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A blog about all things allergen-free and delicious

Entries in food allergies (40)


Interview w/ Dr. Alessio Fasano Part 3: Gluten Sensitivity (a new "food allergy")

Let's Review

THERE ARE 3 FORMS OF GLUTEN-BASED REACTIONS:   Celiac Disease, Gluten Sensitivity, and a Gluten/Wheat Allergy.  There are four different types of wheat allergy -- and each type behaves differently.

In Part 1 of this interview series, I was most privileged to speak with Dr. Fasano about gluten, our bodies’ response(s) to it, wheat allergies, and why so many people today have problems with wheat (plus rye, barley, spelt, triticale, etc.) and gluten-based products.  I learned a surprising fact:  no one can properly digest gluten. Read more...

In Part 2, we discussed testing for celiac disease.  Celiac Disease is a severe auto-immune disease triggered by the gluten protein.  Dr. Fasano and his team put together information on how to get tested for celiac disease.     According to Dr. Fasano the latest research shows that you need to have 4 out of the first 5 of the following markers in order to be diagnosed with Celiac Disease.  Read how to get tested...


Gluten Sensitivity - The New Kid on the Block

In this post, Part 3, Dr. Fasano's team answered questions about what Dr. Fasano calls "the new kid on the block", or... gluten sensitivity.  My thanks to Dr. Fasano and his team at the Center For Celiac Research.


TF: What is gluten sensitivity?

Dr. Fasano: As the word “sensitive” suggests, gluten sensitivity is a reaction to ingesting gluten, which is found in wheat, barley and rye. Symptoms can arise throughout the body and range from fatigue and “foggy mind” to diarrhea, depression and joint pain (see more on symptoms below).

TF: How does gluten sensitivity differ from celiac disease?

Dr. Fasano:  Although symptoms (particularly gastrointestinal) are often similar to those of celiac disease, the overall clinical picture is less severe. Recent research at the University of Maryland Center for Celiac Research shows that gluten sensitivity is a different clinical entity that does not result in the intestinal inflammation that leads to a flattening of the villi of the small intestine that characterizes celiac disease. The development of tissue transglutaminase (tTG) autoantibodies, used to diagnose celiac disease, is not present in gluten sensitivity.

A different immune mechanism, the innate immune response, comes into play in reactions of gluten sensitivity, as opposed to the long-term adaptive immune response that arises in celiac disease. Researchers believe that gluten sensitive reactions do not engender the same long-term damage to the intestine that untreated celiac disease can cause.

TF:  What are the symptoms of gluten sensitivity?

Dr. Fasano:  Just as in celiac disease, gluten sensitivity can affect all body systems and generate a wide variety of symptoms. Gastrointestinal symptoms can include diarrhea, bloating, cramping, abdominal pain and constipation. Behavioral symptoms can include “foggy mind,” depression and ADHD-like behavior. Other symptoms include anemia, joint pain, osteoporosis, and leg numbness.

TF: How many people does gluten sensitivity affect?

Dr. Fasano:  Research from the University of Maryland Center for Celiac Research indicates that it affects approximately 18 million people, or six percent of the population.

TF:  How can I tell if I have gluten sensitivity and what should I do?

Dr. Fasano: This is something to discuss with your family physician or health care provider. If celiac disease and other conditions have been ruled out, i.e., irritable bowel syndrome and other forms of intestinal inflammation, talk to your doctor and dietitian about a gluten-free diet. Please do not undertake the gluten-free diet as treatment without the supervision of health care professionals as nutritional considerations as well as health considerations must be taken into account with this treatment.

TF:  Do I still need to be tested for celiac disease if I think I’m gluten sensitive?

Dr. Fasano:  Yes. You need to be tested for celiac disease to rule out the possibility of long-term complications. Accordingly, do not go on a gluten-free diet until the possibility of celiac disease has been eliminated through testing. If you go on a gluten-free diet and are then tested for celiac disease, the tests could be falsely negative due to the lack of autoantibodies in your blood serum.

Read how to get tested for celiac disease here.

TF:  Is there a test for gluten sensitivity?

Dr. Fasano:  Although researchers at the CFCR are working to develop tests for gluten sensitivity, currently there are no definitive blood tests for the condition.

