Monday, September 27, 2010

You are never too old to get celiac disease, study shows

The number of people in the US who have celiac disease has been doubling every 15 years, with most of the increase found among the elderly, according to a new study released today.

Researchers at the University of Maryland's Center for Celiac Research looked at blood tests of 3,511 people and found that one in 501 were positive for celiac disease in 1974, increasing to one in 219 in 1989. As people in the study aged, the incidence of celiac disease rose, according to  results published in the online version of The Annals of Medicine. The CFCR's landmark study into the prevelance of celiac disease in 2003 put the number at one in 133.

Carlo Catassi, MD, lead author and co-director of the CFCR, said you are not necessarily born with celiac disease and urged physicians to screen their elderly patients. The new research echoes the results of a 2008 Finnish study that found the prevalence of celiac disease in the elderly is nearly two and a half times higher than in the general population.

"You are never too old to develop celiac disease," said Alessio Fasano, MD, director of the CFCR.

Fasano said the study shows that environmental factors cause a person to stop being able to tolerate gluten at some point in their lifetime. If individuals can tolerate gluten for many decades before developing celiac disease, something other than gluten must be in play, Fasano said.

If those factors could be identified and manipulated, new treatments and prevention of celiac disease would be possible, he said.  Researchers have already identified specific genetic markers for the development of celiac disease, but these markers do not guarantee that an individual will eventually get it. How and why someone loses tolerance to gluten remains a mystery.

The increase in celiac diagnosis in the elderly also calls into question the assumption that celiac disease usually develops in childhood.

The study was based on blood samples from more than 3,500 adults who were followed over time. The Universita Politecnica delle Marche in Ancona, Italy, the Johns Hopkins Bloomberg School of Public Health, the Women & Children's Hospital of Buffalo and Quest Diagnostics also participated.

Thursday, September 23, 2010

Are Lipton soup mixes still gluten free?

The oven-roasted potatoes recipe on the Lipton Onion Soup mix box has been a favorite side dish in our house for years.

So when an observant celiac support group leader from Philadelphia called Gluten-Free Living to ask if we knew if it was still gluten-free despite a change in the ingredients, I ran to my pantry. I had just bought a six pack of the mix at a warehouse club.

I am sorry to admit I did not look at the multi-pack in the store, especially since Gluten-Free Living always says you have to read the ingredients list every time you buy a food!

Both Lipton's Recipe Secrets Onion and Vegetable soup mixes now list autolyzed yeast extract made from barley. A consumer representative said this is a change in the formulation.

Lipton has a policy of always listing any potentially gluten-containing ingredient on its labels. Allergen labeling laws require wheat to be noted, but Lipton, a Unilever brand, voluntarily also lists any barley or rye. Consumers are advised to use the labels to determine if products are gluten free.

But the consumer representative said the onion soup is estimated to contain only 0.09 parts per million of gluten and the vegetable only 0.04 ppm. These levels are far below the 20 ppm of gluten the Food And Drug Administration has proposed as the cut-off for foods that can be considered gluten free.

I contacted Unilever's press office for more information about the tests used to get these amounts. Barley can sometimes present specific problems when it comes to testing. But so far I have not heard back. I'll follow up when I do.

Meanwhile, I had already researched autolyzed yeast extract made from barley for an On Your Plate column in an issue of Gluten-Free Living published earlier this year.

It turns out that autolyzed yeast made from barley is fairly rare. But I did find one company, Bio Springer, that produces some. Jean-Marc Pernet, head of market development for Bio Springer, said soup is one place that you might expect to find it.

Pernet said only a small amount of barley malt extract is used and only minimal traces of gluten remain in the final autolyzed yeast extract -- far below 20 ppm. In fact, Bio Springer certifies its product as gluten free.

Also keep in mind that yeast extract is typically used in very small amounts in a finished food. Pernet said there is little, if any, risk of finding gluten from yeast extract in a soup.

