The gluten thing

[DanM]

Thomas Keller is not the only one riding the gluten free gravy train. King Arthur Flour sells their own gluten free blend. I have also heard that Peter Reinhart is working on a book about gluten free bread/baking.

[kayb]

My daughter, now 25, has celiac disease, diagnosed about four years ago. She had had a number of unexplained ailments for some time, including severe gall bladder dysfunction that necessitated removal at age 19 (she weighed 105, was an athlete, had never had a child, i.e., none of the risk factors for gall bladder probs at the time). She had a thyroid problem and had to take supplemental whatever-it-is the thyroid produces. She was extremely anemic -- oral iron supplements did no good, and she had to have IV iron infusions every six months (most people who have to have them find one every two years is enough). She had a great deal of stomach pain, nausea, vomiting, diarrhea. We were at our wits' end trying to figure out what was wrong.

We finally went to ANOTHER hematologist, who did the standard blood work, called us in, and told us,"You need to go to a GI specialist, but I'll bet you $100 you're gluten intolerant and have celiac disease." We looked at each other quizzically, because we'd never heard of it. But she had an upper GI which confirmed the guess, and she's been gluten free ever since. It's not a real hardship for her, as she's never been a sandwich person, and she's adapted to GF pizza crust and pasta. She loves vegetables and fruit, and that's 75 percent of her diet, anyway.

Now they have a six-month-old and their pediatrician has advised them to feed her GF foods only for the first year, until it's a little easier to watch and see if she has any ill effects from gluten introduced gradually, in small amounts.

Her husband is vegan. Cooking dinner for them can be entertaining.

[Darienne]

So glad to read a happy ending to your story, kayb.

We are cooking this weekend for a couple...the wife is seriously gluten affected. I didn't ask for medical particulars as in whether it is an intolerance, an allergic reaction, etc. Her husband says gluten makes all her cells swell, including the ones in her brain and the result is terrible for a period.

She is fine with bananas, raspberries, whipping cream, chocolate and Chambord (dessert), so not all is lost for her.

[azlee]

I've been living gluten free for almost 3 years due to a severe gluten intolerance. So far, I've had the blood testing but the results were borderline and inconclusive. I haven't had an intestinal biopsy yet, but will soon. I've been diagnosed with another autoimmune disease and my gastroenterologist strongly suspects celiac disease, as it often accompanies that illness. Both my rheumatologist and gastroenterologist suggested a gluten diet and it made an immediate difference in my symptoms.

It's not too hard to follow the diet by eating a gluten free and mostly whole food diet at home. If you come to my home for a meal you will eat gluten free but so far, I've had no complaints. I'm an accomplished home cook and once had a very successful business baking with wheat. I cook almost everything from scratch and probably eat a much healthier diet than ever before in my life. I find the manufactured supermarket packaged and frozen foods have lots of empty carbs, low nutritional value and loads of salt and/or sugar to make them palatable, in addition to many additives to provide familiar texture, elasticity and improved mouth feel that tries to replicate the chew of wheat, rye and barley and they are insanely expensive. I didn't eat a lot of manufactured foods before my diagnosis and I don't want to now, so I cook.

Eating out is another story, I, was used to frequent restaurant meals, in connection with business meetings and travel but now find it hard to feel safe ordering much more than grilled steak w/o sauce and plain salads. A lot of salad dressings used in restaurants contain wheat products (modified food starches as thickener and may contain malt vinegar. Jeez, even McDonald's burgers and fries contain gluten and so do some Starbuck's flavored coffees. A cross-contaminated or mis-identified dish can cause me great pain and intestinal inconvenience and put me out of commission for a couple of days, so I'm very careful. Fine dining where tasting menus are the focus is almost impossible, except at places like Per Se and The French Laundry where they go the extra mile, providing gluten free fresh bread service and will tweak signature dishes to accommodate. I think it's mostly a marketing move, but I'm glad that Keller is paying attention and I now have a place on each coast, where I can feel safe dropping a load of cash on a meal. I suspect Keller's gluten free flour and dessert mixes (which are overpriced to be sure) are private label versions from an established gluten free flour manufacturer but that's okay if they are of good quality and people get to enjoy foods they miss.