TF:  Is there a cure for gluten sensitivity?

Dr. Fasano:  Just as in celiac disease, there is no cure for gluten sensitivity. The only treatment currently available is the gluten-free diet.


Other Articles on Gluten-based Reactions

Interview w/ Dr. Alessio Fasano Part 1:  Should Anyone Eat Gluten?

Interview w/ Dr. Alessio Fasano Part 2:  How to Get Tested for Celiac Disease.


About Dr. Fasano & the Center For Celiac Research

Alessio Fasano, M.D., is the director of the University of Maryland Center for Celiac Research, professor of pediatrics, medicine and physiology at the University of Maryland School of Medicine and director of the Mucosal Biology Research Center at the University of Maryland School of Medicine.  Dr. Fasano is an expert on gluten/wheat allergies and celiac disease.  In 2011, he led the research team who discovered a new immune reaction called "gluten sensitivity".

University of Maryland Center for Celiac Research is an institution engaged in clinical care, diagnostic support, education, and clinical and basic science research in Celiac Disease.

The paramount goal of the Center for Celiac Research is to increase the awareness of Celiac Disease in order to provide better care, better quality of life, and more adequate support for the Celiac Disease community.  To view the CFCR's brochure, CLICK HERE.




Recipe: Brownie Tart (Dairy- & Gluten-Free)




My love for brownies led me to try every gluten- and dairy-free brownie mix on the shelves.  Not floored (although there are some great mixes out there now), I started making my own from scratch.  Then with alternative flour in my hair and coconut oil on my shirt, I looked for a brownie-like cake that I could take to parties and have people ask, "Who made this?"  To achieve this lofty goal, I thought it wise to start with a recipe from one of the brownie masters, The Barefoot Contessa.  I adapted her recipe so that I could safely and joyfully consume, but also have "normal" guests demand a repeat performance.  This recipe is rich (you don't need big pieces), chocolatey, chewey - all of the different textures that you want in a brownie. 

And this tart gets people to make naughty sounds. 

 Just out of the oven. It smells so, so good.


6 TBS of coconut oil

20 oz. (3.25 cups) of Enjoy Life Semi-sweet Chocolate Chips (or bittersweet chunks if you are really in a decadent mood)

1 cup of sugar

3 large eggs

1/2 tsp. of gluten-free vanilla extract

1/2 tsp. of GF coffee extract (rounds out the flavor of the chocolate)

1/4 c. GF brown rice flour (I find white rice flour too sweet) - I use Bob's Red Mill

1/4 c. GF tapioca flour -- I use Bob's Red Mill

1/4 tsp. baking powder

1/4 tsp. sea or kosher salt

2-3 TBS of rice, almond, coconut (or other alternative) milk


Put it Together

Preheat the oven to 350 degrees F.

With coconut oil (or safflower, grape seed), grease a 9-inch tart pan with removable sides.  Then flour the pan with brown rice flour.

Wet Ingredients:  Melt the 6 TBS of coconut oil in a bowl over simmering water.  Make sure the water isn't touching the bottom of the bowl.  Add 2 cups of the chocolate chips to the bowl with the oil, then remove from heat until the chocolate melts.  If you need more heat, put the bowl of back on the simmering water for a few seconds.  (Chocolate burns easily, hence this method.)  Let chocolate cool completely.

In a bowl of an electric mixer (use the paddle attachment) beat the eggs, sugar, GF coffee extract and GF Vanilla on medium-high speed until light and fluffy - about 3 minutes. Stir in the cooled chocolate.

Dry Ingredients:  In a medium bowl, combine the tapioca and brown rice flours, baking powder, salt and 1 cup of chocolate chips.  Fold the flour mixture into the chocolate mixture until just combined.

Bake:  Pour the batter into the pan and bake for 35 to 40 minutes until the center is puffy.  Don't overbake - if the center puffs up and possibly cracks, it is good to go.  The inside will still be very soft, but the outer rim will be perfectly chewy. 

Dress Up:  Melt the remaining chocolate chips with the 2-3 TBS of rice milk (or other alternative milk).  You can do this right in the double boiler you used for the first melted chocolate.  Drizzle over the top of the tart in whatever pattern floats your boat.

