Autism: Gluten Free?

For a success story involving autism and the GFCF diet, read Jake’s Story.

By Dr. Selena Eon, ND

The prevalence of autistic spectrum disorders appears to be increasing, either through increased incidence or through better diagnosis.

Currently, there is no known cause, and no known cure.

Without a known cure, desperate families are turning to a variety of potential treatments discovered through the internet, television and other parents.

These new therapies may work, however, at this point in time there is no scientific evidence that ANY treatment works for autism.

Without known treatments, families are left with a choice: to either do nothing, or to try alternative treatments. Many families make the choice to try a variety of potential treatments rather than do nothing. These treatments can become expensive.

Frequently, parents need to do something to help even if there’s no scientific data to support the efficacy of the chosen treatment. If your child has autism now, waiting for scientific research validating any treatment could take years, or even decades—while your child goes untreated into adulthood. I certainly understand why a parent would choose to treat rather than to sit by and do nothing! Yet, it is extraordinarily important to ensure that all treatments are not harmful and in the long-term best interest of the affected child and their family.

The GFCF diet is the most popular treatment for autism. The GFCF diet is completely gluten-free and casein-free. Therefore, no wheat, spelt, kamut, triticale, rye, barley, semolina or dairy! As gluten and dairy are frequently found in prepared foods, this diet requires careful attention to detail and should only be implemented when appropriate and with adequate foresight.

Interest towards a GFCF diet as a treatment for autism grew after a study by Cade. 87% of the children in the study had high levels of IgG to gliadin, and that 30% of the children had high levels of antibodies to casein or gluten. An astonishing 81% of the children were considered improved by parent and teacher reports after 3 months on the diet. Unfortunately, this diet study lacked a control group of children who were not following the GFCF diet.

Therefore, the results have been widely discounted by scientists and physicians. I was particularly interested in how the number of children with antibodies to gluten was very similar to those who were considered improved at the end of the trial, leading me to believe that the children who demonstrated improvement on the GFCF diet were likely gluten intolerant or had celiac disease. More on this subject later!

It is incredibly important for scientists to continue investigating the effects of this diet systematically, in well-controlled trials. At the present time, there is no strong research that supports the use of a GFCF diet as a treatment for autism, despite the diet’s position as one of the most popular treatments for autism.

It is hypothesized that some autistic symptoms may be the result of opoid peptides formed in the intestine from incomplete digestion of foods containing gluten and casein. In a person with “leaky gut”—increased gut digestion and gut permeability, the gluten and casein that should be completely digested are not, and these larger molecules are able to pass directly into the bloodstream. In a healthy gut, proteins are digested fully and absorbed as individual peptides (the building blocks of proteins) rather than as complete proteins.

After the gluten/casein enter the bloodstream, they may be capable of crossing the blood-brain barrier—a protective group of cells that selectively allow molecules to enter the central nervous system. The gluten/casein proteins have a similar appearance and chemical makeup to opoids, and may be capable of affecting the internal opiate system and transmission between nerve cells.

Much of this process is not fully understood, but it is possible that opoidlike peptides affect the central nervous system in such a way that increases stereotypical behaviors, ritualistic behaviors, perseveration, hyperactivity, speech/language delays and other oddities frequently seen in autism.

The leaky-gut opoid theory above depends upon the presence of a leaky gut, and there is evidence that points towards this being the case in many causes of autism. It is common for autistic children to experience GI symptoms that could be a result of leaky gut, including diarrhea, constipation, abdominal pain and reflux. A number of studies have reported significant dysfunction of the gastrointestinal system in autistic children.

As a naturopathic physician, I firmly believe in treating the whole person rather than a “condition” or symptoms. I often spend time thinking about a patient and trying to elicit what is the root cause of their health concerns. The success of the GFCF diet in many cases of autism leads me to wonder if gluten and dairy intolerance are more common in autistic populations.

I don’t believe removing foods from a person’s diet forever is appropriate without good reason to back up the suspicion that the food is problematic. But, I am aware of the tremendous impact that removing problem foods can have on health! It is important to carefully consider each case as an individual before making the decision to remove foods from an autistic child’s diet, and also, to not neglect removing additional foods, as appropriate.

