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Why self-diagnosis of Celiac Disease and gluten intolerance is so common

Published on March 29, 2012 by in Featured, Science

And why you should probably give the benefit of the doubt

In a discussion at Reddit, someone pointed out that wheat allergies are actually rather rare, and suggested that most people who claim gluten problems are just making things up.

This is my response, or why self diagnosis is so common and why there is probably merit to those conclusions:

Technically, wheat allergy is relatively rare compared to Celiac Disease and non-Celiac gluten sensitivities. Allergy is an acute IgE reaction, Celiac and non-CD sensitivities tend to be mediated by the slower acting IgG and/or IgA antibodies. However, that is a lot of technical stuff to explain to your server, so it is usually a lot more convenient for gluten sensitive individuals to just say they’re allergic. “Intolerant” doesn’t quite carry the importance of gluten sensitivities, because there is a strong and direct correlation between gluten consumption in sensitive individuals and all-cause mortality. That hasn’t been established so clearly with other types of “intolerance” originating from different mechanisms (ie, lactose intolerance)

Anyway, we can diagnose CD with intestinal biopsy, and we can diagnose non-CD sensitivities with blood serum tests. HOWEVER: Once someone has been on a gluten-free diet for a significant amount of time, the intestines heal and the blood serum drops to healthy levels. So you just can’t test someone for gluten reactions if they’re already on a gluten-free diet. It isn’t instant like an allergy, and it could take months or years of gluten consumption to build up the diagnostic markers our tests are looking for.

The puzzled doctor - a familar image to the gluten intolerant

Ultimately though, I see no reason why anyone would choose to adhere to such a restrictive and difficult diet unless they feel a significant subjective improvement. Instead, it is extremely common to hear stories from people who were diagnosed but choose to ignore their doctors’ dietary advice. Even with full knowledge of the disease, maintaining the diet is an extreme act of mental fortitude.

Self-diagnosis is an interesting… problem. American doctors are notoriously bad at detecting Celiac Disease. Many were taught that it is extremely rare and only effects children. Based on what we know from random blood sampling, about 1% of the population has Celiac Disease and only 5% of them have received a “real” diagnosis from a doctor. Non-Celiac gluten sensitivity is 5-10 times more common than Celiac, yet almost 0% of those patients will ever get an official diagnosis beyond IBS or CFS. An elimination diet can be conducted in a relatively scientific manner, but the data is highly subjective.

Granted, the gluten-free diet may act as a placebo in some cases. Anything could be a placebo, though, so why would anyone choose such a difficult placebo over cheaper and more convenient ones?

 
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Happy Gluten Free Holidays

Published on November 29, 2011 by in Featured, Food

With Thanksgiving a recent memory, Christmas will be upon us soon – and that means a season of food and potentially tough times for Celiacs and anyone on a gluten-free diet.

Luckily, knowledge of the condition and appropriate products are spreading like wildfire.  We attended a few Thanksgiving meals in the last few weeks, and at each one I was able to find some appropriate grub.  With a six- or twelve-pack of Woodchucks in hand, I’d even have some drinks to keep up with the college kids.

For our actual Thanksgiving meal, we had some beef ribs marinated in Stubb’s regular BBQ sauce.  I also cooked up some green beans with bacon and red bell pepper, grean peas with minced onion and garlic, as well as Colcannon – an Irish dish so nice they made a song about it.

Ok, so the song might be about a little bit more than just the potatoes, but they still taste pretty great.

First you cook potatoes, fry up some bacon or ham, boil up some kale, and heat a bit of milk and cream with scallions. Drain the kale well and chop it finely before mixing the whole thing up, and serve it with a bit of melted butter in an indentation at the top of a potato hill.

Anyway, we had some gluten-free muffins on hand but there wasn’t much talk of dessert. We pretty much ate the main course until we were ready to pass out for the holiday nap.

On that front, my fiancee has been baking quite a bit in our new, gluten-free kitchen. Since we don’t have any wheat products in the house, she’s been craving some breads and pies so in the last few weeks there have been some very interesting and delicious experiments in biscuits, apple pie, and banana-nut muffins.

The recipes are definitely in an experimental phase or else I’d share them, but for now I can at least post some pictures of that delicious gluten free applie pie we enjoyed last month:

The taste was spot on, but the texture of the crust was a bit too crumbly and it didn’t hold up well with cutting. Hopefully we get that figured out before too long and I’ve got some tips to share about overcoming that little defect of the gluten-free flours.

Until then, here’s hoping that you and your loved ones have a happy, and gluten-free holiday season!

