GLUTEN AND AUTISM: UNDER INVESTIGATION

A big health story this week relates to new reports of the American Academy of Pediatrics (AAP) calling for vigilance regarding signs of autism. "What's brand-new is that we're asking pediatricians to screen all children for autism at the 18-month and 24-month well-baby visits—not just children with speech delays and children of parents who have a concern. We're also telling pediatricians to ask parents about social and language deficits that may be present in very young children," Chris Plauché Johnson told U.S. News & World Report.

The AAP press release refers to the use of gluten-free diets to help children with autism spectrum disorders (ASDs):

Although use of the gluten-free/casein-free diet for children with ASDs is popular, there is little evidence to support or refute this intervention. More studies are in progress, and it is anticipated that these studies will provide substantially more useful information regarding the efficacy of the gluten-free/casein-free diet.

So what's to be done while the world awaits the result of the studies?

Well, I see some benefit in pediatricians and parents being similarly vigilant for celiac disease and other forms of gluten intolerance. Some reasoning:

The frequency of autism is about 1:150; the frequency of celiac disease is higher, about 1:133.

Blood screening for celiac disease is a relatively safe procedure that should not jeopardize a child's health (though a pediatrician should make sure that the blood tests are evaluated correctly).

Even if tests for celiac disease are negative in children suspected of having autism, there should be some consideration that there could be a neurological gluten intolerance that does not fully register in tests for celiac disease. A recognized example of a neurological gluten intolerance (not to be confused with celiac disease or autism) would be gluten ataxia.

PRODUCTS ON PARADE: NOTTA PASTA & BIONATURAE PASTA

When I first went gluten-free, there was basically one gluten-free pasta to be found at supermarkets. It was made from corn and it was pretty awful—fragile and mealy.

Things continue to look up. At my local Food Emporium I can find relatively protein-rich Bionaturae gluten-free pastas, which are made with rice, potato, and soy...



















...and I can also find Notta Pasta. I've had a soft spot for this Thai-made rice pasta (especially the broader varieties) since I spotted it at an Upper East Side health food store. It cooks fast (which makes it convenient and a good choice for cooking in hot weather) and has a slightly chewy consistency that's somewhat similar to that of cellophane noodles. It's not quite a substitute for traditional pastas, but it has its own noodle-y merits.



















Photos: David Marc Fischer

ZAGAT NYC RESTAURANTS 2008

Last year Zagat seemed to make a giant step forward by mentioning gluten-free options in its listings for Risotteria ("sets the standard for gluten-free dining") and Sambuca ("also offers a gluten-free menu - 'is that an oxymoron for Italian?'").

This year the restaurant guide seems to have taken a baby step backward. It still doesn't acknowledge gluten-free dining in its Cuisine and Special Features sections...and its choices of comments for Risotteria and Sambuca are actually misleading. The guide says that at Risotteria "'everything is gluten-free,'" which is just not true. And the guide says that at Sambuca "a separate sans-gluten menu lets everyone 'eat freely'"—a bit of an exaggeration.

Risotteria is still a bargain spot compared to the other rated restaurants. Asia de Cuba still gets a special "top spot" designation. According to the guide, the average tip went up a smidgen to 19%. And I still suspect that Outback Steakhouse is treated too harshly.

So here are the ratings for the NYC GFRAP restaurants listed in Zagat 2008. Alas, the ratings tended to stay the same or decline in comparison with last year's results.

Candle 79
Food: 23 (down 1)
Service: 21 (down 2)
Decor: 17 (down <4)
Estimated dinner for one: $36 (down $4)
Top-rated vegetarian restaurant

ASIA DE CUBA
Food: 23
Service: 20
Decor: 24 (down 1)
Estimated dinner for one: $58 (up $2)
"Hottest Servers"

Risotteria
Food: 21
Service: 16 (down 2)
Decor: 10
Estimated dinner for one: $23

Gus' Place (reopened, relocated)
Food: 20
Service: 20
Decor: 16
Estimated dinner for one: $37

Lumi (unlisted 2007)
Food: 19
Service: 19
Decor: 18
Estimated dinner for one: $52

