot 2013-08-22 at 12.12.42 PM

Since starting my low sugar diet in January, I had given up KIND bars; the ones I was eating had way too much sugar. It wasn’t until recently that I learned about their Nut & Spice line which offers flavors with 5 grams or less of sugar per bar!

KIND began in 2004 with just 8 varieties and has grown to over 22 bars and 6 healthy grains snackable clusters.IMG_4223

All KIND snacks are made from all-natural whole nuts, fruits, and whole grains. There is no refined sugar or anything artificial in any of their products. KIND believes that if you can’t pronounce an ingredient, it shouldn’t go into your body, and I agree with them 100%.

KIND offers three lines of whole nut and fruit bars—KIND Fruit & Nut, KIND PLUS, and KIND Nuts & Spices.

Although they are a little low in protein, KIND bars are a clean and quick on-the-go choice with healthy fats, fiber, and a low sugar content. Although the amount of sugar in some of the fruit and nut bars is rather high for me – 9 to 16 grams– many of the bars do contain fewer than 6 grams per serving.photo

All KIND products are dairy free (except the yogurt bars), cholesterol free, and gluten free. Every product is tested for gluten, and meets the FDA’s requirement of 20ppm. KIND’s manufacturing plant is dedicated gluten free, and has a strict allergen control program. Moreover, their products are non-GMO, low in sodium, and have zero trans fat.

KIND PLUS bars are made with unique ingredients that include supplements such as added calcium, antioxidants, omega-3s, fiber, and B vitamins to offer enhanced nutrition.Screen shot 2013-08-22 at 12.12.58 PM

What I look for when choosing a bar is a sugar content of less than 6 grams per serving, at least 4 grams of fiber, low sodium, and less than 3 grams of saturated fat. The bars highlighted below are the bars I love and buy all the time.

Screen shot 2013-08-22 at 11.56.01 AM

Note: This is not a complete list; it is a partial list for comparison.

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Dark Chocolate Nuts & Sea Salt

KIND healthy grain clusters (aka granola) contain healthy, unique 100% whole grains like amaranth and quinoa; superfoods like blueberries and chia; and delicious ingredients like dark chocolate and maple syrup.

My favorite is the Maple Walnut Clusters with Chia and Quinoa, and with only 6g of sugar per serving it’s not too high for me! I love the healthy blend of chia, quinoa, amaranth, oats, milte and buckwheat, with the sweet touch of maple syrup. Each serving contains 300mg of Omega-3 fatty acids and provide 17g of whole grains!

KIND products can be purchased in local grocery and health stores. They can also be purchased online.

Eight Things No Gluten-Free Person Ever Wants to Hear

If you are gluten intolerant or have coeliac disease then the chances are that you will have heard every one of these at some point in your life.

I believe that the awkward questions stem from people feeling uncomfortable because they don’t fully understand, but I have to admit that at times it’s difficult not to burst out laughing.

These are eight things that will either infuriate anyone who’s gluten-free, or will have them in fits of laughter:

1. Oh! I was thinking of trying that diet too!

Although the gluten-free diet has attracted many people who don’t need to live a gluten-free lifestyle for their health, the majority of people on a gluten-free diet are not doing so because they think it’ll help them to lose weight. If anyone with coeliac disease or gluten intolerance eats gluten it’s typically a very uncomfortable and often painful experience. It is NOT a diet. It’s a lifestyle change because their bodies can’t tolerate gluten.

2. You’re such a picky eater!

This is possibly the most common thing said to anyone who is gluten-free because they always have to ask what ingredients are in recipes, or pack what might appear to be strange things for lunch. If they are asking for a 100% beefburger without the bun it is because they can’t eat bread. If they request salad without the dressing it’s because most sauces contain hidden gluten. It isn’t being a picky eater, it’s trying to avoid the pain that they experience when they’ve eaten gluten by mistake.

3. Why don’t you just try a bit and see how you get on?

If someone has been advised by a doctor to follow a gluten-free diet then it’s a permanent change. Your body can’t just suddenly stop being intolerant to something, particularly if you’ve completely stopped eating it. Once you cut something out of your diet it actually becomes even harder to reintroduce it, so yes, just one sandwich will hurt. In many cases even a crumb will hurt. No, they are absolutely sure they don’t want to just try.

