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Tuesday, May 23, 2017

Gluten-Free Facts and Information

FAQS: Helpful facts and information about the Gluten-Free Diet.


What is Gluten?

The word "gluten" comes from the same latin root as the word "glue" which describes gluten's function quite well. It is the protein (specifically, gluten in comprised of the gliadin and glutenin proteins) found in foods containing grains such as wheat, barley, rye, triticale (a wheat-rye hybrid), spelt, kamut and other crosses of these grains. Gluten can also be found in some cosmetics, body care products, vitamins and medications. There are numerous hidden sources of gluten, such as soy sauce, surimi, processed foods, etc.

During the baking process, gluten forms thick, stretchy, glue-like properties, providing bread and other baked goods with elasticity and chewy texture. Gluten also helps dough rise by trapping/gluing bubbles from fermenting yeast within the dough, enabling the dough to rise up light and airy.
 

Why Gluten-Free?

According to researchers, nearly one third of North American adults are following a gluten-free diet. See the data here. Gluten-free diet recommendations have been linked to over 55 medical conditions to date. Those diagnosed with celiac disease or non-celiac gluten sensitivity cannot tolerate gluten. In those cases, proper adherence to a gluten-free diet is recommended. Many celiac advocates, however, believe a grain-free or paleo diet is a better diet for celiacs. A gluten-free diet is also recommended for those with other health issues. Some people choose a gluten-free lifestyle for the health benefits.

The gluten-free diet is recommended for numerous health reasons, including many chronic and autoimmune diseases, and mental health conditions. Here are some of the reasons why so many health professionals recommend the gluten-free diet: http://www.glutenfreefind.com/blog/why-are-people-following-a-gluten-free-diet/. Always seek advice from your health professional before making any changes to your diet.

A diet free of gluten means reading food labels very carefully is a must. Gluten is a protein found in several grains, including wheat, barley, rye, triticale, spelt, kamut and others. These ingredients (as well as other ingredients containing gluten) are often hidden in processed, pre-packaged foods. Be aware of cross-contamination issues when shopping and dining out, and always check the status of any gluten-free foods you plan to consume.


What is Celiac Disease?

According to the Celiac Sprue Association, "Celiac disease (CD), also known as celiac sprue or gluten-sensitive enteropathy, is a genetically linked autoimmune disorder that can affect both children and adults. In people with CD, eating certain types of grain-based products set off an immune response that causes damage to the small intestine. This, in turn, interferes with the small intestine’s ability to absorb nutrients found in food, leading to malnutrition and a variety of other complications. The offending amino acid sequences are collectively called “gluten” and are found in wheat, barley, rye, and to a lesser extent, oats* (WBRO). Related proteins are found in triticale, spelt, kamut.

In people with CD, eating certain types of protein fractions, collectively called gluten (gluten is commonly known as the "glue" in baked goods, thus, providing a chewy texture), set off an immune mediated response at the site of the epithelial cells. This abnormal, cellular level immune activity evokes damage to the lining of the small intestine. The damaged small intestinal lining, mucosa and villi, interferes with the ability to absorb the nutrients available in food. Without adequate nutritients available, malnutrition and a variety of other related complications become apparent." It's important to note that those with celiac disease can suffer from a wide range of symptoms, or no symptoms at all! Diagnosis can take place at any age, and most people with the disease have not yet been diagnosed (about 80%).

In December 2012, the U.S. Department of Justice (DOJ) classified severe food allergies, including celiac disease and gluten sensitivity as a disability under the Americans With Disabilities Act (ADA).

