Diet and Romance

Here's a short Thanksgiving video on the ever-relevant issue of romance (and toothbrushing) on a gluten-free diet. Here's previous coverage. Thoughts?



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Thanksgiving

The American Celiac Disease Alliance (ACDA) recently sent this letter to The Chicago Tribune in response to the paper's articles on poor food labeling practices.

Dear Chicago Tribune Editor:

On behalf of the American Celiac Disease Alliance (ACDA) and the thousands of Americans now affected by Celiac Disease, thank you for publishing the two-part investigative series on food labeling and food manufacturing oversight entitled Allergy Threat: A Tribune Investigation" (Nov. 21 and Nov 23, 2008).

Mr. Roe's thorough and well researched article exposes the serious and sometimes life-threatening problems that can be caused by mislabeled food products. His article paints a compelling and very personal portrait of the challenges people with Celiac Disease, food allergies and other health concerns face each and every time they shop the grocery store aisles.

Celiac Disease is the world=92s most common autoimmune disease. Although most have yet to be diagnosed, it is estimated that at least 1% of the U.S. population has this inherited disease. Today, the only known treatment is strict adherence to a gluten-free diet for life.

On behalf of those living with Celiac Disease, the ACDA applauds the Chicago Tribune's efforts to raise awareness of the issue and to demand stricter oversight of food labeling and enforcement by the U.S. Food and Drug Administration (FDA). The Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) was an important first step in protecting celiac, gluten intolerant and food-allergic consumers. Mr. Roe's article clearly indicates that more stringent oversight is necessary. We agree.

In January 2007, the FDA proposed a standard for "gluten-free" labeling. Under its proposal the maximum threshold level for gluten would be set at 20 parts per million (ppm). When finalized these regulations will help to ensure that individuals with Celiac Disease are not misled by incorrect food labels and that they have truthful, accurate and easily accessible information on processed food labels.

Until this regulation goes into effect and FDA oversight is strengthened, food-sensitive consumers will be left wondering what products they and their families can safely consume. In the case of those with celiac disease, they will also be questioning the safety of adhering to the gluten-free diet, their only medical treatment.

Andrea Levario, Executive Director
American Celiac Disease Alliance (ACDA)

Photo: David Marc Fischer

Recall: Chicken Products from John Soules Foods

John Soules Foods has recalled its Italian Style and Rotisserie Style versions of Fully Cooked Chicken Breast Meat with Rib Meat because they may contain wheat even though they are supposed to be gluten-free.

It's too bad that the food was released, but John Soules Foods deserves some credit for detecting the problem and recalling the products.

A Very Celiac Thanksgiving?

Consider this!

Photo: David Marc Fischer

Still more on Whole Foods, Wellshire Farms, and Labeling

Below are updates related to The Chicago Tribune's food labeling articles. (For previous GFNYC coverage, see the posts from Friday and Sunday.)

As you might recall, the Tribune's reporting dealt in part with products marketed by Wellshire Farms and sold at Whole Foods as "gluten-free" even though, on investigation, they appear to have harmful amounts of gluten in them.

* In a follow-up article, "A recipe for disaster: Whole Foods' handling of chocolate bar shows how warnings fail" (November 23, 2008), reporter Sam Roe critiques the unreliability of some manufacturing processes as well as the warnings and assurances found on products sold at Whole Foods. Curiously, the article's gluten-free example has to do with tortillas that seem to qualify as gluten-free even though they are apparently made at high risk of cross-contamination.

* For at least a limited time, you can hear an informative interview with Roe on Chicago's Steve and Johnnie Show. (Co-host Steve King has celiac sprue.)

Part One
Part Two
Part Three

* Chicago-based Enjoy Life Foods president Scott Mandell issued a statement saying that "This kind of investigation is long overdue."

* Wellshire Farms president Louis Colameco has posted a response to the article. As you can see, the response focuses largely on one product and avoids addressing many of the serious issues—such as the >200ppm levels of gluten found in several of Wellshire's "gluten-free" products—raised in Sam Roe's article and this blog.

