Monthly Archives: November 2009
You feel awful most of the time. You’re tired, achy, and it seems like you’ve either got diarrhea or constipation almost constantly. Maybe your skin itches and flakes, or you get unexplained rashes or hives. You may even throw up occasionally, for no obvious reason.
If you’ve sought medical help for your problems, you might have left the doctor’s office frustrated– feeling as if you weren’t being taken seriously. Perhaps the doctor threw out terms like irritable bowel syndrome or chronic fatigue syndrome, leaving you just as confused as when you came in. So you started looking online, and you found something interesting. Is it possible that you suffer from a food allergy or intolerance?
In short– yes. It’s very possible.
There are many types of food intolerance and allergies, and wheat intolerance is one of the most common. But all wheat sensitivity is not created equal. Broadly speaking, health problems related to wheat consumption fall into three categories:
1) Celiac (or Coeliac) Disease
Celiac disease is an immunological (allergic) response in the intestinal tract to a very specific protein contained in wheat and several other grains, called gliadin– a gluten protein. It has many other names, including gluten allergy, gluten enteropathy, gluten intolerance, and coeliac sprue. Over time, it can cause damage to the intestinal tract, but it can be effectively treated with a gluten-free diet. The bad news is, people with celiac disease have it for life. There’s no cure, and they don’t “grow out of it”. The good news is that much of the damage done to the body can repair itself after gluten is removed from the diet.
2) Wheat Allergy
Wheat allergy is also an immunological response to wheat. Unlike celiac disease, however, it includes allergic reactions to many different proteins found in wheat and related cereal grains. It can be gastrointestinal, but it can also be similar to hay fever, causing asthma-like respiratory symptoms, hives, rashes, contact dermatitis, cough, runny nose, and itchy eyes. Sometimes called “baker’s allergy”, wheat allergy may be exacerbated by exercising or taking aspirin, causing a very violent and dangerous– even life-threatening– allergic condition called anaphylaxis. Once again, avoidance is the key, though some wheat allergy sufferers are able to tolerate alternative gluten-containing grains such as barley and rye.
3) Wheat Intolerance
Confusingly, celiac disease is sometimes called “gluten intolerance”. However, wheat intolerance generally refers to a non-allergic negative reaction to eating wheat. Wheat intolerance is not usually as violent or acute as wheat allergy, and can be a lot harder to diagnose because the symptoms may manifest many hours after the consumption of wheat; even up to a couple of days later. Though poorly understood, it’s still an immune-related response, but one which affects a totally different part of the immune system than that which causes a ragweed sufferer to sneeze or someone with a peanut allergy to go into anaphylactic shock. Avoidance is still the main approach to solving the existing problem in individuals with wheat sensitivity, but there’s good news– with careful management, some people may be able to build up a tolerance for small amounts of wheat over time.
If you think you may have a form of wheat sensitivity, there are a range of testing and treatment options, which we will cover in future articles– along with some great tips and recipes for living gluten-free… with style.
The vast majority of wheat consumed in the world today is either common wheat (also called bread wheat) or durum wheat (used to make semolina). But these forms are relatively new, historically speaking. Several species of ancient wheat plants are making a bit of a comeback as people become more concerned about their own health and the dwindling diversity of plant crops. These include spelt, einkorn, and emmer wheat varieties, all of which have been cultivated for food from ancient times.
All three of these plants contain gliadin, the part of gluten which is implicated in celiac disease, and as such, they are probably not appropriate for celiac sufferers. That said, there is some evidence that einkorn wheat’s gliadin is chemically different from that of other wheat, and that it is less toxic to celiac sufferers than other varieties.
However, all of these wheat varieties may be of interest to those with wheat intolerance and wheat allergy symptoms. They are genetically very dissimilar to common and durum wheat, and many with wheat intolerance and allergy can tolerate one or more of the ancient varieties quite well. As with any experimentation, care should be taken when introducing new foods into the diet. If wheat intolerance or allergy symptoms have been severe in the past, introducing ancient grains may not be worth the potential health risks at all, but should definitely only be attempted under the guidance of a health professional.