Cool to room temperature before removing the tart pan sides.

 The End.



Finding Balance with Food in the Classroom


Guest Tender Blogger, Melanie Potock of My Munch Bug, gives lend her advice on food in the classroom after reading a   recent news article about the latest debate in Plymouth, MA schools.  Melanie is the kid expert for The Tender Palate.

According to the article:  "The proposal triggered some of the most heated debate the School Committee has seen in years, with some advocating for the ban in the name of student health and others complaining that the district was overstepping its bounds."


Physics 101

I was never very good in Physics 101,  except for the unit on balance.   Maybe that’s because I have always understood the principles of balance in our daily lives.  Achieving it isn’t a simple task, but I know what it feels like. When life is in balance, it feels smooth, steady and easy.  When life is out of balance, it feels inconsistent, erratic and even chaotic.  Change makes us suddenly lose our balance and no one, absolutely no one, likes that feeling.

Recently, changes in school district policies regarding food being allowed in classrooms has created controversy and upset among parents, teachers and students.  The pendulum has swung from allowing ALL food in the classroom to the recommendation by some that NO food be allowed in the classroom.  Whoa!  That’s one big push in the opposite direction.  Time to find a little balance, but that requires effort.  That’s why many of us don’t like change; returning to balance takes effort on our part.  We’d rather just stay where we are.


Where is All of This Drama Coming From?

To find the balance, consider the following viewpoints that prompted the massive swing of the pendulum:

In Plymouth, Massachusetts,  the food ban “was proposed at the start of the year to reflect changes in state and federal nutritional guidelines for schools.” 

Anne Powers, the nurse leader of the Plymouth school district, had views that were not supported by the majority of parents.  She cited the following reasons for banning food in all elementary classrooms:

•    Increasing childhood obesity statistics
•    Increasing food allergies in the student population

When the school district surveyed the parents, it was clear that the  elementary school parents felt strongly that food should be allowed in their child’s classrooms:

•    80 percent of respondents were opposed to a ban on allowing food in classes for celebrations like birthday parties
•    Parents felt there should  be no ban on offering food as a reward and limiting  the number of parties during the school day
•    Respondents narrowly supported a policy that would establish an allowable food list for school celebrations

If nutrition, the national obesity epidemic and increasing food allergies require changes in our classroom to keep our children healthy and safe, yet most parents prefer little to no change in policy, what is the most efficient and effective way to find the balance


Let's Simplify

What if we prioritized the individual issues?  Perhaps by classroom rather than by school?  If teachers are allowed to set the rules for their students’ needs, then the pendulum doesn’t need to swing so dramatically.  By setting ground rules based on the distinct needs of the children in each class, teachers, parents and students can adjust classroom rules accordingly if they consider these two questions:

#1 Does it keep the classroom safe for all?
#2 Does it foster learning in the classroom?

It’s not a perfect solution to a complicated problem.  It’s a reasonable solution.  It’s one that a smaller group of parents can ultimately support for 9 months of the year, until their child moves to another classroom.  Life is about compromise for the good of all.  That’s called being a good neighbor.

In her article on achieving balance, Terri Trespicio  writes: “Balance comes when we adapt to change, rather than try to resist it.” 

Adapting to new situations or challenging issues in our society such as childhood obesity and keeping children with food allergies safe requires effort and collaboration.  That feels achievable on a classroom by classroom basis.  No two groups of kids are alike and one, district-wide, sweeping rule “NO FOOD IN THE CLASSROOM” certainly does not foster collaboration among the community.  It creates resistance.

About Melanie

Melanie Potock, MA, CCC-SLP, of  Melanie is speech language pathologist who specializes in feeding.  Her work brings her into the homes and schools of her clients, kids, who for various reasons have difficulty with food or with eating. She works with kids and their parents to develop effective strategies that help children become “more adventurous eaters”.  At least 50% of her clients have food allergies or intolerances, and for them, “adventurous eating” takes on a special meaning.  Melanie is also the author of Happy Mealtimes with Happy Kids” and the executive producer of “Dancing in the Kitchen.”



