Since gluten-containing grains such as wheat, rye and barley have been a staple of our diet for 10,000 years, it is not clear why both gluten sensitivity and celiac disease are on such a sharp rise. I have shared Joseph A. Murray’s research before, and he says about celiac disease that “people aren’t born with this. Something triggers it and with this dramatic rise in all ages, it must be something pervasive in the environment”. One of the possible answers: agricultural changes to wheat and other gluten containing grains that have boosted their protein content.

Gluten intolerance or gluten sensitivity, however is much less researched and thus much more vague. As our friend Cynthia Kupper, Executive Director at Gluten Intolerance Group of North America, rightly points out: “There’s a lot more that needs to be done for people with gluten sensitivity. But at least we now recognize that it’s real and that these people aren’t crazy.” As of now, a gluten-free diet is the only treatment recommended for both gluten sensitivity and celiac disease.

Have you or your child tested negative for celiac disease but seen significant improvements on a gluten-free diet? What tests did your doctor run on you to determine a gluten sensitivity?

Stephen has celiac disease and has the exact same concerns that you might have. From both his personal and professional experience, he understands the challenges of a gluten-free diet, and is very passionate about helping you. Similar to us, his passion was a call that he answered by co-founding The IBS Treatment Center in Seattle, WA, blogging as The Gluten Free Doctor, and serving on the Board of Trustees for the Gluten Intolerance Group of North America. We invite you to read more about Stephen and his books in our introduction to our advisors.

Dr. Wangen is going out of his way to provide this wonderful service, and we appreciate your understanding that out of respect for Dr. Wangen and his time we have to limit each session to 5 questions on a first-come, first-served basis. Please join us at Custom Choice Cereal in thanking Stephen for taking the time off his busy schedule to address your concerns.

Asking your question is easy and can be done in just 4 simple steps:

1. Post your question as a comment to this blog entry
2. We send all questions to Dr. Wangen
3. Dr. Wangen’s answers will be published in reply to your comments
4. To check for the answer to your question you can either subscribe to our blog or simply check back in a few days

Wondering what tests you should have taken? What areas do you have difficulties with? What kind of (unusual) symptoms do you have? Any concerns about the constant “are oats gluten-free” debate? He can help so don’t be shy and ask away!

In my humble opinion, it all boils down to how well the manager and staff of the respective restaurant are educated about what celiac disease and gluten intolerance are. While P.F. Chang’s does an outstanding job teaching all its kitchen employees and waiters about their allergy-friendly menu and even goes so far to use separate color codes and plate shapes to distinguish gluten-free from conventional dishes, this is by far not the norm. Our latest poll (see on the right and please take it if you haven’t already) reflects this challenge of going out gluten-free style.

Getting mad at servers and managers or raving on blogs after a bad gluten-free dining experience does not help anyone. Instead, I pledge to educate the waiters and managers when corporate pushes down an allergy-friendly menu on them without telling them what it means or who needs it. And it certainly can get maddening when neither of these show the slightest interest. However, we’re on a mission here… So when I saw Amy Leger aka The Savvy Celiac blog about questions to ask when ordering a gluten-free pizza I thought I extrapolate this to gluten-free dining in general. Hopefully this will help you next time you dine out with friends or family!

• Ask first. You’ll quickly find out if the staff truly understands their gluten-free menu!
• Understand the “behind the scenes”. Are they using separate utensils, pots & pans for their gluten-free menu items?
• Double-check. Sounds paranoid but see if special meals come on differently shaped or colored plates/trays!
• Don’t be afraid to ask for replacements. If there is an obvious mess-up (e.g. breadcrumbs on your salad) ask to have it replaced and do one of two things: (A) take Tiffany’s advice and hold on to your plate until the replacements arrives from the kitchen or (B) be evil, hide a toothpick or piece of your napkin under your salad and double-check when it comes back…
• Be polite. Let’s be honest. You probably cause the waiter quite some extra work. Showing your appreciation makes it easier for everyone!

These and other tips are also available in Custom Choice Cereal’s section on gluten-free advice, tips & tricks.

Remember, a gluten-free dinner is also safe for people who have to eat wheat-free while wheat-free foods are not necessarily safe for people with celiac disease. Since I heard enough “horror stories” I’d be great to learn where you have made exceptionally good gluten-free dining experiences? Do you have any any advice to share? Do you ask the waiters or go straight to the manager?

