For 20 years, Maurie Ange of El Cerrito, Calif., suffered from chronic belly aches. A decade ago, she was diagnosed with irritable bowel syndrome and told to exercise more and increase her fiber intake. But the pain, bloating and digestive issues continued into her 60s.
Finally, four years ago, at the suggestion of an osteopath she was seeing for sinus trouble, Ange went on a gluten-free diet, avoiding everything that contained the protein found in wheat (durum, semolina, spelt, kamut, einkorn and faro), barley, rye, contaminated oats, and a host of products including lipstick, soy sauce and pharmaceuticals.
"Ninety percent of my issues are gone," Ange says. "When I fall off the wagon the pain and yuckiness return."
Ange is one of many who has benefited from gluten-free living. Whether they suffer from gluten intolerance, hope to temper the symptoms of autism, or have been diagnosed with celiac disease, an autoimmune disorder that affects one in 133 adults and is getting overdue attention, they are going gluten-free for good, not as a fad. It is a lifestyle, that, when approached naturally and under medical supervision, provides relief and bonuses such as avoiding processed and packaged foods.
Still, cutting out gluten is difficult. It requires vigilant label reading and a dedication to eating at home. Most American staples such as pizza, pasta, beer and burgers are off limits. On the bright side, the things you can eat -- proteins and fruits and vegetables -- are good for you.
As a result, Pleasanton, Calif., personal chef Claudia Imatt has seen an overwhelming surge in the number of requests for gluten-free menus.
"People are requesting it for their ailments," says Imatt, owner of Shall We Dine. "Everything from headaches and weight loss to fatigue, seasonal or wheat allergies and fibromyalgia."
A typical dinner menu emphasizes fruits, greens, proteins and creative spins on rice, corn, beans and potatoes in lieu of wheat-based starches. Imatt struggles to find gluten-free products that meet her standards and don't "break the bank," she says. Overall, she has found that people who come to her for help changing their diet "embrace it and live well. "It's less garbage and less processed foods," she says. "You know where the food is coming from and you can see the ingredients that are in it."
Ten years ago, Kay Junta of Concord, Calif., marched into her general practitioner's office and told him she was so sick she was afraid she would die. The year before, he had diagnosed her with IBS and sent her to a specialist who put her on medication for digestive issues and abdominal pain. But, her health continued to deteriorate. Eventually, she went into malnutrition.
Finally, the doctors performed a blood test and intestinal biopsy. They confirmed the culprit as celiac disease, a multi-system, multi-symptom autoimmune disorder that often mimics the symptoms of other bowel disorders. According to the Celiac Disease Foundation, when individuals with celiac disease ingest gluten, the villi, tiny hairlike projections in the small intestine that absorb nutrients, are damaged. Damaged villi do not effectively absorb basic nutrients such as proteins, carbohydrates, vitamins and minerals.
Junta, a passionate baker, educated herself and eliminated gluten from her entire diet, reading labels for cross-contamination warnings and seeking out celiac-friendly restaurants.
"I have my life back," says Junta, now 65. "But I still have to be careful. Even a breadcrumb can make me very ill." She has even transformed her favorite cake and cookie recipes by using bean or potato flour and relying on yogurt or applesauce as thickening agents. Her friends can't tell the difference, she says. "It's not rocket science," Junta says of living gluten-free. "Do you want to save your life or do you want to go on being sick? I chose not to be sick."
But, not everyone with celiac disease has perceptible gastrointestinal symptoms, which can include fatigue, gas, bloating, abdominal pain or chronic diarrhea or constipation. Unexplained anemia and behavioral changes such as depression are not uncommon. If left untreated, damage to the small intestine can be chronic, causing an increased risk of associated disorders and issues such as infertility, intestinal lymphomas and Dermatitis Herpetiformis, a skin manifestation of celiac disease characterized by blistering, itchy skin.
"It can be a very indolent disease," says Gary M. Gray, professor of gastroenterology at Stanford University and director of its celiac management clinic. "There are a lot of people who have food intolerances but many true celiacs have intermittent symptoms or no symptoms. In most patients it's hard to diagnose."