For some with wheat intolerance and wheat allergies, though, einkorn, emmer, and spelt may offer a chance to once again enjoy common baked goods that were previously off limits.
For more information, and to purchase flour from ancient grains, check out the following sites:
Finally, here’s a video from the UK showing how to bake a loaf of bread using spelt flour:
For those in the US, 170 degrees Celsius is 350 degrees Fahrenheit; 190C is 375F.
You’ve decided to go on a gluten-free diet… so now what? Unfortunately, it isn’t as simple as swearing off bread, pasta, cookies and cakes. It’s not just wheat; there are other foods containing gluten. As far as grains and flours go, you’ll need to cut out all wheat, barley, and rye. In addition, some lesser-known relatives of wheat will have to go: bulgar, farina, kamut, semolina, triticale, and spelt all contain gluten. So does matzo, seitan, and graham flour.
Unless you have other food sensitivities, rice, corn, flax, sorghum, millet, buckwheat, amaranth, tef, and quinoa are all safe to eat. There are also other non-grain flours which do not contain gluten, such as tapioca, potato, soy, arrowroot, nut, and bean flours.
You may have noticed a glaring omission in the previous lists: oats. This is because, while oats do not contain gluten, a large number of people with celiac disease and wheat intolerance or allergy still react to them. The vast majority of oats are contaminated with gluten during processing, making it necessary to avoid them. The good news is that some companies are now introducing certified gluten-free oats. So if you just can’t face giving up your morning oatmeal, check the label and proceed with care. Honestly, though, it’s probably easiest to just skip the oats, at least in the beginning.
Simplicity is really the key to a diet free of foods containing gluten. Processed food is a bit of a minefield– even if you check the labels obsessively, gluten creeps in to places where you would never think to look. Beer has gluten. Many processed meats have gluten. Canned soup and broth often has gluten. Soy sauce? Yes, it has gluten. Imitation bacon bits? Yup… gluten.
If this all sounds terribly scary and insurmountable, don’t worry. It’s not. It does, however, mean that you have to make a fundamental change in the way you view food. Instead of worrying about the things you can’t have, start making a list of the things you can have… then build your meals around those.
What do I mean by that? Look at it this way. A baked potato with salt and butter absolutely does not contain gluten. Neither does a salmon fillet from the seafood department, brushed with olive oil and sprinkled with salt, pepper, and dill. Nor a handful of steamed asparagus. In fact, those things together sound like a rather delicious meal, and one which can be cooked in about 15 minutes if you microwave the potato and run the salmon under the broiler.
What about breakfast, though? Missing that morning bowl of cereal? How about a two-egg omelet sprinkled with chives, instead. Prep time? Five minutes, once you get the hang of shaking an omelet pan.
All this is not to say that you won’t have some truly unpleasant cravings during the first week or two of a gluten-free diet. What’s important to understand is that those cravings are a result of a health problem; not a sign that you need wheat for nutritional purposes. Once the body has got its chemistry squared away, I defy anyone to feel unsatisfied after either of the meals suggested above– and there are literally thousands of such meals available.
The key is to use a gluten-free diet as a reason to add wonderful “whole foods” to your repertoire, instead of worrying about what you have to take away from your diet. Yes, there are many foods containing gluten, but there are far more foods that don’t, and as you experiment, you’ll find that most of those gluten-free foods are utterly delicious.
If you found this article helpful, you may also be interested in the following discussion about foods which commonly cause allergies and sensitivities:
- Dangers Of Artificial Sweeteners – How you react to certain foods is largely dependant on your genetic makeup, however in general you are most likely to experience health problems with man made foods. Here is a list of the most common causes of food allergies, food intolerance and the health problems they can cause.