4. But all of the best foods have gluten in them!

Yes, most of them do. All that this statement does is simply remind anyone who’s gluten-free of what they are missing out on… as if they weren’t already aware.

5. So what exactly can you eat? Just celery?

This always makes me laugh; celery is gluten-free yes, but there are many other foods that are acceptable on a gluten-free diet. Although it’s restrictive it’s not THAT restrictive. There are many gluten-free foods available and many foods are even naturally gluten-free.

6. Would you like some cake/a cookie?

People who are gluten-free are aware that this is often simply a slip-up because the person offering has forgotten they are gluten-free, and that’s totally understandable, but it doesn’t mean that it feels any less like a slap across the face. Although it gets easier with time, it is always hard to watch someone offer you something you can’t have.

7. I would literally die if I couldn’t eat gluten!

In some very rare but very severe cases of coeliac disease this could actually be a possibility if someone does eat gluten, so it’s not the best thing to say.

8. What actually happens to you if you eat gluten?

Most gluten-free people don’t mind being asked this, although it does become a little irritating after a while. If you want to know what happens when someone who is unable to tolerate gluten eats it, please Google it, because it’s likely the person you’re asking has already been asked that exact question countless times.

If you enjoyed these, this video will give you a good laugh.

What Happens When You Tell People You Can't Eat Gluten

 

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Gluten-Free? Vegan? Thanksgiving Recipes For Alternative Diets

It’s like the start of a bad joke: a vegan, a gluten-free and a paleo walk into a bar — except it’s your house, and they’re gathered around your Thanksgiving table.

More and more Americans are passing on gluten — some for medical reasons, most by choice. Others are adopting diets that exclude meat, or insisting on the kinds of unprocessed foods that early man would have hunted and gathered.

All of this is a challenge to the traditional Thanksgiving feast.

In The Salt’s informal survey of 4,700 readers, nearly a quarter of you agreed that you have some difficulties in coming up with ways to meet everyone’s dietary lifestyle choices at the holiday table.

Whether you’re a host or a guest attending a potluck-style dinner, if you’re still scrambling to find the perfect, uncontroversial dish, NPR Morning Edition’s Renee Montagne turned for help to Chris Kimball, the host of America’s Test Kitchen.

Here are some of his recommended dishes to satisfy alternative diets, and notes on what to try this Thanksgiving holiday.


Brussels Sprout and Kale Slaw with Herbs and Peanuts

Note: Make sure to tell your guests that this dish contains peanuts — as peanut allergies can be life-threatening.

“One reason people don’t like Thanksgiving is their badly cooked Brussels sprouts,” says Kimball. “So we’re actually gonna take a pound of Brussels sprouts and shred them into, essentially, very thin pieces.”

1/3 cup cider vinegar

3 tablespoons sugar

1/2 teaspoon ground coriander

2 tablespoons extra-virgin olive oil

1 pound Brussels sprouts, trimmed, halved and sliced very thinly (“You could probably also shred it with a food processor,” says Kimball.)

8 ounces Tuscan kale, stemmed and sliced into 1/4-inch strips

1/4 cup dry-roasted, salted peanuts, roughly chopped

1 tablespoon chopped fresh cilantro

1 tablespoon chopped fresh mint

Lime juice

Salt and pepper

Whisk vinegar, sugar, coriander, 1/2 teaspoon salt and 1/4 teaspoon pepper together in a large bowl. Whisking constantly, drizzle in oil. Add Brussels sprouts and toss to combine. Cover and let sit at room temperature for at least 30 minutes and up to 2 hours.

Vigorously squeeze and massage kale with hands until leaves are uniformly darkened and slightly wilted, about 1 minute. Add kale, peanuts, cilantro and mint to bowl with Brussels sprouts and toss to combine. Season with salt and lime juice to taste and serve.


