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Should I Go Gluten-Free? Break it Down for Me

 

 

Google “gluten free” and you get roughly 150,000,000 results.

Clearly, the topic of gluten is trending.  You probably know at least one person that has cut gluten from their diet.  This begs the question: Is eating gluten-free a fad?  Will it pass by us eventually à la fat-free diets?  And what about the choice of whether or not you should go gluten-free?  Friends, that question is one we hear a lot.  And we want to help you find the answer.

Without having a severe gluten intolerance or celiac disease, it can be tough to know if it’s worth it, right?  How do you know if you have a gluten intolerance, celiac disease, or a sensitivity?  Well, while there is a test that can identify whether or not you have celiac disease, the only surefire way to know if you have a sensitivity is by eliminating gluten from your diet and seeing how your body responds after gradually reintroducing it thereafter.

To start, it’s important to understand the different types of gluten sensitivities.  These varying sensitivities can have different OR similar symptoms—and it’s often much more than just a bad stomachache.  Here’s a deeper look at the different sensitivities so you can better identify how gluten may be impacting you:

1. Gluten is a BIG problem for you (e.g., celiac disease)

Celiac disease is on the rise.  The condition, also called celiac sprue, coeliac, and gluten-sensitive enteropathy, once considered rare now affects more people than ever: 1 in 100.  Many physicians believe it is a grossly undiagnosed disease, and some doctors now regularly screen anyone with severe digestive complaints for the troubling illness.  The reality is that celiac is more than an uncomfortable condition—it can be life threatening, and is characterized by autoimmune antibodies.  It’s important to understand that celiac CANNOT cause anaphylaxis—a severe and potentially life-threatening allergic reaction—unlike a wheat allergy, for example.  Most people will not die from the immediate symptoms of celiac disease. However, left untreated, it can lead to several other conditions, some of which can be fatal.

●      Common symptoms: Stomach pain, chronic diarrhea, bloating, fatigue, floating or foul smelling stool, depression, fatigue, infertility, and weight loss.

●      Associated symptoms & conditions: Itchy rash, peripheral neuropathy, ataxia, osteoporosis, behavioral changes, irregular menstrual cycle, infertility, Addison’s disease, fibromyalgia, autism, anxiety/depression, chronic fatigue syndrome, inflammatory bowel disease, irritable bowel syndrome, severe headaches/migraines, rheumatoid arthritis, Hashimoto’s thyroiditis, Graves disease, type 1 diabetes, pancreatic disorders, and multiple sclerosis.

●      Diagnosis: To diagnose celiac disease, your doctor will administer a blood test called a Tissue Transglutaminase Antibodies (tTG-IgA), and you must have gluten in your system at the time of the test—if you’re on a gluten-free diet the test may produce false negative results.  This test is 98% accurate in patients with celiac disease.

2. You don’t have celiac disease, but something is way off (e.g., gluten intolerance/sensitivity)

Many people experience symptoms like those of celiac disease, despite negative tTG-IgA test results and intestinal biopsies revealing no tissue damage. It is unclear what the underlying cause is for a gluten intolerance or sensitivity, and is often diagnosed based on a patient’s response to a gluten-free diet.

●      Common symptoms: Often the same as celiac, and primarily digestive distress.

●      Dietary Recommendations: Having a severe gluten intolerance is becoming increasingly common, and it can be very frustrating because it’s difficult to obtain a clear diagnosis.  Gluten sensitivity can manifest in the same way as celiac disease, but with greater variability in severity and duration.  Your best bet may be to try an elimination diet, which you can find in many of our programs!  We recommend eliminating for two months for best results.  Determining if you’re gluten sensitive is just as important as determining if you have celiac disease, because over time, the integrity of your gut health can be compromised.  Gastrointestinal health is the cornerstone of optimal health—it plays a major role in the balance of hormones, mood, cognitive function, and other aspects of overall health and well-being.

3.  Gluten doesn’t make you feel too sexy

For those that don’t have celiac disease or a diagnosed intolerance, you may just not feel so hot after you eat gluten-containing foods.  Low energy, less endurance, and overall “slowness” are common words used to describe these feelings.  By removing gluten from your diet, many in this category see a positive change in their appearance, and many professional athletes have gone gluten-free to improve athletic performance!

●      Common symptoms: Digestive distress, fatigue, energy loss, and overall blah.

●      Dietary Recommendations: We recommend eliminating gluten from your diet for two months.  Why?  Gluten is pesky and can linger in the blood stream for a long time.  Add it back into your diet gradually over time and see you how feel.

4.  Gluten ain’t no thang

You feel absolutely fine with gluten.  No cramping or chronic side effects.  Perhaps you have headaches, digestive issues, or some joint pain.  You’ve tried going gluten-free for two months and noticed zero difference.  You’re realizing maybe something else is to blame.