I don't know if the Lipton soup mixes use the Bio Springer yeast extract. But it would still seem the mixes poses little risk of containing any significant gluten.

I should also note the soup mix label says they are made in a facility that also processes wheat. It is very hard to know exactly what advisory statements like this mean because they are not regulated or required. A shared facility does not mean a product is automatically cross contaminated by other foods made there, but allows for the potential to exist.

Like all things gluten free, you have to weigh the facts that are available in deciding whether to keep using the Lipton soup mixes.

And remember to always read the label!

Amy Ratner

Tuesday, September 21, 2010

Gluten-free news from Gluten-Free Living magazine

A study getting some recent online attention reports that when people are newly diagnosed the first place they go for information is the Internet. This doesn't surprise us at Gluten-Free Living.

We have been active online for a number of years, offering information on our website, blog, Twitter and Face book page, especially with the newly diagnosed in mind. It's not unusual for someone seeking information of any kind to do their initial searching on the Internet.

But we do think it's a little premature to use the study to declare that those who follow the gluten-free diet rely only on online information. And when we read the study for ourselves, we did not find evidence to support one blogger's declaration that "people are no longer subscribing to magazines because they can get pertinent information more quickly on Twitter."

In fact our own growing circulation and distribution -- up 130 percent -- would refute that claim, which was based on only one comment in the study.

The study was done by Mitch McKenney, an assistant professor of journalism and mass communications at Kent State University-Stark, for the Civic and Civilian Journalism Interest Group. He interviewed 24 people who maintain gluten-free websites or blogs to find out about their "civilian journalism" activities. One blogger posted his questions on her site, which generated another four responses. McKenney says that "to round out the reporting," the contents of sites mentioned by others in the reporting process were examined and included. Personally, I question the real value of a study that relies on a group with a vested interest in a particular outcome.

Since Gluten-Free Living is in the fairly rare position of both producing a gluten-free magazine and being active in the online gluten-free community, we can see the strengths of each.

Online you have speed.

You can ask a question and get an answer almost as fast as you can type it. (This is true about everything, not just the gluten-free diet.) But even the Internet writers in the study said they have some reservations about the accuracy of some information shared online. We know about this uncertainty because we regularly get letters and emails that start something like, "I just read on the Internet ....Can you tell me if this is true?"

In addition to speed, we love being in constant contact with our Twitter followers and Face book fans. We thoroughly enjoy being able to "talk" regularly on our blog and share ideas and experiences that might not make it into the magazine. And we hold all of our Internet sites to the same standard of accuracy as the magazine.

But in print, you have both accuracy and depth.

In each issue, Gluten-Free Living offers 62 pages, cover to cover, of well-researched information and advertisements completely about the gluten-free diet and lifestyle. We have nearly 20 years of experience looking into gluten-free topics and our reputation is well established. We have always advocated a common sense approach to the diet based on fact and not unfounded fear.

Our readers tell us they save issues of the magazine and go back to refer to them again and again. And they pull them out when someone else has a question about ingredients, labeling, nutrition, dining out, going to school - well you get the drift.

One part of the study in particular caught our attention and has some valuable lessons to teach, even if unwittingly. A support group blogger recalls how accurate information was hard to come by when she was first diagnosed 10 years ago, saying that there were rules that don’t apply today. “We were told to avoid all items that had vinegar,” she said, while it’s known today that most items with distilled vinegar are fine.

The study's author, who did not include specialty gluten-free magazines in his research or any of his questions, probably did not realize that Gluten-Free Living is responsible for the information on vinegar. Most newer bloggers also probably don't.

But we looked into this question a number of years ago when all the dietetic, support, and medical groups said distilled vinegar was not safe. Slowly all of them came to accept our reporting and research on the fact that distilled vinegar is gluten free.

Without the kind of work a gluten-free magazine can do -- and not simply "retweeting" -- we would all still be worrying about distilled vinegar in salad dressing and marinades, not to mention distilled alcohol which is gluten free for the same reason as distilled vinegar.

