Maureen McDonnell,RN… (my favorite gluten free cookie recipe at end)
Let’s start by identifying exactly what gluten is: According to Lisa Lewis, PhD, author of Special Diets for Special Kids and coauthor of The Encyclopedia of Dietary interventions for Autism and Related Disorders, gluten is a protein found in members of the grass family including wheat, spelt, barley, rye and triticale. In their pure form oats do not contain gluten, but commercial oats are almost always contaminated with wheat. Gluten can also be found in products derived from these grains such as malt, soy sauce, grain alcohol and some fillers found in vitamins and medications.
Like most of the information I’ve learned about health over the years, my understanding of the significance of removing gluten from ones diet was not acquired during my education, training or career as a registered nurse working in hospitals. It all started when I began interacting with children with autism and listening to parent’s reports of the remarkable improvement in their child’s behavior, attention and speech when they eliminated gluten from their diets. Actually, it was Lisa Lewis the author mentioned above (and parent of a child with autism) who first told me about these parent testimonials as well as the studies coming out of Europe supporting the theory (1) and frankly….. I thought she was nuts! How could something so fundamental to our diet like wheat be a culprit in causing autistic-like behaviors? But seeing positive changes in these kids, made a believer out of me.
The theory behind the positive response goes like this: studies have shown that some children on the autism spectrum lack specific enzymes to properly breakdown the protein in gluten (and casein which is the protein in dairy). As a result, instead of completely disassembling these proteins into amino acids (as most of us do,) they break them into clumps of amino acids called peptides. These peptides can mimic or interfere with proper neurotransmission and cause what some refer to as “an opiod affect” in the brain resulting in abnormal behaviors that often manifest as an inability to properly interact or communicate. Subsequently, when gluten is removed, initially children go through a phase with similar features to a drug withdrawal before the fog lifts. After that, socialization skills and eye contact often improve allowing the child to become more engaged and connected. Dr. Cade, a researcher at the University of Florida published a study in 2000 showing that when gluten and casein were removed from the diets of children with autism, 80% experienced significant improvements in socialization skills, eye contact, speech, learning skills, hyperactivity and self injurious behaviors. (2)
After seeing first- hand what removing gluten can do for children with autism, I began doing research on, and meeting individuals who had other conditions that improved as a result of this special diet. The most common of these of course is Celiac Disease which according to the Celiac Dz Foundation is “a lifelong inherited autoimmune condition affecting children and adults. When people with CD eat foods that contain gluten, it creates an immune-mediated toxic reaction that causes damage to the small intestine and does not allow food to be properly absorbed. Even small amounts of gluten in foods can affect those with CD and cause health problems.. “
One of the problems with this condition is that individuals often spend years affected by agonizing symptoms, but often go undiagnosed. The symptoms vary but usually include: diarrhea, bloating, abdominal pain, gas, headaches, anxiety and fatigue, .
Heather S. has a degree in nutrition and is knowledgeable about both traditional as well as alternative approaches to health. For 15 years however, she was unable to figure out why she was suffering from bloating, anxiety, fatigue and irritability. It certainly wasn’t from lack of trying, as she consulted many physicians over the years. But none of the doctors even suggested she be tested for Celiac. Finally, after reading about the Celiac symptoms , she asked her doctor to order a blood test. Subsequently, she discovered she was positive for the gene (DQ2 and DQ8). Although not completely conclusive (without additional blood tests and an intestinal biopsy), being positive for the gene was enough evidence to convince Heather she should remove all gluten from her diet. Like most individual who embark on this dietary change, she found it challenging at first. However, almost immediately she felt relief from her symptoms and her health improved making the elimination of gluten well worth her efforts. What puzzled Heather more than anything was why, during all those years ,and all those doctor visits, had no one suggested she be tested for Celiac? She’s never found an answer to that question other than the fact that “if you don’t look, you won’t find” and unfortunately many doctors aren’t looking.