The King Arthur gluten free flour and gluten free mixes has been a real gift to gluten intolerant bakers and in my opinion and experience are a superior product to many gluten flour options that preceded KAF to market. Their gluten free flour products milled to strict standards in gluten free, allergen free facility (that is free of the 8 most common food allergens) and they are milled from whole grains.

I don't tell others how or what to eat, but a gluten free diet has improved my life and health immensely. Sure I miss pizza and fresh baked brioche, but I don't miss diarrhea, crippling gut pain and internal bleeding. It would be nice if some of you doubters would try to understand and respect that.

Sure it's a fad diet for some, but for many, many others it's a lifesaving discipline and as serious as shellfish and peanut allergies.

[KD1191]

It seems that cultures which have diverse eating habits have much less allergy issues.

Interesting thought... I wonder if there's evidence to support that. I feel like the US has pretty diverse eating habits. We're a wealthy nation with much available in our markets and representation in our country from other cultures all over the world.

Do other cultures have considerably fewer allergy issues? The first thought that came to my mind when I read that was that most of the Asians I know have lactose intolerance.

Bolded for emphasis.

With wealth comes advances in medical technology, which either increase detection of previously undocumented ailments or seek 'problems' to continually justify their expense (depending on which philosophical camp you fall in).

Given that the tendency to develop many allergies is hereditary, the reasons why less-wealthy societies might exhibit lower rates of severe allergies is rather simple Darwinism.

[Fat Guy]

Michael Pollan has a quotable comment in the New York Times Magazine this weekend. I shall quote it:

What Do You Think of Gluten-Free Diets?

They are very important if you have celiac disease or can't tolerate gluten. But it's hard to believe that the number of people suffering from these conditions has grown as fast as this product category. Gluten has become the bad nutrient of the moment, the evil twin of Omega 3 fatty acids. Could it really be that bread, a staple of Western civilization for 6,000 years, is suddenly making millions of us sick? I'm dubious.

[ElaineK]

I've been living gluten free for almost 3 years due to a severe gluten intolerance. So far, I've had the blood testing but the results were borderline and inconclusive. I haven't had an intestinal biopsy yet, but will soon. I've been diagnosed with another autoimmune disease and my gastroenterologist strongly suspects celiac disease, as it often accompanies that illness. Both my rheumatologist and gastroenterologist suggested a gluten diet and it made an immediate difference in my symptoms.

Did anyone warn you that after three years on a gluten free diet you're almost certain to have a negative biopsy? Even in people who are eating significant amounts of gluten, the intestinal damage is -usually- patchy. Several small samples are taken, but as a fraction of the total area, it's quite small. That means that a positive biopsy is the gold standard for a positive diagnosis, but a negative biopsy doesn't put you in the clear. After three years of a strict gluten-free diet, I'd be very surprised if you had a positive biopsy, since the vast majority of the damage should be healed.

My GI told me I'd need to do a six-week gluten challenge (4 slices of wheat bread per day minimum) in order to have any chance of testing positive, and that he really preferred more like six months.

[ChrisTaylor]

I will give GF one thing though: Everyone I know who has adopted it has lost significant weight (and all could use that loss). They feel much better now!

You'd lose weight too if you were faced with the choice of gluten free bread or nothing.

[Mjx]

Michael Pollan has a quotable comment in the New York Times Magazine this weekend. I shall quote it:

What Do You Think of Gluten-Free Diets?

They are very important if you have celiac disease or can't tolerate gluten. But it's hard to believe that the number of people suffering from these conditions has grown as fast as this product category. Gluten has become the bad nutrient of the moment, the evil twin of Omega 3 fatty acids. Could it really be that bread, a staple of Western civilization for 6,000 years, is suddenly making millions of us sick? I'm dubious.

I'm not so dubious, at least when the consumption of gluten-containing substances is taken in conjunction with the amount of food people have been able to – and do – eat in the Western world today.