And in the magazine we continue to use our expertise to follow other gluten-free developments. We have extensively covered labeling, from the very first mention of new laws governing it through work on a definition of "gluten free." We were among the first to look into the controversy over McDonald's french fries and gluten. The topics we cover are often complex and some answers might not come as quickly as a blog that just repeats what is found in a study. But we are hard at work looking for the facts that can have a big impact on your gluten-free life.

We see Gluten-Free Living and the world of blogs, Twitter and Face book existing all at once. Each one can provide those in the gluten-free community with different kinds of important information.

Although we have recipes in each issue, we enjoy many of the cooking, baking, you-name-it sites that provide readers with information, instruction and inspiration in the kitchen.

We know that reading a personal story of diagnosis and return to good health can be comforting for someone who is newly struggling with the gluten-free diet. Many of these stories are available online. Although we advocate learning how to read a label yourself, when you are new to the gluten-free diet, you might want lists of specific brands of products that are safe and these can be found on the Internet. Other sites chronicle every study related to celiac disease or give details about gluten-free dining and shopping opportunities in individual cities. And some provide very specific advice for those who have other allergies or intolerances in addition to celiac disease. Many give their opinion on products sent to them by gluten-free companies.

We read numerous online sites as part of the process of keeping tabs on gluten-free concerns. We like many of them. And we count ourselves as part of the online community that can help anyone with celiac disease, gluten intolerance or gluten sensitivity live a happy, healthy gluten-free life.

But we know there is still a lot of room, and more important, a real need for Gluten-Free Living, the magazine.

Amy Ratner

Wednesday, September 15, 2010

Food Rules

I recently read Michael Pollan's pocket sized novelette, Food Rules, which is a collection of mostly common sense rules about healthy eating. We have all heard about smaller portions, the importance of fruits and vegetables and the gospel of local, organic foods as better for the environment and for our health. It never hurts to read these rules if only to reinforce what you already know. It never makes the “right” decisions about eating any easier in tempting situations though!

The funny thing from my perspective is that he opens the book with two mentions of “gluten-free,” but then never mentions gluten-free again in any of his food rules. I was really hoping he would set everyone straight in one of his rules that a gluten-free diet is a fabulous diet for people with celiac disease or a gluten intolerance, and that includes a lot of people in the US, but that folks should look to other rules to lose weight…like portion control and decreasing sugary and fatty foods.

There was one little tip that I thought was particularly brilliant, which I will share. The tip was to save the water from steaming vegetables to re-use in sauces or soups because flavor and nutrients are in that water!

I have visions of putting spinach water into pasta sauce or steaming carrots in chicken broth and then using the broth later for a soup. Imagine the color if you put steamed beet water into a muffin mix?

Since the farmer’s markets are bursting with end of summer produce, now is the time to steam vegetables and then freeze the water for winter stews!

Maybe I didn’t glean any gluten-free wisdom from Food Rules, but I am definitely going to make flamboyantly pink gluten-free blueberry muffins after my next batch of steamed beets!

Kendall Egan

Monday, September 13, 2010

Our take on Celiac Awareness Day

Today is Celiac Awareness Day, by resolution of the US Senate.

With news of celiac disease and the gluten-free diet everywhere, I couldn't help but think of how far we have come in raising awareness of a disease hardly ever heard of when my own daughter was diagnosed almost exactly 18 years ago.

It has come with some very hard work by every day people spreading the word, as well as through organized efforts by foundations, support groups, businesses and the medical community.

At Gluten-Free Living we have tried to do our part with a commitment to wipe out incorrect information about the gluten-free diet, while searching for the most reliable information we can find. We think this is the best way to ensure that you have a happy, healthy gluten-free life.

But every once in awhile I am reminded that there is still a lot of work to do.