Along with bread, one of the things that people on a gluten-free diet miss most is dessert. Fortunately, there are many delicious wheat free recipes for decadent desserts– including this one for wheat free brownies. The beauty of this recipe is that it can easily be adapted for those with chocolate, nut, and dairy allergies, as well.
Rachel’s Decadent Gluten-Free Brownies
• 1/4 cup butter (or substitute 1/4 cup shortening for the dairy-allergic)
• 1 cup brown sugar
• 1 egg
• 1 teaspoon vanilla
• 1/2 cup rice flour (available in the Asian & health food sections of most supermarkets)
• 3 Tbsp cocoa powder (substitute 3 Tbsp carob powder for the chocolate-allergic)
• 1 tsp double-acting baking powder
• 1/2 tsp salt
• 3/4 cup nuts (omit or substitute 3/4 cup chopped dates for the nut-allergic)
Preheat oven to 350 degrees. Grease a 9×9 inch baking pan.
Melt the butter or shortening in a heavy saucepan over medium heat. Stir in the brown sugar until it dissolves. Cool slightly, then beat in the egg and vanilla. Sift the rice flour with the cocoa or carob powder, baking powder, and salt. Stir the dry ingredients into the mixture in the saucepan. Fold the nuts or chopped dates (if used) into the batter, and pour into the greased 9×9 inch pan.
Bake about 20 minutes, or until a toothpick inserted into the center comes out clean. (NB: These brownies are a bit crumblier than those made with wheat flour. You can mitigate this to some extent by making sure not to over-bake them. Trust me, though– once you start eating them, you really won’t care about the crumbs!)
That’s it for today… keep an eye out for more wheat free recipes coming out soon. And in the mean time, check out these adorable Pilgrim Hat Cookies!
Thanksgiving Pilgrim Hat Cookies – Tip: Some of our family has a gluten/wheat intolerance so we use the Mi-Del Gluten-Free Ginger Snaps. They are actually softer and better tasting than their standard counterparts! Photo: Scribbit …
10. It’s not normal to get “food poisoning” (cramps and diarrhea) several times a month.
9. Two-day-long migraines don’t have to be a weekly occurrence. Who knew?
8. There’s a difference between feeling full and satisfied, and feeling sluggish and bloated.
7. Your early thirties is a bit (okay, a lot) young to have arthritic joint problems… even if you do lead an “active lifestyle”.
6. It’s not normal to spend half of every day with gas so bad that it’s a struggle not to double over in pain when no one’s watching.
5. Most people don’t have cravings that lead them to scarf down half a loaf of bread in one sitting just because it “smells really good”.
4. Most people don’t have the urge to devour half a batch of raw, unbaked pie crust dough because they “like the taste”.
3. Most people don’t have to run to the bathroom thirty minutes after every. Single. Meal.
2. Most brands of soy sauce contain more wheat than they do soy. Perhaps the should call it “wheat sauce”?
And the top thing that I realized after finding out I had wheat intolerance…
1. Despite what I originally thought, life without foods containing gluten really is worth living. In fact, it’s quite a bit more pleasant to live when you don’t feel like death warmed over half of the time.
Happy Gluten-Free Thanksgiving, everyone!
You may have seen the ads online or in magazines– “Use These Pills and Eat Wheat with No Problems!”. The product in question is marketed as “glutenase”, and the implication is that it is a special enzyme which breaks down gluten in the digestive system and makes it harmless to those with wheat intolerance. So… is it any good?
Well, that’s debatable. First off, scientifically speaking, there’s no such thing as “glutenase”. It’s a catch-all term for several enzymes which act on gluten, among other things. Studies conducted in vitro (i.e., in a Petri dish) and in animals have shown that various combinations of enzymes are effective at breaking down gluten molecules into smaller parts. The most promising enzymes are called aspergillopepsin (ASP), dipeptidyl peptidase IV (DPP-IV), and cysteine endoprotease (EP-B2). That said, at least one study in monkeys has shown an unexpected rise in gluten-specific antibodies in the blood after both gluten and EP-B2 were administered. This may be because the smaller, partially-digested gluten molecules can more readily pass through the intestinal lining and into the blood stream, where they can provoke an immune response.