QUALITY CONTROL
November 21, 2008
To Whom It May Concern:
There have been some questions about the status and production of our Wellshire and Garrett County gluten free Dino Bites as a result of a recent article printed in the Chicago Tribune. Our understanding after speaking with the author is that this article relates solely to reactions from children with anaphylaxis, that is, with severe reactions to any level of allergens.
We have not discontinued making this product, but we are in the process of improving its formulation. Our products are governed by the USDA and its regulations, not the FDA's regulations. We are in complete compliance with the USDA regulations. However, in light of a new FDA proposal under consideration to re-define "gluten-free" to a lower level of gluten parts per million (ppm) in the product than is currently allowed under FDA regulated foods, we are also working on our products conforming to their definition of "gluten-free." As the FDA considers setting a new regulation, this does not affect our legal obligation to comply with USDA regulations, which specifically govern the food products we produce. Our effort to reduce permitted gluten content is a proactive improvement of our product to meet our customer's needs, and an effort to comply with the strictest standards.
Our Wellshire products are tested at a level of 200 ppm or less, which is equivalent to 99.98% gluten free. The FDA is now considering a new proposal that would reduce the amount of gluten to be 20 ppm or to 99.998% gluten free. This will be difficult to achieve as wheat and other grains can become cross contaminated from growth in the fields, or milling in the combines. It becomes very, very difficult if not impossible to control.
The FDA interprets the definition of gluten free to concern the level or amount of gluten in the product; thereby recognizing that there is still a contaminate of gluten in the product. The USDA bases the gluten free claim on the identity of the ingredients listed in the product, that is prohibiting the use of ingredients that contain gluten, such as wheat, barley, or rye.
It may take a month more to fully complete the transition of the Wellshire products, but the Dino Bites will be returning to store shelves as soon as possible. This new Dino Bite will be a better tasting product, suitable for child and adult palates alike.
Wellshire is committed to improving the quality of our products. We apologize for any inconvenience this confusion between the USDA and FDA regulations may have caused our customers.
Thank you.
Louis B. Colameco, III President

* I have yet to see any response or statement from Whole Foods.

More on Wellshire Farms

A Look at the Findings

Following up on Friday's post, let's focus on some of the Chicago Tribune's test findings.

The Tribune wrote the following in a kind of sidebar:

The FDA doesn't define "gluten free," but generally "free" means a product contains none of the substance in question. The FDA has proposed adopting a 20 parts per million standard. In July, an international health commission recommended a similar standard.

The USDA, which has jurisdiction over meat products (including those below), has no policy specifically addressing "gluten-free" claims. The agency OKs labels before products go to market....

The Tribune bought three popular Wellshire Farms products advertised as "gluten free" and sent multiple samples to a lab for testing.

Chicken Bites: Tested at 204 parts per million and 260 ppm

Chicken Corn Dogs: Tested at 116 ppm and 2,200 ppm

Beef Corn Dogs: Tested at 191 ppm and 1,200 ppm

Wellshire Farms provided the Tribune with its own testing results, conducted in the spring. Their results showed: chicken nuggets tested at 200 ppm, chicken corn dogs 150 ppm, and beef corn dogs 120 ppm.

Prior to the adoption of the 20 ppm standard, the standard for many was 200 ppm, which might explain why Wellshire Farms claims the 200/150/120 levels (though I think that 200 ppm for the chicken nuggets was really pushing it).

Setting those numbers aside, the Chicago Tribune story, which seems credible, strongly suggests that, in practice, test levels are actually very variable with the possibility of highly problematic levels of contamination.

This makes me lean more toward labeling standards that include a ppm rating that indicates the probable level of gluten plus the possible high level, based on up-to-date testing (using the most appropriate testing equipment, which varies according to product). I'm not sure if a score of <20/120 or (in the case of the beef corn dogs, perhaps 120/1200) would be the best solution, but something in that direction should be seriously considered. And, as Ben Cappel has suggested, label dates would be good to heighten understanding of how up-to-date (or out-of-date) a food rating might be.

Warning: Deceptive Labeling from Wellshire Farms

Whole Foods, USDA, FDA May Also Be Passing the Buck

It's bad when a company mislabels food as "gluten-free" when it isn't. It's even worse when, after being "caught," it continues to do so. And that seems to be the case with Wellshire Farms and, by association, Whole Foods Market.

In 2006, GFNYC shared a report about mislabeled Wellshire Farms Lemon Herb Turkey Breast bought at Whole Foods Columbus Circle. Now Sam Roe of The Chicago Tribune reports the mislabeling of Wellshire Kids' Dinosaur Shapes Chicken Bites (which, Roe writes, are marketed exclusively by Whole Foods) as well as Chicken Corn Dogs and Beef Corn Dogs, both marked as "gluten-free."

