Showing posts with label celiac. Show all posts
Showing posts with label celiac. Show all posts

Sunday, March 24, 2013

Nutrition Corner: A Valuable Resource

When I was in our local health store last week, a woman who was working there asked me if I had any advice for those who are looking for healthy gluten-free grains to buy.  I told her that I didn't have a specific list, but I asked her if we could use the computer at the store to research for any information from the Celiac Center at Columbia University.  I was excited about the helpful information we found.  Here it is:


Nutrition Corner

A Message From Anne Lee, Nutritionist

Hippocrates said, "Let thy food be thy medicine". In some ways he must have been thinking about people with celiac disease. Years later, the only treatment for celiac disease remains the gluten-free diet. Food is not only their medicine, but also all the other things food is to everyone: the joy of birthday cake; the fun of pizza at a social gathering; traditional dinners of Passover, Thanksgiving, Christmas, and every other occasion worth celebrating; and, the simple joy and satisfaction from our daily meals.

Nutritional concerns for people with celiac disease are similar to any person. It is important to make sure your diet has enough fruits and vegetables for many vitamins and minerals, dairy products for calcium, and protein for muscle building. Adequate rest and exercise are vital parts of any healthy lifestyle. Of particular concern to people with celiac disease is the grain group, and here, the gluten-free diet varies considerably from a regular diet. The grain group provides fiber, B complex vitamins and iron. Unfortunately, many gluten-free vendors do not enrich products with these key nutrients. However, all is not gloomy. In fact, this opens up many tasty and adventuresome opportunities in the world of grains. Many native and ancient grains are packed full of the nutrients. Amaranth, wild rice, and quinoa add a wonderful variety of flavors and textures (see Grains).

It is important to remember a gluten-free diet is not a restrictive diet in the sense of limiting foods. Rather, a gluten-free diet includes all the same great meat, fish, poultry, milk products, fruits and vegetables, spices and herbs a regular food plan contains. Only grain usage changes and therefore cooking methods need adapting. Gone are the days of deep fried coated mystery morsels. Here are the days of good tasting grains, recognizable meats, and generally, far fewer calories and fat.

As a nutritionist, I feel strongly that food is more than just something you eat. Yes, it does provide the vital nutrients your body needs to thrive. A proper balance and variety of different foods is essential to ensure the delivery of a wide range of nutrients. But as importantly, food provides us with social and emotional experiences. Just because you are on a special diet does not mean you cannot enjoy good food. With a positive outlook, maneuvering through a gluten laden social scene will be as easy as a piece of gluten-free cake.

Replacing wheat, rye and 
barley

You may have just been diagnosed with celiac disease or just starting on a gluten-free diet.  Either way, the prospect of eating in a wheat-laden world may seem overwhelming.  But, there's no need to panic.  A gluten-free diet is actually simple, healthy, and not the end of good food.

In general, fruits, vegetables, meats are safe and gluten-free.  Most dairy products are also fine.  Lactose intolerance may be a transitional problem until the villi heal.  The starch/bread/grain group is really the only area of change.
We like to think about this grain group in a positive fashion.  By eliminating wheat, rye and barley, you actually leave many of the high nutrient dense grains like quinoa, buckwheat, millet and amaranth.  These grains provide variety and great taste.  You can also include some old favorites like rice, risotto, potato and corn.  But don't forget the beans and legumes, lentils, chickpeas and black beans make great salads, flours and soups
.
A gluten-free diet can be really tasty, healthy and even make dinner interesting again. So let's begin!

Glossary of grains for the adventurous palate

Do not be intimidated by the unusual names of some grains. They are just as easy to cook and just as delicious as our old standbys.  So be adventurous.  Try one of the nutrient packed alternative grains and taste buds watch out!  Use grain as hot cereal, side dish, in soups and stews, as flour for pancakes, baked products and commonly found as cold cereal.
Amaranth: Once a sacred food of the Aztecs, has a corn like aroma and woodsy flavor.  Best suited to porridge-type dishes or ground into flour for bread.  High in protein,  dietary fiber, iron, magnesium, zinc, calcium and B vitamins.
Buckwheat: Called kasha if toasted.  Best recognized for its use in flour form for pancakes and soba noodles.  Use this heartiest of grains in salads and stuffings.  As a grain as hot cereal, side dish or added to soups, stews and casseroles, as a flour for baking, thickening, and pancakes.  High in high quality protein, magnesium, B6, dietary fiber, iron, niacin, thiamin and zinc.
Millet: Dry and airy when cooked with a little water, but moist and dense when cooked with extra water.  Bland in flavor, millet readily takes on flavors of foods cooked with it.  As a grain as hot cereal or side dish, as flour in baking.  High in protein, fiber.