Our feelings?  Being gluten-free is not a fad.  We have worked with too many people who notice legitimate improvements by removing it from their diet.  With that said, it’s important to consider a few things—when you cut out gluten, you are often cutting out a lot of unhealthy food too.  You will not be able to eat most fast food, many packaged items, and other foods that simply aren’t healthy.  So you have to ask yourself, was it the gluten or was it the crummy food?  One way to determine the difference is to eat healthy sources of gluten as a trial: wheat berries, farro, and couscous are just a handful of naturally gluten-filled whole grains.  On the flip side, going gluten-free and replacing those packaged foods with gluten-free versions may not necessarily improve your health, as they’re often laden with added sugars and fats to improve flavor.  The ticket is to try removing it from your diet and trying a healthy whole foods diet (with gluten grains) to see if gluten is the cause!

SO, what do you think? 

We hope this information helps guide you in making the decision of whether to go gluten-free.  Ultimately, the best way to find out whether a gluten-free diet is right for you is to remove it from your diet, then gauge how your body responds upon reintroduction.  We help people explore this in our 20-day nutrition program: Prescribe 20.  Because going at these things alone is never easy, and rarely successful, we believe that community is the key to success.  With our programs, we’re with you every step of the way, offering recipes, educational materials, and professional guidance.  With this support system in place, the process of discovering how to feed YOUR body isn’t so bad. Not one bit.

 Megan Morris is a certified nutritionist, Co-Founder & CEO of Prescribe Nutrition, and Founder of The Root of Health: an online digestive health resource. 

 

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OIT—Is It For Me?

Feeding your peanut-allergic child peanuts is not easy as a mother—I would know, I do it every day. Your instincts as a parent are to keep your child as far out of harm’s way as possible. But in today’s world, peanuts may be the best management tool we have for my peanut-allergic child.

Let me explain.

My daughter was born with a severe allergy to peanuts and tree nuts. For the first three years of her life, we strictly avoided these foods. She’s now four. Last April, we agreed to undergo an oral food challenge at her allergist’s office to find out if she was still allergic. Her peanut blood test numbers had dropped considerably—this blood test measures levels of Immunoglobulin E (IgE) to individual allergens in the body. IgE is the antibody that triggers food allergy symptoms. Plus, she hadn’t been exposed to peanut since she was a baby. Unfortunately, the oral food challenge outcome wasn’t as we hoped: after ingesting ¼ of a peanut, split into three gradually increasing doses over a 45-minute period, she experienced an anaphylactic event and we had to administer epinephrine. It was an emotional day, to say the least.

After discovering that she was still severely allergic to peanuts, we decided to explore oral immunotherapy: a method of food desensitization that involves re-introducing the immune system to the allergenic food in gradually increasing amounts over time, with the goal of eventual tolerance.

For our family, the results have been life changing. The same little girl that reacted to ¼ of a peanut now eats 12 peanuts daily with zero symptoms. But OIT is not necessarily for everyone, so I’d like to share our family’s journey and offer some insights into the process so that you can determine whether it’s a good fit for you or your child.

If your allergist doesn’t have a clear picture of your allergy severity, treatment may start with an oral food challenge. Once the individual has been identified as an OIT candidate, they are typically provided a juice-like beverage containing tiny amounts of the allergen. This beverage is consumed during the same two-hour period every day. Depending on how quickly a patient builds up a tolerance, your allergist may recommend coming in every week or two for an “updose”—an increase in the amount of allergen consumed. As the immune system grows more tolerant, the patient eventually moves to a powder form (which is typically sprinkled onto food), and finally to solids (e.g., whole nuts).

Importantly, OIT requires a considerable time commitment. Although updosing typically occurs every week or two, the allergen must be consumed every day to build and maintain tolerance. OIT also places constraints on physical activity. During OIT, the patient can only engage in calm, quiet activity half an hour before dosing, and at least two hours afterwards (during their observation period). This ensures that the immune system doesn’t get “revved up” unnecessarily and trigger an allergic reaction.

Is OIT perfect? Not quite. For the foreseeable future, my daughter must eat 12 peanuts with a two-hour observation period everyday. However, we can now choose the time frame each day, and expect the observation period to shorten over time. There’s also a measure of unpredictability. On two occasions, our daughter developed a couple hives after her prescribed dose, and we had to give her antihistamines. Other times, we had to lower her dose because she was sick, which can compromise the immune system. It is these situations, and the risk of producing a more serious adverse outcome, that discourages many allergists from taking up the practice. Indeed, OIT is still relatively controversial. Additionally, OIT treatments are still in their nascent stages and are not widely practiced, so there is less data and information available.

Importantly, not every food-allergic child or adult is a good candidate for OIT. For example, if a patient has severe environmental allergies, acute asthma, or eosinophilic esophagitis, they will not likely qualify for OIT. Additionally, OIT treatment is not available for all allergens—desensitization to peanuts, for example, is far more common practice than, say, shellfish.

If you think OIT may be of interest to your family, I’d encourage you to talk to your allergist and seek out additional information and guidance. You can also reach out to me at mnohe@allergyamulet.com for more on the parent perspective—I’m always up for a good food allergy chat!

- Meg, Director of Strategic Development

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B the Change: The Future of Business

 

Occasionally, our blog content may depart from its typical focus on food allergies to discuss topics related to business and entrepreneurship. We are a start-up, after all. In this post, we examine the role of corporate social responsibility in today’s world. This piece also coincides with a guide I wrote for entrepreneurs on the same topic, which Yale and Patagonia jointly published today.

In a recent column in The Week, William Falk discusses the loss of civility in America. He starts with a story of his pregnant co-worker standing in a crowded NYC subway car, waiting for someone to offer her a seat (spoiler alert: no one did), and segues into what he sees as a “me-first” mentality overtaking common decency in America. I was reminded of a recent experience at an airport, where I witnessed two disabled men and a member of the military waiting until the platinum, gold, and first-class passengers boarded before they were invited on the plane. Capitalism at its finest.

Falk attributes this culture shift partly to our “brutally Darwinian” workplace culture, in which overtime is encouraged and vacation is a luxury few can afford. Falk submits that this workhorse mentality fuels an economic struggle of survival that leads to competition and hostility, both inside and outside the workplace. I think few would dispute the considerable amount of economically motivated resentment in our country right now.

So how did we get here? Why the Darwinian corporate culture? I think the problem started, in part, with one man; and the solution, I believe, lies partly in the guide I mentioned at the start of this piece.

Let me explain.

In 1970, Nobel Prize-winning economist Milton Friedman, a champion of free market economics, famously stated: “There is one and only one social responsibility of business[:] to increase its profits.” In other words, companies must value profits above all else and are not bound by a commitment to the communities and people they employ and serve. This ideology came to be known as the doctrine of shareholder primacy. But the problem with this theory is that profits often come at the expense of worker well-being, community health, and the environment.

Now, say your businesses decided to consider employee well-being on par with shareholder profits in corporate decision-making. What then?  

In 2006, the nonprofit organization B Lab launched a certification process aimed at supporting just those kinds of stakeholder-driven business decisions. The objective was to separate the truly “good” companies from those that merely had good marketing departments by implementing a standard vetting process. B certification created a system that measures social and environmental impact, and ensures reporting compliance through more stringent measures of accountability and corporate transparency. In 2010, states began implementing statutes under which companies could incorporate as Benefit Corporations: an alternative to a C-Corp or LLC that builds the same values of Certified B Corporations into the company’s charter and articles of incorporation. The same principles inform both certification and incorporation: to place stakeholder interests (shareholders, employees, community, and environment) on equal footing in corporate decision-making. The guide I mentioned offers a detailed roadmap for businesses interested in securing either B certification or incorporation status.  

If all of this B stuff is new to you, you’re not alone—though you’ve probably heard of Patagonia, Etsy, or Warby Parker, all of which are either a Certified B Corporation or a Benefit Corporation. To date, there are nearly 4,000 Benefit Corporations and 2,000 Certified B Corporations in existence, and these entities are just the tip of the iceberg. According to a recent report, “social impact has evolved from a pure PR play to an important part of corporate strategy to protect and create value.” JP Morgan estimates that the market for socially responsible investing stands somewhere between $400 billion and $1 trillion.

We live in an increasingly interconnected world, one in which we are (ironically) becoming more and more disconnected from the communities and people around us. We often don’t know the people who sew our clothes, the farmers who grow our produce, and the manufacturers who assemble our electronics. Globalization and interconnectedness have increased trade and communication between countries, but they have also fueled income inequality and transferred millions of jobs overseas. 

Our nation’s businesses and economy are only as healthy and as strong as the communities, environment, and employees they serve and on which they depend. Milton Friedman was wrong. The rise and popularity of Certified B Corporations and Benefit Corporations is largely a response to that realization. Now, more than ever, businesses must build social values into their bottom line. It’s not just good for society—it’s good for business.

-Abi, CEO & Co-Founder

 

Allergy Amulet is neither a Certified B Corporation nor a Benefit Corporation. Our company is currently pre-revenue and does not yet have a product on the market. Because of this, it is too early for certification and too costly to reincorporate. The company plans to pursue both designations at the appropriate time.

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