Overt celiac disease presents in at least 1:133 people and may be found in higher rates within the autistic population. It is advisable to test for celiac disease through bloodwork before beginning a gluten-free diet for any reason, including autism treatment. This is because once the person eliminates gluten from their diet, future blood tests are likely to be negative, even if the person does have celiac disease.

Recommended tests to include are: Anti-gliadin antibodies (AGA) both IgA and IgG, Anti-endomysial antibodies (EMA) – IgA, Anti-tissue transglutaminase antibodies (tTG) – IgA andTotal IgA levels.

Patients who test positive in a full celiac panel can then be monitored for compliance with the diet. If they follow the diet, subsequent results (titers) should be lower after a period of time; if they fall off the diet secretly or accidentally, the celiac panel can provide evidence of the lapse. This is particularly helpful if dealing with a child who may sneak unacceptable foods without the family being aware or in situations in which the family may not be following the diet accurately.

But if the patient goes gluten-free without the testing, there will be no pre-diet baseline test results, and no way to objectively assess compliance. Also, as celiac disease is hereditary, a positive test indicates a higher level of suspicion in other family members. Celiac can present with a wide variety of symptoms, some of which are not gastrointestinal, therefore being aware that celiac disease runs in a particular family can be very helpful.

It is important to know that even if a full celiac panel comes back negative, this does not mean the child is not gluten intolerant. Additional research is sorely needed in the topic of gluten intolerance, but gluten intolerance appears to present on a spectrum, much like autism. At one end are individuals who test positive for celiac—the most severe of gluten intolerance. The rest of the spectrum is made up of the many individuals who should not consume gluten who do not have celiac disease.

This condition is frequently termed “non-celiac gluten intolerance”. Gluten intolerance is linked to a variety of conditions including infertility, poor quality dental enamel, neurological disorders, skin conditions, diabetes and a variety of autoimmune disorders. A person need not have gastrointestinal symptoms to be gluten intolerant.

At present, testing for gluten intolerance is not scientifically validated, although Enterolab has a stool test that appears to be fairly accurate in detecting cases of non-celiac gluten intolerance. Other labs also offer similar tests that can be helpful. Genetic testing for celiac disease is also available. A positive genetic test only shows if a person has the most common genetic markers found in celiac disease/gluten intolerance.

It appears possible to test positive on a genetic test for celiac disease and never develop celiac or overt gluten intolerance. Many labs offer blood and stool testing for dairy intolerance as well, I recommend including this testing along with testing for gluten intolerance. The testing topic is very complex and much is still unknown about the gluten intolerance- celiac disease spectrum. Most families will be best served working with a knowledgeable physician like myself throughout the testing process to avoid harm from misinterpreted test results.

I suspect that the children who are helped the most by a GFCF diet are those children who have celiac disease or gluten intolerance and reactivity to dairy products. A GFCF diet may yet be proven to help a wider group the autistic population and I strongly support further research. For now, it seems reasonable to begin with a test for celiac disease.

If this test is negative, expand testing to either stool antigens to gluten and dairy, and consider genetic testing. Individuals who test positive on any of these lab tests are probably more likely to be helped by a GFCF diet and should consider it more strongly than those who do not test positive.
Before implementing the diet, it is incredibly important to consider several important factors. Adequate preparation before starting a gluten-free, casein-free diet can make the difference between success and failure!

1. Does the family have the resources to purchase foods in a gluten-free casein-free diet that are often more expensive, and are these foods readily available? If not, is a family member willing and ready to produce home-made GFCF foods and are adequate supplies available?

2. Is there a commitment by at least one family member to keep accurate daily records of food intake and behavioral change to assess the outcome of this treatment?

3. Are there clinicians such as naturopathic physicians, pediatricians and nutritionists in the family’s geographical area who might assist in systematically assessing the gluten-free casein-free diet to ensure nutritional adequacy?