Other Articles & Opinions On This Subject

Schools adapting, banning foods, for students with allergies

Why I Don't Believe Food Allergens Should Be Banned From Schools



Parents: The 12 Days of Christmas -- Pop Nutrition, Super Sprouts & Snot Hoovers (Part 3)

Welcoming Melanie Potock of My Munchbug with Part Three in her series on gifts for parents to help children eat (and play) more adventurously.  There are great ideas for any kid, and also for kids who have food allergies, autism, or other special needs.


What About Days 1 through 8?

In Part 1 of this 12 Day of Christmas series we looked at my favorite lunchitime things.  In Part 2. we discovered more great products for adventurous eating and play.   What's in store for Day 9?  Read on... we are counting down...

On the 9th day of Christmas my Tender Foodie asked of me - VitaRocks™!

Nine Packs of VitaRocks™…vitamins that pop!  VitaRocks are a sure-fire way for kids ages 4 and up to get more vitamins, because they are fun and easy to take!  Sweetened with evaporated cane juice and loaded with vitamins A, B, C, D, E and minerals, the tiny crystals come in individual packets that truly “POP” thanks to a little CO2 to create a party in your mouth. 

Oh, and forget the nine packs, because right now, you can get a “stocky stuffer special” of 56 packets for less than $40 in either Cherry Blast or Lemon Burst.  Sure, it’s not a “daily vitamin” at that cost, but it’s definitely worth a little assurance that your kiddo is getting the occasional, extra burst of vitamins because it's impossible to resist those little crackles and pops on your tongue!

Note: VitaRocks contain lactose and are not dairy free.   Be sure to read the ingredient list carefully against your child's particular allergies.  If you have any questions, contact the company.



On the  10th day of Christmas my Tender Foodie asked of me -- Vegucation!

10 heroes and villains from Super Sproutz where “vegucation is made easy…and fun.” The cast of characters includes Brian Broccoli, Colby Carrot, Suzy Sweet Pea and Radha Radish, also known as Radha Agrawal, founder and CEO of Super Sproutz.  Check out their video “All the Veggie Ladies to learn more about Radha’s dream of helping children see vegetables and nutrition differently “through catchy music and lovable characters.”



On the 11th day of Christmas my Tender Foodie asked of me .... a Snot Hoover!


“The Snoover Snot Hoover” aka the BabyComfyNose nasal aspirator.  Now, what does this have to do with the number eleven?  Absolutely nothing.  And why are we bringing up mucous (gross!) when we were just talking about food?  Because, without being too nosey (great pun, right?) I’d like you to recall the last time you had a stuffy, snotty nose.  I know you didn’t feel like eating.  Kids with stuffy noses can’t smell, can barely taste anything and mucous makes it really difficulty to swallow completely.  And, if your tiny Tender Foodie becomes congested after reacting to a specific allergen or food sensitivity, you’ll be glad you own the BabyComfyNose.  Here’s the scoop from One Step Ahead, which chose this unique aspirator for its highly-selective catalogue:

•    Thanks to the nasal bulb's egg-shaped design (not to mention basic principles of physics), mucus is trapped inside the receptacle and can't advance up the tube. Crumple an ordinary tissue inside the bulb to enhance its filtering properties.
•    Each child should have their own personal nasal aspirator; we offer you a choice of colors for easy identification
•    BPA and phthalate-free

Okay, so now you are curious, right?  Check out the video that demonstrates this brilliant invention!


On the 12th day of Christmas my Tender Foodie asked of me ... MOMables!

A 12 month subscription to MOMables!  Mom-a-what?  MOM-ables!  Invented my yet another savvy mother, MOMables sends busy parents a weekly lunch menu with a shopping list every single Friday.  Each recipe includes a photo of exactly what the lunch will look like (these photos are variations to the "sword" lunches) and never includes processed food.  According to their website,  

“In nearly all recipes, you’ll be able to swap ingredients to accommodate for food allergies and ultra-picky eaters.” 

I perused through several recipe cards and it does appear to be quite easy to substitute as needed.  What parents love about this system is having a plan.  I love a good plan, don’t you?  A nice, easy plan that makes my life simpler, more organized and more fun.  That’s MOMables!