Sambuca
Food: 18 (down 1)
Service: 18
Decor: 16 (up 1)
Estimated dinner for one: $38 (up $2 from 2006)

Outback Steakhouse
Food: 14 (down 1)
Service: 15 (down 1)
Decor: 12 (down 1)
Estimated dinner for one: $32

CNN REPORT

Here's a YouTube video of Heidi Collins's substantial October 15, 2007 CNN Newsroom overview of celiac disease featuring Georgetown University gastroenterologist Dr. Aline Charabaty, who talks about the range of symptoms (which can include diarrhea, bloating, fatigue, anemia, depression, malnutrition, infertility, osteoporosis, joint pains, abdominal pain, neurological disorders, non-Hodgkin lymphoma, gastrointestinal malignancies, and weight and growth problems), the fact that celiac disease can manifest at any age, difficulties in raising research money, and the presence of gluten in many items including some pharmaceuticals.

I hope that week's other celiac disease coverage shows up on YouTube too.



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BULLETIN: GLUTEN-FREE FOOD FOR DISPLACED SOCALIFORNIANS

Gluten-free people who have been displaced due to the recent fires in Southern California can call the Celiac Disease Foundation (CDF) at 818-990-2354 for emergency gluten-free food, according to Maryrose Hopke of the CDF.

Do what you can to spread the word to those who are displaced and might not have easy access to the Web, phones, etc.

How prepared would you be in the event of an emergency? Here the New York City Office of Emergency Management on the glories of a Go Bag. I like the idea of using a bag with wheels; gf multi-vitamins seem to make sense, too.

STARBUCKS UPDATE


















Perhaps you remember that Starbucks test-marketed gluten-free brownies in New York City earlier this year.

Now there's an update: In today's Clan Thompson newsletter (Issue #115/October 21, 2007), Lani Thompson writes that Starbucks is curious as to how many people want the stores to offer gluten free products.

I called Starbucks (1-800-235-2883), pressed 0 for a customer service representative, and let my opinion be heard.

I said that it would be great if Starbucks would add healthy gluten-free items (such as sandwiches) to its roster of foods, and described how great it would be to be able to get a light gluten-free meal at any Starbucks. I specifically mentioned the difficulty of trying to find gluten-free food at airports, where Starbucks can often be found.

Please consider calling Starbucks to let your own voice be heard. You might even get a Starbucks gift card in the process.

And now, just to underscore how great it would be to find gluten-free sustenance at an airport, here's a scene of desperation from a terminal in Atlanta.



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Fortunately, Anj managed to scrounge up more gluten-free food and enjoy it near a player piano! But still...wouldn't it be nice if she could count on getting a complete meal at a Starbucks?



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Photo: David Marc Fischer

GF VIEWS

Et tu, Leno?

On Thursday/Friday's Tonight Show, Jay Leno featured at least two gluten-free products in his "truth in labeling" routine.

Gluten Free Pancake Mix from Bob's Red Mill? Jay called it Mouth Grout.

Perky's Nutty Rice? Jay called it Bipolar Disorder Rice Cereal.

Har de har har. (But kudos to the audience members who cheered when Jay mentioned gluten-free food.)

Here's something that's more enlightening: a student video from Hong Kong! (I recognize the Orgran, but a lot of the other products are new to me. It's been more than 20 years since I was last in Hong Kong.)



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A BIG WEEK FOR CELIAC TV


















As has been reported elsewhere, it seems that today (Wednesday) Joy Bauer will present a Today show segment on gluten-free diets for kids.

And CNN Newsroom is in the midst of a celiac week featuring daily segments hosted by anchor Heidi Collins, spokesperson for the National Foundation for Celiac Awareness. Here's the schedule:

Monday: What is celiac disease?
Dr. Aline Charabaty of Georgetown University Medical Center's Division of Gastroenterology will join CNN's Heidi Collins in the Newsroom to discuss the basics of celiac disease, diagnosis and treatment with a gluten-free diet.