Wild Rice Dressing

Says Kimball: “This is ‘I didn’t realize it was gluten free and I don’t care.’ “

2 cups chicken broth

2 cups water

1 bay leaf

2 cups wild rice

10 slices (about 10 oz.) gluten-free sandwich bread, torn into pieces

8 tablespoons unsalted butter

2 onions, chopped fine

3 celery ribs, chopped fine

4 garlic cloves, minced

1 tablespoon minced fresh sage or 1 1/2 teaspoons dried

1 tablespoon minced fresh thyme or 1 1/2 teaspoons dried

1 1/2 cups heavy cream

2 large eggs

3/4 teaspoon salt

1/2 teaspoon pepper

Bring broth, water and bay leaf to boil in medium saucepan over medium-high heat. Stir in rice, reduce heat to low, cover and simmer until rice is tender, 35 to 45 minutes. Strain contents of pan through fine-mesh strainer into large liquid measuring cup. Transfer rice to bowl; discard bay leaf. Reserve 1 1/2 cups cooking liquid.

Adjust oven rack to lower-middle position and heat oven to 325 degrees. Pulse 5 slices bread in food processor until only pea-size pieces remain, and transfer to rimmed baking sheet. Repeat with remaining 5 slices bread and transfer to sheet. Bake bread crumbs until deep golden brown, about 15 to 17 minutes, stirring occasionally and rotating sheet halfway through baking. Let bread crumbs cool completely, about 10 minutes. (Do not turn off oven.)

Chris Kimball slices up some cooked heritage turkey. i

Chris Kimball slices up some cooked heritage turkey.

Steve Klise/Courtesy of America’s Test Kitchen

Melt 4 tablespoons butter in 12-inch skillet over medium heat. Add onions and celery and cook until softened and golden, 8 to 10 minutes. Add garlic, sage and thyme and cook until fragrant, about 30 seconds. Stir in reserved cooking liquid, remove from heat and cool 5 minutes.

Whisk cream, eggs, salt and pepper together in large bowl. Slowly whisk in onion mixture. Stir in rice and toasted bread crumbs until well combined, then transfer to 13 by 9-inch baking dish. Melt remaining 4 tablespoons butter in an empty skillet and drizzle evenly over dressing. Cover dish with aluminum foil and bake until set, 45 to 55 minutes. Remove foil and let cool 15 minutes. Serve. (The dressing can be cooled and refrigerated for up to 1 day. Reheat, covered with foil, in 325-degree oven.)


Heritage Turkey

“We should clarify a few things about what paleo is and what it’s not,” says Kimball. “It’s not a meat diet. It’s really about unprocessed food. In fact, if you think about 2 million years ago, when Homo erectus was running around hunting and gathering, they probably didn’t have a tremendous amount of meat in their diet, ’cause the hunters went off and came back with nothing.”

Heritage turkeys haven’t been hybridized or bred to have huge breasts and small legs. They’re very different from your average supermarket bird, says Kimball. The meat is darker and it has a lot more flavor. However, they’re much more expensive and difficult to cook. The legs contain dense dark meat that needs to be in the oven long before the rest of the bird. Then it all goes in on low heat for a long time, until you crank the heat up quickly to crisp the skin before serving.

Highly recommended turkeys from Cook’s Illustrated include:

Mary’s Free-Range Heritage Turkey

Testers say: Our top pick was “richly flavored,” with “great texture and moisture,” and exquisitely “crisp” skin. This big turkey (just over 14 pounds) was “quite fatty,” with “remarkably tender, moist white meat that tastes like poultry, not just wet fiber. Dark meat is dee-lish and also very tender.”

Elmwood Stock Farm Organic Heritage Turkey

Testers say: This turkey was “supertender and juicy,” with white meat “so rich in flavor that it tastes like dark meat.” The dark meat was even more tender and flavorful, prompting one taster to ask, “Is this dark turkey or pulled pork? So fall-apart tender that it’s almost shredding itself.”

Good Shepherd Poultry Ranch Heritage Turkey

Testers say: Tasters enthused about this generously sized heritage bird, raised by the dean of heritage turkey breeders, Frank Reese. They praised its “very, very moist and intensely sweet breast meat,” that was “moist but not wet,” with “substantial turkey flavor,” and dark meat that was “rich, almost fatty, in a good way, like duck” and “incredibly tender, quite fat-streaked.”


Gluten-Free Pie Crust

Note: This recipe may be gluten-free, but it’s not vegan.