And to All a Good Night

And so the season of giving is upon us and I hope that you have a few ideas for keeping mealtimes joyful while you share this time with your precious family.  In the spirit of the season, 25% of profits from the sales of My Munch Bug's CD, Dancing in the Kitchen, will be donated to Allergy Kids Foundation until the 'twelfth night" or midnight, January 5th, 2012.


About Melanie

Melanie is speech language pathologist who specializes in feeding.  Her work brings her into the homes and schools of her clients, kids, who for various reasons have difficulty with food or with eating. She works with kids and their parents to develop effective strategies that help children become “more adventurous eaters”.  At least 50% of her clients have food allergies or intolerances, and for them, “adventurous eating” takes on a special meaning.  Melanie is also the author of Happy Mealtimes with Happy Kids” and the executive producer of “Dancing in the Kitchen.”



More Posts from Melanie

The 12 Days of Christmas -- My Favorite Lunchtime Things (Part 1)

The 12 Days of Christmas -- Gifts for Adventurous Eating (and Playing (Part 2)

Tips to Help Your Food Allergic Child Belong During the Holidays

How to Talk Turkey (and Food Allergies) at Thanksgiving

How Can Parents Feel Less Stress with a Food Allergic Child in School?



Interview w/ Dr. Alessio Fasano, Part 1: Should Anyone Eat Gluten?


Alessio Fasano, M.D., Medical Director for the Center for Celiac ResearchSince March of this year (2011), I’ve had it on my list to speak to Alessio Fasano, the Medical Director for The University of Maryland’s Center for Celiac Research.    What happened in March?  Honest-to-goodness food allergy research happened, that’s what.  Scientists now have a better understanding of why it seems like everyone (and his or her brother) “suddenly” has trouble eating wheat, rye, and barley. 

Ten years ago, most of us didn’t know what it was.  But now “gluten” is a household buzzword.  Even if we don’t understand what “gluten” actually means (or even is), we see menus and products that are free of it.   I would also wager that every person in the U.S. knows someone who gets sick after eating it.


Quick Facts 

Gluten is that pesky protein that is unusually rich in the amino acids glutamine and proline.  The gluten protein (really, the "gliadin" protein) is found in wheat, with similar trouble-causing proteins found in rye, barley, and triticale. 

Because of studies that people like Dr. Fasano and his team have done, we know things we didn’t know before.  Things like:

  1. There are four different kinds of wheat allergies, with four different types of immune responses.
  2. We also now know that 18 million people (aka everyone and his/her brother) have a newly discovered immune response called “gluten sensitivity.”  People with this condition can have up to 100 symptoms, many similar to Celiac Disease.  The difference is that Gluten Sensitivity does not involve the immune system attacking the intestinal wall of the patient.
  3. The number of people with Celiac Disease has quadrupled in the last 50 years.
  4. Once thought a genetic disease triggered in childhood, recent cases of celiac disease have shown up in people who are in their 70’s and in people who have genetic markers but no genetic history of the disease.
  5. Celiac Disease is the only autoimmune disease that has a clear trigger (gluten).  Therefore, scientists may be able to learn how to better manage other autoimmune diseases, like diabetes, multiple sclerosis, and rheumatoid arthritis through research on celiac disease.
  6. Today, 1 in 133 people have celiac disease, a genetically linked, autoimmune response to gluten.  That’s more than 2 million people in the U.S., and 1 percent of the global population.  However, most do not know it.



The Interview

I was most privileged to speak with Dr. Fasano about gluten, our bodies’ response(s) to it, allergies, Celiac Disease, and what Dr. Fasano calls “the new kid on the block,” Gluten Sensitivity.  We discussed why there are so many issues with gluten and how you can get tested for an immune reaction to it. 

I learned a great deal from Dr. Fasano, including the fact that no one can digest gluten.   I know, this surprised me, too; so I asked again and got the same answer.  No one can digest gluten.  Not properly.  


Read on, oh seekers of answers.


TF:  Why did you do this most recent study on gluten?

