Posts Tagged ‘Celiac Disease’

“Gluten-free” May not Mean Gluten-free

August 12, 2010

Ironically, now that so many “gluten-free” products are on the market, “gluten-free” may not in fact mean free of gluten. A new survey found that seven out of 22 naturally gluten-free grains were “contaminated” with gluten, probably as a result of cross-contamination when processed in plants with other grains that contain gluten.

Gluten, a protein found in grains such as wheat, rye and barley, is extremely harmful for those with celiac disease, for whom ingesting gluten triggers an immune reaction that damages their small intestine villi and prevents absorption of nutrients. It is estimated that as many as one in every 133 persons has celiac disease, but many more have a mild to moderate gluten intolerance. Furthermore, it seems the disease may be on the rise.

The following grains are naturally gluten-free: oats, millet, buckwheat, quinoa, sorghum, soy, flax and amaranth seed and rice. While they are inherently gluten-free, oats have long been risky for those with celiac disease because of their high potential for cross-contamination as they are frequently processed in food manufacturing plants next to grains containing gluten. According to this study, other gluten-free grains may be subject to the same problem.

With the exception of those of us with celiac disease, until recently few people even knew what gluten was. Today it seems everyone is reaching for gluten-free foods similar to the way they did during the fat-free craze back in the 90s.It’s important to note, that just because a food is “gluten-free” does not mean it is more nutritious. Many processed, packaged gluten-free foods are no better and in some cases are more processed than their gluten-containing counterparts. If you need to avoid gluten for health reasons, the best way to ensure you’re eating truly nutritious, gluten-free food is to eat fewer packaged and/or processed foods. And, when shopping for gluten-free grains, it’s a good idea to check the label to make sure they were not processed in the same plant as gluten-containing grains.

Be Well,


Celiac Disease Appears to be on the Rise

September 7, 2009

We now know that Celiac Disease (CD) strikes one in every 133 persons. But new research has found that CD has increased four-fold over the past 50 years. 

In an effort to compare gluten intolerance in populations 50 years ago with those of today, researchers took frozen blood samples from Air Force recruits 50 years ago. They found that CD is four times more prevalent today than it was in the 1950s, refuting the theory that CD is more common today because of better diagnosis.

More troubling was the finding that the recruits in whom CD was detected via the blood samples (but not diagnosed during their lifetime) were four times as likely to die an earlier death than those without the disease. Early detection is the best insurance that individuals with CD can live a long and healthy life. 

For more information on CD, its consequences and its treatment, please visit my website.

Be Well,


A Celiac Travels to the Land of Bread

August 14, 2009

As I’ve been discussing, I recently vacationed in France, a country I had not visited for 22 years, long before I was diagnosed with Celiac Disease (CD). Knowing I was venturing to the land of “pain et croissant”, I was a bit wary, so in preparation, I packed plenty of gluten-free food (GFF) just in case. I also discovered a terrific website with traveling tips for celiacs. The site provides cards with a short explanation of CD and the need for a GFF in 43 languages. I printed out 10 copies of the French version, planning to use them only if I couldn’t decipher a menu or couldn’t find any GFF on it.

All was going well until my second day in France when the maids at my hotel in Paris mistakedly confiscated my bag of GFF. Suddenly, my safety net was gone. Though I was a bit dismayed at the time, in hindsight it ended up being a good test of whether or not I could truly enjoy France gluten-free.

Fortunately, when I needed them to be, the restaurants in France were very accommodating. The French cards I brought worked wonderfully. Even if you speak French or your server speaks English -providing a written French explanation of CD is still a convenient, low-key way of communicating your needs to the wait staff and chef. And even though I had several cards and didn’t expect them to be returned, each time I used one, my server nicely returned it to me at the end of the meal. I also gave them to my French hosts when they entertained us in their homes- it was easier than my trying to explain to them my situation. In every case, the French people were very understanding and, in fact, my GF meals were often more appealing than what the rest of the group received when it was a fixed menu. On more than one occasion my fellow diners looked at my “special meal” with envy.

And while I watched with envy as they enjoyed fresh baguettes daily, the meals I had were fantastic – full of fresh, seasonal ingredients and not overly complicated. Just real food prepared really well. Portions were larger than I expected – not to the level we have in the US, but generous all the same. So it turned out I didn’t need my GFF afterall, as I ate very well in France.

If you’re a celiac traveling at home or abroad, be sure to visit It’s a great resource offering, among other things,the  GF restaurant cards in 43 languages. If you’re going to France specifically, a Gluten Free Guide to Paris is also very helpful.

Be Well,


A Gluten-Free Blog/Website Worth Checking Out

June 28, 2009

I recently discovered glutenfreegirl, a blog/website for celiacs and others with varying degrees of gluten intolerance. It offers gluten-free recipes and product recommendations as well as links to other celiac disease blogs and websites. The author, Shauna James Ahern, is refreshingly candid in discussing her own experiences before and since her diagnosis and she approaches the challenges of living with celiac disease in positive, upbeat manner.