4. Does the child have a limited food repertoire that, if further limited by the gluten-free casein-free diet, might result in a dangerously compromised nutrition status?

Many children with autism have restricted food repertoires and may not consume a nutritionally adequate when food choices are restricted further. I strongly recommend working with a physician like me– someone who has a strong background in nutrition, or with a nutritionist who understand the GFCF diet.

There are many support groups available for families in need. Gradual transition to the GFCF diet, and “revising” old favorites to follow the diet may helpful. It can be hard to implement the diet when there are family members who are not following the GFCF diet. Parents may need special locks for cabinets and refrigerators, carefully watch their autistic child to ensure that they are not sneaking unacceptable foods and working closely with school personnel to ensure compliance at school.

The preparation aspect is easier if the whole family is eating GFCF otherwise, the family may need to prepare two individual meals at each mealtime! Shopping takes a considerable extra effort at first, but as the main food shopper becomes adept at reading labels, will become less of an issue.

Overall, I am encouraged by the reports of autistic children who have reported improvement on the GFCF diet. It seems reasonable to continue researching this area to determine if those children who respond favorably indeed test positive for celiac, gluten intolerance and dairy intolerance. At the same time, we may find that the children who do not respond favorably are indeed not intolerant to gluten and dairy!

To avoid potential harm from unnecessary dietary restrictions, I strongly urge all parents considering the GFCF diet for their child to have laboratory testing for celiac disease and meet with a qualified health care professional before adopting the GFCF diet long-term.

Families need support to successfully implement the diet and I believe planning and education are key to long term success. This allows families to being the diet with the best possible circumstances, and will likely lead to best possible outcomes for their child.

Related reading:

Celiac Disease

Eating Gluten-Free On A Budget, Parts 1, 2 and 3

Autism: 10 Strategies for Implementing Diet Changes

If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

Gluten-Free Alcoholic Drinks

58555113905215721By Dr. Selena Eon

As a physician, I don’t encourage drinking alcoholic beverages in the early stages of the gluten-free diet—please give your gut time to heal before adding alcohol to your diet. However, consumption of alcoholic beverages can be part of a healthful gluten-free diet for many, so long as the beverages chosen are gluten-free and consumed in moderation.

There is no one definition of “moderation”, but generally the term is used to describe a lower risk pattern of drinking, as shown in various epidemiological studies.

According to the Dietary Guidelines for Americans, drinking in moderation is defined as having no more than 1 drink per day for women and no more than 2 drinks per day for men. This definition refers to the amount consumed on any single day and is not intended to be used as an average over several days.

It can be frustrating trying to find alcoholic beverages that are gluten-free, primarily because alcoholic beverages are not required to display an ingredient label. Because alcohol is not regulated by the FDA, the FDA ingredient labeling requirements do not apply. How do you know if your beverage is gluten-free when there is no label and no ingredient list? It can be tricky!

The Center for Science in the Public Interest is has been petitioning the Alcohol and Tobacco Tax Bureau since 2003 to require ingredients and nutrition facts on alcohol labels, but so far, there is no law requiring ingredient lists on alcoholic beverages. You can help your lawmakers understand how important the labeling issue is to people with food sensitivies, check out this petition for more information.

Finding appropriate alcoholic beverages can certainly be a challenge, but Kitchen Table Medicine is here to help! Luckily, there are many choices that ARE gluten-free!

Alright, enough already—WHAT CAN I DRINK?

Previously, persons on the gluten-free diet were advised to consume only pure wine, potato vodka, rum and tequila. This is still good advice, and the safest approach possible, but I believe this approach is overly cautious and unnecessarily limits your choices.

False information about gluten and alcoholic beverages is rife on the internet, so it is easy to become confused. I agree that being cautious is incredibly important when following a strict gluten-free diet, but I also believe that causing unnecessary lifelong restriction of any food is unacceptable!

Newer wisdom on the subject dictates that all distilled liquors are gluten-free, even those derived from a gluten containing grain. Distilled liquors are gluten-free no matter what the original source ingredients are because the distillation process ensures that none of the gluten from the original ingredients can remain in the finished product.