In the article "Children at risk in food roulette" (November 21, 2008), Roe writes

Take the example of Peggy Pridemore, a Kentucky woman who bought Wellshire Kids' Dinosaur Shapes Chicken Bites because her son Patrick has a severe wheat allergy. Bold letters on the packaging said the item was "gluten free," or contained no wheat, rye and barley proteins.

After Patrick, then 3, ate the nuggets in December, he started coughing, his eyes swelled and he had trouble breathing. His mom jabbed his leg with a large needle containing epinephrine, a drug to help him breathe, then raced him to the hospital, where he recovered in the emergency room.

Pridemore said she contacted both the U.S. Department of Agriculture and the food manufacturer and that neither offered to test the chicken nuggets.

The Tribune recently bought the product on two occasions at a River Forest supermarket and sent the samples to one of the nation's leading food-allergy labs, at the University of Nebraska. Both times, the lab found gluten. The item remains on shelves across the U.S.

* * *

Pridemore recalled how she bought Wellshire Kids' dinosaur-shaped chicken nuggets, made by New Jersey-based Wellshire Farms, because the item specifically claimed to be gluten free. She also found the same claim on the Wellshire Farms Web site.

After her son had the severe reaction to the nuggets, she took some to his allergist, who ran tests, including gently rubbing a nugget on the boy's arm to see if it would cause a small welt. It did, and the allergist concluded the nuggets were to blame for his full-blown reaction.

Pridemore contacted the USDA, which sent agency investigator Michael Maxwell to her home just outside Cincinnati. He took photos of the package, but did not test the nuggets for undisclosed allergens.

The investigator also obtained a copy of a brief, unsigned in-plant inspection report, which found no problems with the nuggets. He later acknowledged to the Tribune he wasn't sure who wrote the report—another USDA inspector or a plant worker. The report said workers routinely sent the nuggets out to a lab for testing. The report stated that those lab results, from last fall, "were all negative for gluten."

In an e-mail in January, Maxwell indicated to Pridemore that in light of that inspection report and the fact that no other consumer had complained, no action would be taken. "You may want to have the product tested," he wrote, according to a copy of the e-mail exchange.

Pridemore said she was taken aback that the USDA suggested she test the food herself. But she sent the remainder of the nuggets in her freezer to the Nebraska lab.

The results showed high amounts of gluten. So she e-mailed a copy of the findings to the USDA and reminded Maxwell that the product advertises itself as gluten free.

The investigator wrote back that the government had "archived your complaint." The investigation went no further, according to Pridemore. She also e-mailed the test results to Wellshire Farms. The company, she said, never responded.

In May, several weeks after Maxwell told Pridemore her complaint was archived, a second child with a known wheat allergy—Timmy Osterhoudt, 5, of Lemoore, Calif.—had a severe reaction after eating the same product, his mother said.

"He said, 'Mommy, I don't want to die!'" Michelle Osterhoudt recalled. "I told him, 'Mommy won't let you die.' "

She jabbed him with the epinephrine needle and raced him to the military hospital on the base where the family lives. There, he recovered.

Like Pridemore, Osterhoudt sent the chicken bites to the Nebraska lab for testing. Again, the results showed high amounts of gluten. She said she complained to Wellshire Farms, USDA and FDA, but to no avail.

USDA spokeswoman Amanda Eamich said one reason it did not ask Wellshire Farms to recall the chicken bites is because the agency did not trust the consumers' testing results. The consumers had sent samples of chicken nuggets from opened packages, raising the possibility that the product was contaminated somewhere between their homes and the lab.

Pridemore said it was the USDA's job—not consumers—to test samples from unopened packages.

"I'm not a doctor. I'm not a scientist," she said. "I'm just a mom trying to keep her child safe."

The Tribune recently bought two samples of the chicken nuggets and sent them to the same Nebraska lab. Both tested positive for gluten—including a sample from an unopened box.

The nuggets, said Steve Taylor, the lab's director and a leading allergy expert, "are not safe for people with wheat allergies or celiac disease," often characterized by chronic abdominal pain.

The newspaper also tested two other Wellshire Kids' products: the "Gluten Free" Chicken Corn Dogs and the "Gluten Free" Beef Corn Dogs, finding high amounts of gluten in both.