It started about two or three years ago after a critical mass of people with various symptoms came to our clinic, and the numbers of these particular people increased exponentially at that time.  Though they had symptoms similar to Celiac Disease, they did not have Celiac Disease.  We would give them a negative diagnosis for celiac disease, but they kept coming back with the same symptoms.  Many had started a gluten-free diet on their own, and the gluten-free diet seemed to be a cure, a miracle.  We had reached the conclusion that though this group of people did not have Celiac Disease, there must be something else happening that is gluten related. 


TF:  I understand that there was some research to build upon, correct?  Tell me about the Banana Babies Study.  How did Celiac & Gluten Sensitivity research all begin?

Shortly after World WUntreated children with Celiac Disease. Photo used with permission from the UMD Center for Celiac Researchar II,  we learned that gluten was the cause for the onset of Celiac Disease, thanks to the Dutch pediatrician, Willem-Karel Dicke. He was puzzled by high infant mortality rates (due to unknown celiac disease) after the war, because in the last few years of the war when bread was unavailable,  the mortality rate (from this condition) was 0.. Dicke noticed that these kids improved without bread, and that their condition deteriorated when bread became available again.

The modern era of gluten research started, however, with Samuel Ghee in the United Kingdom at the end of the 19th Century.  He gave a famous speech (in a lecture at the Hospital for Sick Children, Great Ormond Street in 1887) based on his report called, “On the Coeliac Affection.”  Ghee knew what Celiac Disease was (a chronic, genetically pre-disposed, digestive disease that can affect any age), knew that diet was involved, but didn’t know what triggered it.  It is believed that he also followed the observations of a physician named Aretaeus the Cappadocian, who with others had described the celiac state more than 2000 years before his time.

1st Case of Celiac Disease at U of Maryland in 1938 being treated. Photo used with permission from The Center for Celiac Research.

Before Dicke's discovery and development of the gluten-free diet, one of the diets physicians tried with the afflicted children was the banana diet, used at the University of Maryland in the 1930s.  Bananas contain enough calories and nutrients for survival.  Parents were instructed to drop their children off for 6 months, and if they were still alive, they could pick them up and take them home. 





TF:  Did any Banana Babies survive? 

Oh yes, in fact there are some survivors who are still around!  In fact I invited a  Banana Baby who was treated at the University of Maryland Hospital in the 1930s, Barbara Hudson, to speak during one of my recent lectures.  She is doing great!

  Listen to Dr. Fasano and Barbara Hudson Speak


TF:  How many forms of gluten reactions are there?

Dr. Fasano:  There are 3 forms.  Celiac Disease, and Gluten Sensitivity, and Gluten/Wheat Allergy – and there are four different types of wheat allergy that all behave differently.


TF:  What is behind all of these reactions?

Dr Fasano:  Gliadin.  Gliadin is one of the proteins found in gluten.  When someone has a reaction, it’s because gliadin cross talks with our cells, causes confusion, and as a result, causes the small intestine to leak.  Gliadin is a strange protein that our enzymes can’t break down from the amino acids (glutamine and proline) into elements small enough for us to digest.  Our enzymes can only break down the gliadin into peptides.  Peptides are too large to be absorbed properly through the small intestine.  Our intestinal walls or gates, then, have to separate in order to let the larger peptide through.  The immune system sees the peptide as an enemy and begins to attack.  The difference is that in a normal person, the intestinal walls close back up, the small intestine becomes normal again, and the peptides remain in the intestinal tract and are simply excreted before the immune system notices them.   In a person who reacts to  gluten, , the walls stay open as long as you are consuming gluten.  How your body reacts (with a gluten sensitivity, wheat allergy or Celiac Disease) depends upon how long the gates stay open, the number of “enemies” let through and the number of soldiers that our immune system sends to defend our bodies.  For someone with Celiac Disease, the soldiers get confused and start shooting at the intestinal walls.

Used with permission from the Center for Celiac Research


TF:  That sounds like everyone is gluten intolerant in some way.  Is that true?  Everyone? 

Yes.  No one can properly digest gluten.  We do not have the enzymes to break it down.  It all depends upon how well our intestinal walls close after we ingest it and how our immune system reacts to it.


TF:  Why have so many people been diagnosed within the last few years?