It is reasonable to assume that all pure distilled liquors must therefore be gluten-free. For more information, check out this article on gluten and distillationThe only exceptions to the blanket statement that distilled liquors are all gluten-free are situations in which gluten-containing ingredients are added in after distillation.

I researched rumors about gluten-containing whiskey mash being added in after distillation of whiskey, but found no major manufacturers in the US who report adding gluten-containing mash to the distilled whiskey.

Another potential problem could be liquors in which caramel coloring is added. Caramel coloring may contain gluten, primarily if the ingredient is produced outside the USA, but not always. Thus, many on gluten-free diets may choose to avoid dark colored liquors because caramel coloring may be in the liquor and represent a potential source of gluten.

It is safest to avoid dark colored liquors because without food labels it is difficult, if not impossible, to know if caramel color is used in the liquor, and if so, if the caramel color is gluten-free. Individual consumers may be able to request this information from manufacturers, but most manufacturers are unlikely to promise the product gluten-free because manufacturers in mass-production environments are typically unaware of the source of an ingredient like caramel color.

If gluten-containing caramel color is present in a particular liquor, it is usually found in very small amounts, and people typically consume small amounts of liquor, so the amount of gluten in the alcohol may be negligible. Even so, I still recommend avoiding these suspect beverages as the safest long-term choice of action because there is no way to know how much gluten is in the drink.

I also recommend avoiding most prepared cocktails (strawberry daiquiris, margaritas, mojitos) when out, as the mixes commonly used contain lots of sugar, usually in the form of disgusting high-fructose corn syrup- a non-food best avoided by everyone.

If you want to order one of these cocktails, it is best to ask your bar or restaurant if you can see the ingredients on their mixer before you order. I found that many of my favorite restaurants carry a high-quality mixer made from real juices and pure cane sugar—but you can only get it if you order the “top shelf” drink with more expensive liquor.

If you mix your alcoholic beverage with another beverage, such as soda, tonic water, root beer, orange juice, be sure to check that your mixer is also gluten free. I have listed some popular mixers below, but did not mention sodas or juices. Most sodas and juices are gluten-free, but check the label to be sure.

Gluten-free alcoholic beverage choices- the list below is in alphabetic order.

  • Armagnac – made from grapes.
  • Beer: most beers contain gluten. However, there are now gluten-free beers on the market!
               Redbridge- easiest to find nationally, produced by Anheiser-Busch.
               Bard’s Tale brand (several varieties, most common is Dragon’s Gold)
               Green’s (several varieties)
  • Bourbon – Makers Mark is definitely GF.
  • Brandy
  • Champagne
  • Cider – fermented from apples or other fruits. Some are safe, however, many add barley for enzymes and flavor. Be sure to read labels or contact manufacturer. Spire Ciders are GF.
  • Cognac – made from grapes.
  • Gin
  • Grappa
  • Kahlua
  • Kirschwasser (cherry liqueur)
  • Margarita Mix:
            Jose Cuervo.
            Mr. & Mrs. T.
  • Martini: traditional martinis are generally GF. Common mixes:
           Club Extra Dry Martini (corn & grape).
           Club Vodka Martini (corn & grape).
  • Mead – distilled from honey.
  • Mistico:
           Jose Cuervo Mistico (agave and cane).
  • Mixes & Cooking Alcohol:
           Club Tom Collins (corn).
           Dimond Jims Bloody Mary Mystery.
           Holland House – all EXCEPT Teriyaki Marinade and Smooth & Spicy Bloody Mary Mixes.
           Mr. & Mrs. T – all Except Bloody Mary Mix.
           Spice Islands – Cooking Wines – Burgundy, Sherry and White. However, I suggest cooking with REAL wine as cooking wines are poor quality.
           Stirrings- they make a variety of cocktail mixes, higher quality that most mixes.
  • Ouzo – made from grapes and anise.
  • Rum
  • Sake – fermented with rice and Koji enzymes. The Koji enzymes are grown on Miso, which is usually made with barley. The two-product separation from barley, and the manufacturing process should make it gluten-free.
  • Scotch Whiskey.
  • SherrySparkling Wine
  • Tequila
  • Vermouth
  • Vodka
  • Wine – all wines, including port wines and sherry, are gluten-free.
    Wine Coolers: Despite the name, most wine coolers are malt based and contain gluten.
           Bartle & James – wine-based beverages only.
           Boones – wine-based beverages only
  • Whiskey- Jack Daniels’ Black Label Whiskey is GF. Maker’s Mark Whiskey is GF. Seagram’s Crown Whiskey is also GF. Other whiskeys likely are, as per previous discussion, however are not confirmed by the manufacturer.