Wellshire Farms owner Louis Colameco said his products are safe. But he said that in light of the two consumer complaints and recent moves by regulators to tighten "gluten-free" rules, he halted production of the three Wellshire Kids' products in June.

Colameco said he would start making the food again when he finds a supplier who can guarantee that the batter used in the products is gluten free. The old supplier, he said, could not give such an assurance.

He said he has not recalled the Wellshire Kids products still on store shelves because he believes they are in compliance with federal regulations.

But weak and murky federal rules on gluten leave food companies wiggle room and consumers at risk.

The USDA, which has jurisdiction over meat-based products such as chicken nuggets, said it has no policy specifically addressing "gluten-free" claims. The agency must approve labels before products go to market, and packaging claims are reviewed on a case-by-case basis.

The FDA's rules are tougher. Though the agency has no specific rule for "gluten-free" products, the agency's policy generally is that absent a standard, products claiming to be "free" of an ingredient cannot contain it.

Recognizing that food companies may interpret these rules as they wish, the FDA has pushed a proposed rule that products advertised as "gluten-free" must contain less than 20 parts per million of gluten. A UN health panel this summer recommended a similar standard. Tribune tests of Wellshire products all far exceeded those levels.

Apart from online sales, the Wellshire Kids' gluten-free products are sold exclusively at Whole Foods Market, the upscale chain..

Whole Foods said it was investigating the issue, but that it was the supplier's responsibility, not Whole Foods', to ensure the Wellshire products are safe and legal.

GFNYC encourages you to spread the word and bring this matter to the attention of your local Whole Foods Market. And keep an eye on your legislators to ensure that labeling becomes more reliable and enforceable. Budget cuts could make the situation worse.

Help for the Gluten-Free Displaced by SoCal Fires

From Maryrose Hopke of the Celiac Disease Foundation (CDF):

If you have celiac disease and have been displaced from your home by the recent fires in the Southern California area and are in need of assistance in finding gluten-free foods, please contact CDF at 818-990-2354. We're
here to help!

"Joan's" Lunch in December

Joan's GF Great Bakes—Long Island purveyors of top-notch gf goodiess—will host a product testing and pizza-making party starting at 11am on Saturday, December 13, 2008. In addition to pizzas and new pumpernickel dinner rolls, there will be bagels, cookies, and English muffins.

For more information, see the New York City Celiac Disease Meetup Group (NYCCDMG) or the Long Island Celiac Disease Meetup Group (LICDMG).

Chefs in the News (and Newsday)

Rosemary Black's article-with-recipes "Flour power! Learning to bake gluten-free breads and cookies" (Daily News, November 14, 2008) revolves around chef Richard Coppedge of Hyde Park's prestigious Culinary Institute of America (CIA)—and author of Gluten-Free Baking. According to the article, Coppedge will hold a gluten-free baking class on Saturday, December 13, 2008.

Days earlier on Long Island—on Tuesday, December 9—gluten-free chef Joseph Felicetta is to serve up "a gluten-free international wine dinner" at the Sayville restaurant Oysterman's. It's a six-course meal for $75 per person plus tax and gratuities, according to Joan Reminick on Newsday's Feed Me blog.

Shameless Shirt Promotion

The Gluten-Free NYC Boutique feels that every season is gift-giving season, but if any one season is gift-giving season, it would have to be this one.

Whenever you're thinking of gift-giving, please keep the GFNYC Boutique's products in mind.

Thank you for your attention.

Special designs, including the Gluten-Free Alphabet (right), by Debbie Glasserman Design

Celiac on the House

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The doctor who is the title character of House is a jerk. But at least he knows from celiac disease! The oft-misdiagnosed condition played an important part in the November 9, 2006 episode "Forever"—and it also came up in the November 11, 2008 episode "The Itch" (Season 5, Episode 7) according to a recap by Charmaine P. Dennis.

One of the medical clues that raised the question of celiac disease was villous atrophy; another was peripheral neuropathy. According to the Fox TV episode summary, House rejects the conventional strategy of starting diagnosis with a celiac blood panel and instead orders the following diagnostic technique: "force-feed the patient wheat, then do an endoscopy as it hits his duodenum to see if there's an allergic reaction." Sounds very radical to me—it seems part of the goal to make the patient experience symptoms—and I'm not even sure it's possible. But what do I know? I'm just a layperson. Is there a doctor in the house? If so, feel free to chime in!