If you or a loved one has celiac disease, it’s worth checking out.

Be Well,


Navigating the Cereal Aisle in World Full of Sugar

May 22, 2009

Cereal can either be a nutritious food or  an excuse for dessert (think “Lucky Charms”), depending on what’s in your bowl. Navigating the cereal aisle in the grocery store has become increasingly challenging thanks to the plethora of choices, many of which are wolves in sheep’s clothing.

Here’s a basic guideline for choosing a healthful, whole grain cereal. Millet, amaranth, quinoa and oats are always whole grain, but if you don’t see the word whole in front of wheat, corn, barley and rice these grains have been refined.

In addition to looking for whole grains, you need to examine the box for the sugar content. Did you know that there are at least 11 popular breakfast cereals on the market containing 12g or more of sugar per serving?  That’s about the same amount in a frosted doughnut! Furthermore, watch for hidden sugars in cereals. They come in many different forms, including:  brown sugar, corn sweetener, corn syrup, high fructose corn syrup, dextrose, fructose, invert sugar, maltose, malt syrup and molasses. Skip cereals that list any form of sugar within the first three ingredients (which are listed by weight in descending order). Also, keep in mind that total sugars listed doesn’t distinguish between added and naturally-occurring sugars.   

For that matter, avoid artificial sweeteners and sugar alcohols, too. Top your cereal with fresh fruit – or, if necessary, add a little honey or maple syrup or agave nectar for a natural sweetness. If you’re watching your weight, choose a high volume, low-calorie whole grain cereal such as puffed brown brown rice. Also, look for the words high fiber on the box – that ensures at least 5g fiber per serving. This naturally occurs in most whole grain cereals verses refined grains.

Or create your own cereal!  For about the same price you’d pay in the grocery store you can custom-design your own cereal mix from more than 50 natural and organic ingredients using They even offer gluten-free options for celiacs. Here’s how it works: you pick your ingredients, they mix it, box it (along with nutrition information on your choices) and then ship it off to you. Check it out.

Be Well, 


New Laser Technology Measures Antioxidant Levels

April 14, 2009

Recently I was invited to measure my antioxidant levels using a new laser technology that measures the cartenoids in your skin.  As a nutritionist who advocates getting as many nutrients as possible from food, I was a little skeptical in that the company that makes the laser also sells supplements. I was therefore happy to discover that my antioxidant levels were in the extremely high category so the technician didn’t bother trying to convince me that I need their nutritional products.

Frankly, from a personal health perspective I was also a bit relieved as I have celiac disease , which can impair nutrient absorption when it goes unmanaged. I went undiagnosed for many years so some of the damage to my  small intestine is probably permanent. Nevertheless, these results were very encouraging.

I think this technology can have a valuable purpose in providing a baseline measurement before a person embarks on a nutrition overhaul. But in my opinion, those whose scores reveal low cartenoid levels should focus first on increasing their antioxidant levels by eating more vegetables and fruits rather than reaching for them in a bottle.

Be Well,


Nutrition and Dental Health, Part II -Celiac Disease and Dental Abnormalities

February 25, 2009

In my last blog I discussed the importance of nutrition for dental health and how poor eating habits can harm your teeth. Certain conditions such as celiac disease can also negatively impact oral health -particularly when they go undiagnosed.

Celiac disease, which affects approximately 1% of the US population (or 1 in 133 persons) is an autoimmune disorder of the small intestine caused by a reaction to gluten proteins found in wheat, barley, rye, other grains and many processed foods.  For those with the disease, ingesting gluten causes an inflammatory reaction that prevents efficient absorption of nutrients in the small intestine. Dental defects are one of the many manifestations of celiac disease and a vigilant, knowledgeable dentist, can be key in discovering and diagnosing the disorder. 

Dental enamel defects are common among celiacs, particularly children, according to Alessio Fasano, M.D., medical director at the University of Maryland Center for Celiac Research. In fact, according to Fasano,  dental enamel defects might be the only obvious manifestations of celiac disease. Here again, a dentist may be the critical factor in a patient receiving a correct diagnosis.

Dental enamel problems stemming from celiac disease include tooth discoloration — white, yellow, or brown spots on the teeth — poor enamel formation, pitting or banding of teeth, and mottled or translucent-looking teeth. 

Unfortunately, tooth defects resulting from celiac disease are permanent and do not improve once the patient adopts a gluten-free diet — the only available treatment for celiac disease. But dentists may use bonding, veneers, and other cosmetic solutions to cover enamel defects in older children and adults.

While dental enamel defects are the most common, other oral problems celiacs can encounter include: recurrent canker sores or ulcers  inside the mouth; atrophic glossitis, a condition characterized by a red, smooth, shiny tongue; dry mouth syndrome; squamous carcinoma of the pharynx and mouth; and delayed eruption of the teeth.