If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Related reading:

Celiac Disease

Eating Gluten-Free on a Budget

Wheat and Gluten-Free Recipes

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

Eat Gluten-Free Without Going Broke, Part 3

PhotobucketBy Dr. Selena Eon, ND

It is handy to be able to purchase GF baked goods ready-made fresh or frozen. I will not try to dispute that. However, for long-term physical and financial health, I maintain that preparing these foods yourself whenever possible is a better choice. You get far more for your money and you choose the ingredients.

A person who does poorly with corn, soy or dairy may have extreme difficulty finding ready-made gluten-free products that are acceptable for them—preparing at home is an optimal choice. If your diet tends to be low in fiber, you can choose higher fiber flours and incorporate nuts, seeds, fruits and vegetables into your baked goods. Home-made foods are also fresher and frequently taste better.

As a resident of the Puget Sound (Seattle) I tend to purchase various flours, mixes and certified gluten-free oats from Bob’s Red Mill as they are located in Oregon. I also use Pamela’s Baking Mixes as they are located in southern British Columbia (Canada). Both manufacturers pay careful attention to ensuring that their products are safe for individuals who need to follow a gluten-free diet. If you are an east-coaster, you might choose manufacturers if buying local is important to you.

PhotobucketWhen you cook or bake at home, you get far more food for your money. Depending upon the ingredients you choose, it’s likely that you could bake 24 muffins for what buying 6 would cost. There are some good gluten-free breads on the market, but loaves can cost over $9. Using a gluten-free mix, you can make a loaf at home for $5-6. With practice, a loaf can be made from scratch for approximately $4.

You can make multiple loaves at the same time and freeze slices for reheating later. A large pot of organic lentil soup may cost $8 to prepare and provide up to 20 meals—where a can of lentil soup might provide 2 skimpy servings for $2.79. A large home-made batch of gluten-free meat & vegetable lasagna using mostly organic ingredients may cost $25 to prepare at home and provide 25 generous servings, while purchasing a single frozen serving could cost over $5.

I do purchase ready-made GF baked goods. Please do not get the impression that I am in any way against them! I love that they are available and support producers of these foods whenever possible. But as a budget-conscious consumer, I choose use them sparingly as a convenient part of a healthy diet that focuses on vegetables, fruit, whole grains, legumes and sparing amounts of meat, poultry fish & dairy products.

Related Reading:

Eat Gluten Free Without Going Broke, Part 1
Eat Gluten Free Without Going Broke, Part 2

If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

Eat Gluten-Free Without Going Broke, Part 2

PhotobucketBy Dr. Selena Eon, ND

Healthy diets come in many kinds and depend on the needs & tastes of individual households. Finding a healthy diet that fits you and your family takes trial, error and knowledge.

You may need to consult a health care practitioner for advice. Budget conscious cooking can be an extremely healthful way to feed your family- and even include organic foods.

The secret is to focus on inexpensive, natural, wholesome gluten-free whole foods. A whole food is anything that you could imagine growing, or that you eat all the edible parts of over time (such as a chicken). This reduces the cost of your food and may help you recover from any damage that gluten caused you.

PhotobucketI encourage individuals and families to frequent farmers markets for extraordinary deals on organic, local produce in the summer and autumn months.

Bumper crops can be frozen or canned for eating later in the year. Purchasing an organic, whole chicken often costs less than the breasts alone!