“We do use all butter in this — 16 tablespoons for two crusts,” says Kimball. He also warns: “Here’s the thing about gluten-free pastry: It doesn’t have any gluten in it. And gluten is what makes the dough stick together!” The Test Kitchen recommends you roll the dough out between two sheets of plastic wrap to prevent breakage.

First, pick your substitution:

King Arthur Gluten-Free Multi-Purpose Flour

Note: The pie dough will be less sturdy.

6 1/2 ounces (for single crust) = 2/3 cup plus 1/2 cup

Bob’s Red Mill Gluten-Free All-Purpose Baking Flour

Note: The pie dough will be darker in color, drier and slightly rubbery and will have a slight bean flavor.

6 1/2 ounces = 1 1/3 Cups

Single-Crust Pie Dough

2 1/2 tablespoons ice water

1 1/2 tablespoons sour cream

1 1/2 teaspoons rice vinegar

6 1/2 ounces gluten-free flour blend

1 1/2 teaspoons sugar

Pumpkin pie filling is naturally gluten-free, so we weren't worried about changing it. But baking a gluten-free pie crust meant tinkering with the Test Kitchen's favorite recipe. i

Pumpkin pie filling is naturally gluten-free, so we weren’t worried about changing it. But baking a gluten-free pie crust meant tinkering with the Test Kitchen’s favorite recipe.

Steve Klise/Courtesy of America’s Test Kitchen

1/2 teaspoon salt

1/4 teaspoon xanthan gum

8 tablespoons unsalted butter, cut into 1/4-inch pieces and frozen for 10 to 15 minutes

Combine ice water, sour cream and vinegar together in bowl. Process flour blend, sugar, salt and xanthan gum together in food processor until combined, about 5 seconds. Scatter butter over top and pulse mixture until butter is size of large peas, about 10 pulses.

Pour half of sour cream mixture over flour mixture and pulse until incorporated, about 3 pulses. Pour remaining sour cream mixture over flour mixture and pulse until dough just comes together, about 6 pulses.

Turn dough onto sheet of plastic wrap and flatten into 5-inch disk. Wrap tightly in plastic and refrigerate for 1 hour. Before rolling out dough, let it sit on counter to soften slightly, about 15 minutes. (Dough can be wrapped tightly in plastic and refrigerated for up to 2 days.)


Pumpkin Pie

Servings: 8

Note: This recipe may be gluten-free, but it’s not vegan.

From The Test Kitchen’s The How Can It Be Gluten-Free Cookbook: “Pumpkin pie filling is naturally gluten-free, so we weren’t worried about changing it, but when we used our favorite recipe to bake one in a gluten-free pie crust, we found that the loose, liquid-y filling turned our once-flaky crust gummy and raw-tasting. We needed to start with a thicker mixture that would not readily soak into the crust.”

1 single-crust pie dough

1 (15 ounces) can pumpkin puree

7 ounces (1 cup packed) dark brown sugar

2 teaspoons ground ginger

2 teaspoons ground cinnamon

1 teaspoon ground nutmeg

1/2 teaspoon salt

1/4 teaspoon ground cloves

2/3 cup heavy cream

2/3 cup whole milk

4 large eggs

Adjust oven rack to middle position and heat oven to 375 degrees. Roll dough into 12-inch circle between 2 large sheets of plastic wrap. Remove top plastic, gently invert dough over 9-inch pie plate, and ease dough into plate. Remove remaining plastic and trim dough 1/2 inch beyond lip of pie plate. Tuck overhanging dough under itself to be flush with edge of pie plate. Crimp dough evenly around edge using your fingers.

Cover dough loosely in plastic and freeze until chilled and firm, about 15 minutes. Remove plastic and bake until crust is light brown in color, 20 to 25 minutes, rotating pie plate halfway through baking. Transfer pie plate to wire rack. (Crust must still be warm when filling is added.) Adjust oven rack to lower position and increase oven temperature to 425 degrees.

While crust bakes, process pumpkin puree, sugar, ginger, cinnamon, nutmeg, salt and cloves together in food processor until combined, about 1 minute. Transfer pumpkin mixture to medium saucepan (do not clean processor bowl) and bring to simmer over medium-high heat. Cook pumpkin mixture, stirring constantly, until thick and shiny, about 5 minutes. Whisk in cream and milk, return to simmer briefly, then remove from heat.