For this reason, people with celiac disease should not attempt to use glutenase pills as a way to consume gluten. Unfortunately, with celiac disease, a diet free of foods containing gluten is the only way to go. Similarly, those with wheat allergy are risking an allergic response after eating wheat, regardless of how many enzymes they take.
The one place where glutenase supplements may have some use is in the case of wheat intolerance, which does not involve an allergic immune response. After a period on a strict gluten-free diet, once symptoms have disappeared for several weeks, someone who has been positively diagnosed with wheat intolerance (as opposed to celiac disease or wheat allergy) can begin to experiment cautiously with reintroducing gluten. This would be the appropriate circumstance for trying glutenase pills.
As with all dietary supplements, do a bit of research to see if a specific brand is reputable. Check to see if they list one or more of the specific enzymes above as ingredients, as opposed to just saying “glutenase”. See if they offer any information about clinical trials (they probably won’t– there don’t seem to be any published human trials). If the brand seems reputable, try it.
In the largely unregulated world of dietary supplements, it’s up to the consumer to determine if something works for them or not. At best, a glutenase supplement will help you eat foods containing gluten without suffering wheat intolerance symptoms. At worst, it won’t. Until more serious scientific research is done, the only way to find out if a specific product will work for you is to try it cautiously.
Wheat intolerance is basically a catch-all term for any negative reaction to wheat which is not celiac (also spelled coeliac) disease or wheat allergy. Those two conditions are diagnosed through blood tests or biopsies which show positive results for antibodies to gluten or other wheat proteins. However, someone can test negative for antibodies and still have a miserable reaction after eating wheat– that’s wheat intolerance.
To make things even more interesting, wheat intolerance symptoms can show up as long as 48 hours after eating wheat… which makes connecting the cause and the effect a real nightmare for an uneducated sufferer. As with wheat allergy, symptoms can be limited to digestive discomfort such as diarrhea, constipation, gas, and cramps, or can extend to skin rashes, itching, eczema, and hay fever-like symptoms including sneezing, cough, runny nose, and itchy, watery eyes.
Wheat intolerance is not a true allergy, though. It involves a completely different part of the immune system. The mechanism is not well understood, but wheat intolerance symptoms are thought to be a result of incomplete digestion of wheat proteins– probably caused by an individuals lack of the particular digestive enzymes needed to complete the job.
Since there aren’t any handy antibodies to test for in the lab, a more hands-on approach is used for diagnosis. The main test is called an elimination diet, because it eliminates wheat. All foods containing gluten are taken out of the person’s diet for a period from a couple of weeks to a couple of months. This can be a real shock to someone used to a western diet, but strict adherence is really, really important. The idea behind the elimination diet is simple: if you suffer from wheat intolerance, your symptoms will disappear once you remove wheat and gluten from your diet for an extended period. If you remove wheat and gluten from your diet for an extended period and your symptoms do not improve, it’s obviously not wheat intolerance.
There is one final part to the diet; if your symptoms improve or disappear, undergoing a challenge test will confirm the diagnosis. A challenge test means suddenly eating large amounts of wheat again, after going gluten-free in the elimination diet. If your symptoms return with a vengeance– bingo! You have wheat intolerance. If that’s the case, it’s time to get serious about a balanced diet free of foods containing gluten.
There’s good news, however. Unlike celiac disease, wheat intolerance sufferers may be able to build up a tolerance to small amounts of wheat eventually. This doesn’t work for everyone, and it doesn’t work for anyone until the body has had a chance to fully heal on a gluten-free diet. After a few months, though, an attempt can be made (preferably with the help of a doctor and/or nutritionist) to introduce tiny amounts of wheat at regular intervals, in hopes of “training” the immune system to ignore it as non-threatening. The concept is similar to that behind allergy shots, although the exact mechanism is a bit different.