If you are not used to preparing and eating natural, unprocessed foods, please, be patient with yourself!

It takes time to learn how to cook new foods. It takes time to determine the best way to set up your kitchen as a productive workspace. It takes time for tastes to adjust to a more natural diet. Give your family time to adjust by changing gradually whenever possible. Spend afternoons preparing foods with loved ones.

If you know a great home cook, ask to spend time in their kitchen with them so that you can learn from their expertise. Most cooks are flattered by the attention. Experiment with new flavors and tastes- but gradually. There are many strategies you can use to gradually accustom your family to a new diet. If you need help, seek it!

Once you start eating whole, fresh, naturally gluten-free foods, you are likely to notice that you feel better too. A whole foods diet, prepared at home from fresh, natural foods is also higher in necessary nutrients to keep your body healthy long term. Whole food contains a broader spectrum of health-promoting nutrition than pills.

PhotobucketBut don’t throw out your multi-vitamin or discontinue any supplements that your doctor recommends.

Many people starting on a gluten-free diet need extra, even specialized nutrition to make up for the nutrients that were absorbed poorly, or not at all because of intestinal damage caused by gluten.

It can take months, or even years in severe cases, for your body to heal and gain adequate nutritional status.

Check out the previous article in this series, and keep your eye out for the conclusion of this three part series on saving money while eating gluten-free!

PhotobucketIf you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

Eat Gluten-Free Without Going Broke, Part 1

PhotobucketBy Dr. Selena Eon, ND

If you have been on a gluten-free diet for any length of time, you have likely noticed the explosion of ready-made gluten-free foods available. At my local Red Apple Market, I can now purchase ready-made pasta, cookies, crackers, bagels, macaroni box meals, English muffins, bread, doughnuts and brownies. The freezer cases contain a variety of gluten-free frozen meals, from pizza to macaroni & cheese. I can buy mixes for bread, cookies, brownies and cakes.

Garlic Jim’s now delivers gluten-free pizza to your home from most of their locations in the state.  PF Chang’s offers a gluten-free menu. Overall, I consider the increased availability of these foods a positive leap forward for those of us who must follow a gluten-free diet for health reasons.

It is wonderful to have the option to use these foods to create healthful meals when time is short. It is incredibly useful for relatives to be able to purchase foods like this when gluten-free family members come over for dinner. But, there are many reasons to limit consumption of these foods. Today I am going to focus on financial reasons for doing so.

Many gluten-free goods are specialty products that are produced in much smaller quantities than most mass produced prepared foods. Manufacturers should take steps ensure that all the ingredients are gluten free. The products need to be tested for gluten on a periodic basis to ensure that they are safe for individuals who must avoid gluten completely.

Creating these products in a gluten-free manner generally requires a dedicated facility—one that never houses gluten containing foods, although some manufacturers use carefully cleaned shared facilities with wheat products (these foods may not be acceptable for some individuals). The ingredients must be shipped to the manufacturing facility. The food must be produced, packaged and shipped to your grocer. The cost of these processes is ultimately passed on to you, the consumer.

I choose to purchase food that is produced locally whenever possible. One reason for this choice is financial. When you purchase food produced hundred or even thousands of miles away the cost of the food goes up because you are also paying for the additional packaging and transportation. Packaging needs are increased to keep the food intact during shipping with the extra costs passed on to you, the consumer.

Transportation costs include the cost of fuel, maintaining the vehicles, paying the shipping company employees and more. I’m not going to discuss in detail today, but must mention the environmental impact of producing the fuel for transportation and the materials for packaging as well as increased pollution from using the fuel for transportation of food. Because of these factors, it is a good idea to purchase local products with little or no packaging whenever it is reasonable to do so. Purchasing local saves both money and resources.

Most families purchase food on a budget and cannot afford to substantially increase spending on food. Following a gluten-free diet may become an intolerable financial burden if a person tries to follow a gluten-free version of the standard American diet.  Gluten intolerance frequently runs in families, so it may be necessary to purchase gluten-free foods for multiple family members, compounding the financial issue. A family where only some members are gluten-intolerant may find that feeding the whole family gluten-free is the best way to ensure a gluten-free diet for those members who need it.