Process eggs in food processor until uniform, about 5 seconds. With machine running, slowly add about half of hot pumpkin mixture through feed tube. Stop machine, add remaining pumpkin, and continue processing mixture until uniform, about 30 seconds longer.

Immediately pour warm filling into warm, partially baked pie crust. (If you have any extra filling, ladle it into pie after 5 minutes of baking, by which time filling will have settled.) Bake until filling is pulled and lightly cracked around edges and center wiggles slightly when jiggled, about 25 minutes. Let pie cool on wire rack until filling has set, about 2 hours; serve slightly warm or at room temperature.


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Baked Squash Kibbeh

Note: This dish may please the vegetarians at the table, but it’s not gluten-free. It calls for feta cheese, so it’s not vegan, either.

From The Test Kitchen’s The Complete Vegetarian Cookbook: “Middle-Eastern kibbeh is a finely ground combination of beef or lamb, bulgur, and onions either formed into balls and deep-fried or pressed into a pan and baked. For a vegetarian version of this flavorful dish, we loved the idea of pairing butternut squash with the warm spices.” .

2 pounds butternut squash, peeled, seeded and cut into 1/2-inch pieces (6 cups)

3 tablespoons extra-virgin olive oil

1 onion, chopped fine

2 garlic cloves, minced

1 teaspoon ground coriander

1/4 teaspoon five-spice powder

1 1/2 cups fine-grind bulgur, rinsed

1/2 cup all-purpose flour

1/4 cup minced fresh cilantro

2 tablespoons minced fresh mint

1 teaspoon salt

1/2 teaspoon pepper

4 ounces feta cheese, crumbled (1 cup)

2 tablespoons pine nuts, toasted and chopped

Adjust oven rack to middle position and heat oven to 400 degrees. Spray 9-inch springform pan with vegetable oil spray. Microwave squash in covered bowl, stirring occasionally, until tender, 15 to 20 minutes. Process cooked squash in food processor until smooth, about 1 minute; let cool.

Heat 1 tablespoon oil in 12-inch nonstick skillet over medium heat until shimmering. Add onion and cook until softened, about 5 minutes. Stir in garlic, coriander and five-spice powder and cook until fragrant, about 30 seconds. Stir in pureed squash and cook until slightly thickened, 2 to 4 minutes. Transfer squash mixture to large bowl and let cool.

Meanwhile, place bulgur in separate bowl and add water to cover by 1 inch. Let sit until tender, about 10 minutes. Drain bulgur through fine-mesh strainer, then wrap in clean dish towel and wring tightly to squeeze out as much liquid as possible.

Stir bulgur, flour, cilantro, mint, salt and pepper into squash mixture until well combined. Transfer to prepared pan and press into even layer with wet hands. Using paring knife, score surface into 8 even wedges, cutting halfway down through mixture. Brush top with remaining 2 tablespoons oil and bake until golden brown and set, about 45 minutes.

Sprinkle with feta and pine nuts and continue to bake until cheese is softened and warmed through, about 10 minutes. Let kibbeh cool in pan for 10 minutes. Run thin knife around inside of springform pan ring to loosen, then remove ring. Slice kibbeh into wedges along scored lines and serve.

If you want a baked pumpkin kibbeh, substitute 1 15-ounce can unsweetened pumpkin puree for the squash and skip the microwaving and processing squash in the first step.

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Is Gluten-Free Healthier or Does it Just Cost More?

Despite the dramatic growth in popularity of gluten-free food, studies have failed to find that they provide any health benefits to people who have no diagnosed intolerance to gluten. New research has now produced the largest database of gluten-free products, showing that gluten-free products are not nutritionally superior to gluten-containing counterparts, but they are more expensive.

The availability and variety of gluten-free (GF) foods is important to guarantee a satisfactory diet to patients with celiac disease (CD), and GF products have become extremely popular with the wider public, under an aura of being a “healthier” option.

People with celiac disease suffer from strong intestinal inflammation whenever they eat gluten-containing products. The only way to alleviate symptoms is a life-long GF diet. The protein complex gluten, found in wheat, rye, barley, is present in many common dishes of western diets, like bread and pizza, as well as many processed foods. Because of food restrictions, CD sufferers need to have an in-depth nutritional knowledge to be sure they’re following a balanced diet: between one-fifth and one-third of patients with CD might be at risk of mineral and vitamin deficiencies.