For more information on nutrition and dental health, listen to me on Sat, Feb 28th from 9-10am on KDOW 1220AM (broadcast from the San Francisco Bay Area) when I’ll be a guest on the Dr. Smiles radio program. For more information on nutrition for celiac disease, please visit my website at

Be Well,


Adult-Diagnosed Celiac Disease: The Challenges of Going Gluten-Free

December 19, 2008

Previously, I discussed Celiac Disease and the unique physical and psychological challenges adults face when being diagnosed with the disease later in life. Equally, if not more challenging, is the adoption of a gluten free diet.

Adults have years to acquire eating habits and “unlearning” them can be difficult and initially even downright depressing. Converting to a gluten-free diet is not an easy undertaking when the typical western diet contains approximately 20g of gluten per day. Moreover, after years of consuming gluten, many adult celiacs develop a physical addiction to gluten and experience unpleasant withdrawal symptoms, including irritability, cravings, shortness of breath and mental fogginess. This makes the treatment process – that of adhering to a strict gluten-free diet – even more daunting. 

When I learned I had Celiac Disease back in 1999 I was initially relieved. Finally I had a name for the cascade of symptoms I had been suffering with for years. Little did I know that my battle was just beginning. A former “bagel queen”, I had to completely alter my diet. Gluten, I discovered, is not only found in most whole grains and flours, its derivatives are now used as fillers in many commercially processed foods – including salad dressings and even ketchup!  Furthermore, once I adopted a gluten-free diet, it still took awhile for me to feel better and for my health to improve because it takes time for the intestinal tract to heal itself after years of gluten ingestion. Adherence to a gluten-free diet takes considerable discipline particularly when obvious, measurable results aren’t forthcoming.

Furthermore, the psycho-social ramifications of Celiac Disease can be particularly challenging when faced with a gluten-full menu at a restaurant or dinner party. It’s awkward when the office party features only pizza or when you’re at a birthday party and you’re the only one not eating cake. Living a gluten-free lifestyle also requires greater preparation and planning of snacks and meals. Celiacs must bring gluten-free food with them when they anticipate it will be unavailable, such as on an airplane flight,or  when traveling in a foreign country or in remote areas. 

Dealing with the challenges of Celiac Disease was one of the main reasons I decided to study nutrition. While today there is a relatively wide selection of gluten-free foods available in many supermarkets, as a celiac and a professional nutritionist I advocate a mostly whole-foods, gluten-free diet. It’s actually one of the easiest and healthiest ways to ensure gluten-free compliance. When you eliminate most of the processed, packaged foods from your diet, you don’t have to read labels to know whether something is gluten-free. Furthermore, just because a food is labeled “gluten-free” doesn’t necessarily mean it’s good for you. A “gluten-free” candy bar is still a candy bar! For more information on nutrition counseling for Celiac Disease and other health concerns, please visit my website at

Be Well,


Adult-Diagnosed Celiac Disease: Better Late Than Never

December 16, 2008

Hippocrates said “Let food be thy medicine and medicine be thy food”. How right he was when it comes to Celiac Disease. I’ve  learned this personally since being diagnosed with Celiac Disease 10 years ago.

Celiac Disease is the only disease where nutrition is both the cause and the “cure”. For 1 in 133, or an estimated 1.5 million Americans, “give us our daily bread” might as well be “give us our daily arsenic”.  Not long ago, Celiac Disease, also known as “Celiac Sprue”  was considered primarily a childhood disease. Today, however, the average age of diagnosis is between 45 and 55 years, with 25% of diagnoses in people 60 years and older. In fact, Celiac Disease is now considered one of the most commonly under-diagnosed genetic disorders despite its relative prevalence.

Typically it takes longer to diagnose adults than children, with the average length of ten years from the initial doctor’s office visit to the date of the actual diagnosis.  This is largely due to the fact that symptoms in adults are more diverse and often more subtle than in children. In my case, I suffered for years with digestive difficulties which, while annoying and uncomfortable, were mostly tolerable. I had no idea my intestinal issues were part of a larger, systemic problem. It was only after my undiagnosed Celiac Disease led to more serious health issues that I sought medical attention. Even then it took more than a year of doctor visits to uncover the underlying source of my problems.

Further complicating the diagnostic process is the fact that as many as 40% of adults with Celiac Disease lack the textbook intestinal symptoms physicians are most familiar with. My sister, for example, was also diagnosed with Celiac Disease as an adult, but her symptoms were quite different than mine.

The physical and psychological health consequences of Celiac Disease in late-diagnosed adult celiacs can include: unexplained anemia, osteoporosis, intestinal lymphomas and other cancers of the digestive system, pancreatic insufficiency, malnutrition, other autoimmune diseases, depression, infertility, and dental problems, including tooth enamel erosion and periodontal disease. Quite a daunting list and another reason why a correct and timely diagnosis is so critical. 

Fortunately, some of these health consequences are reversible when the celiac patient adheres to a strict gluten-free diet.Unfortunately, adhering to a gluten-free diet is generally more challenging for adults than it is for kids. In a future blog I’ll discuss some of those challenges. In the meantime, for more information on nutrition counseling for Celiac Disease and other conditions, please visit my website at

Be Well,