An example, using prices found at a local supermarket:

  • A package of 5 gluten-free bagels costs $5.59 while you can purchase wheat bagels for about $3 for 6.Photobucket
  • A 5 oz box of crackers is $4.99 while a 14.5 oz box of Ritz crackers is only $4.11.
  • A 12oz package of gluten-free spaghetti noodles costs $3.79 while a 16 oz package of wheat spaghetti  noodles can cost as little as $.99.

You can see from that, a person accustomed to a bagel with breakfast, crackers with a snack & spaghetti for dinner runs into a substantial difference in cost over time. This is particularly noticeable when feeding multiple people.

Learning that gluten is not a good food for you or a loved one is an incredible & life changing event. The positives of assuring that your amazing body is fed properly so far outweigh the negatives that it is worth the effort to learn how to feed yourself gluten-free and well.

Adopting a gluten-free lifestyle is a challenge for many people, and reasonably so! It can be difficult to change, especially without adequate support. I believe that learning how to cook & bake healthfully in your own home is a critical step in adapting to healthful gluten-free living on a budget. Preparing your own food does take time. I know people are very busy today, however, preparing extra food takes little additional time and then you have leftovers in your fridge or freezer, ready for healthy, low cost meals on busy days.

Many home cooks choose to set aside a morning, afternoon or evening each week to prepare several dishes to set aside for eating later in the week or month. This is an excellent strategy that cuts down the amount of time you need to spend preparing food on a daily basis.

PhotobucketNext up by Dr. Selena Eon is Part 2 in this three part series, “How to Eat Gluten Free on a Budget.” If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

What is Celiac Disease?

Photobucket

By Dr. Selena Eon

What is Celiac Disease/Gluten Intolerance?

Celiac Disease is an autoimmune condition found in people of all ages who are genetically susceptible. To develop Celiac Disease, you must inherit genetics for it, consume gluten, and have the gene triggered. Celiac Disease causes gradual destruction of the inner lining to the small intestine, leading to poor absorption of a wide variety of nutrients, and consequently a wide variety of patient presentations.

Gluten intolerance is a similar, less severe condition in which a person who does not have overt intestinal damage, but still experiences negative health effects from consuming gluten containing foods. Gluten is found in wheat, rye, barley and products derived from these grains. Gluten is also a frequent contaminant of oats and perhaps other grains.

What are the signs and symptoms of celiac disease?

There are many signs and symptoms of Celiac Disease and gluten intolerance. They range from none (silent Celiac Disease), to severe weight loss and malnutrition. A selection of signs and symptoms include: weight loss, weight gain, abdominal pain & cramping, diarrhea, constipation, osteopenia or osteoporosis, fatigue, bloating, iron deficiency anemia, megaloblastic anemia, nutritional deficiencies, mouth ulcers, inadequate tooth enamel, lactose intolerance, inadequate growth in children and infertility.

What are the risks to the patient if they are not compliant with their gluten free diet?

A person with Celiac Disease risks continued intestinal damage when knowingly (or accidentally!) consuming gluten, even if they do not have symptoms. As a result of intestinal damage from continued exposure to gluten, the person may experience a worsening of the signs and symptoms they experienced before diagnosis, or one of a host of other possible additional symptoms. Over time, damage can become severe enough to cause both adenocarcinoma and lymphoma of the small intestine, ulcerative jenunitis or small intestine strictures.

PhotobucketAs patient with Celiac, what are the biggest challenges with this disease?

Eating away from home was very difficult at first, but with practice, experience, and perseverance, I found eating out to be enjoyable again. Learning how to cook and bake gluten-free were huge, but very fun challenges

Can you share five of your favorite tips for coping with the challenge of this disease?