 
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Gluten free sandwiches at Jason’s Deli and at home

Published on April 2, 2011 by in Food

 

Five years in to the gluten free diet, there wasn’t a whole lot of food I still missed.  It has basically gotten to the point where feeling good is better than the meals I’m missing out on, but there was always the lingering sense of loss around two things:  pizzas and sandwiches.

As far as gluten free pizza goes, I’ve had a little success in making my own recipe and in finding some local pizzerias with GF options.  It isn’t quite the same since it costs twice as much money or effort than the traditionally cheap & easy pizza, but at least there was a choice.

However, finding a good sandwich has been quite a bit trickier.  Or it was, anyway.

Jason’s Deli to the rescue

Jason’s Deli has been around town for a while, but it was never really one of my favorites.  I generally prefer the sub-style sandwiches, and in my wheat eating days I would often choose quantity over quality.  So back then, I didn’t think too highly of the attention to detail and wholesome ingredients that goes in to a Jason’s Deli sandwich, but I did always enjoy their catering at various events.  It just seemed a little bit pricey for a regular meal.

Anyway, that opinion flew out the window when I found out they regularly carry gluten free bread.  This isn’t just something the local branch does because some gluten-free employee pestered them, this is a commitment they’ve made to dietary diversity across all of their locations.  And it fits right in to their insistence on pure & natural foods.  Whether you’re trying to avoid artificial dies, gluten, or processed corn syrup, Jason’s Deli is looking out for you with some of the freshest and healthiest sandwich toppings around.

Expensive isn’t so expensive anymore…

Normally, buying a gluten-free version of something boils down to paying more for less food.  Whether it is a small, personal pizza for $20 or nine cookies for $4, you can get whatever you want in a gluten-free version if you’re willing to shell out extra bucks.

Except at Jason’s, where you pay the regular price for a full-sized gluten-free sandwich.

Here’s the combo I recently enjoyed at Jason’s Deli for less than ten bucks:

  • Roast beef
  • Swiss
  • Mayo
  • Mustard
  • Spinach greens
  • Purple onions
  • Oil & vinagerette
  • A pickle
  • Coca-cola (with free refills)
  • and a Bag of Lay’s plain potato chips (that have always been my favorite)

Yeah, it was amazing.  I cannot recommend it enough, especially if you love sandwiches as much as I do.  Hell, I once took a job making subs after I graduated college, because the employee discount effectively added a whole bunch to my wage – and I was eating enough to make the job competitive with some entry-level corporate gigs.  In retrospect though, I can see why I got so sick and miserable during that time frame.

Gluten free sandwiches from home

After the pleasant shock of a gluten-free Jason’s Deli sandwich, I had to learn some more.  It turns out the bread they used is actually available in a lot of places.  The brand is called Udi’s, and while I’d heard good things about it before I prematurely gave up on finding a good GF bread because of a few bad initial experiences.

It turns out my favorite local grocery store has loaves of this stuff in their freezer, so I picked one up today and now I’ve got sandwiches popping out of my own kitchen again for the first time in ages.

Are there downsides?  Of course.  A loaf of about 12 small pieces costs almost $5, and the bread itself is a little bit dry when compared to something fresh from the bakery.  However, when you consider it is a gluten free bread that has traveled from Colorado to Florida, it really is pretty impressive.

Oh yeah, they also have some bagels and pizza crusts available, but I haven’t quite had a chance to check that out yet.

It just gets easier…

Right now, gluten free diets have become a bit of a trend.  There might be a lot of people who don’t really need to go GF who are jumping on that bandwagon, but if you do have a bad intolerance you might as well take advantage of that popularity.  Whether it is sandwiches at the corner deli, or passable gluten free breads in the grocery store freezer, there are now a lot of options for Celiac patients today that just weren’t there a few short years ago.

So, if you or someone you know is new to the gluten free diet, try to help them be patient and relaxed.  As time goes on, more choices become available and recognizing sources of wheat contamination becomes easier.  All in all, your health will continue to improve long after the burden of watching your ingredients has become second nature!  And yes, there is a sandwich at the end of that long, dark, gluten-free tunnel!  Come join us, it is actually a much nicer place to be than I ever would have imagined…

 
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Gaining weight on a gluten free diet seems easy with GOMAD

Published on February 25, 2011 by in Food

Before I started eating gluten free, I had no energy but I had too much extra weight.  Since I found out about wheat intolerance though, I dropped weight in no time flat and I’ve had the opposite problem:  being way too skinny.