The aim of the study was to compare the nutrients provided by gluten-containing and GF food. This was done by looking at 63 GF and 126 gluten-containing products obtained from 12 different Austrian supermarkets.

The research indicates almost no difference between GF and gluten-containing counterpart products. The amount of carbohydrates, fat and fibers contained were about the same, although GF foods were found to have a lower protein content. There were some differences regarding vitamins and minerals, but they were found to be within tolerance levels when accompanied with a balanced diet. For example, GF products had a lower zinc and potassium content, both of which are important nutrients, but on the other hand they tended to have lower cholesterol and salt.

The team was also able to compare the cost of GF products against their gluten-containing counterparts. Across all food categories, from flour to pasta to snacks, GF products were found to be twice, and in some cases more than 2.5 times, more expensive than regular products. So unless you have a diagnosed gluten intolerance, the evidence seems to be stacking up that they are not worth the money.

The researchers hope that larger databases in the future could be used to help the formulation of GF food and make life easier for people with celiac disease. The research is published in PeerJ.

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Oats and the Problems of Gluten-Free Labeling

The blogosphere was in a tizzy late this summer when General Mills announced that Cheerios were going gluten-free. People with celiac disease waxed nostalgic for a childhood staple that would soon be safe for them to consume again, and celebrated the imminent arrival of a low-sugar, respectably fiber-containing cereal option for their breakfast rotation. But since this announcement and roll-out, there’s been controversy about how gluten-free the new Cheerios actually are. The ensuing debate has exposed the fault lines of the Food and Drug Administration’s relatively new gluten-free labeling guidelines and exemplifies some of the dilemmas faced by gluten-free eaters in the modern supermarket.

By way of background: The FDA rule for gluten-free labeling states that foods can carry a gluten-free label if they don’t contain gluten-containing grains such as wheat, barley or rye – or any ingredients derived from them. It does not, however, require manufacturers to test their final products to prove that they actually contain less than 20 parts per million of gluten – the threshold under which a product must fall to be considered gluten-free. In reality, this means it’s unlikely anyone has ever tested a given product carrying a gluten-free label to verify it meets the gluten-free standard and is also free from cross-contamination.

Moreover, the FDA guidelines allow foods containing conventional oats to carry a gluten-free label because oats are a naturally gluten-free grain. This principle has been controversial, as it disregards the fact that oats are widely known to be cross-contaminated with gluten from contact with wheat and barley during growing (from crop rotation in the same fields) and processing (in the same plants on the same equipment). Although oat products carrying the gluten-free label are required to fall below the 20ppm standard, the fact remains that manufacturers aren’t required to check, and the FDA is unlikely to do so either. While there are some companies who market certified gluten-free oats that have been grown in dedicated fields, processed in dedicated mills and then tested to verify their gluten-free status, supplies of this specialty crop are limited.

In this context, it’s understandable how the new gluten-free Cheerios are poised to present a novel challenge for the young-ish FDA gluten-free labeling guidelines, calling into question how reliable and useful the label can actually be for people with celiac disease. Old Cheerios contained both wheat starch (derived from a gluten-containing grain) and conventional oats (likely contaminated with gluten during processing). New Cheerios no longer contain wheat starch, but they are still made with conventional oats due to supply constraints of certified gluten-free oats grown in dedicated fields. In this scenario, General Mills would be allowed to attach a gluten-free label to the product without any testing or any disclaimers alerting consumers to the possibility of cross-contamination. And in fact, multiple smaller manufacturers of oat-based products – granola and energy bars especially – do just that. (Consumers with celiac disease, beware!)

But this is General Mills – a large food company with deep pockets and a reputation to protect. And as such, the company has gone to great lengths in order to keep gluten out of its gluten-free Cheerios. According to the company’s website, they have implemented a system to sift their conventional oats and remove stray grains of wheat or barley before milling them into flour. They also claim to conduct three separate rounds of testing for gluten content during the manufacturing process – testing the whole oats, the milled flour and the finished product, respectively – to ensure that the FDA standard is met at each point along the way. Indeed, three random boxes of Cheerios were tested by the independent and reputable Gluten Free Watchdog group in August, and were found to be in compliance of the FDA standard of less than 20ppm of gluten.