Not only are mainstream physicians not quick to order the tests for Celiac (see lists of recommended tests below), but many of them (not fully understanding the damaging effects of gluten and just how many nutritious gluten- free grains options there are), rarely recommend a trial off of gluten to see if symptoms abate. A new age of holistic wellness with its emphasis on self care has arrived however, and savvy individuals like Reva (a licensed massage therapist and a certified practitioner of therapeutic and visionary cranio-sacral work) didn’t wait to be told what to do. Instead of undergoing various tests, Reva relied on the same intuitive powers she uses when working with her clients to guide her to do a trial of a gluten free diet. Reva states that she battled skin rashes, an inability to lose weight and anxiety for years. Although she had previously been on a healthy diet and a host of supplements and herbs that helped, it wasn’t until last year when she had the realization that she needed to remove gluten, that her rash disappeared, her weight dropped, she felt less bloated and her anxiety diminished. So although she did not have the traditional blood work, genetic testing or an intestinal biopsy to confirm the diagnosis, Reva trusted her intuition and found that being off of gluten allowed her to be symptom free. For her, the best test results came from listening to the signals she received from her own body. The key says Reva “is to pay attention when the body speaks!”
Reva may or may not have Celiac, but she knows without a doubt she feels better without gluten. Up until recently people eliminating gluten for symptom control without being diagnosed with Celiac were considered to be eccentric or hypochondriacs and to be enforcing unnecessary dietary restrictions.
Science may be on the side of those of us who see a positive change in our symptoms without a diagnosis of Celiac. One recent study out of Australia published last month in The American Journal of Gastroenterology (3) validates what Reva and many others know instinctively. In the conclusion of the double-blind, randomized, placebo-controlled rechallenge study, it was reported that patients with symptoms of irritable bowel syndrome without celiac disease reached satisfactory levels of symptom control with a gluten-free diet showing that gluten is indeed a trigger of gut symptoms and tiredness. In plain language, the study supports the existence of a non-celiac gluten sensitivity and that symptoms do improve when gluten is removed.
Until recently, eating a gluten free diet was not exactly an epicurean’s dream. Although one can still consume most forms of protein (meat, chicken, fish, turkey, eggs, nuts) , vegetables, fruits, salads and eat a variety of gluten free grains such as quinoa, millet, corn, brown rice and amaranth, some of the gf breads used to taste like cardboard and no matter how long you cooked the gf pasta, it was never quite the same as the good old semolina version. But that’s old news. Companies have emerged that now carry delicious gluten free products including breads, muffins, pasta and cookies Examples: Bob’s Red Mill www.bobsredmill.com , Rudi’s Bakery www.rudisbakery.com , Glutino www.glutino.com, Venice Bakery www.venicebakery.com, Solterra www.solterrafoods.com and many more can be found at the product news section of www.celiac.org . Just a word of caution: watch the sugar content of some of these products as I’ve seen companies over compensate with sweeteners when removing gluten.
In addition to the chain of restaurants offering gluten free option that include Outback Steak House, PF Changs, Bone Fish and others, here in Asheville, North Carolina where I live, we have a privately owned restaurant that not only offers an amazing variety of popular foods all made with gluten free grains, but it’s a cool, comfortable and beautiful place to hang out. No longer relegated to eating home or in some tiny back room of a health food store, those of us enjoying the health benefits of a gluten free diet can now dine in great restaurants.
They say those of us of Irish and Scottish descent are more likely to be gluten intolerant. Well, I’m 100% Irish, and I can definitely do without the gas, bloating and fatigue that come when I consume gluten. Besides, in addition to all this tasty gluten free food out there, you can now get gluten free beer.…… so I no longer feel deprived… even on St. Patty’s day!