Quinoa: Native  South American grain with a soft, crunchy texture, boasts the highest nutritional profile of all grains--it's often called "super grain."  More high quality protein than other grains and cereals.  Also high in iron, magnesium, B vitamins, calcium and flour.

Wild Rice: Taste, aroma, size and color depend on whether it is wild or cultivated, where it is harvested and the processing method.  Dietary fiber, protein, potassium and zinc. Grain used as a side dish.
Teff: As a grain, use as a hot cereal, side dish, casseroles, cold as salad. As flour to thicken sauces.  Also available as pasta. High in protein, calcium, iron and B vitamins.


Grain preparation table
Now that we have been introduced to these grains we need to know how to prepare them.  These grains need to be cooked before incorporated into most salads, and soups.  They are also delicious just hot out of the pot as a side dish.

GrainAmount
of Liquid
Amount
of Grain
Cooking time
Amaranth1 c1 cSimmer 7 minutes, let stand covered 5-10 minutes.
Buckwheat2 c1 c15 minutes
Millet1.5 c1 cSimmer 15 minutes, let stand covered 10 minutes.
Quinoa2 c1 cSimmer 10 to 15 minutes.
Teff2 c.5 cSimmer 15 to 20 minutes.
Wild Rice1 c1 cSimmer 30 minutes.


Hidden sources of gluten
Sources:Reason for caution
Hydrolyzed vegetable protein:May use wheat, rye, oats, or barley as hydrolyzed plant protein, HVP or HPP protein source.
Malt or malt flavoring:Derived from barley.
Dairy substitutes:Rice or soy milk products may contain barley or malt flavoring.
Soy sauce:May contain wheat or barley.
Modified food starch:May be derived from wheat.
Processed cheeses:Cheese slices may contain modified food starch.
Prepared cake frosting:May contain wheat starch.
Sauces, jams, gravies:May contain wheat starch as a thickener.
Packaged foods:May contain flour, modified food starch, wheat or barley.
Prescription drugs, over the counter drugs:May contain wheat starch as a filler or dispersing agent.
Lipstick:May contain wheat starch as a filler or dispersing agent.
Play dough:Contains wheat.

In addition, natural and artificial flavors, dextrin, brown rice syrup, malt vinegar, mono and di-glycerides, and flavorings in meat products may contain gluten.

With a gluten-free diet, it is important to focus on the positive. Rather than list all the various additives to avoid or that are allowed, we decided to focus on those main ingredients (besides the obvious) that may contain gluten. Remember that ingredients change and even the sources of those ingredients. Therefore, you must be aware and diligent about checking labels.

http://www.celiacdiseasecenter.org/A_Patients/A05-Nutrition.htm

Friday, January 4, 2013

One Step in the "Gluten-Free Kitchen Makeover"

I love a little booklet I received from the Celiac Disease Center at Columbia University.  It is called, The Ultimate Guide to Gluten-Free Living.  There are many great tips in this booklet.  Here is one for us to remember (though I added a note at the end about something I feel strongly about):

"Even if you follow...precautions, you may still be vulnerable.  Crumbs on the counter, flour gone astray from baking or cooking, re-used utensils and canisters, can make safe foods very unsafe for you.

"For protection, there's nothing like basic good housekeeping techniques.  Thoroughly clean any surface that's been used for regular bread, cake, pastry or flour before you use it for safe foods.*  Divide your utensils and containers into two sets, one strictly gluten-free, and keep them separate."

*I would add that it is better not to have airborne flour in a kitchen where you are striving to keep things gluten free.  When my mom was first diagnosed with celiac disease, she thought she could make gluten rolls for my dad...as long as she didn't taste the dough.  She nearly went into anaphylactic shock from breathing the dust from the flour.

Saturday, August 25, 2012

Coping and Support for People with Celiac Disease


It is comforting to be in the same room with people who have similar struggles.  We can learn so much from others.  My sister and I started a support group with this in mind.  We have learned about other gluten-free products from members of our support group, and we have shared recipes and ideas with each other.

I have felt that there are earthly angels who strengthen us, and heavenly angels who support us. 

