January - March 2013 Edition: Naples Health

nose in the past. Gluten intolerance can also manifest as dermatitis herpetiformis, an itchy, blistering skin rash that tends to present with no abdominal difficulties. Regardless of symptoms, the intestinal damage can become so great over time that it negatively affects the absorption of nutrients, causing fatigue, weight loss and vitamin deficiencies that deprive the brain, bones, nervous system and other organs of vital nourishment. There is no medicinal treatment for celiac disease, but the condition can be managed—and damage reversed—by removing gluten from the diet. So just what is gluten? It’s a protein that lends elasticity (texture) to foods. It’s most commonly found in wheat, prompt- ing many to confuse celiac disease with wheat allergy. But gluten is also present in malt, barley, rye and a host of other processed foods. Scientists aren’t sure what causes celiac disease or why it’s occurring more frequently nowadays. Dr. Murray has suggested that the cross-breeding of wheat in the 1950s, to develop hardier, better-growing plants, might have some- how yielded gluten that is harder for What can you eat? The wheat, rye, barley and maybe oats restrictions can leave a person diagnosed with celiac disease wondering just what grain-type foods are OK. For- tunately, the American Dietetic Association, the Mayo Clinic and other respected sources offer lists of acceptable foods. Among them are the following:

some people to digest properly. Others point to the increased use of processed wheat products like whole-wheat pastas, cereals and baked goods. A genetic component has been identi- fied, and celiac disease often runs in families. Twice as many women as men develop the disease. Those with type 1 diabetes, autoimmune thyroid disease and Down syndrome are also at greater risk. For all of them, the answer to stop- ping their discomfort is simple: Get rid of the gluten in their diets. Rooting out gluten Getting rid of gluten might seem an easy, straightforward task, especially nowa- days with the plethora of gluten-free products on the market. But as Audrey McKernan, a registered dietician with the von Arx Diabetes Center of Excel- lence and Nutritional Health, notes, it can be a daunting challenge. “When you’re on a gluten-free diet, you cannot eat anything with wheat, barley, rye or oats—unless the oats are gluten- free,” McKernan says. “But a lot of people forget that many processed foods also contain wheat or gluten—things like soy sauce, gravies, cold cuts. Even com- munion wafers and some medications.” Becoming an excellent and discerning label reader is vital, particularly since wheat byproducts don’t always have the word “wheat” identifying them. The Food Allergen Labeling and Consumer Protection Act of 2004 mandated that the word be included when it was part of such ingredients as “dextrin,” “caramel color” or “modified food starch,” but the act left latitude in how such a disclosure could be executed. The American Dietetic Association also advises that the presence of wheat may be masked by such terms as “farina,” “semolina,” “graham” or numerous variations on “flour.” McKernan adds that “einkorn,” “emmer,” “spelt” and “kamut” are all kinds of wheat. Moreover, people often forget that barley is used in making beer, ale and other

A FEW DECADES AGO , FEW PEOPLE HAD heard of gluten. Celiac disease, a digestive condition triggered by the consumption of that particular protein, was virtually undiagnosed and unknown. Today, about 1.8 million Americans are believed to have the disease, and gluten- free diets are all the rage. Why the change? Have physicians simply gotten better at recognizing and diagnos- ing celiac disease? Or has the marketing of gluten-free products prompted people who don’t need them to assume they do? To find out, Joseph Murray, M.D., a gastroenterologist at the Mayo Clinic in Minnesota, and a team of research- ers looked at blood samples taken from Americans in the 1950s and compared them to samples taken from people today. Their findings showed that the incidence of celiac disease was indeed increasing in the U.S. to the tune of being four times more common now than it was 50 years ago. But the study also suggested that as many as 1.6 million people currently on a gluten-free diet do not have the dis- ease. And following the gluten-free route may leave them vitamin-deficient. Seeing the picture clearly requires looking at celiac disease and who should or shouldn’t go gluten-free. Con- sider it a matter of separating the wheat from the chaff. The trouble with gluten In true celiac disease, the consumption of gluten triggers an immune reaction in the small intestine. The intestinal walls become inflamed and eventually damaged, and the person can experience bloating, cramping and/or diarrhea. Or the person can be symptom-free, which is why the condition was difficult to diag-

Amaranth Arrowroot Buckwheat Corn Cornmeal Quinoa

Rice Tapioca Millet Nuts Potatoes Yucca

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JANUARY-MARCH 2013 | Naples Health

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