A Pain in the...Mouth

Celiac disease is just one of many conditions associated with canker sores, as noted in the nj.com health advice column "Treat mouth tenderly to reduce canker sores" (November 11, 2008).

People with conditions such as Crohn's disease, celiac disease, ulcerative colitis or Reiter's syndrome are more commonly affected. Factors that can contribute to the development of canker sores are stress, trauma and deficiencies of iron, folate, zinc and vitamin B12.

Here's a recent study that found that "The epidemiological association found between coeliac disease and aphthous-like ulcers suggests that recurrent aphthous-like ulcers should be considered a risk indicator for coeliac disease, and that gluten-free diet leads to ulcer amelioration." In other words, canker sores can be a sign of celiac disease, and a gluten-free diet can treat canker sores in people with celiac disease.

Do you wonder if you have celiac disease? Before trying to to go gluten-free, seek a conventional diagnosis by consulting with an informed doctor about getting the blood panel used to test for the condition.

Gluten-Free Thanksgiving Recipes

Catherine Oddenino of A Gluten-Free Guide website just took the plunge into online video with a set of Thanksgiving cooking videos for MyRecipes.

The viewing options include Turkey...



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...Sweet Potato Casserole...



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...and Cheesecake!



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A Gluten-Free Mum and Her Hardrocking Son

This WalesOnline article focuses on Lostprophets lead singer Ian Watkins and his mum Elaine Davies's kidney transplant, but it also mentions coeliac disease and osteoporosis as being among her other ailments. Here's to their health—and here's to organ donation!

And here Watkins uses some strong language to encourage fans to offer their hearts for transplantation.



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Gluten-Free, Politically

It's a very good morning over at Gluten-Free NYC, filled with the promise of positive change—and not just because of enthusiasm over Barack Obama's victory. As the nation moves toward a fresh start and the possibility of more unity, it strikes GFNYC that a health policy that raises public awareness of celiac disease is something that both Democrats and Republicans can agree upon.

As you might recall, GFNYC supported Barack Obama but noted that both of the big party presidential tickets could offer improvements for people with celiac disease. Gluten Free Blog expressed a similar position in favor of Obama.

As John McCain and Sarah Palin return to their regular jobs as senator and governor, they can still follow through on their concern for "special needs" households, including those affected by celiac disease and associated conditions, including Down Syndrome and, possibly, autism as it is currently being diagnosed.

Palin in particular should also be aware that millions of Americans may still be undiagnosed with celiac disease, as her prominent supporter Jane Swift and her outspoken advocate Elisabeth Hasselbeck are known to have the condition. So perhaps the Anchorage GIG group can do something with that.

Closer to home, Kemp Hannon retained his seat in the New York State Senate. He has recognized that early screening for celiac disease is an idea worth consideration.

As far as the national government is concerned, GFNYC notes that Representative Nita Lowey, Senator James Inhofe, and Senator Ben Nelson all remain in office. They might not agree on much, but each has advocated on behalf of people with celiac disease.

Also remaining in office is Senator Hillary Clinton, an advocate of universal health care whose husband Bill recently talked up the value of "gluten-free" cassava.

Presiding over all of these politicians will be Barack Obama, a supporter of preventive medicine and universal health care for children who recognizes that some government programs are worth additional funding even during budgetary crises. GFNYC hopes that the FDA's ability to enforce food labeling accuracy will improve under his administration.

Celiac disease might not mean much to the general population in the great scheme of things. But sensible, progressive policies regarding celiac disease should find a place on the agenda as American leaders search for ways to build unity and consensus.

Pumpkin Soup

I just love me a hearty and warming pumpkin soup. I've already posted on the subject, but I thought I'd return to it, what with it being pumpkin season again. So I found this promising recipe—from Oklahoma!

Photo: David Marc Fischer

Gluten-Free Recession?

For months the typical marketing story on gluten-free products described (and predicted an additional) boom in the market, due to people on medical diets as well as trend or fad followers.

But might the recent shakiness of the economy lessen the extent of the boom? That might be the case if the cost of gluten-free products remains relatively high. Consider the articles "Gluten-Free Diet: A Cure for Some, a Fad for Most" (U.S. News and World Report, October 31, 2008) and "Budgets Squeezed, Some Families Bypass Organics" (The New York Times, November 1, 2008).