I heard a quote once that “Good information leads to good inspiration.”  Education and information about our sensitivities will help us in our quest to live healthy lives.  As we learn more about celiac disease and become more comfortable with how to cope with it, we can then move on to helping others with celiac disease or with another medical condition.  

One way we can show support for others is by taking a few minutes to research about  whatever medical issue another person has.  It doesn’t take too long to do…yet it means so much to the person going through it to sense empathy and concern from another person.  I appreciate those who have learned about celiac disease and offer support.  I hope that I can do better at helping others as they go through their afflictions and strive to learn more about their medical condition.

After diagnosis, I realized that my attitude made all of the difference.  If I faced this trial with courage and strength and a positive outlook, my children did the same.  I know we can do this!  

Coping and support

By Mayo Clinic staff
Living with celiac disease can be difficult. Every day can be a challenge. Over time, however, managing your disease will become second nature. In the meantime, these suggestions may help you manage more easily:
  • Gather information about celiac disease. Talk to your doctor, look for information on the Internet, and read books and pamphlets. Ask your doctor for advice about reliable resources. Find cookbooks featuring gluten-free ingredients. Being informed about your condition can help you take better charge of it.
  • Seek out others with celiac disease. Talking to people who know what you're going through can be reassuring and informative. Your doctor may be able to refer you to a celiac disease support group in your community, or you may find one listed on the Internet or in your local paper.
  • Don't hesitate to seek guidance. If you're having difficulty coming up with suitable menus, talk to a registered dietitian. A dietitian has extensive knowledge of the nutritional aspects of food and what you can and can't eat. He or she can help you think in more creative ways about your favorite foods.

Friday, June 15, 2012

Red Robin's Gluten-free Hamburger Buns are Awesome, but BEWARE the Ranch Dressing!

**Susan's note:  This post is a little outdated now.  The last time we went to Red Robin (early 2014), the ranch dressing recipe has changed and now it is gluten free!  :)

Last Friday, we took the kids to Red Robin.  We lined up the three "celiacs" on one side of the table:  myself, our 13-year-old daughter, and our 17-year-old son.  My husband and our 10-year-old were lined up on the other side.

We loved the gluten-free hamburger buns and my Avocado Burger was delicious. We felt so NORMAL!  No lettuce wrap...and no fork and knife to eat a hamburger without the bun.

We got our gluten-free French fries and the waitress brought out ranch dressing for us to dip our fries in, which is something that I love.  I have a recipe in my cookbook for ranch dressing and we consume some nearly every day.  After the first dip, I loved the ranch dressing so much that I started to worry.  Could it have wheat?  Another dip, and another.  Hmm.  I started to think about how 99% of the time that I have checked on ranch, it is gluten-free.  One more dip.  Uneasy feelings.  I decided I had better ask the waitress.

She came back and said that she had learned from her manager that gluten is wheat and that she was very sorry but the ranch has wheat!!  I don't fault her, since many people are still learning what a gluten-free diet is all about.

About ten minutes after I ate the French fries with ranch dressing, I got a sharp stabbing pain in my upper stomach.  Every ten or twenty minutes after that, the pains kept coming and changing position.  I went to bed feeling a little miserable.  I was awakened at 5:45 a.m. feeling a lot miserable.  There was a horizontal line of searing pain across my gut.  It felt like it was on fire.  I could picture little villi in my small intestine getting flattened.  All from about one tablespoon of gluten-laden ranch dressing.  We can never be too careful.

Learn from my mistake, but do go ahead and enjoy an awesome gluten-free hamburger from Red Robin. 

http://www.redrobin.com/img/content/cms/Wheat_Gluten_Allergen_Menu-3.pdf

Friday, May 11, 2012

Celiac Disease and Iron Deficiency

My sister-in-law e-mailed me to let me know about her friend's blog which details the problems she has had with iron deficiency. She hasn't been able to absorb iron through supplements or food, and then reacted to the iron given to her through an IV.  She recently had an upper g.i., and they found that her villi were flattened.  She is waiting for an official diagnosis, but it appears to be celiac disease.

Isn't it surprising how many symptoms there are for celiac disease?  It seems extremely important that those of us with celiac disease are aware of the most common symptoms, so we can help others to know if they should be tested.  Here is a list from the Mayo Clinic:

There are no typical signs and symptoms of celiac disease. Most people with the disease have general complaints, such as:
  • Intermittent diarrhea
  • Abdominal pain
  • Bloating
Sometimes people with celiac disease may have no gastrointestinal symptoms at all. Celiac disease symptoms can also mimic those of other conditions, such as irritable bowel syndrome, gastric ulcers, Crohn's disease, parasite infections and anemia.

