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Get The Facts On Gluten


How can it be that over 20 million Americans are “gluten sensitive” yet most don’t know it?


“Gluten intolerance can be dormant for a number of years or manifest without major gastrointestinal symptoms,” explains Alexander Shikhman, MD, PhD, medical director for Restorative Remedies in San Diego and co-author of Gluten Nation. “The physician’s awareness and knowledge about gluten-related symptoms are very low. That is why most of the patients suffering from this condition are misdiagnosed or the diagnosis is delayed for a number of years.”


Gluten is a complex protein found in wheat, rye, barley, and related grains. Most of us rely on gluten not only as an important source of plant protein but for desirable food texture, particularly in baked goods. But gluten’s presence in foods is extremely undesirable if you are sensitive to it.


In order to better understand gluten sensitivity, it’s important to make some distinctions.


The term “wheat allergy” is often incorrectly interchanged with “wheat intolerance” and thus mistaken for gluten sensitivity. In fact, wheat allergy is actually a histamine response to wheat, much like an allergic reaction to peanuts or cat dander. Unlike gluten sensitivity, which is a result of consuming gluten over time, wheat allergy manifests quickly and with single exposure, usually beginning within a few minutes or a few hours of ingesting wheat. You may experience stomach cramps and nausea, but more likely you will experience skin rash or difficulty breathing.


There is also a difference between general gluten sensitivity and celiac disease (CD), an extreme form of gluten intolerance. CD is an autoimmune disorder where gluten proteins trigger the immune system to overreact with antibodies that actually attack the nutrient-grabbing hairs — called villi — in the small intestine. Without these internal hairs, the body is unable to absorb nutrients from foods passing through the lower digestive tract. CD is a debilitating, chronic inflammatory disease that left untreated will lead to severe malnutrition. Unfortunately, diagnosing CD can be difficult because it presents symptoms similar to other conditions such as irritable bowel syndrome, gastric ulcer, and Crohn’s disease. Also, it is possible to have CD with no obvious symptoms.


It’s not much easier to diagnose gluten sensitivity. “The most common misconception is that gluten intolerance is limited to the intestinal tract,” says Shikhman. “In fact, it is a systematic illness with a broad spectrum of manifestations varying from abdominal discomfort to skin diseases, psychiatric illnesses, autoimmune diseases, diabetes, cancer, arthritis, and more.”


Evidence of gluten intolerance and CD may include weight gain or weight loss, gastrointestinal issues, aching joints and muscle cramps, depression, headaches, exhaustion, irritability, frequent infections, or changes in the menstrual cycle.


There are a number of clinical symptoms and laboratory tests used to diagnose gluten intolerance, but your best bet, says Shikhman, is to eliminate gluten products from your diet for several months. Upon reintroducing gluten into your diet, a recurrence of symptoms will confirm the diagnosis. In diagnosing CD, a biopsy of the small intestine usually is required.


If you and your doctor determine that you are gluten intolerant, the best way to deal with the diagnosis is to adopt a gluten-free diet. This means no breads, cakes, cookies — anything that contains gluten. “In general, it is a lifetime commitment,” says Shikhman.


But this is no reason to fret. Gluten-free versions of your favorite carb-loaded foods are becoming more abundant every day. They’re becoming better tasting, too. Here, a few local sources to get you started:


Claire’s On Cedros

Answering the cries of family and friends who can’t eat wheat products, chef and owner Claire Allison provides a gluten-free bread option for sandwiches, breakfast toast, and French toast, as well as scrumptious brownies and chocolate chip cookies that taste as good as they ought to. (858/259-8597, www.clairesoncedros.com)


Pizza Fusion

The environmentally-friendly pizza franchise uses garbanzo beans, fava beans, and rice flour to make its gluten-free pizza crust, and every topping, with the exception of barbecue sauce and sausage, is gluten-free. On Gluten-Free Thursdays, patrons get two free $1 or $2 toppings with every gluten-free crust. For dessert, there are gluten-free brownies and to wash it all down — gluten-free beer. (619/278-0057, www.pizzafusion.com)


La Jolla Cups

The cupcakery and lounge features a variety of gluten-free cupcakes including lemon-ricotta, double chocolate, chocolate flourless, and carrot. Added bonus: everything is made in-house with local, sustainable, organic ingredients, even the strawberry milk on tap. (858/459-2877, www.cupslj.com)


Julian Bakery

Every loaf of bread baked at La Jolla’s Julian Bread Bakery is free of pesticides and chemicals and bursting with whole-grain goodness. Eighteen flavors include three gluten-free selections. The healthiest of which has to be “Purity,” a sprouted whole-grain, complete protein bread that is gluten-free, wheat-free, sweet-free, yeast-free, low-calorie, and low-carb. (858/454-1198, www.julianbakery.com)   REBECCA CHAPPELL


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