1) Learn how to cook and bake at home!
2) Keep a ready-mixed gluten-free flour substitute (home-made or purchased) on hand AT EVERY HOME YOU EAT FREQUENTLY for easy substitutions in favorite wheat-flour recipes.
3) Focus on eating nutrient-dense foods that are naturally gluten-free.
4) Always bring something you can eat to the potluck and keep GF snacks in your bag or car.
5) Avoid new restaurants during busy, peak times-you are more likely to end up with some unwanted gluten.

What do you typically eat for breakfast lunch and dinner?

Breakfast: Fresh fruit in season! We love gluten-free homemade waffles, Bob’s gluten-free oatmeal, cornmeal mush (polenta) and veggie frittatas.

Lunch: Leftovers to the rescue!

Dinner: We have a large rotation of recipes and strive to eat at least ½ plate of veggies along with the main dish. Household favorites include: turkey meatballs, chicken soup, lentil soup, tuna noodle veggie casserole, noodles with peanut sauce, vegetable soups, mixed salads, enchilada casserole, fish cakes, risottos, and a wide variety of creative homemade pizzas.

Care to share your favorite gluten free recipe?

Cheddar Dijon Waffles:
This is a wonderful recipe to start off an active day right, or a outside-the-box lunch or dinner. I like to serve these waffles topped with a gently fried egg (low temperature to avoid damaging the protein) and lots of chunky salsa. This recipe can be doubled or tripled and frozen for quick future meals.

Yield: 4-5 6” waffles

1.5 cup Pamela’s Pancake & Baking Mix (or substitute your favorite GF flour blend)
2 eggs, separated
¾ cup water
1-2T vegetable oil
1/3-1/2 cup shredded smoked or, less desirably, sharp cheddar cheese
1tsp-1tb Dijon mustard (to taste)
1 bunch thinly sliced green onions (white and light green parts only)

If necessary, spray waffle iron with nonstick spray or brush with oil. Preheat waffle iron.

Separate the eggs. Put the egg yolks into a small bowl or glass, and the whites into a medium bowl. Add the Dijon mustard and vegetable oil to the egg yolks, stir to combine and set aside. Whip the egg whites until stiff peaks form and set aside.

In a medium bowl, gently toss the green onions and cheese to coat with the Pamela’s Mix. Add the water, the egg yolk mixture and mix until no dry spots remain. The batter will be thick. Gently fold in the egg whites.

Cook on preheated waffle iron until golden brown. I use about ½ cup per waffle and spread the batter evenly before closing the lid, but use your judgment for your particular waffle iron. Repeat until remaining batter is used up.

Note: you can make these waffles using three whole eggs and skip the egg separating/whipping step. Just mix the whole eggs with the mustard and vegetable oil and skip folding in the egg white. The finished waffles will not be as light and fluffy.

Ps: If your waffle iron is from your “gluten days”, be sure to clean it very thoroughly to remove all gluten-containing crumbs before using for gluten-free waffles or replace the waffle iron with a new, dedicated gluten-free one.

What kind of resources and support groups are available for celiac disease?

ACK, the hyperlink thingy for The Gluten Intolerance Group is all messed up. It should be www.gluten.net
Celiac Disease Awareness Campaign from the National Institutes of Health
Celiac Disease Foundation
The Gluten Intolerance Group
Celiac Disease practice guideline from the World Gastroenterology Organisation (WGO)
Celiac Sprue Association
• Outcomes of 2004 consensus development conference, National Institutes of Health
National Foundation for Celiac Awareness
University of Maryland Center for Celiac Research

Books and Magazines (does NOT include cookbooks)
Celiac Disease: A Hidden Epidemic by Peter Green, M.D. and Rory Jones

Gluten-Free Diet A Comprehensive Resource Guide by Shelley Case, R.D.

Gluten-Free Friends: An Activity Book for Kids by Nancy Patin Falini, M.A., R.D., L.D.N.

Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy Gluten-Free Children by Danna Korn

Gluten-Free Living Magazine

Living Without MagazinePhotobucket

Next up by Dr. Selena Eon is a three part series of “How to Eat Gluten Free on a Budget.” If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.

Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com

Photobucket Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™