Celiac disease may also present itself in less obvious ways, including:
  • Irritability or depression
  • Anemia
  • Stomach upset
  • Joint pain
  • Muscle cramps
  • Skin rash
  • Mouth sores
  • Dental and bone disorders (such as osteoporosis)
  • Tingling in the legs and feet (neuropathy)
Some indications of malabsorption of nutrients that may result from celiac disease include:
  • Weight loss
  • Diarrhea
  • Abdominal cramps, gas and bloating
  • General weakness and fatigue
  • Foul-smelling or grayish stools that may be fatty or oily
  • Stunted growth (in children)
  • Osteoporosis
Another gluten-related condition
Dermatitis herpetiformis is an itchy, blistering skin disease that also stems from gluten intolerance. The rash usually occurs on the torso, scalp and buttocks. Dermatitis herpetiformis can cause changes to the lining of the small intestine similar to that of celiac disease. However, it may not produce noticeable digestive symptoms. This disease is treated with a gluten-free diet, in addition to medication to control the rash.

http://www.mayoclinic.com/health/celiac-disease/DS00319/DSECTION=symptoms

Friday, April 27, 2012

Help from the Celiac Center at Columbia University


(Photo source:  amazon.com)

Dr. Peter H.R. Green has written this informative book.  He has been doing a great work at the Celiac Center at Columbia University.  Don't worry...I don't get paid anything to encourage others to read his book.  :)   It is simply a great book.  I appreciate the way he weaves medical information into the book without making it overbearing or difficult to understand. Here is a link to the Celiac Center at Columbia University website:

http://www.celiacdiseasecenter.org/CF-HOME.htm

Dr. Green kindly wrote the foreword for my cookbook.  Here it is:


 "People with celiac disease and gluten sensitivity need to own a copy of Susan’s book. It is a great resource presented in a beautiful way. The recipes add diversity and nutrition to a diet that frequently lacks these important components.

"Celiac disease is common, occurring in about 1% of the population worldwide. It is unfortunate that the majority of those who have the disease are yet to be diagnosed. There is a lack of physician awareness about the disease, its frequency, its great variety of manifestations, and its ease of diagnosis. As a result the majority of those with the disease are unaware of how their life could be altered for the better by adopting a gluten-free lifestyle.

"Because of underdiagnosis, those with the disease lack adequate support systems. There is insufficient food labeling, lack of awareness in the food industry, inadequate knowledge among chefs, and a generally inadequate availability of gluten-free products. When products are available they are usually more expensive than gluten-containing products. School, college, and eating out of the home are a minefield. Susan’s book helps fill the void. It is readily readable, and the food tastes great!

"People with gluten sensitivity experience symptoms that are relieved by avoiding gluten, which is found in wheat, rye, and barley. These people are often self-diagnosed. Diagnosing celiac disease typically requires a small-intestinal biopsy and documented improvement, both clinical and pathological. Blood tests often suggest the diagnosis; a small-intestinal biopsy confirms it. We encourage a biopsy because one needs to be certain of the diagnosis prior to making a lifelong commitment to a gluten-free diet. This especially applies to children.

"We at the Celiac Disease Center at Columbia University are attempting to fill the medical void by increasing the quality of the patient care of those with celiac disease, educating health-care professionals, and facilitating a great variety of research projects. It is through dietician, nutritionist, and physician education that more will be diagnosed with celiac disease and their care will improve. Until the number of people diagnosed with celiac disease increases, the difficulties will continue. However, wonderful cookbooks like this one can lessen the burden of the disease."

Peter HR Green, M.D.
Author of Celiac Disease:  A Hidden Epidemic
Professor of Clinical Medicine
The Celiac Disease Center
Columbia University, New York

Thursday, December 1, 2011

Interesting Article in the New York Times

I cheer people who realize that one person can make a difference.  Debbie Deaver (see article below) is no exception.  What a wonderful event the Gluten Free Expo must have been.  I wish I could have been there.  You truly sense the support that those of us who are on a gluten-free diet are getting from companies that are producing gluten-free products.  It is awesome!

November 25, 2011

Should We All Go Gluten-Free?