The new regulations are specifically aimed at strengthening Canada’s labeling of food allergens and gluten sources to allow Canadians with food allergies, sensitivities and celiac disease to make more informed choices about the foods they buy.

The new regulations will require additional labelling and strengthen the labelling requirements to require clearer language and the declaration of otherwise “hidden” allergens, gluten sources, and sulphites. Because of the complexity of the changes and the shelf-life of foods, industry has been given 18 months to implement the new allergen labeling regulations. The new regulations will become effective on August 4, 2012.

While this is a great success for the food allergy and gluten-free community in Canada and shows that persistence pays off, the new law excludes beer companies from the new labeling restrictions. Even an open letter to the Prime Minister of Canada could not prevent this exemption. The Brewers Association of Canada successfully raised concerns about the cost of making labeling changes, especially those whose labels are painted directly on the bottles, as opposed to paper labels. They argued that the label changes will force them to state the obvious – beer contains wheat and barley.

We at Custom Choice Cereal congratulate our Canadian friends on their success (despite the exemption)! So what do you think? Can something similar be reached here in the US? Will it take us another 10 years to get this far? When will the FDA’s proposed voluntary use of the term “gluten-free” from January 2007 become a law?

Researchers from the University of Chicago’s Celiac Disease Center used mice to identify a biochemical interaction that may trigger an autoimmune reaction in the intestines of genetically susceptible people. Specifically, they found that the compound retinoic acid in combination with high levels of the a pro-inflammatory substance known as interleukin-15 was able to break the body’s tolerance to gluten.

Study author Dr. Bana Jabri and her colleagues examined the records of patients at University of Chicago’s Celiac Disease Center, which showed that many of them had high levels of IL-15 in their intestines. Then they conducted experiments using a new mouse model of the disease developed in Jabri’s lab. When the researchers increased levels of IL-15 in mice, the animals developed all the early symptoms of celiac disease. Adding retinoic acid only worsened the disease. But when the researchers blocked IL-15 in the mice, their symptoms improved and they could tolerate gluten again.

Dr. Bana said that “This is the first time that we actually show how inducing a specific dysregulation in the intestines can lead to losing tolerance to a food antigen, and in particular to gluten.” She continued that this represents a key finding because they now know what to target for a re-introduction of tolerance to gluten.

Dr. Fasano added that he was really intrigued by the new discoveries about the role of retinoic acid, “which we’ve always thought helped to prevent the immune response rather than make it worse. It’s a most provocative finding.”

While these are promising and important research discoveries in the understanding of celiac disease, much more research is needed. It also needs to be noted that promising research done with animals often fails to produce beneficial results for humans.

The great Angel Burch of Gluten Free Life TV where she talks about her road to diagnosis. Despite the staged audience reactions – which I thought are pretty funny – this gives a comprehensive overview of celiac disease (yeah, it’s not an allergy), what’s available in the gluten-free market, food safety & reading labels as well as the omnipresent issue of cross-contamination, typical symptoms and how to get tested.

If you look closely at the right side of the screen you’ll even be able to catch a glimpse of a bag of your one and only Custom Choice Cereal – Organic Corn Flakes with Natural Almonds, Cranberries and a double serving of Organic Raisins (copy mix ID 9894fd into the re-order box to get this cereal)!

There are two ways to see all of our awesome gluten-free cereal: 1) roughly two thirds into the video the camera shifts and you’ll see our cereal in its entire beauty or 2) design your own perfect breakfast cereal and enjoy Your Gluten Freedom at home! I’m just saying – I know what I’d do…

http://www.khou.com/v/?i=115569239

P.S. Also watch the video Cut Out the Sodium for a bigger mentioning of Custom Choice Cereal right at the beginning!

Fortunately for me, the one and only Katie Chalmers, mother to a daughter with celiac disease and author of the book “Mommy, What Is Celiac Disease”, has already done the work and compiled a list of 10 gluten-free summer camps in 2011. She has even be so nice to allow me to copy it here, so THANK YOU, Katie!