Tuesday: "Non-Gastrointestinal Complications of Celiac Disease"
Dr. Richard Mandel of the Center for Advanced Orthopedics in Philadelphia will discuss the orthopedic complications of celiac disease and celiac patients can improve bone health. Also in the CNN Newsroom, Dr. Robert Mangione, dean of the St. Johns University College of Pharmacy, will explain how gluten in medication can impact celiac patients and discuss the immediate need for labeling of gluten in medication.

Wednesday: "Gluten-Free School Lunches"
Rep. Steve Kagen (D-WI) will offer tips for safely sending celiac children to school and federal school lunch requirements to provide gluten-free meals.

Thursday: "Hope with Celiac Disease"
Vanessa Maltin of the National Foundation for Celiac Awareness and Beyond Rice Cakes author will be on CNN discussing new resources available to help patients cope with celiac disease including cookbooks, video podcasts, cupcake parties and celiac camps.

Friday: "Gluten-Free Dining in Restaurants"
Tips for managing food allergies at restaurants and how patients can ensure a safe dining experience.

Photo: David Marc Fischer

PETER GREEN RETURNS TO THE 92ND STREET Y

Last November at the 92nd Street Y, celiac disease specialist Peter Green gave a lecture on Celiac Disease: An Emerging Epidemic. This coming November, Dr. Green returns to the Y accompanied by a trio: pediatrician Amy DeFelice, nutritionist Anne Lee, and pediatrician Anna Nowak-Wegrzyn.

Their presentation, Sorting Through Celiac Disease and Food Allergies, is scheduled to take place Sunday, Nov 18, 2007 from 3:00 to 5:30 pm. It's another good opportunity to hear the latest from medical professionals who are "in the know." If you're interested, then RSVP ASAP. OK?

Thanks to the New York City Celiac Disease Meetup Group for keeping me in the know!

PDA @ PDA

The People's Design Award (henceforth known here as PDA) welcomes your vote for good design by 6 pm EST on October 16, 2007.

I'm such a great admirer of Debbie Glasserman's Gluten-Free Alphabet design (pictured) for my Gluten-Free NYC Boutique that I've nominated it in a shameless Display of Public Affection (henceforth known here as PDA too).

So far it seems to be the only gluten-free design in the competition. If you like it, please go ahead and indulge in your own Public Display of Affection—the design is up against such heavy-hitters as the iPhone and the Vaughan S-2 Split-head Hammer!

You can find the design, comment on it, and vote for it by searching for the word gluten.

UPDATE As of about 10:22 pm Sunday, the Gluten-Free Alphabet seems to be 109 in a field of 290—not bad considering it's late entry? And there's still time to put in some more votes and/or comments....

WEEKEND UPDATE

Scroll down for an update added after the original posting.

This weekend is shaping up as a big one for those of the gluten-free persuasion. I've been reading on the message board of the New York City Celiac Disease Meetup Group that Everybody Eats—purveyors of great gf rolls and baguettes, among other baked and bready goodies—will now have Saturday storefront hours from 10:00 am to 5:00 pm at 294 Third Avenue in Brooklyn. Checks and cash will be accepted along with plastic from Visa, Mastercard, and Diner's Club.

Everybody Eats will also be at the Colin Leslie Walk For Celiac Disease in Rye on Sunday. Note that registration has been extended for the Family Screening—take care of that asap if you're interested.

Also coming to the Colin Leslie Walk will be Gluten-Free Girl and The Chef, as part of their whirlwind book tour including a few events in NYC. I hope those two Beatle fans have as good a time in the city as John Lennon seems to have in this video.



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WEEKEND UPDATE UPDATE I had a feeling I'd forgotten something: Tomorrow is that 20% discount day at Macy's. Even if you haven't yet made the donation to the National Foundation for Celiac Awareness (NFCA) (thereby qualifying for the discount), you might still have a shot on the premises tomorrow.

PRODUCTS ON PARADE: CASCADE FRESH YOGURT

Buy yogurt? If you do, how much do you spend on a 32 oz. container? I was shelling out about $4.00 for each one until I noticed Cascade Fresh yogurt clearly labeled as GLUTEN FREE and priced at $2.39 at Westerly Natural Market.

Pretty good, huh?