By KEITH O’BRIEN
The singer was a no-show. The Gluten Free Expo in Sandy, Utah — one of the nation’s largest events dedicated to foods untainted by wheat — was going to have to start without the national anthem. But Debbie Deaver, the expo’s founder, didn’t have time to worry about that. The song, to be honest, was the least of her problems.
Deaver had slept four hours in the last three days. The 34-year-old woman — who has celiac disease and therefore must avoid eating gluten, a key protein in wheat — was running on prayer and Diet Dr Pepper. She needed sleep, and syrup.
A day earlier, a shipment of maple syrup failed to arrive, forcing her to scramble to find a topping suitable for the expo’s enormous gluten-free pancake breakfast. A last-minute donation of 35 cases of marionberry syrup would have to do. And then there was the issue of actual attendees. With the sky spitting rain outside and temperatures hovering around 40 degrees on a dark October morning, Deaver was becoming convinced that no one was coming to her expo in suburban Salt Lake City. “I’m getting nervous,” she admitted as she scanned the empty concourse of the sprawling, glass-walled South Towne Exposition Center just 30 minutes before the show started. “People aren’t showing up.”
But seemingly all at once, they did. When Deaver opened the front doors at 9 a.m., she was stunned by the huge crowd waiting to get inside. At the sight of these people — her people — Deaver stopped cold in her Puma sneakers and began to cry.
“I’m just so excited about those gluten-free pancakes,” she announced to the crowd. “Is everybody ready to eat some pancakes?”
Four hundred people surged into the expo hall in the first 10 minutes, 1,200 in the first hour and nearly 6,000 by the end of the single-day event. They came from as far away as Arizona and Nebraska, like pilgrims to a sort of gluten-free Mecca. Once inside, many were soon listening to one man: Dom Alcocer, a 33-year-old marketing manager, who stood on a chair in an expo booth, barking at the attendees and throwing gluten-free granola bars into the crowd.
“Ohhhhh! Dropped pass!” Alcocer shouted to one person. And then, to another: “Nice catch!”
The crest on Alcocer’s golf shirt said Gluten Freely, as did the sign above the booth promoting a Web site of the same name. But Alcocer wasn’t here representing some Internet start-up. He was from General Mills, the Minnesota-based food-manufacturing giant, which perhaps more than any other mainstream corporation has begun focusing on gluten-free consumers. In the last three years, General Mills — best known for Cheerios, Betty Crocker and that wheat-filled Pillsbury Doughboy — has put gluten-free labels on more than 300 products already made without gluten, reformulated the recipes of five Chex cereals, introduced gluten-free dessert and pancake mixes and, most recently, asked Alcocer to make GlutenFreely.com America’s go-to Web site for the gluten-free life.
“So General Mills funds you?” Annika Lovell, the mother of a 6-year-old with celiac disease, asked. “You’re part of them?”
“Yes,” Alcocer replied. “We are from Minneapolis. We are General Mills. And we are Gluten Freely — here to bring everything together in a one-stop shop for you guys.”
“That’s awesome,” Lovell replied. “I’m so excited.”
Alcocer was excited, too, as usual. The Cornell University graduate was once a captain in the Air Force, where he worked on decoys to confuse enemy missiles and became a Global Positioning System expert who negotiated international treaties on behalf of American interests — heady, scientific stuff. But this job, he said, is just as important as his former military duties. He’s in charge of selling products to a large and once-unknown consumer population: gluten-free America.
“We’ve got food everywhere,” Alcocer said from atop his chair at the expo. “It’s coming out of everywhere. You can’t slow it down. We won’t slow it down.” He paused and smiled. “It’s like I’m selling cars up here,” he chuckled. “How do I get you into a Nature Valley bar today?”
Food companies are always trying to take advantage of the latest dietary trend or health craze. (Low carb, anyone?) But the story of how we got to a place where celiac disease is suddenly mainstream, prevalence rates are rising, perfectly healthy people are opting to eat gluten-free and General Mills is coveting these customers is an especially unlikely business narrative.
I should know. It’s a story I’ve been following for years, ever since I was told I had celiac disease in 1999. I was 26 and until that point healthy. But then I started shedding weight like a sailor lost at sea, and became increasingly gaunt and anemic. So pale, so tired. My doctors told me to prepare for the worst. Cancer, probably. But a biopsy of my small intestine found no tumors in my gut, just withered and destroyed villi. I had celiac disease, a genetic autoimmune disorder. And though it was serious — the disease, when undiagnosed, has been associated with an increased risk of death — I would live. My villi, the tiny, fingerlike protrusions in the small intestine that help the body absorb nutrients, would recover as long as I stayed off gluten, found in wheat, and similar proteins in barley, rye and malt.
