Monday, August 31, 2009

The Best Gluten-free Bagel

They say rules are made to be broken and August has been such a month for me. I no sooner mention that I never make product endorsements only to find myself doing just that – twice! A few weeks ago I endorsed Udi’s bread and now I find myself on a bagel bandwagon –specifically Joan’s GF Great Bakes (www.gfgreatbakes.com).

Last spring my husband and I were part of the NFCA (National Foundation for Celiac Awareness) Cook-off in D.C. We were there for a book signing and presentation of our book “The Gluten Effect”. There were many wonderful vendors and chefs who participated in the event and at the end of the evening my husband mentioned tasting a truly wonderful bagel. I scurried over to taste for myself only to find that they had run out.

As a New Yorker who grew up on bagels as a Sunday morning ritual, it has definitely been something I’ve missed…a lot. While I hadn’t personally tasted Joan’s bagels my husband’s recommendation was so strong that I just had to try them.

Joan is a New Yorker as well (no wonder she knows how to make bagels!) and the only unfortunate part was negotiating a shipment to California. A good portion of my staff went in on a large enough order to defray what turned out to be rather expensive shipping and I waited with bated breath for my order.

What I didn’t know is that the bagels arrive not only frozen but raw. The pale bagel looked a little sad in the package until I read the directions and discovered the need for a little baking. Part of my childhood memory was warm bagels fresh from the oven as the bakery was close to our home. Therefore the prospect of baking individual bagels and enjoying them fresh from the over was an even better option as far as I was concerned.

Joan’s did not disappoint – quite the contrary. They were truly delicious and undetectable as being gluten-free. Following a dairy-free diet as well, I was thrilled that she also provided that option and a multiple of flavors.

Those of you living on the east coast are fortunate. You can simply place an order and enjoy. For those west of the Rockies a little more thought and collaboration is involved, but it’s truly worth it if you’re a bagel fan.

Joan’s also makes English muffins, pizza crust and cookies. I haven’t tried them yet but I’m sure they’re all delicious.

As a side note, the shipping company was a little rough on our boxes and the bagel bags were a little worse for wear. When I called customer service I spoke to Joan herself and she was wonderful to deal with. As a business owner who prides myself on excellent service it was great to meet someone who shared similar values.

And now the cautionary tale: don’t eat these daily as simple carbohydrates are not as nutritious as all those fruits and vegetables I prefer that you eat. But there’s nothing wrong with a bagel meal as a weekly indulgence – enjoy!

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Wednesday, August 26, 2009

Gluten Dangers: The Truth Is Here To Stay

If you’re gluten sensitive or have celiac disease you may have heard the comment that gluten is a "fad" from a curious friend or family member. Granted one would have to be quite “out of the loop” these days to not have heard of gluten, but more and more those who haven’t been diagnosed are asking: Why now? Why is it suddenly so large a problem?

These are good questions and I’d like to provide some possible answers.

Recently I had the good fortune to listen to Dr Harris, a celiac and gluten researcher out of the University of Maryland who works with Dr Fassano, a long time researcher in the field. Dr Harris felt that increased awareness and better detection of celiac disease has definitely gone a long way towards diagnosing more of those afflicted. (Considering there are over 90% of celiacs who remain undiagnosed, we obviously still have a long way to go but any improvement is appreciated.)

Dr Harris additionally noted that viruses and vaccines can perhaps cause an increased reaction to gluten in susceptible individuals. Viruses have been identified that trigger an immune response that cross reacts with gluten through molecular mimicry. Rotavirus is such an example. Rotavirus typically strikes children causing them to suffer with diarrhea for several days and is the most common cause of childhood diarrhea. The virus works by attacking the lining of the small intestine, causing often copious loss of fluids and electrolytes. Antibodies in celiac patients are known to cross react with rotavirus.

What does this all mean? We review this mechanism in our book The Gluten Effect. Remember that gluten is a protein (actually an array of proteins but we’ll discuss that later). It is known that certain fragments of the gluten proteins are quite similar to structures within our body as well as that of viruses. The rotavirus has such a structure. When the body has been exposed to rotavirus the immune system remembers it. Due to gluten’s similar structure, gluten ingestion occurring after the viral infection causes the body’s immune system to attack the gluten molecule “thinking” it’s the rotavirus again. In sum, this infection causes the immune system in the gluten susceptible individual to be primed to react.

My research revealed that rotavirus affects 3 million people in the US each year, 5 every minute.

What about the vaccine comment? The number of vaccines that our children are exposed to has increased dramatically over the past several decades. Based on the above mechanism of molecular mimicry a susceptible GI tract can begin reacting to gluten after receiving a vaccine.

How does one explain the genetically susceptible individual who seems to eat gluten with impunity? Dr Harris’ research is looking at a co-variable concept that I believe, based on my clinical experience, makes a lot of sense. It is thought that while an individual can possess the genes that make him or her susceptible to reacting to gluten, the reason not everyone does and the age of onset is so variable is dependent upon the presence of other factors. Dr Harris thinks that without some underlying inflammation already present in the gut, a healthy individual might go on consuming gluten with no negative effects.