I'm basing this conjecture on very limited, empirical evidence, but I think it is suggestive. I have unpleasant problems with wheat and a number of other starch-based substances: no suggestion of celiac disease, but instead, upper respiratory-tract symptoms, alarmingly rapid joint swelling, and a sense of general malaise. However, if I've fasted the entire day, I can eat a bunch of croissants, or a big batch of potatoes, and suffer little more than a runny nose.

I know about a dozen or so other people who have problems similar to mine (if we get together and indulge in those things that we love but with which we have problems, the gathering looks like a hay fever convention), and who respond similarly to the overall amount of food consumed over the course of the day, which does suggest that this plays a significant role in individual response to problematic substances in food. Hardly conclusive, but a suggestive pattern.

For thousands of years, even 'enough food, most of the time' was inconceivable for most. Most people ended up fasting fairly often, and those who couldn't handle that presumably were less likely to survive/reproduce. Today, overeating can actually be difficult to avoid, and with that, it's hardly surprising that people's overloaded systems are responding far more emphatically to potentially problematic substances in our food.

Given the pervasiveness of both overeating and wheat (anyone who reads ingredient labels is aware of how pervasive wheat is, even where you wouldn't expect to find it), that allergies and intolerances can worsen over time with ongoing expsure to the allergen/irritant, increased awareness of the condition, and improved diagnostic techniques, the apparent explosion of celiac disease diagnoses doesn't seem surprising.

I will give GF one thing though: Everyone I know who has adopted it has lost significant weight (and all could use that loss). They feel much better now!

You'd lose weight too if you were faced with the choice of gluten free bread or nothing.

I admit that gluten-free bread (like most would-be substitutes) is relatively wretched, but the weight-loss aspect goes beyond that: I've lost breathtaking amounts of weight, even with not-infrequent breakfasts featuring a lot of bacon and sausage (Wasa and carrots are involved too, but that doesn't cancel out the other items... and I don't do 'lite', 'lo-cal', or fat-free).

[Jenni]

I feel like this topic comes up again and again on various food boards. Can't we just all agree that yes, some people genuinely have health difficulties with wheat and/or gluten and that also yes, some people use it as a diet fad which muddies the issue and sometimes makes real sufferers look bad?

Also just want to point out that I unintentionally eat wheat and gluten free many days a week and its perfectly easy to not immediately lose weight. It's called rice, people! Other popular non-wheat staples are potatoes, cassava and millet. I expect there are plenty of people in the world who would easily go without wheat bread but would fight you tooth and claw for their regional non-gluten-containing staple.

[Panaderia Canadiense]

Certainly that's true here in Ecuador, Jenni. Most people, even in Ambato which is famed for wheat breads, can take or leave it, but threaten to take away the Quimbolitos (a quinua-based steamed bread) or Humitas (the same thing, with corn instead) and they'll weep inconsolably.

Other great gluten alternatives (also, incidentally, staples here in Ecuador) include Plantain, Achira (canna rhizome) and Taro (and by extension Pelma, Sigueme, and other Aroid tubers).

[mgaretz]

Very timely! My 21-year-old daughter has had stomach issues for the last few years - the docs can't find any real physical issues so they were chalking it up to stress of college etc. But now they want her to try a gluten and dairy free diet for a while and see what happens. We don't think she's lactose intolerant because the symptoms don't match (though me and her older brother are) and she wouldn't appear to have celiac disease, but something is going on. Anyway it will be an interesting couple of months!

Edited October 2, 2011 by mgaretz (log)

[daisy17]

Very timely! My 21-year-old daughter has had stomach issues for the last few years - the docs can't find any real physical issues so they were chalking it up to stress of college etc. But now they want her to try a gluten and dairy free diet for a while and see what happens. We don't think she's lactose intolerant because the symptoms don't match (though me and her older brother are) and she wouldn't appear to have celiac disease, but something is going on. Anyway it will be an interesting couple of months!

It's not easy at times, so please tell her to hang in there! Well worth doing an elimination diet, in my personal experience.