But I wouldn’t eat — not really. Gluten-free packaged foods — in which wheat has been replaced by alternative ingredients like rice, sorghum and tapioca flours, among others — were almost impossible to find in the 1990s. Most of what did exist was dreadful: think cardboard. It was also hard to find people who understood the disease itself. Doctors believed it wasn’t much of a problem in this country.
“Nobody really was ready to accept the 1 percent prevalence of celiac disease,” says Dr. Stefano Guandalini, founder and medical director of the University of Chicago Celiac Disease Center, who came to the U.S. from Italy in 1996 and found very little awareness of celiac disease. Even experts ignored it, Guandalini says, noting that a prominent medical textbook published as recently as 1999 questioned how widespread it was. “The chapter on celiac disease,” Guandalini says, “quotes a prevalence of 1 in 10,000 in the U.S. and adds that this is mostly a European condition — and the prevalence is decreasing. This is the formal, official teaching in ’99.”
But Guandalini didn’t buy it. And neither did Dr. Alessio Fasano, another Italian who was practicing at the University of Maryland. The genes were here, Fasano recalls thinking, courtesy of our European ancestors, and so was the gluten, a natural component of wheat that provides the elastic qualities that make for delicious baked goods. But the protein is also difficult to digest. And even a healthy intestine does not completely break gluten down. For those with celiac disease, the undigested gluten essentially causes the body’s immune system to lash out at itself, leading to malabsorption, bloating and diarrhea — the classic gastrointestinal symptoms — but also, at times, joint pain, skin rashes and other problems. In Italy, Fasano routinely saw celiac disease. Surely it was in the U.S. too. Hence, in 1996 Fasano published a paper, asking, in the title, a simple question: “Where Have All the American Celiacs Gone?”
The same year that he published the paper, he founded the University of Maryland Center for Celiac Research. He started small; Fasano had only one patient the first year. In a 1998 paper, however, he reported that he had randomly screened 2,000 blood samples for the antibodies that typically indicate a diagnosis of celiac disease and discovered that 1 in 250 tested positive.
Still, doubts lingered. So Fasano set out to do a more comprehensive study — or, as he called it, “the most insane, large epidemiological study” on celiac disease in the U.S. to date. More than 13,000 subjects in 32 states were screened for the antibodies. Those who tested positive underwent further blood tests and, when possible, a small-bowel biopsy to confirm the presence of celiac disease. The results, published in 2003, were stunning: 1 in every 133 people had celiac disease. And among those related to celiac patients, the rates were as high as 1 in 22. People were listening now — and everything about gluten-free living was about to change. “Believe it or not,” he says, “the history of celiac disease as a public health problem in the United States started in 2003.”
As awareness of the disease became more widespread, Fasano expected celiac diagnoses to increase. That, in fact, is what has happened. Since 2009, Quest Diagnostics, a leading testing company, has seen requests for celiac blood tests jump 25 percent. But Fasano didn’t anticipate other developments. He now estimates that 18 million Americans have some degree of gluten sensitivity. And experts have been surprised, in general, by the rising prevalence of celiac disease overall. “It’s not just that we’re better at finding it,” says Dr. Joseph A. Murray, a gastroenterologist at the Mayo Clinic in Rochester, Minn. “It truly has become more common.”
Comparing blood samples from the 1950s to the 1990s, Murray found that young people today are nearly five times as likely to have celiac disease, for reasons he and others researchers cannot explain. And it’s on the rise not only in the U.S. but also in other places where the disease was once considered rare, like Mexico and India. “We don’t know where it’s going to end,” Murray says. “Celiac disease has public health consequences.” And therefore, it has a market.
Gluten-free products aren’t just selling these days; they appear to be recession-proof. According to a recent Nielsen report on consumer trends, the volume of gluten-free products sold in the past year is up 37 percent. Spins, a market-research-and-consulting firm for the natural-products industry, says the gluten-free market is a $6.3 billion industry and growing, up 33 percent since 2009. Niche companies like Amy’s Kitchen, Glutino, Enjoy Life, Bob’s Red Mill and Udi’s Gluten Free Foods are reporting incredible growth.
Major corporations have also been moving into the marketplace: Anheuser-Busch introduced Redbridge, a gluten-free beer, in 2006, and Kellogg rolled out gluten-free Rice Krispies this year. Other companies have begun adding labels that indicate when their products are gluten-free — that is, when they contain fewer than 20 parts per million gluten (the proposed federal standard). Both Frito-Lay and Post Foods have begun such labeling in the past year. It’s the golden age of gluten-free.
Celiacs aren’t the only ones who are grateful. Athletes, in particular, have taken to the diet. Some claim to have more energy when they cut out gluten, a belief that intrigues some experts and riles others. Guandalini dismisses the idea as “totally bogus.” Yet no one can argue with the success of the world’s No. 1 men’s tennis player, Novak Djokovic. Within months of revealing this year that he had a gluten allergy and had altered his diet accordingly, Djokovic posted a remarkable 64-2 record. By September, sportswriters barely let a moment pass without asking about, as one called it, his “off-court eating habits.” After his victory at the U.S. Open final, a reporter wanted to know what he ate for dinner the night before, for breakfast that morning and what he planned to eat that night. “I’ll give you a simple answer,” Djokovic said with a smile. “Last night I didn’t have any gluten, and tonight I will have a bunch of gluten.”
The reporters burst out laughing. Some even clapped. It was funny. But celiacs everywhere winced. Djokovic’s answer didn’t just trivialize the seriousness of their disease. The answer made it official: gluten-free was a full-blown fad. And while that meant more products on the shelves, it also signaled the possibility that this moment might not last.
Back at General Mills in Minnesota, however, Dom Alcocer insists that gluten-free is here to stay. What he sees, he told me, is a growing number of Americans who have no choice but to be gluten-free. Earlier this year, ConAgra Mills, a leading flour supplier, published a report characterizing gluten-free specialty products as a $486 million industry. That’s much smaller than the $6.3 billion figure from Spins, but it doesn’t include mass-market items like Chex cereals. What’s more, David Sheluga, the director of consumer insights at ConAgra Mills, found something significant about who’s buying gluten-free specialty products and why. More than 80 percent of the market, he estimated, is being driven by core consumers — people on the diet for medical reasons. In other words, Sheluga says, even if some occasional customers give up on gluten-free products, it will have little impact on sales. “That core,” Sheluga says, “is not going away.” These are the customers General Mills set out to reach four years ago when a few employees began floating a radical thought: What would happen if they made Rice Chex gluten-free?
General Mills has for generations boasted about the quality of its wheat flour (“Makes the Bread of Life”) and other wheat-laden products. “We love gluten,” Jodi Benson, a longtime General Mills employee, told me when I visited the company’s headquarters outside Minneapolis last month. “We are,” she added, “the very best of gluten.”
Still, a senior food scientist named Dean Creighton was willing to try to take the gluten out of Rice Chex when the idea was first raised in late 2007. In nearly two decades at the company, Creighton had never tried to remove gluten from a product. But he had tinkered with cereal recipes. “That’s my job,” he explained. And he was pretty sure that he could make Rice Chex gluten-free. He just needed to solve the problem of “brown notes.”
Chex is at its best when it has what experts call brown notes: a toasted flavor and brownish hue. And what contributed to the sweet brown notes was malt syrup, a glutenous ingredient that would end up being replaced by molasses. Just like that, Chex would have a new audience: millions of customers who previously didn’t bother to go down the cereal aisle. “That’s a huge opportunity,” Liz Mascolo, the Chex marketing manager, told me.
As Rice Chex was being reformulated — it arrived on shelves in 2008 — the Betty Crocker team was experimenting with gluten-free mixes for cookies, brownies and cakes. “We were sticking our necks out, because we’re General Mills, and we’re used to doing things mass — big — appealing to everyone,” says Dena Larson, a marketing manager in the baking division at the time. “And we knew that we were inherently going against that.” There were other problems. The early cake recipes fell flat, literally. “Think of yellow cake,” Benson says, “in a brownie height.”
But a thousand batches later, General Mills got it right. Four different mixes, with large gluten-free labels, went on sale just as the cereal division was planning four more gluten-free Chex products: Honey Nut, Corn, Chocolate and Cinnamon. Gluten-free Bisquick pancake and baking mix was in the works, too. Then General Mills asked Dom Alcocer to rebrand the Web presence behind its gluten-free business strategy. Alcocer, in his four and a half years at General Mills, had previously marketed soup and cookies — he liked his gluten. But once tapped for the job, he lived gluten-free for 40 days and began building GlutenFreely.com.
General Mills reached out to the nation’s top experts on the topic — Fasano­ and Guandalini — and asked them for medical advice and scientific guidance. The science, Alcocer said, needed to be front and center. Competitors needed to be acknowledged, too; Alcocer believed customers should be able to buy their products on the Web site. And finally, Alcocer and others at General Mills have pushed for greater transparency: detailed ingredient lists showing which products were gluten-free.