Click here to find the Cascade Fresh nearest you.

And did you know that yogurt goes well with fresh apples...and this is apple season? Maybe this will help you to remember!



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CNBC ON THE MONEY SEGMENT

CNBC recently featured an upbeat On the Money segment (Friday, October 5, 2007) in which Scott Cohn reported on the improving situation for gluten-free consumers following a long period of being ignored by corporate America. The item quotes Vanessa Maltin of the National Foundation for Celiac Awareness (NFCA) to the effect that the market is projected to reach $1.7 billion by 2010. Maltin also praised Bell & Evans and Bob's RedMill for their gluten-free products.

Coverage also included interviews at GFRAP restaurant Risotteria. One interview cited soy sauce as a source of "hidden gluten"—okay...but she also mentioned "all the preservatives" in canned foods, which might not have been the best example as it sounds like an exaggeration. Cohn mentions that an estimated 3,000,000 Americans have celiac disease and also mentions that there are an additional 10,000,000 Americans with "gluten intolerance." I'm not sure where he got that latter figure.

COMING SOON TO THE BIG APPLE: GLUTEN-FREE GIRL!

As mentioned here in September, Shauna James Ahern (a.k.a. Gluten-Free Girl) has a book (a.k.a. Gluten-Free Girl) out this month. To promote the book (right), she and her hubby The Chef (a.k.a. Daniel Ahern) have put together a DIY book tour, with a stay in New York (a.k.a. NY) from October 12 to October 16.

Here's an Amazon excerpt. And here's the itinerary:

Saturday October 13 11:30 pm
Imagine Circle at Strawberry Fields, Central Park
Book-signing and "Imagine" sing-along

Sunday October 14 morning
Colin Leslie Walk for Celiac Disease 2007

Sunday October 14 8:00 pm
Book Launch Party at Sambuca
Minglers receive wine, appetizers and a copy of the book.
Cost is $50. RSVP by calling 212-787-5656.

Monday October 15 7:00-9:30 pm
Cooking Demonstration at Whole Foods Bowery (book-signing afterward)
Pasta with salmon, chicken thighs braised in pomegranate molasses, fig cookies
Cost is $30, including book. Register here.

REPORT: CELIAC DISEASE REVERSED AFTER STEM CELL TRANSPLANT

The October 2007 issue of Pediatrics—the official journal of the American Academy of Pediatrics—offers a case report entitled "Correction of Celiac Disease After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myelogenous Leukemia."

It's a fascinating glimpse into the world of Hematopoietic Stem Cell Transplantation (HSCT). Did you know that, as the authors note, there are documented cases of patients developing celiac disease due to stem cells from donors who have celiac disease, but that this case report might be the first to describe a "cure" of the condition due to a stem cell transplant? Or that there has been documentation of improvement or stabilization of systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, and Crohn's disease after stem cell transplantation?

The report concludes

Although we do not, at this time, advocate allogeneic HSCT as the definitive treatment of CD, the decreased morbidity and mortality associated with the use of reduced-intensity stem cell transplants may someday allow HSCT to be an acceptable alternative to a lifelong gluten-restricted diet, which, at best, is extremely difficult to remain adherent to for life. Whether HSCT will reduce the purportedly increased risk of enteric malignancy in this population remains unclear.

My reaction to this is mixed. I'm fascinated by the thought that HSCT might reverse celiac disease, but I'm also skeptical about this isolated case. There have been tales of remission before, especially for people in this patient's age group. Further monitoring and more research should shed light on what sounds like a very promising medical development.

NOW ONLINE: U.S. DRAFT POSITIONS FOR CODEX COMMITTEE

Ever wonder where labeling standards come from? Yeah, me too. Well, from November 12 to November 16, 2007, the international Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) will meet in Germany. Standards for identifying gluten-free foods will be on the agenda.

Earlier this year, the United States requested input on the subject via the Food and Drug Administration. Now the United States has produced draft positions for the upcoming meeting. The positions include a single standard of 20ppm as the limit for a food labeled "gluten-free."

The draft positions can be found in this PDF document, which includes directions for emailing comments by October 10, 2007.