Dr. Fasano:  Some of this is because the medical community has become more aware and because there has been an increase in the incidents (of gluten reactions) in recent years.  The environment in general is also a factor.  The quantity of grains that we now eat has increased.  Breast-fed babies seem to be more protected from developing adverse reactions to gluten.  We’ve found that certain good bacteria, or probiotics that live within us also play a part in “turning off” an adverse reaction to gluten.  Antibacterial soaps and other things are reducing the number of these bacteria, changing the microbial environment in our gut.


TF:  You’ve mentioned in the study that Agricultural Changes in Wheat have played a role.  Can you tell me more about this?

Dr. Fasano:  Ten thousand years ago there were no gluten grains.  Wheat, rye, barley and triticale are relatively new grains that have been introduced to our diet.  We haven’t had enough time to evolve in order to digest these grains properly.  In recent years the protein content has increased greatly in our modern wheat.  Now, 14% of dry wheat is gluten.  This is a lot.  I understand why this has happened - more gluten gives characteristics to baked goods that are more desirable, like more elasticity; it’s more palatable, but less digestible. 


TF:  What about GMO’s (Genetically Modified Organisms)?

Dr. Fasano:  These are all GMOs’!  (Dr. Fasano indicated that we’ve been manipulating agriculture for a long time*).  The problem is that if you do this too fast, like we’ve done in the last 50 years, we pay a price.  It takes centuries for our bodies to adapt.  There is always a balance between the advantages and the disadvantages.  Agricultural mutations are all by chance so it takes time to rule out problems that are created by these mutations.  It is unfair to blame GMOs as the only cause, although they are a factor.  Our immune system evolved to only fight one enemy, bacteria.  Now we have a host of environmental toxicities to fight and each person’s immune system does its best to manage those. 

(*Note:  It's important to note that we did not discuss the types of genetically modified mutations, such as seeds created to withstand pesticides or those that actually produce pesticides.)


TF:  Are certain countries more prone to have a population with gluten sensitivity, gluten allergies or Celiac Disease?


Dr. Fasano:  In earlier years, Celiac Disease was more common in Ireland and Italy, so it was typically easier to diagnose.  People of European descent had a higher tendency to carry the genetic code that predisposes someone to that disease.  Now, with the recipe of DNA plus the availability of gluten, Celiac Disease is being found at a surprising rate in India and China.  As the quality of life and income improves in these countries, their diet is changing, and it now includes gluten.  So, there is a rise in Celiac Disease and in Gluten Sensitivity everywhere.


TF:  You’ve mentioned earlier that doctors are diagnosing more cases.  Do you feel that awareness has increased in the last 5 years?

Dr. Fasano:  Oh yes.  Physicians are more aware, and because of this (Gluten Sensitivity) study they have more information.  But we still need to learn a lot--starting with understanding the many symptoms associated with Gluten Sensitivity and Celiac Disease.  Celiac Disease is systemic (it affects a number of organs and tissues).  Doctors need to better understand how to test and diagnose it.  Nutritionists are the ones to help patients manage food allergies and Celiac Disease, not the doctors.  Doctors, however, need to learn about this new entity called Gluten Sensitivity.  We all need to be able to clearly define these conditions and speak in the same language.  And that starts with the right tools to diagnose gluten-related disorders.


TF:  What are the markers for Celiac Disease that doctors and patients should look for?

Dr. Fasano:  The latest research shows that you could have 4 out of the first 5 of the following markers for Celiac Disease.  Gluten Sensitivity has many of the same symptoms.  (Please see "Part Two:  How to Get Tested for Celiac Disease" for these markers and their in-depth descriptions.")



PART TWO:  How to Get Tested for Celiac Disease

PART THREE:  Gluten Sensitivity - A New Food Allergy


For more frequently asked questions on testing for Celiac Disease and Gluten Sensitivity, visit the Center for Celiac Research’s website.



University of Maryland Center for Celiac Research is an institution engaged in clinical care, diagnostic support, education, and clinical and basic science research in Celiac Disease.

The paramount goal of the Center for Celiac Research is to increase the awareness of Celiac Disease in order to provide better care, better quality of life, and more adequate support for the Celiac Disease community.  To view the CFCR's brochure, CLICK HERE.

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