It is an interesting theory. What we see here in the clinic is a varying time of onset of symptoms. While someone has been consuming gluten their whole life, they may have been “fine” until their 30s, 40s or 50s. And then there are the infants whose first exposure causes dramatic results. The time of expression may very well be dependent upon the underlying health and stability of the immune system. A stable, healthy, uncompromised immune system and small intestine could well sustain a gluten-containing diet with no apparent negative results. It’s not unusual for a patient to have suffered a severe infection of some sort or a stressful life period, after which they began to react to gluten.

And finally the structure of our grains was discussed as it relates to different cultivars containing different protein fragments. Some fragments of proteins are inflammatory and some are not. Witness the Americans who travel to Italy and eat older cultivars of wheat with seeming impunity. Don’t book a flight just yet…

There is a lot more to learn and that’s a tremendous understatement. But as a clinician I do find that the health of the small intestine and immune system plays a large role in how quickly a patient will see a resolution of their symptoms. And it also give credence to the protocol we follow that goes beyond simply removing gluten from the diet. Concurrent with a gluten-free diet one must heal the gut, remove pathogens, recolonize with healthy probiotic bacteria and follow a healthy diet – otherwise the result will be unsatisfactory.

There is much more to come on this topic and to answer the question: No, gluten sensitivity is not a fad!

Until next time,
I wish you good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect

Wednesday, August 12, 2009

Is All Gluten Bad?

The good news is that awareness of gluten has increased dramatically the past several years. This has resulted in improved health for many people and the food industry has noticed the interest and responded in kind with more and more gluten-free offerings.

“Gluten” is no longer a strange word with even fast food restaurants and candy companies becoming savvy to its ill effects on health.

But we do have a problem in nomenclature because “gluten” is actually a protein found in many grains that are not problematic for what we call the gluten sensitive patient. A more correct term would be “gliadin sensitive” vs “gluten sensitive”.

Don’t groan; I’ll explain. The word we should be using is “gliadin” because that is the component in the protein portion that celiacs and gluten sensitive patients react to in the offending grains wheat, rye and barley. Gliadin is a specific fragment or sequence of amino acids in these offending grains.

“Gluten” is the storage protein found in wheat but other proteins that are similar are also called gluten despite being found in such innocuous grains as rice, oats, corn, millet, etc.

The reason for this blog post is that a patient recently saw corn gluten on a label and got confused. She knew that she was fine with corn but the “gluten” word confused her.

I’m not trying to start a movement to change our vernacular from “gluten” to “gliadin” – personally I’m just glad that the awareness has increased so well. But I did want to clarify the point to allay any confusion.

Here’s a little information about the grain families that might help:

Within the family of Grasses are two subtypes: Monocots and Dicots.

Monocots have 3 subgroups:
1. Wheat, Rye, Barley
2. Rice, Oats
3. Corn, Sorghum, Millet

Dictots also have 3 subgroups:
1. Buckwheat, Rhubarb (fruits)
2. Quinoa, Spinach
3. Amaranth


So to sum up – wheat, rye, barley, spelt, kamut, bulgur, etc are gliadin containing grains for which an individual suffering with celiac or gluten sensitivity cannot ingest safely. (Please go to: http://www.healthnowmedical.com/info/gluten_foods.html to get a complete list of allowed and disallowed foods)

The gluten found in rice, oats, corn, sorghum, millet, quinoa, amaranth and buckwheat is just fine.


I hope this helps!

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect

Gluten Sensitive Patients Rejoice: The Best Gluten-free Bread Ever Made!

If you’ve been following this blog at all you know that it is not commercial in any way. I don’t push products or sell anything. But sometimes you just need to give credit where credit is due.

My family and I just got back from a beautiful 5 day vacation (who can get away for longer!) in Jackson Hole, WY. We rode horses, hiked, enjoyed white water rafting and the amateur photographer in me had a field day!

Being a diligent mother I checked out gluten-free options in Jackson Hole and found a great health food store. Upon arrival I asked for help finding gluten-free breads and a knowledgeable sales person directed me to the freezer and mentioned that a new bread was selling very well and getting rave reviews.

I’m adventurous and I already recognized the rest of the breads they offered so I happily purchased two varieties of Udi’s gluten-free bread. They offer a whole grain and sandwich bread.

As many of you know, even the best gluten-free bread usually requires toasting. But Udi’s defrosted and was instantly soft. Before we even tasted it, it was obvious that we were dealing with a “new breed” of gluten-free bread. Then came the tasting and we were smitten. It was unanimous that if you didn’t know it was gluten-free you’d never know by tasting it. I’ve said this before about certain dessert items (like brownies) and I defy anyone to figure my lasagna for being gluten-free, but bread had never remotely fit into that category. The best we could hope for was that it wasn’t too bad – as in dry and crumbly…

That was until Udi’s came along. For those of you living in the Rocky Mountain area of the U.S. you’re in luck. Udi’s is produced out of Denver, CO and they are well represented there. For the rest of us, there’s going to be a waiting period. I recommend you go online and order from there: www.udisfood.com. The gluten-free portion of their website is being worked on currently so you may need to call- 303-657-1600.

But believe me any trouble you have to go through is well worth it. You’ll be a happy little bread eater! And did I mention that it’s not only gluten-free but dairy, soy and nut-free?

I won’t ruin this good news by encouraging you to keep such simple carbohydrate consumption to a minimum… I’ll save that for a later blog!

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect