Thursday, August 28, 2014

What's the Deal With Gluten?

By Caroline Shannon-Karasik

These days, it’s hard to pick up a newspaper, turn on the television or surf the Web without seeing a mention of two little words: gluten-free.  But the truth is, while there is more information out there than ever, the wealth of knowledge has also caused a bit of misconception about the lifestyle, how it affects certain people and what the difference is between healthy gluten-free food and gluten-free junk food. 

Well, guess what? I am a gluten-free gal who has celiac disease, so I say now is as good a time as ever to suss out the details, right?  According to the National Foundation for Celiac Awareness (NFCA), an estimated 1 in 133 Americans has celiac disease, yet 83% remain either undiagnosed or misdiagnosed. And, as you might have guessed, the only treatment is a strict, lifelong gluten-free diet.

Why Is Gluten the Bad Guy?

Here's the short of it: When people with celiac disease eat foods containing wheat, rye, barley, triticale and/or contaminated oats (i.e. gluten!), their immune systems cop an attitude and create a toxic reaction that causes damage to their small intestines, making them feel like crap. Talk abut a host of symptoms that come hand-in-hand with celiac disease –– digestive discomfort, diarrhea and vomiting, chronic fatigue, nutritional deficiencies, migraines, reproductive health issues and anxiety are just a few. 

What’s more, mild to severe symptoms resulting from gluten intolerance and sensitivity are plaguing people left and right. According to the NFCA, research estimates that 18 million Americans have non-celiac gluten sensitivity. That’s six times the number of Americans who have celiac disease. Unlike celiac diseases, non-celiac gluten sensitivity does not result in an autoimmune response, but many of the symptoms, including digestive discomfort, bloating and cramping, migraine headaches, and fatigue, are similar. 

"The prevalence of gluten intolerance and celiac disease diagnosis is certainly remarkable and has clearly caught the attention of the medical community by surprise," says Jennifer Fugo, certified health coach and author of The Savvy Gluten-Free Shopper: How to Eat Healthy Without Breaking the Bank. "They've spent a massive amount of time generally believing that an immune reaction to gluten was of little interest and problem for those of us complaining of various issues that don't quite make sense when viewed separately."

Gluten on the Rise

So, why now? Why the increase in diagnoses? Experts say there are two main reasons pointing to the increased awareness of gluten and the nasty spell it has cast on many: 

Today's "wheat" isn't exactly wheat. Kiss that idyllic vision of farmers harvesting their grains goodbye. The truth is, very little of our grain production is done in a wholesome manner. These days, we're chowing down on refined grains that have been modified to suit the business that agriculture has become.
We like to eat ... a lot. Take the fact that glutenous grains have been hocus-pocused and match it with the fact that the overconsumption of food is an ever-expanding problem, and you've delivered quite the double-whammy to your guts. "What might be an occasional issue in the past for those sensitive has now become a monster storm of inflammation that rolls through the body at every bite, [causing] repeated damage to the body," Fugo said.

Gluten-Free Game Plan

So what are you to do? If you suspect gluten may be a creeper that lurks in your gut, then it’s time to pay a visit to your doctor for testing. And listen up: Don't stop eating gluten before you have a blood test –– it may provide a negative result. If the blood test proves you're a dead ringer for celiac disease or gluten intolerance, then the doctor may order a small bowel biopsy. Don't worry –– after the hell your intestines have been through, a teeny biopsy is a walk in the park.

Left untreated, celiac disease can lead to even more health problems, including Type 1 diabetes, infertility, certain types of intestinal cancer and osteoporosis. So guess what that means? This isn’t something you want to mess around with, mmmk?

Need More Help?

The National Foundation for Celiac Awareness and Celiac Disease Foundation offer loads of information, including a symptoms checklist, recipe ideas, shopping tips and information on the latest research.

Do you have questions about celiac disease or a gluten intolerance? Visit my Website for recipes, shopping lists, and more, or send me an email at


Pad Thai Veggie Noodles
gluten-free and vegan

  • 4 cups spiralized zucchini and/or yellow squash
  • 1/4 cup gluten-free soy sauce or tamari
  • 2 Tablespoons toasted sesame oil
  • 1/4 cup pure maple syrup
  • 2 Tablespoons natural chunky peanut butter
  • 1 Tablespoon arrowroot or tapioca starch
  • 1-2 garlic cloves, minced
  • juice of 1/2 a lime


(1) Peel zucchini and/or squash. Prepare spiralized pasta using a spiral vegetable slicer, like the Paderno World Cuisine model, and place in a large bowl. Set aside. (No spiralizer? Use your vegetable peeler to make quick “pasta” by simply continuing to peel the zucchini or squash, creating ribbon-like noodles!)

(2) In a small saucepan, combine soy sauce, sesame oil, maple syrup, peanut butter, arrowroot starch, garlic and lime, whisking consistently over medium-low heat. Continue whisking throughout cooking process, until sauce begins to thicken. Remove from heat and pour over veggie pasta, stirring to combine. Top with desired toppings and serve!

Caroline Shannon-Karasik is the author of The Gluten-Free Revolution, a certified health coach and author of the popular gluten-free blog Sincerely Caroline. Her writing and recipe development have been featured in several publications, including, VegNews, Kiwi, and REDBOOK magazines. She has been a long distance runner for more than 15 years and certified Pilates instructor for more than a decade. Caroline lives with her husband Dan and four adopted cats in Pittsburgh, Pennsylvania. 

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Thursday, August 14, 2014

"You're American, I presume?"

[originally posted at my old tumblr blog in 2011]
I just returned from a short trip to the Dominican Republic.  I initially thought that the DR was an oversized Cancun, but this trip changed my mind.  My sister - who is currently living there - was my tour guide.  The highlight of the trip was Cabarete.
The majority of the non-locals at the beach aren’t travelers from what I could gather.  They were living/working in the small beach town, and I left the DR inspired as a result of the mostly Europeans’ outlook on life.  
I’m currently finishing my second year of med school, so I brought my USMLE Step 1 prep book with me to the island, and I opened it up on my lap as soon as my butt hit the lounge chair.  A Dutch man approached me, took my book from my hands, and closed it at the foot of the chair.  
Him: “You’re studying medicine, correct?”
Me: “Yeah…how did you know?”
Him: “I was just watching you walk from the restaurant to your chair, and your behavior reminded me of a doctor.  You’re American, I presume?”
Me: “Yeah.  Why?”
Him: “Americans work too much.  I suggest you just relax and enjoy your vacation.”
My book remained closed for the rest of the day.  I played frisbee with a kid on the beach. I shared some jokes with my sister.  Admired the dozens of kite surfers.  Tasted the salt water. Got a sun burn.  Spoke with some locals.  Bought a mango from a Haitian lady.  Soaked up the smell of the sand.
We spend so much time worrying about our happiness in the future that we forget all about enjoying the present.  In med school, the majority of our time that isn’t spent sleeping is spent with our heads in the books.  We complain of the misery, madness, and frustration that comes with the demands of our program, yet we trudge on because we crave a future in which we enjoy financial stability, a dream career, and the respect and admiration carried by physicians.  Yet there are far too many variables at play to guarantee that all of this hard work will bring us happiness in the future.  
On the other hand, we have complete control over our present.  The variables are laid out on the table in clear view.  You can dwell on the negative or focus on the positive.  In the future, your career-driven focus will hopefully pay off.  But it’s not a guarantee.  Taking time to visit friends, write letters, kiss your significant other, savor your dessert, indulge a runner’s high, smile like a unicorn while plunging face first into the waves off the North coast of the Dominican Republic: In the present, there are various devices which can guarantee you happiness.  
When you’re on your death bed, you won’t dwell on the test score or the career status that were part of an indeterminable future.  Rather, you’ll reflect on those little guarantees that you indulged in throughout your ever-changing present.
Reform Yourself.  Tomorrow could end today.

Nathan Riley, MD, is [now] a Resident OB/Gyn at Kaiser Permanente in Los Angeles.  He writes about food, movement, sleep, relationships, and stress in order to bridge the gap between his patients and evolutionary theory and clinical evidence. You call follow him on Twitter @BeyondtheMD.  He can be reached at You can also connect with him on Google+. 

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