Gluten Free Questions and Answers
Recent studies have shown the incidence of this disease in the US to be 1 in 133 people. First and second degree family members of a person with celiac have a much higher chance of having the disease, more like a 1 in 20 chance. This percentage is high enough that first and second degree relatives of people with celiac should also be tested for the disease. (After all, if you had a 1 in 20 chance of winning the lottery, how many tickets would you buy?)
In people with CD, eating certain types of protein fractions, commonly called gluten, set off an autoimmune response that causes damage to the small intestine. This, in turn, causes the small intestine to lose the ability to absorb the nutrients found in food, leading to malnutrition and a variety of other complications.
Q. What symptoms can you have?
A. The symptoms of this disease are many and varied. They range from chronic diarhea to chronic constipation and include depression, irritability, unexplained anemia, failure to gain weight, and early onset osteoporosis. You could also have anxiety, Attention Deficit Disorder, Chron's disease, type 1 diabetes, or autism. (This list is by no means all inclusive. For more complete information, please visit www.celiac.com or www.celiac.org.) No one person has all the symptoms of celiac. (Who could have constipation and diarhea at the same time?) Though the obvious symptoms vary, however, the problem behind the symptoms is the same for all sufferers.
Q. What happens when I do eat gluten?
A. When the body detects gluten in the digestive tract, it attacks, trying to destroy the invader. Unfortunately, the result is that the intestines (especially the small intestines) are damaged in the fight. The interior of the small intestines have small, finger-like projections called villi. The villi are used to absorb nutrients from the food that passes through the digestive tract. When a person with celiac disease ingests gluten, the villi become damaged when the body tries to destroy the gluten in the intestines. Through time, the villi become blunted and shorter, decreasing the surface area available for the absorption of nutrients.
Some people's intestines are damaged badly enough that they cannot absorb any nutrients. They eat and eat and still look like they are starving to death. This is because they ARE starving to death. The food they eat cannot be absorbed by their bodies and basically goes right through them. Other people seem to have "selective" absorption problems . . . fat gets through all right, but iron (or calcium, or something else) doesn't seem to make it. Many doctors will refuse to believe that a person might have celiac if they do not appear to be on the verge of starvation. THIS IS A MISCONCEPTION ON THE PART OF THE DOCTORS. My mother was about 25 pounds overweight when her diagnosis came through. One need not be at death's door to be negatively affected by absorption problems.
Q. I think I have a gluten intolerance, what should I do?
A. The first thing to do is to find out as much as you can about the disease. More research on celiac is being completed all the time. Again, www.celiac.com is a great site to visit if you are looking for recent information. The next thing to do is to visit your doctor. Talk to him or her about your concerns. Explain why you want to be tested for celiac, and ask them to order the blood work. (There are currently 3 blood tests that are commonly run to check for celiac: anti-gliadin antibody, anti-reticulin antibody, and anti-tissue-transglutaminase antibody. iNOVA had a new test pass through the FDA in January of 2006, but (as of June 2006) no one is really using it yet.
Research has shown it to be more specific, sensitive, and accurate than the other tests, though, so hopefully labs will start using it soon.) If your doctor refuses to acknowledge your concerns, you are always free to change doctors. Your doctor should always be willing to listen to you. Now, what should you do if you are tested for celiac and everything comes back negative, but you still feel awful? Discuss a gluten-free diet with your physician, and (if recommended) try it for a while. You should also continue working with a physician to determine if there are other possible roots to your problems. (Avoiding gluten would do you little good if your real problem was cancer, for example). On the other hand, if you ARE diagnosed with celiac . . .we are here to help.
Q. What Can't I Eat?
A. Stay away from anything with gluten in it. This includes wheat,rye,and barley, and anything that is derived from these sources. Most celiac's can not eat oats as well. Oats are usually cross contaminated with wheat and should be avoided. This includes byssinian Hard (Wheat triticum durum) Alcohol (Spirits - Specific Types), Hydrolyzed Wheat Protein,Atta Flour,Barley Grass (can contain seeds),Barley Malt,Beer (most contain barley or wheat) Bleached Flour,Bran,Bread Flour,Brewer's Yeast,Brown Flour,Cookie Crumbs,Cookie Dough,Criped Rice,,Enriched Bleached Flour,Enriched Bleached Wheat Flour Graham Flour,Groats (barley, wheat),Hard Wheat,Hydrolyzed Wheat Gluten,Hydrolyzed Wheat Protein,Malt,Malted Barley Flour,Malted Milk Malt Extract,Malt Syrup,Malt Flavoring,Malt Vinegar,Pasta,Spelt,Sprouted Wheat or Barley,Teriyaki Sauce, most canned soups, some seasoning packets, some chocolate.
Q. What Can I Eat?
A. This list is too long for us to list everything here, so we suggest you sit down and make your own list. We'll get you started.All fresh fruit and vegetables, Fresh meats that don't have any fillers, eggs, cheese, milk, icecream (not the cookie kinds), cottage cheese, yogurt, fruitsnacks, certain hotdogs, hamburger patties, steak, pork, chicken; and the list goes on and on.
We do most of our shopping at the same grocery stores we've always shopped at, because most of the things we cook require regular ingredients. Things like eggs, milk, fruits and vegetables (fresh, frozen, or canned), and plain cuts of meat are naturally gluten free. These stores are also a great place to buy mainstream, convenient products that are gluten free. These include things like chips, pudding mixes, applesauce, juices, lunchmeats, and more. (Wal-Mart has even started labeling the gluten content of its store brands, making it very easy to shop for gluten free products there.) In addition to the items they already carry, most supermarkets will carry items they receive requests for. So get all your family members and friends to fill out request forms for gluten free products whenever they enter the grocery store!
Health Food Stores:
If you are looking for gluten free baking supplies, Health Food stores are the best place to look. As more people are diagnosed with Celiac, Health Food stores have responded. Many now have gluten free sections, making it easier to find their gluten free products. Call the stores that are nearest your house and ask about their gluten free selection. You can also buy gluten free flours in bulk from health food stores. Some even offer discounts if you are buying a 25 or 50 lb. bag of flour.
Purchasing things on the internet can be a great way to find gluten free products. Amazon.com currently has a large selection of gluten free mixes and other products at very low prices, as long as you are willing to buy them by the case. We recommend that you try a product at least once before buying 6 or 12 of them. Other websites also sell gluten free products. (OUR website sells gluten free mixes, interestingly enough!) Shipping can be expensive, but internet purchases are a great way to get gluten free products if you live far from any health food stores.
Q. What Resturaunts Are Safe To Eat At?
A. Even if the restaurant doesn't have a special menu, restaurant owners and chefs are generally happy to help customers with dietary restrictions. Call ahead to make sure the restaurant has menu options that you will be able to eat, and once you are seated, be very specific when explaining your needs to your waiter. (Don't just say "No wheat"- let them know that you also can't eat flour, wheat starch, or anything made from those ingredients, such as croutons.) It can also be helpful to speak to the chef who will actually be cooking your food.
Outback Steak House www.outback.com
PF Chang's www.pfchangs.com
Chick Fil A www.chickfila.com
Cold Stone Creamery www.coldstonecreamery.com
Dairy Queen www.dairyqueen.com
Jamba Juice www.jambajuice.com
Carrabba's Italian Grill www.carrabbas.com
Old Spaghetti Factory* www.osf.com