According to the Celiac Sprue Association, Celiac Disease is:   

  • an inherited disease. Celiac disease affects those with a genetic predisposition.
  • COMMON. Approximately 1% of the population has CD, however, most have yet to be diagnosed.
    This number is based upon a milestone multi-center study of blood samples collected from 13,145 people from February 1996 to May of 2001. This means that there were over 2.1 million undiagnosed people with celiac disease in the United States in 2001.
  • characterized by (IgA mediated) damage to the small intestine's mucosal lining, known as villous atrophy.
  • responsible for the malabsorption of nutrients resulting in malnutrition.
  • linked to skin blisters known as dermatitis herpetiformis (DH).
  • linked to gluten ataxia.
  • not age-dependent. It may become active at any age.
  • linked to genetically transmitted histocompatibility cell antigens (HLA DR3-DQ2, DR5/7 DQ2, and DR4-DQ8). Other genetic links have been identified.

In December 2012, the U.S. Department of Justice (DOJ) classified severe food allergies, including celiac disease and gluten sensitivity as a disability under the Americans With Disabilities Act (ADA).

Watch this video from The University of Chicago Celiac Disease Center, which illustrates how many people have Celiac Disease in the USA: https://www.youtube.com/watch?v=GLKOVDclJp4


How Can I Find Out if I have Celiac Disease?

Either the IgA-human tissue transglutaminase (TTG) or the IgAendomysial antibody (EMA) test, or a combination of both are recommended by medical doctors as screening tests for celiac disease. The TTG and EMA tests have been found to be approximately 90% accurate for individuals (not including those under the age of 3) who make serum IgA. Depending on the results of this blood screening, your medical doctor may then recommend an intestinal biopsy to confirm the diagnosis of celiac disease. Here is more information about blood screening from the Canadian Celiac Association (CCA): http://www.celiacguide.org/articles/blood_test.pdf


What is Gluten Intolerance or Gluten Sensitivity?

Gluten intolerance (also commonly referred to as gluten sensitivity) takes place when a person cannot tolerate gluten. Any individual who has celiac disease is in essence gluten “intolerant/sensitive”. Usually, the term “gluten intolerant” describes individuals who get symptoms when they eat gluten, and feel better on a gluten-free diet, but do not have celiac disease per se. Those with gluten intolerance can exhibit a variety of symptoms, or no symptoms at all (Canadian Celiac association, 2011). Those who do not have celiac disease, but are gluten intolerant are now described as having "non-celiac gluten sensitivity."

In December 2012, the U.S. Department of Justice (DOJ) classified severe food allergies, including celiac disease and gluten sensitivity as a disability under the Americans With Disabilities Act (ADA).
 

Does the Gluten-Free Diet Work for all Celiacs and those with Gluten Sensitivity?

The short answer to this question is no. Definitely no.

Going gluten-free alone is not enough for most to regain their health fully. Some individuals are diagnosed with what is referred to as "
unresponsive celiac" or "refractory celiac disease" which is currently not commonly diagnosed. Those with refractory celiac disease (as well as many celiacs who are not diagnosed with refractory celiac disease) are not able to make a full health recovery on a gluten-free diet alone. In these situations, health professionals may recommend a completely grain-free diet, Paleolithic (Paleo) or Caveman diet, or Specific Carbohydrate Diet (SCD) and some health professionals may recommend including raw foods into such diets. Some celiacs need to go both gluten free and dairy free. It is common for celiacs to be unable to tolerate dairy.

Many celiac advocates recommend a grain-free diet, Paleo diet or Specific Carbohydrate Diet (SCD) for celiacs (including those who do not have refractory celiac disease) for a variety of reasons. One major reason why these diets are recommended is because research shows over 80% of all celiacs do not completely heal, nor make a complete health recovery on a gluten-free diet alone.

There are a number of directions one's diet may need to take. It is important to find out from your health provider whether the gluten-free diet alone is right for you. Your "gut feeling" may not always be the correct answer, so always check with your health provider before making a diet related decision.
The gluten-free diet now recommended by health professionals in connection to over 55 health conditions.


What Can I Eat if I Go Gluten-Free?

Adjusting to a gluten-free diet can be overwhelming and challenging. Keep the long-term goal in mind, which for many people is to get well and be free of a variety of symptoms caused by celiac disease or gluten-intolerance. There are associations such as the Celiac Sprue Association, and the Canadian Celiac Association that provide education, programs and support.

For a list of ingredients containing gluten please click here.
For a list of ingredients that are gluten-free, please click here.


Check out our gluten-free Recipe Collection by clicking here.
Visit our blog for information about people and products for a healthy gluten-free lifestyle by clicking here.
Click on a city, and then click on a category for more gluten-free finds!


What's the Deal on Oats?

Oats continue to be a controversial grain for those who have celiac disease or are gluten-intolerant.
Click here to read this article, which sheds light on oats and why they have been a concern for those with celiac disease It also explains current labeling and marketing regulations/claims for products containing oats.

Another note worth mentioning: In the USA, gluten-free products containing oats are permitted to labeled "gluten-free", however, in Canada this is not the case. In Canada, labeling laws prohibit products containing oats (even if the oats are pure and uncontaminated) from being labeled "gluten-free." (This information is accurate as of December, 2012, however, it may change at any time).

*Bottom line: get the all clear from your physician before consuming (pure, uncontaminated) oats!

 

What about Gluten Removed Beer?

According to the Canadian Celiac Association (CCA), "the CCA does not recommend that Canadians with celiac disease or gluten intolerance drink any barley-based beers. This is regardless of whatever enzymes might be used to supposedly break down gluten. Yes, the companies may wave tests around showing that samples came up at less than 20 parts per million (ppm) gluten, but what they're usually less interested in discussing is the scientific accuracy of such tests on a liquid product. Using currently available testing methods, some beers report a number less than 20 ppm, but there is significant evidence that suggests the tests do not detect all the gluten in the beer. Until we have a test that we are confident is detecting all of the toxic proteins in the beer, we recommend that people with celiac disease (and gluten intolerance) not consume it." The CCA's position on this issue is published here: http://www.celiac.ca/b/wp-content/uploads/2013/12/eNews-December-2013.pdf
 

What about Food Labeling?

New food labeling regulations went into effect in Canada via Health Canada on August 4, 2012. From that date forward, labels for all food products sold in Canada must carry clear identification of priority allergens, gluten, as well as added sulphites. You can read Health Canada's 2012 'Position on Gluten-Free Claims' here: http://www.hc-sc.gc.ca/fn-an/securit/allerg/cel-coe/gluten-position-eng.php.

In the U.S., the Food Allergen Labeling and Consumer Protection Act requires that wheat be declared on all food product labels. You can read about the FDA's Food Allergen Labeling and Consumer Protection Act here: http://www.fda.gov/food/labelingnutrition/FoodAllergensLabeling/GuidanceComplianceRegulatoryInformation/ucm106187.htm

How much gluten is allowed in pre-packaged foods?
After many years of advocacy work by celiac advocates, the amount of gluten permitted in store bought foods labeled "gluten-free" has become officially regulated by the government in North America. In Canada, Health Canada allows gluten to be present in pre-packaged foods at levels not exceeding 20 parts per million (20 ppm or milligrams per kilogram). This number is equivalent to 10 milligrams per day, which is considered to be a “safe” amount of gluten for celiacs. In the U.S., the Food and Drug Administration (FDA) has followed suit, and formalized a 20 parts per million gluten-free food labeling regulation, however, the FDA states “food must contain less than 20 parts per million of gluten.”



What about Food Recalls?

In Canada: If you would like to receive information about food being recalled, you can sign up for the Canadian Food Inspection Agency's (CFIA) "Food Recalls and Allergy Alerts" notification service. Once you sign up, you'll automatically receive food recall public warnings. This is the link: http://www.inspection.gc.ca/english/util/listserv/listsube.shtml


Where Can I Get More Information?

*For more information about the above topics and many more, check out Gluten-Free Beginnings Easy Starter Guide. The guide was written by celiacs/holistic nutritionists specifically for adults and children who are new to the gluten-free diet. It is available as a PDF eBook, or paperback.




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