I ate a decent amount, but never exercised aside from a few walks each week with the dog.  What made things even worse though, was over the winter when I caught a bad flu.  Couldn’t eat for weeks, and ended up dropping about ten pounds to a level slightly below the recommendations for my height.

GOMAD makes protein easy

GOMAD is the plan that got me those ten pounds back, and I’m glad to say that they’re almost entirely muscle.  What is it all about?  Well, GOMAD stands for a “gallon of milk a day.”  Yeah, that sounds like a lot, and it is, but the results are quite noticeable and it is a great gluten free solution for muscle gain (as long as you’re not intolerant to lactose, casein, or something else in the milk!).

Each gallon of milk has about 128 grams of protein, and if you’re eating that in addition to sensible meals that include a little lean meat and a lot of vegetables, you’ll have more than enough fuel to build up muscle and gain weight.

Of course, you can’t just stuff yourself and expect to gain strength, you’ve also got to lift some weights and get active.  Find some dumbells that are almost too heavy to lift – or even ones that require a second hand to get started – and do whatever you can every other day.  Don’t just stop with the bicep curls either, be sure to work on the overhead trilateral pulls as well as overhead shoulder lifts.  If you don’t have any weights, pushups will work if you do a bit of research to learn the variations that target different muscles.

Then, when you wake up and your upper body is sore, it is time to give the legs a workout!  Jumping jacks are a good free standard, and there are also some stretches and lifts that will help you build muscle.  Of course, squats are ideal, but you’ll need some equipment, or a gym membership, and some guidance to make sure you’re doing it right.

Watch the fat…

One potential problem with GOMAD is that there is a whole lot of fat in milk.  If you’re as skinny as I was, this probably won’t be a problem at first, but once you’ve started to fill out and you get passed the easy gains that any new lifter can take advantage of, you’ll probably want to switch down to 1% or skim milk.  You’ll get just as much protein, calcium, and vitamin D, but you’ll save on your daily saturated fat intake.

Oh, and it is convenient!

Finally, the convenience of milk might be one of its greatest advantages in the gluten free diet.  There isn’t a whole lot of food out there that is ready to go out of the container, nutritionally balanced, and safe for people with Celiac Disease.  Milk is ready to go just as quickly as you can get to the fridge, and no matter where you’re out and about it shouldn’t be too hard to find a pint of whole milk.

 

 
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Eating good, cheap, and gluten free

Published on February 8, 2011 by in Food

When I started this blog, my idea was to figure out how to eat good gluten free food on a slim budget.  Then I got back from the grocery store the other day with an expensive pile of gourmet grub and I realized just as soon as I had an opportunity I was spending as much as I could on steaks, fruit, wine, and fresh veggies.

So before I completely forget, here are some of the foods that got me through the times when I couldn’t afford such luxuries at the grocery store:

  • Rice is a great choice for a lot of reasons.  For a starchy food, it is also pretty good for ya.  In addition to that, it stores well for long periods of time and cooks easily.  Did I mention you can get giant bags of the stuff for next to nothing?  It can be bland on its own, but a little bit of salt, butter, soy sauce, or sesame oil does wonders for making it taste great.
  • Beans are a great, cheap way to get some protein and iron.  Mix them up with the rice and you’ve got a classic dish that is well balanced for taste and nutrition.
  • Eggs are the closest you’re going to get to meat though, without completely breaking the bank.  Eggs rich in omega-3 fatty acids can be a little more expensive, but they still deliver a great amount of protein and essential fats for a couple of bucks.
  • Milk isn’t exactly the cheapest stuff in the world, but if you’re able to tolerate lactose, it is really pretty good to have around.  It is well balanced between sugar, fat, and protein, and it is heavy on calcium & vitamin d (assuming it is fortified).   What is really great about milk is that it is one of the most balanced whole foods you can eat without any kind of preparation.  When you’re hungry and don’t want to cook, a glass or two of whole milk can be pretty satisfying.
  • Onions and peppers can vary wildly in price through the year, but when they’re cheap they’re a great way to add fresh vegetables to your eggs and rice.
  • Tea is probably going to be the best drink around in a rock bottom price range.  A box of 100 bags is available for the price of a soda bottle, but instead of processed sugars you get some antioxidants.  It is also enjoyable hot or cold, so it is a drink that can stick with you through the year.

While it might not be the world’s most exciting diet, it is a pretty healthy one that remains both cheap and completely gluten free.  It can be expensive to rely on meat for every meal, but it is definitely a great treat to mix up the routine and on special occasions.

 
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