While the cause of celiac disease is unknown, it is genetic and can be triggered by a viral infection, severe emotional stress, pregnancy or childbirth. So if someone in your family has been diagnosed with it or a related autoimmune disorder, it is best to get tested, Gray says.
The biggest problem is when people go off gluten on their own and then come in to get tested for celiac or gluten intolerance, he adds.
"If they've done it (the diet) for a month or longer, it's likely we can't diagnose it," he says. Furthermore, he adds, some people gain rather than lose weight as a result of the diet because they load up on fat-laden, gluten-free packaged goods.
Like Gray, San Ramon registered dietitian Kathi Nichols doesn't recommend launching into a gluten-free diet without a diagnosis. It's too hard, she says. Nichols, 51, was diagnosed with celiac disease three years ago after seeing numerous physicians for unexplained anemia and dermatitis.
"It is one of the most difficult things I've ever had to do," she says, of going gluten-free. "I thought I could just go to the store and buy anything. But a food manufacturer could suddenly change their recipe and add gluten. So it takes twice as long to do a grocery store trip because you have to read everything. And it's more expensive."
The bright side, Nichols says, is that she has discovered food items from different cultures, including a tapioca flour Bolivians use to make rolls. And her disease hasn't kept her from traveling overseas. Quite the contrary. Many celiacs enjoy going to other countries, particularly to England and Australia, where awareness is higher and restaurants are accommodating, Nichols says.
Overall, she advises people to stay focused on what they can eat and remind themselves that there's more to life than diet.
"The only place I have not walked into in years is McDonald's," she says, laughing. "Celiac controls my choices, but it doesn't control my life," she says.
Lori Crowley of San Ramon, Calif., helped reclaim control of her son's life when she took him off gluten last October. Aidan, 5, suffers from a developmental delay known as sensory integration dysfunction. It affects his ability to balance, process information and discern touch.
"He had these moments where he seemed spaced out," she says. "He also had issues with aggression and compliance."
While her son has not been diagnosed with an autism spectrum disorder, Crowley was aware of the research circulating about the link between diet and developmental issues. According to the Autism Research Institute and Defeat Autism Now, some children with autism cannot properly digest gluten. Instead of passing through the digestive system, the protein breaks down into peptides that leak into the bloodstream of children with ASDs and trigger an opiatelike effect in the brain.
With help from a friend with a celiac child, Crowley made the transition. And, within two weeks, Aidan had changed.
"The spaciness is gone. So is the aggression," Crowley says. "I think the fog in his brain kind of cleared. It doesn't mean that it's gone away. But we've seen profound improvements."
Gluten.net: The Gluten Intolerance Group of North America provides links to annual conferences, recipes and restaurants that serve gluten-free foods plus other events and support groups.
Celiac.org: The Celiac Disease Foundation site has a comprehensive section on diet and lifestyle with a downloadable guide for those who have been recently diagnosed with celiac disease. Also includes a list of chain restaurants that accommodate gluten allergies.
Gfreecuisine.com: A menu-planning service that caters to gluten-free families by sending weekly e-mails including 10 customizable meal recipes designed by gluten-free cookbook author Carol Fenster plus tips on baking, entertaining and holiday menus. Fenster also calls out gluten-free brands, which means less label reading.
Gluten-Free Living: A national magazine devoted to living a gluten-free life, from dining in college, maintaining a healthy pregnancy and raising children with gluten allergies. Blog comments on up-to-the-minute gluten-free happenings, like Starbucks' first gluten-free cake. www.glutenfreeliving.com.
Jacqueline Mallorca. Former San Francisco Chronicle food writer with numerous gluten-free cookbooks, including "The Wheat-Free Cook" (HarperCollins).
"The G Free Diet": Targeted to celiacs and those who want to "lose weight or maintain a healthier lifestyle," "The View" co-host Elisabeth Hasselback's new book includes tips on targeting gluten-free food and beauty products, creating gluten-free shopping lists, dining out and maintaining a gluten-free diet during travel.
(c) 2009, Contra Costa Times (Walnut Creek, Calif.)
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