[Dianabanana]

If someone says that a certain food makes them feel unwell, you have to take them at their word. If they are being obnoxious about it, then that's a separate issue from whether they actually have a health problem. If they claim to have gluten sensitivity but then sometimes eat gluten-containing foods anyway, how is that different from the thousands of diabetics who eat foods they shouldn't? You've always been able to follow whatever diet you've been on?

There simply is no good to be gained from questioning people's assertions about their own health. You can't possibly know the truth. Half the time they don't know the truth, and their doctors don't, either. They're just doing the best they can. I'm quite sure that many of the people now following a gluten free diet are doing it in the hope that it will help some previously unresolvable heath issue. So let them try it. My goodness.

[Fat Guy]

If someone says that a certain food makes them feel unwell, you have to take them at their word.

I think, de facto, that's true. But I do think the issue deserves broader discussion, because things have gotten a bit out-of-control with the food-sensitivity claims. Maybe I'll start a separate topic for the general discussion.

[MsDivinaLoca]

1. C4C (Cup-for-cup) is: cornstarch, white rice flour, brown rice flour, milk powder, tapioca flour, potato starch and xanthan gum.

Article in the San Francisco Chronicle (SFGATE)

- where they do a taste-test.

1) Anyone know what Keller is milling for his GF flour?

[JAZ]

If someone says that a certain food makes them feel unwell, you have to take them at their word. . . .

There simply is no good to be gained from questioning people's assertions about their own health. You can't possibly know the truth. Half the time they don't know the truth, and their doctors don't, either. They're just doing the best they can. I'm quite sure that many of the people now following a gluten free diet are doing it in the hope that it will help some previously unresolvable heath issue. So let them try it.

The fact is that people are often not very good about gauging their own health. They might feel fine and have serious health problems, or feel "unwell" with no underlying sickness, disease or condition. The placebo effect is well documented; how people "feel" is dependent on a lot of things, including whether they think a given treatment will work. It's why self-diagnosis is so scientifically unreliable.

Please understand that I'm not saying or implying that celiac disease and gluten sensitivity don't exist. They do, and for those who suffer from the conditions of course a gluten-free diet will make them feel better and make them healthier. But I think what's happened may be that with all the heavy marketing of gluten-free products and diets, some people with no indications of gluten sensitivity go on a gluten-free diet on their own, without any tests or doctor's opinions. (And, people being what they are, some people will also give up dairy products and other foods at the same time.) If they feel "better," it might be because they've given up gluten or the other foods; it might be a coincidence; it might be the placebo effect. It's great that they feel better, but my concern would be they might have some other serious health condition that's going untreated because they've convinced themselves that gluten was the problem, when in fact it's irrelevant in their case.

[Dianabanana]

A gluten-free diet is expensive, inconvenient, and, as amply demonstrated by this thread, rather a social liability. If people are going to all the trouble of trying a gluten-free diet in lieu of proper medical diagnosis, I'm inclined to aim my disapprobation at a health care system in which it costs $1800 to get a 10-minute upper endoscopy, the entire cost of which must be borne by the person with high-deductible health insurance. Of course some people will try diet first.

[Paul Kierstead]

We have government health care and people are still flocking to GF.

[Paul Kierstead]

If someone says that a certain food makes them feel unwell, you have to take them at their word.

I'm not sure what you mean by my having to take them at their word. If they eat in my home, I'll honour their wishes and take care to ensure they don't get that food. I'll not prevent them from taking on whatever diet they want. In fact, I point out new GF food sources around town that I trip up over to my GF friends. But I most certainly will not accept it as true simply because they said so, nor will I necessarily 'agree' with them by keeping silent if keeping silent would indicate consent.

Self observation is pretty close to hopeless. If people want to try out various things and make their conclusions, that is ok, but you can't expect everyone to roll over an agree just because those people have found comfort.

[Country]

To follow that up: When I was born some 70 years ago and then growing up, I do not recall any instances of children allergic to peanuts or much of anything else. And there was scarcely any asthma compared to our own children's generation...we had two asthmatic kids of three in a family which had never had any incidence of asthma ever...and then today's children who have many allergies and asthma and autism, etc. DH was a high school teacher who saw puffers galore in every class.

