O Canada!

July 1 is Canada Day

Just thought I'd offer a round-up of various items related to our neighbors north of the border....

At this week's Fancy Food Show in New York City, I enjoyed the gluten-free (and egg-free) butter crunch (sample at right) from Toronto's CocoMira.

Quebec microbrewery Les bières de la Nouvelle-France now advertises two gluten-free beers: Messagère pale ale and the new Messagère Red Ale. Judging from the website, it looks like the brewers expect distribution in the United States soon!

Thanks to Saskatchewan dietitian Shelley Case, I'd like to draw your attention to Health Canada's Celiac Disease: The Gluten Connection, a clear, concise, and recently produced overview of celiac disease. (For the inevitable United States comparison, click here to see materials produced as part of the Celiac Disease Awareness Campaign of the National Digestive Diseases Information Clearinghouse of the National Institutes of Health (NIH).)

Here's Health Canada's Celiac Awareness Month 2009 statement (May 4) from Canadian Minister of Health Leona Aglukkaq.

And here's a videotaped May 4, 2009 statement by Ontario politician Yasir Naqvi.



Source (1:29)

Dietitian Shelley Case Cautions Readers of The G-Free Diet

Today Yesterday, registered dietitian Shelley Case issued a press release advising people who might consider adopting a gluten-free diet following the publication of Elisabeth Hasselbeck's The G-Free Diet.

Highlights:

"It's a myth that everyone should be on a gluten-free diet," says Case. "Just because alternative health practitioners, personal trainers and celebrities are jumping on the gluten-free bandwagon, doesn't mean it is right for everyone." Case worries that too many people will look to the diet to solve a multitude of problems such as arthritis, ADHD, elevating energy levels and even weight loss. "Contrary to popular buzz, the GF diet is not a panacea diet" says Case....


Case refutes the common myth that a trial gluten-free diet is the best way to determine if you have celiac disease. "Unfortunately a growing number of people are attempting to self-diagnose their own gluten sensitivity without proper medical assessment and nutrition counseling," says Case. "It's absolutely imperative to see a physician BEFORE adopting a gluten-free diet."

Celiac disease is diagnosed by a specific blood test and small intestinal biopsy. Gluten must be present in the diet in order for these tests to confirm the diagnosis.

Without an official diagnosis, people may not be motivated to strictly follow the diet for the rest of their lives or receive further follow up care to monitor for potential complications of the disease that can include osteoporosis and gastrointestinal cancer. Furthermore, their relatives may not get screened for celiac disease if the family member does not have a confirmed biopsy proven diagnosis.

Case worries that many people will try this diet as the latest "fad" because of a celebrity status associated with it. As result, "those with celiac disease may not be taken as seriously in restaurants because everyone thinks it's just a lifestyle choice or trendy obsession." Even small amounts of gluten can damage the intestinal tract. Because celiac disease is a serious lifelong disorder, it should be accorded the respect it deserves.

Other responses to The G-Free Diet can be found here.

FDA Wants Input on Gluten-Free Labeling

"The FDA is charged with ensuring the safety of $417 billion worth of domestic food and $49 billion worth of imported food each year. That's no small task," observed a recent Chicago Tribune editorial ("Peanut Peril," March 7, 2009).

One part of the FDA's big task involves examining issues related to labeling food as "gluten-free." Here's info on a proposed study, garnered from a FDA web page on the project:

The Food and Drug Administration (FDA) is announcing an opportunity for public comment on the proposed collection of certain information by the agency.....Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information and to allow 60 days for public comment in response to the notice. This notice solicits comments on a voluntary consumer study entitled "Gluten-Free Labeling of Food Products Experimental Study."

* * *

The Gluten-Free Labeling of Food Products Experimental Study will collect information from both consumers who have celiac disease or gluten intolerance and those who do not have either condition. The purpose of the study is to gauge perceptions of characteristics related to claims of "gluten-free" and allowed variants (e.g., "free of gluten," "without gluten," "no gluten"), in addition to other types of statements (e.g., "made in a gluten-free facility" or "not made in a facility that processes gluten-containing foods") on the food label. The study will also assess consumer understanding of "gluten-free" claims on foods that are naturally free of gluten, and gauge consumer reaction to a product carrying a gluten claim concurrently with a statement about the amount of gluten the product contains.

The data will be collected over the Internet from samples derived from two sources: (1) A membership list from a celiac disease special interest organization and (2) an online consumer panel. Participation in the study is voluntary.

* * *

FDA invites comments on these topics: (1) Whether the proposed collection of information is necessary for the proper performance of FDA's functions, including whether the information will have practical utility; (2) the accuracy of FDA's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used; (3) ways to enhance the quality,
utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques, when appropriate, and other forms of information technology.

* * *

DATES: Submit written or electronic comments on the collection of information by May 5, 2009.

ADDRESSES: Submit electronic comments on the collection of information to http://www.regulations.gov. Submit written comments on the collection of information to the Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. All comments should be identified with the docket number [FDA-2009-N-0083]....

FOR FURTHER INFORMATION CONTACT: Jonna Capezzuto, Office of Information Management (HFA-710), Food and Drug Administration, 5600 Fishers Lane, Rockville, MD 20857, 301-796-3794.

So be sure to check out the FDA web page devoted to this project, put together your thoughts, feel free to air them here, and make sure you hit the May 5 deadline!

I'll offer my two cents eventually.

Thanks to Shelley Case for promptly spreading the word online.

CANADIAN CELIAC HEALTH SURVEY

I strongly recommend reading this recently published report--on a survey of Canadians with celiac disease (via PDF)--that appeared in the April 2007 issue of Digestive Diseases and Sciences. Surveyed were members of the Canadian Celiac Association who responded to a questionnaire reviewed by Dr. Peter Green, among others.

The report offers a detailed overview of people with celiac disease in north North America and concludes with remarks that seem applicable to people with celiac disease everywhere:

The results of this study emphasize the need for early diagnosis, treatment and follow-up of celiac disease. Despite the availability of excellent antibody screening tests, delays in diagnosis of celiac disease remain a key issue. This needs to be addressed given the current prevalence estimates of 1 in 133 having celiac disease in North America. Better awareness among family physicians, dietitians and other health professionals about the variety of clinical presentations, especially anemia, osteoporosis, reproductive problems and autoimmune disorders is essential. Utilization of antibody testing for screening at-risk groups, especially first-degree relatives, would be potential strategies to reduce delays in diagnosis.

Having to follow a strict gluten-free diet for life has a major impact on the quality of life of individuals with celiac disease. Given the difficulty in determining the gluten-free nature of foods, there is a need for food manufacturers to ensure complete and accurate labeling of gluten sources and for food service establishments to provide accurate information on the gluten content of food served. Comprehensive education of newly diagnosed patients, by dietitians and physicians with expertise with expertise in celiac disease, will help optimize compliance, improve quality of life and reduce the risk the numerous complications associated with this common disease. [sic]

Also highly recommended: Rosie Schwartz's "Gluten Be Gone!"--a related article from Canada's National Post (June 5, 2007).

Thanks to dietitian Shelley Case for spreading the word about the article and this thorough survey, on which she played a leading role.