I spent several hours on the phone last week with someone recently diagnosed who is struggling to eat gluten-free meals that are safe, varied, nutritious and tasty. In our conversation, I was transported to the early days after my daughter was diagnosed and I stood in the bread aisle of my local supermarket barely able to breath. All I could think was that if we were trapped among the shelves stacked high with food, she would still have nothing to eat.

It's been a long time since I recalled that feeling.But the person I was talking to had just had a very similar experience. She was nearly in tears as she roamed her grocery looking to fill her shopping cart.
One of the things making her job so difficult was bad information she had been given about what was and was not safe to eat. For example, she was desperately searching for gluten-free vanilla extract, having given away the perfectly fine bottle she had had at home. She thought tomato soup was the only one safe on the gluten-free diet. And anything with vinegar, she had read, was out.

It doesn't take long to figure out how someone with celiac disease can get bad information, when only two weeks ago the Wall Street Journal ran a story that incorrectly said ketchup and ice cream have gluten-containing fillers, that vinegar is fermented with gluten and that lipstick and envelope glue contain gluten. In a letter to the editor we wrote in response to the story we said, "The gluten-free diet is the only cure available to those who have celiac disease and results in improved health for those who are gluten sensitive or intolerant. But it is a challenging diet and misinformation only makes it needlessly more difficult."

Although the Wall Street Journal ran a correction, I saw its information about ketchup repeated in a Washington Post blog about barbecue sauce.
To stop the spread of bad information, we don't promote stories that contain inaccuracies on this blog or on our Twitter or Facebook sites. We know how hard it is to pull back bad information once its blasts across the Internet.

The first step in improving celiac disease awareness is to make it so well know that doctors test for it in every case where it is a possibility. The second is to make sure that once a person is diagnosed they are given accurate information about how to follow the diet. From there, we can do amazing things like getting food makers to produce better gluten-free products, restaurants to prepare truly gluten-free meals, schools and colleges to provide options for gluten-free students, and ball parks to offer gluten-free hot dogs, buns and beer.

When I started the gluten-free journey with my then two-year-old daughter, only the most optimistic in the gluten-free community dared to dream about these things--which are now becoming realities. The rest of us were just trying to figure out how to prepare a gluten-free breakfast, lunch and dinner every day.

We can't forget that the challenge of eating gluten-free is still very real, especially for the newly diagnosed. We have come a very long way, but we still have ground to cover.


Wednesday, September 8, 2010

A Bad Turn in “Fad Diet”

Yesterday’s Wall Street Journal’s sports page had a “What You Need to Know” Q & A about football that mentioned a gluten-free diet.

In my opinion, this mention of a gluten-free diet wasn’t really a good thing. They were talking about the Jets (an offensive subject at any level to a diehard Giant’s fan, but I digress). The reporter was answering the question “are the Jet’s for real,” as in are they worth all the media hype they have received thus far in the season.

I quote, “Potty-mouthed head coach Rex Ryan, a/k/a Magic Khakis, is more popular here than gluten-free diets, and the Super Bowl talk flows freely, and alarmingly.”

First off, I highly doubt the Jet’s will make it to the Super Bowl. But, more alarmingly the “popularity” of a gluten-free diet, as it is stated here, is not something I think is entirely positive. Even though medical professionals have stated that a “g-free” diet is not really a weight loss tool, people are still hopping on the trend bandwagon of going gluten-free to lose weight.

I have to say I just get so…ticked off, trying to keep it “G” rated…when a person extols the virtues of a gluten-free diet when it’s just a temporary diversion for them. “I feel so fabulous.” “I have so much energy.” Blah, Blah, Blah…

I know that within weeks a slice of pizza or a loaf of French bread or a plate of pasta will sneak back in and then the door will open to a regular intake of foods containing gluten again. It’s annoying and I regularly point out the big difference between the trendster and a celiac, I am on a gluten-free diet forever and for far different reasons. I’m trying to avoid a plethora of scary diseases, plus I would be sick as a dog if I were to eat a plate of regular pasta.