Maureen McDonnell has been a registered nurse for 33 years (in the fields of: childbirth education, labor and delivery, clinical nutrition, and pediatrics.) She is the former national coordinator of the Defeat Autism Now! Conferences and is the co-founder of children’s green health expos: Saving Our Kids, Healing Our Planet. Her published articles on autism can be found at www.SOKHOP.com . Maureen presently provides private health consultations and can be reached via email for an appointment (MauraHealth@aol.com) In addition to writing a monthly column Common Sense Approaches to Women’ Health. For WNC Woman Magazine, she is the owner of Nutritionist’s Choice multi vitamin: www. NutritionistsChoice.com. Maureen, and her husband H Hanson feel blessed to have six kids, five grandkids and to be living in the beautiful mountains of WNC
1. Reichelt KL, Ekrem J, Scott H. Gluten, milk proteins and autism:
dietary intervention effects on childhood autism. J Appl Nutr. 1990; 42
2. Cade RJ, Privette RM, Fregly M, Rowland N, Sun Z, Zele V,Wagemaker H,
Edelstein, C. Autism and schizophrenia: Intestinal disorders. Nutritional Neuroscience. 2000; 3: 57-72.
3. Biesiekierski , et al. Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: Am J Gastroenterol advance online publication, 11 January 2011; doi: 10.1038/ajg.2010.487
From the Celiac Disease Foundation: www.Celiac.org
Recommended Blood Tests: website:
A person seeking diagnosis MUST be following a daily diet that contains gluten for at least 4 weeks in order for test results to be accurate. Specific antibody blood tests are the initial step in screening for CD. Patients should always consult with a physician to ensure proper diagnosis.
- Anti-tissue transglutaminase antibody (tTG – IgA and IgG)
commonly used whether or not symptoms are present and the most sensitive test available
- Anti-endomysial antibody (EMA-IgA) – highly specific marker for celiac disease
- Anti-deaminated gliadin peptide (DGP – IgA and IgG)
used when tTG or EMA is negative and in cases where patient is IgA deficient
- Total serum IgA – used to check levels to exclude selective IgA deficiency that results in a false negative test
- Anti-gliadin antibody (AgA – IgG and IgA) not considered sensitive or specific enough for adults, but used for children under 2 because tTG and EMA antibodies may be absent. The anti-DGP test is sensitive in this group.
A patient with positive antibody tests and a patient with selective IgA deficiency are strongly advised to consult with their physician regarding a small bowel biopsy (which is performed endoscopically). A positive small bowel biopsy is required to confirm the diagnosis and assess the degree of damage to the villi in the intestinal lining. Antibody test results can only suggest the presence of Celiac Disease but cannot confirm it. When antibody results and biopsy are inconclusive, or when the patient is on a gluten-free diet, genetic testing of the HLA (human leukocyte antigen) DQ2/DQ8 genes may be helpful. The specific genes DQ2 and/or DQ8 are considered necessary for Celiac Disease to develop. Since one-third of the population also has these genes, the presence of DQ2 or DQ8 does not imply that the person will necessarily develop CD, rather, that they have a genetic predisposition to CD.
Genetic testing does not diagnose Celiac Disease – its largest benefit is that the absence of DQ2 and DQ8 essentially excludes CD.
Mo’s gluten free, flaxseed, almond flour, sunflower seed, coconut, Choc chip Cookies
(for those of us who need a treat once in a while)
(all ingredients organic of course)
Preheat oven to 350 degrees
1/2 cup butter
1/4 cup sugar (1/2 of what the recipe originally called for and you can even put less in if you wish)
1 tsp vanilla
Cream melted butter and sugar. Add egg and vanilla. Beat together until fluffy.
In another bowl stir together
1/2 cup almond flour
1/2 cup freshly ground flax seed
1/2 tsp baking soda
Add this to the butter mixture and mix until blended
Stir in 6 oz organic dark chocolate chips
1/2 cup unsalted sunflower seeds
1/2 cup unsweetened coconut
Drop 1 tsp full of mix on buttered (or coconut oil rubbed) cookie sheet 2″ apart.
Bake at 350 for 10-12 minutes
I like to store them in the freezer because to me they taste better when their frozen…..be careful …..they’re addicting!