Please be aware that the camps fill up quickly and that you should act by the end of the month to reserve a spot for your child! Katie has been so nice to organize the camps chronologically. If both you and your child are interested in seeing a few different gluten-free camps and across the country over the summer, you can (at least in theory) attend 7 of the 10 camps this year

• Summer Camp Weekaneatit, May 29 – June 3 at Camp Twin Lakes Will-A-Way in Winder, GA
• Camp Fire USA Gluten-Free, June 19 – 25 at Camp Waluhili on scenic Fort Gibson Lake, 45 min. from Tulsa, OK
• “Free To Be” Camp, June 19 – 25 at Camp Westminster on Higgins Lake in Roscommon, MI
• The Great Gluten Escape, July 10 – 15 at Camp Gilmont in Gilmer, TX
• GIG Kids Camp West, July 20 – 25; July 26 – 29 and July 20 – 29 at Camp Sealth, Vashon Island, WA
• Camp Celiac, July 21 – July 25 and July 25 – 29 at Camp Arroyo, Livermore, CA
• Camp Celiac, August 7 – 12 at Camp Aldersgate, North Scituate, RI
• GIG Kids Camp East, August 7 – 13 at Camp Kanata, Wake Forest, NC
• Gluten-Free Fun Camp, August 14 – 19 at Camp New Hope in McGregor, MN
• Gluten-Free Camp, August 14 – 19 at Camp Manitou-Lin on Ol’ Lake Barlow in Middleville, MI

Stephen suffers from celiac disease himself, understands the challenges of a gluten-free diet, and is very passionate about helping you. Similar to us, his passion was a call that he answered by co-founding The IBS Treatment Center in Seattle, WA, blogging as The Gluten Free Doctor, and serving on the Board of Trustees for the Gluten Intolerance Group of North America. We invite you to read more about Stephen and his books in our introduction to our advisors.

Dr. Wangen is going out of his way to provide this wonderful service, and we appreciate your understanding that out of respect for Dr. Wangen and his time we have to limit each session to 5 questions on a first-come, first-served basis. Please join us at Custom Choice Cereal in thanking Stephen for taking the time off his busy schedule to address your concerns.

Asking your question is easy and can be done in just 4 simple steps:

1. Post your question as a comment to this blog entry
2. Subscribe to our blog (or check back in a few days) so you’ll know when then answer is up
3. We send all questions to Dr. Wangen
4. Dr. Wangen’s answers will be published in reply to your comments

We are looking forward to finding out what you would like to know because it’s a great way for us to learn something new as well!

Please also remember that it’s not enough if it the label bares a statement that the vitamin is wheat-free. Gluten is a protein contained in wheat, rye, barley and most oats (cross-contamination), so everything that’s gluten-free is also wheat-free but not vice versa! Fortunately a few well-known brands specifically label their vitamins as gluten-free, and Lisa was so kind to provide a list that I’m sharing here:

1. Hero Nutritionals Gummy Vitamins
2. Country Life Vitamins
3. Barlean’s Greens
4. NOW Vitamins
5. Bluebonnet Vitamins
6. Pioneer Vitamins
7. Natural Factors Vitamins

Note however that you should always read the labels and call the manufacturer if you’re unsure. Lisa also shares a recipe for nutritious Carob Oat Breakfast Bars (it’s critical to use certified gluten-free oats, as Jules points out in the comments). I’m saving the best for last: you can of course always design your perfect gluten-free cereal! Fortunately our nutrition label updates as you add ingredients to your mix so you can create a blend that not only suits your personal taste buds but provides exactly the nutrients that you need!

“Gluten-free is something on the radar,” said Les Winograd, Subway spokesman. “There are number of people at Subway who are particularly interested in gluten-free items for their own particular digestive needs. It’s not something that’s unusual to us.”

We at Custom Choice Cereal think it’s been about time that the major fast food chains jump to gluten-free action! However, it will take a lot of eduction on the franchisees’ end and tons of effort to prevent cross-contamination. Food safety is important for everyone but especially those with celiac disease and who have to follow a gluten-free diet. Thinking about the processes – cutting and toasting the 9-Grain Wheat, 9-Grain Honey Oat, Italian, Italian Herbs & Cheese or Flatbread – we’re wondering whether or not they are separating operations and using dedicated gluten-free equipment.

The key question is: would you try a gluten-free sandwich from Subway? Why or why not?