What I really feel like saying, is take your trendy enthusiasm for the gluten-free diet and…well, channeling the “G” rating again, you get the idea.

Kendall Egan

Tuesday, September 7, 2010

Blood types and celiac disease

Many years ago, when I was wandering around from doctor to doctor trying to figure out what was wrong with me, I happened to visit one of the Dr. D’Adamos (there is more than one Dr. D’Adamo pushing the blood type theories) at the suggestion of my then yoga instructor, who I liked a lot. That’s probably why I followed up on her suggestion. She seemed to know a lot about health and a lot of doctors didn’t seem to know anything at all about my health in general and my many physical complaints in particular. Plus, his office was not very far from my home.

The Dr. D’Adamo I saw said I had Type O blood and therefore I should eat meat. I was getting desperate, so I did begin to eat a lot of meat. At that point, I was avoiding a lot of food items thinking they made me ill, so the meat I ate was probably plain and therefore gluten free.

But I didn’t get any better because what I really had was celiac disease. Dr. D’Adamo did not advance my health one bit. In fact, he set me back while I experimented with the idea that eating meat would make me better.

The blood type theory arises every few years or so but to be honest, I don’t think it ever pans out in any helpful way. I vaguely remember a quote we had in one issue when a reader wrote in asking about the Blood Type theories. The doctor said (and I am paraphrasing from memory), if that were true, meaning blood type can guide treatment, then wouldn’t we all be much healthier than we are today?

I have been diagnosed with celiac disease for 20 years. I will agree that there are still, in 2010, medical doctors who don’t know squat about celiac disease. But I do know that theories I might term “outrĂ©” can delay a celiac disease diagnosis.

Certainly Dr. D’Adamo did me no good and some harm while I toyed with his theories. So I take issue with the idea that knowing your blood type will help you manage your gluten-free life. Frankly I don’t think it will do you any good at all.


Thursday, September 2, 2010

Gluten-Free Success in the Kitchen

For my second try at real cooking, I decided to stay away from meat altogether and found a perfect sandwich recipe.
As I’ve mentioned before, my sandwiches are usually pretty simple - peanut butter on toasted gluten-free bread. I never put a lot of thought into lunch so I figured this sandwich could help change that.
The recipe for Arugla-Pear Focaccia Panini comes from Carol Fenster’s “1,000 Gluten-Free Recipes.” I think you can find a recipe for almost anything in this book – it has 700 pages!
I did adapt the recipe a little, something that I learned can be important from the last time I cooked. First, I used bread that I already had instead of making the Focaccia. I wanted something that I could make quickly so preparing a special bread wouldn’t have fit my goal.
Second, the recipe calls for a Panini press. I definitely don’t own one of those so I made the sandwich more like a grilled cheese with a little bit of cooking oil on a frying pan. Then I pressed the spatula down hard onto the bread to flatten it out.
Carol Fenster also suggests flattening the sandwich out by putting a heavy skillet on top if you do not own a Panini press.
But before all that I put the sandwich together. The recipe called for a little bit of spinach, Swiss cheese, very thin pear slices, red onion and a special spread (the recipe for the spread is in the cookbook) all layered between two slices of bread. After the sandwich was assembled, I put it in the pan on the stove for a few minutes, flipped it and cooked it for another minute or two. Overall it was a very simple recipe that did not require much more time than it does to toast bread and then put some peanut butter on it.
I did have to go out to get a few of the items because they were not all things that I had at home.
The sandwich tasted great and was not like anything that I have previously tried. I would never have thought of using pears with onions and cheese on a sandwich.
I would definitely make this sandwich again! Another lesson I learned is that I can create interesting and different meals that aren’t much harder than very basic things I’m used to. The key is just to get a little creative and think outside the box.
I know I have said I want to make healthy meals, but once I opened the cookbook I used for this recipe, I couldn’t resist some of the desserts. So that’s what’s up next!