Not drawing any conclusions...can't..just wonderin about it all. In light of dcarch's question about diversity and Jaymes response...my generation, war babies, grew up on a much more limited diet than today's children. What does that signify? If any?

I'm also 70 and, when younger, don't recall all these problems with allergies and various intolerances related to food.

Could it be that "modern" agricultural practices are at least partially responsible? In addition to the application of so many insecticides, pesticides, etc., there is the issue of soil fertility and, I think, there is not much left on those "farms" that produce the majority of the food consumed today.

It could be said that the health of the people is in the health of the soil - and that bears some thought. If the soil growing so much of our food these days can't even support a healthy population of earthworms, how healthy is the food that's grown from it?

[heidih]

I have a new appreciation for the issues after working with a woman who has felt horrible for year s after she ate. She is active, engages in life, and not a "complainer". The current diagnosis is an inability to metabolize some sugars and gluten has been eliminated. She feels so so much better. As noted earlier by others - if it makes you feel better - go for it. That said, this woman does not expect special treatment. She brings a cooler with things she can eat in the event there is nothing that fits the prescribed plan. She is quite slender and appears to have added a few needed pounds now that she can actually enjoy her food and not fear oncoming pain.

[daisy17]

If someone says that a certain food makes them feel unwell, you have to take them at their word.

I'm not sure what you mean by my having to take them at their word. If they eat in my home, I'll honour their wishes and take care to ensure they don't get that food. I'll not prevent them from taking on whatever diet they want. In fact, I point out new GF food sources around town that I trip up over to my GF friends. But I most certainly will not accept it as true simply because they said so, nor will I necessarily 'agree' with them by keeping silent if keeping silent would indicate consent.

Self observation is pretty close to hopeless. If people want to try out various things and make their conclusions, that is ok, but you can't expect everyone to roll over an agree just because those people have found comfort.

I wish I could explain exactly why this offends me so - this, and many of the other posts on this thread. First of all, please do a little reading and have some idea of the facts. There is no test for gluten sensitivity, or other food sensitivities that don't rise to the level of an allergy or celiac. You go on an elimination diet, you see how you feel, and your doctor tells you not to eat what made you feel sick. There is NO TEST. The science has not caught up, and it remains a guessing game. You do not have to agree with what I think or what I eat. My doctors agree with me, and that is more than enough. It is my body and I will eat what I want. I'm not asking anyone - including restaurants, or you - to make accommodations for me. But the constant denial of my experience on these boards - and that of thousands, if not millions, of other people - is beyond insulting. Just because there's not a test to prove to you that I'm right doesn't mean I'm not.

To Country's and Darienne's point, allergies (as well as autism - another phenomenon there is no explanation for) have skyrocketed in recent years. Our food systems are practically beyond repair, and grains are often genetically modified. Is it truly surprising that there might be a backlash?

I would think that there have been enough posts on here and elsewhere reflecting experiences similar to mine for some of you to have a little more consideration for what we are saying. My experience does not depend even remotely on whether or not you agree, but it would be awfully considerate if you could open your minds and ears a little.

[Country]

To Country's and Darienne's point, allergies (as well as autism - another phenomenon there is no explanation for) have skyrocketed in recent years. Our food systems are practically beyond repair, and grains are often genetically modified. Is it truly surprising that there might be a backlash?

While GM crops haven't been around long enough to be responsible for the allergies and problems being discussed here, their development adds yet another layer of questionable agricultural practices. Any adverse effects from GM food may not be known for years, if not generations.

[Dianabanana]

If someone says that a certain food makes them feel unwell, you have to take them at their word.

I most certainly will not accept it as true simply because they said so, nor will I necessarily 'agree' with them by keeping silent if keeping silent would indicate consent.

Self observation is pretty close to hopeless. If people want to try out various things and make their conclusions, that is ok, but you can't expect everyone to roll over an agree just because those people have found comfort.

Perhaps I'm not quite understanding you. If I tell you that green bell peppers give me indigestion, you would not accept it as true simply because I said so?