It’s the sort of thing that worries corporations. When a company labels a product gluten-free, then it absolutely has to be, or the consequences can get ugly. “We call that the R-word — recall,” says Brenda Jacob, General Mills’ manager of product labeling and regulatory compliance. “We don’t want to go there.” But in the end, Jacob listened. General Mills published a list of gluten-free products two years ago and continues to add to it today under the stewardship of Alcocer, who believes the company, not the customer, should bear the “mantle of anxiety.”
General Mills won’t disclose sales figures of its gluten-free products. But in statements to investors, the company has indicated that the strategy is working. Retail sales for Chex cereals, in the first quarter of the 2012 fiscal year alone, are up 29 percent. Meanwhile, Alcocer has been on the gluten-free-expo circuit, visiting half a dozen in recent months. He’s not just a guy handing out samples, his colleague Alison Miller says. “He’s a great face,” she says, “of General Mills.”
“Hey, everybody! Come on up and grab as many as you like. We’ve got Nature Valley bars. We’ve got Larabars. All flavors.”
Alcocer was down off the chair now. But he was still working the crowd at the Gluten Free Expo in Utah, doing what he would later describe as “the circus-barking thing.” It’s an act. But not entirely. “We want to be what the brand is,” Alcocer told me. “It’s energetic, it’s positive, it’s happy — it’s just living.”
Toward the end of the day, he was embracing people. “Let’s hug this out,” he told one weepy woman, overjoyed by the products before her. Then Alcocer began to break down the booth, making sure to give away every last item, all the way down to the container of gluten-free chocolate frosting on the table for decoration.
The purpose of attending the expos is to connect with customers. But Alcocer has found a way to do the same thing back in Minnesota too. He often convenes a meeting of what he calls the Gluten-Free Advisory Board — an official title for a very unofficial group of General Mills employees and on-site contractors who have celiac disease, have children with the disease or are gluten-free for other reasons. During the week of my visit to General Mills, eight women attended Alcocer’s meeting. Lunch was served and questions were asked. Alcocer was interested in the holidays. What did they miss? What did they need? How could Gluten Freely make their lives easier?
The women talked about how hard it was to go to holiday parties and find nothing to eat for their children. They discussed the need for better pie crusts. Then one of them, Mary Podvin, raised a subject that resonated with everyone at the table: Casseroles. There was something, Podvin said, about gluten-free Progresso cream of mushroom soup that simply didn’t work in the casseroles she loved to make. “It needs to be — ”
“Gelatinous!” answered Dena Larson, from across the table.
“Glue,” Podvin said with a nod. A gelatinous glue was exactly what cream of mushroom soup typically brought to a good casserole — and that’s what they wanted now from their gluten-free recipes.
“Is that even possible, though?” Carol Bagnoli, whose 3-year-old son eats gluten-free, asked.
“Anything,” Alcocer replied, “is possible.”
The women at the table laughed. The notion that anything is possible isn’t one that gluten-free folks hear very often. But Alcocer wasn’t joking. It was, he told me after the lunch, “a holy-moly moment.” He had no idea that casserole was a problem for his customers. There were, after all, recipes for casseroles on the Gluten Freely Web site. “But if it doesn’t turn out,” he said now, “it’s no good to anybody. So we’re going to go down to the kitchen, and we’re going to say: ‘We need help. These people need help.’ How can we get that can to become that can?” In other words, how could they get a can of gluten-free Progresso soup to act like the can of condensed soup called for in the recipes that his customers loved? “There’s got to be a way,” Alcocer said, “to take this great product and make it work.”
And it was this exchange, perhaps more than any other, that signified, to me, how much the cultural fault lines have shifted. For generations, major corporations have ignored people with food allergies. The goal was feeding the masses.
Now that is changing. Gluten-free foods — none of which taste like cardboard — fill my kitchen cabinets and those of millions of other Americans. A niche market is going mainstream. Long before General Mills unveiled its first official gluten-free product, consumers had made their needs known in phone call after phone call to Minnesota. The global trend data were there, laid out before the marketers, and so was the science — until, finally, it was clear: These customers needed to eat, too, and there was money to be made in feeding them. “It’s millions of people,” Alcocer told me, “with nowhere to turn, but us.”
Keith O'Brien is a freelance writer and the author of a forthcoming book on high-school basketball.
Editor: Dean Robinson