March 5, 2014

March is “Nutrition Month”

By Julie Suchanek, MBA, MT (ASCP)
Metropolitan Medical Laboratory, PLC

A gluten-free diet is a diet that excludes the protein gluten, which is found in grains such as wheat, barley, rye, and derivatives of those grains. A strict life-long gluten-free diet is treatment for those diagnosed with celiac disease (1 percent of Americans), and is also used by those suffering from non-celiac gluten sensitivity (estimated 6 percent of Americans) or wheat allergy (0.01-0.03 percent).

New Guidelines from FDA

On August 5, 2013, the FDA published a final rule defining “gluten-free” for food labeling. A food may be labeled as “gluten-free” if it does not contain any of the following:

1. An ingredient that is any type of wheat, rye, barley, or crossbreeds of these grains.
2. An ingredient derived from these grains that has not been processed to remove gluten.
3. An ingredient derived from these grains that has been processed to remove gluten if it results in the food containing 20 or more parts per million (ppm) gluten.

Manufacturers will have one year from the publication date to bring their labels into compliance. Many manufacturers strive for even stricter gluten levels (<10 ppm).

Foods that Contain Gluten

In general, the following list is a sampling of foods may contain gluten unless they’re labeled as gluten free: beer, breads, cakes and pies, candies, cereals, cookies and crackers, croutons, french fries, gravies, imitation meat or seafood, matzo, pastas, processed luncheon meats, salad dressings, sauces (including soy sauce), seasoned rice mixes, seasoned snack foods (such as potato and tortilla chips), self-basting poultry, soups and soup bases, and vegetables in sauce.

Foods that are Naturally Gluten Free

Fresh foods without any processing or additives that are naturally gluten free include fruits, vegetables, most dairy products, meat, and beans/seeds/nuts in their natural unprocessed form.

U.S. Gluten-Free Market

An increasing number of food manufacturers have risen to the challenge of producing more gluten-free products. The U.S. gluten-free market was $4.2 billion in 2012, and is predicted to grow to $6.6 billion by 2017. On average, a recent study showed that gluten-free products were 242 percent more expensive than the same products with gluten.

Celiac Disease

Celiac disease is the world’s most common genetic autoimmune disorder. According to Dr. Alessio Fasano, a member of the Medical Advisory Board for the Celiac Disease Foundation, “There must be some environmental factors that explain why most people eat gluten all their lives and stay healthy, and others lose their tolerance. And it could happen at any time. Some people don’t become celiac until they are in their 70s. You’re not out of the woods at any age.”

Dr. Fasano continues, “We also know that prevalence is rising and we’re in the midst of an epidemic. Based on our study, it seems that prevalence has doubled every 15 years in North America. Why? I think it goes back to the microbiome. There are antibiotics; our diet has changed; we travel more. There have been so many changes in the past 50 years.”

Testing

For accurate results, a gluten-free diet should not be started before the blood tests and intestinal biopsy are done. For celiac disease, anti-tissue transglutaminase (tTG-IgA) is a screening blood antibody test that is commonly used. For food allergies, IgE blood tests can be used.

Diagnosis

An endoscopic biopsy of the small intestine (performed by a gastroenterologist) is the standard way to diagnose celiac disease. According to Dr. Fasano, “…the average time [to a confirmed diagnosis] is still 5-6 years, and many still go undiagnosed. The problem is that it’s such a clinical chameleon. Some people have no gastrointestinal symptoms whatsoever, and no one presents in the same way. The most common way that it presents itself is anemia, but this, too, is changing over time.”

In addition, not all people who react negatively to gluten have celiac disease. The symptoms of non-celiac gluten sensitivity are similar to those of celiac disease. People who are gluten sensitive show symptoms after eating gluten, but will not have intestinal damage and have no celiac disease antibodies.

As Metropolitan Medical Laboratory celebrates our 100th year in 2014, your good health continues to be our passion. If you think you have celiac disease or gluten sensitivity, talk to your doctor about getting tested before you start a gluten-free diet.

Metropolitan Medical Laboratory, PLC is one of the largest accredited laboratories in the states of Illinois and Iowa, and has provided this community with quality laboratory services for 100 years. Visit www.metromedlab.com. See Metro’s NEWEST location at the intersection of John Deere Road & 53rd Street in Moline:

5401 44th Avenue Drive
Moline, Illinois 61265
Phone (309) 736-7370;
Fax (309) 736-7344
Hours: Mon.-Fri. 7 am – 6 pm;
Sat. 8 am – noon

Tell your doctor, “I want to go to Metro.

Filed Under: Health & Wellness