So what’s the controversy? Well, as it turns out, the FDA has reportedly received complaints from 39 consumers who claim they’ve gotten sick after consuming the new gluten-free Cheerios. Moreover, the founder of Gluten Free Watchdog, registered dietitian Tricia Thompson, has raised objections to the testing protocols employed by General Mills, arguing that their method of pooling multiple boxes per lot of finished product for testing may obscure the presence of outlier boxes with high gluten content. This is because a single box with high gluten content could be combined with many low gluten boxes, and the lot’s average gluten content would therefore meet the standard and pass inspection. As such, Thompson argues that gluten content of individual Cheerios boxes should also be reported to augment the lot testing process under certain circumstances. She further advises her subscribers with celiac disease to avoid gluten-free Cheerios as a precaution until testing methods are refined. The FDA is currently investigating consumer complaints and will be reviewing random samples of Cheerios boxes before rendering its verdict.

As a dietitian with celiac disease who also counsels others with celiac disease, it’s somewhat of a tough call to make. On one hand, to date no one seems to have actually produced evidence of a single box of gluten-free Cheerios that was shown to be contaminated with gluten. We don’t know whether any of the 39 complainants actually even had celiac disease; whether any of them had medical confirmation of exposure to gluten based on blood tests; and whether they saved the suspected boxes for testing. Furthermore, it is extremely common for patients in my practice to blame gluten for feeling ill when often it is something entirely different actually responsible for their symptoms. For example, it’s possible that some celiacs may react to oats independently, even if they are gluten free.

On the other hand, General Mills’ novel method of sorting oats hasn’t been vetted to ensure efficacy – and lot testing of just a dozen or two boxes of Cheerios produced in a 24-hour period could easily allow outlier boxes to slip through.

What’s an eater with celiac disease supposed to do?

The truth is that there’s no way to eliminate the risk of exposure to gluten entirely if you’re a person with celiac disease who eats anything that comes in a cardboard box or crinkly bag. No matter how much testing and review is done by manufacturers, and how carefully you read labels, there remains a small but inherent risk of cross-contamination. Even naturally gluten-free grains and flours carrying gluten-free labels have been shown to be cross contaminated with gluten; 10 percent of samples contained less than 20ppm of gluten in one Canadian study, and 5 percent of packed foods labeled gluten-free or certified gluten-free exceeded this threshold in excellent research conducted by Thompson herself. Our industrial food supply is massive and imperfect. There are all sorts of risks inherent to eating in America in 2015, and yet we all must do our best to eat our best.

I do not take lightly the importance of dietary vigilance for patients with celiac disease, and am certainly not one to encourage “cheating” under any circumstances. But I’ve seen patients with celiac disease literally give themselves an eating disorder due to fear of gluten cross-contamination – avoiding everything from plain coffee and rice to salad bars. And frankly, I think the detrimental physical and psychological consequences of this type of food paranoia are far worse than the potential ill effects of being exposed to gluten accidentally on an isolated occasion. In my clinical experience, the vast majority of patients who take reasonable precautions to avoid gluten in packaged foods by scrutinizing labels, choosing items labeled “gluten-free” when available and ordering carefully when dining out at restaurants are able to keep their celiac antibodies negative and maintain excellent symptom control without making themselves crazy or isolating themselves socially. Most of my gluten-free patients have hopped on the Cheerios bandwagon, and based on available information, I wouldn’t discourage it any more than I’d discourage them from dining out at restaurants. I’ve even had a few bowls of gluten-free Cheerios myself.

But whether you choose to consume gluten-free Cheerios or not, this news story makes a compelling case for people with celiac disease to visit their doctor annually for screening of celiac antibodies. If symptoms recur, a visit to your doctor is warranted sooner rather than later. (If symptoms occur after consuming any product labeled gluten-free, let the FDA know.) With the data from your bloodwork, you can make an informed decision about whether your dietary patterns and level of gluten vigilance is adequate to manage your condition, and make adjustments as needed.

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