It’s certainly worth trying once your body has recovered from the stress of wheat intolerance, but, whether it works or it doesn’t, you will appreciate the feelings of health and vigor that seemed so far away when you were weighed down by your wheat intolerance symptoms.
It’s almost Thanksgiving– a day which can be a nightmare for those trying to follow a gluten-free diet. If you have wheat intolerance, celiac disease, or wheat allergy, don’t be caught unprepared! Check out this great Gluten-free Thanksgiving Guide.
Every year around the holidays, Celiac.com likes to remind folks that, with a little of planning and a few tips, anyone with celiac disease or gluten intolerance can enjoy a safe, delicious gluten-free Thanksgiving and holiday season without fear of accidentally eating gluten.
Wheat allergy symptoms can be similar to other food allergy symptoms, including stomach pain, cramps, nausea, vomiting, and diarrhea. However, they may also resemble hay fever, with a runny nose, watery eyes, hives, itchy, flaky skin, or rashes. Another common and rather alarming complaint is arthritic joint pain.
At its most severe, wheat allergy can cause chest pain and anaphylaxis, a life-threatening condition in which the body’s allergic inflammatory response runs out of control.
Exercise, taking aspirin or NSAIDs (like ibuprofen or naproxen), and some food additives like MSG and Benzoate may make a wheat allergy attack worse. Attacks may also become worse over time, with repeated exposure.
Sufferers may break out in a rash or hives just from skin contact with wheat or flour, or start sneezing after breathing pollen from wheat plants. People with wheat allergy are also prone to migraines.
There is anecdotal (non-scientific) speculation that wheat allergy may be linked to autism, though, so far at least, scientific studies do not bear this out. Even so, many parents with autistic children have reported a reduction in digestive and behavioral problems after instituting a wheat and dairy-free diet.
If you think you or a loved one have wheat allergy symptoms, there are several methods for testing. These include skin-prick tests, blood tests, and elimination diets or food challenges, all of which will be covered in other articles.
Your doctor will be able to help you decide on the most appropriate approach.
The classic symptoms of celiac disease are bloating, diarrhea, and vomiting. Weight loss and fatigue are common, as is failure to thrive and grow normally in children. However, not everyone who has celiac disease or gluten allergy shows these symptoms. Many may only suffer from fatigue and anaemia, and some have no symptoms at all.
In the case of small children, a red flag is the onset of digestive difficulties and failure to thrive shortly after the introduction of wheat products into the diet. In adults, an often overlooked symptom is an extreme fondness for products containing wheat– someone with gluten allergy symptoms may lapse rhapsodic about the taste of a relatively bland food like bread or pasta, and miss it or even crave it if they don’t eat it every day.
This may seem odd (and a bit cruel), but it’s actually part of the body’s attempt to protect itself. When a person with celiac disease or gluten allergy eats wheat, it causes an immune response and painful inflammation in the gut. The body’s response to inflammation and pain is to release endorphins, which produce a barely-noticeable-but-definitely-there “buzz”, to cover the pain; the same sort of buzz that a hospital patient gets from a dose of morphine, or a drug addict from a shot of heroin.
So, just as the heroin user and the hospital patient may become addicted to opiates, the person with celiac or gluten allergy symptoms becomes addicted to the small “high” that follows a meal containing wheat. It’s completely unconscious, of course– if asked, the person will say that they simply love the taste of the bread, pasta, or whatever– but it can be a strong hint of some sort of wheat intolerance or gluten allergy.
If some or all of these symptoms sound familiar, there are a few different ways to proceed with getting a more accurate diagnosis. These include antibody testing, endoscopic analysis, genetic testing, elimination diets, and challenge tests, which will be discussed more fully in other articles.
Your doctor can help guide you in determining your next step.