MOLECULE OF THE YEAR

Yes, it's that time again! Soon Time will announce the Whatever of the Year!!

Don't get me wrong: Of course I think You should get it. But face it: You already got it last year! And I know you're not the greedy sort.

So instead I'm nominating Gluten as the Molecule of the Year—and not just because of that celiac thing. Sure, that's a biggie, but there was also that melamine scare, when media warned that millions were endangered by food containing wheat gluten...that is, millions of pets were endangered by pet food wheat gluten that contained the poison melamine.

That message about gluten really got through to the public over the past year. Also making some inroads into public awareness was one of this blog's pet issues: Millions of undiagnosed and misdiagnosed Americans are endangered by food containing wheat gluten. As the National Foundation for Celiac Awareness (NFCA) puts it, "Roughly one out of every 133 Americans has celiac disease, but 97% remain undiagnosed. This means that almost three million Americans have celiac disease and only about 100,000 know they have it."

So Gluten gets my vote for the pet food and the human food angles...and also for its metaphoric value. At present, it stands for the way foods and other products can turn out to contain some hazardous surprises...especially when labeling, quality control, and medical knowledge are lacking.

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.

IN MEMORY OF BETTE HAGMAN

In her book The Gluten-Free Gourmet (1990), Bette Hagman wrote

Fifteen years ago, as a newly diagnosed celiac, I was embarrassed to ask questions that might send my waitress or waiter back to the kitchen several times, and as a result I often received food that I had to leave untouched. Now I ask. I explain the reason for the questions, and most serving people have been obliging, sometimes bringing the cook to the table or taking me to the cook. I give the restaurant four stars in my book when the cook understands and makes me a plate that looks great, tastes great, and is completely gluten free. And the cook gets five stars when others in the restaurant look at my plate and wonder where I found that on the menu.

In The Gluten-Free Gourmet, Bette Hagman also wrote this about the gluten-free diet:

I don't think of it as a diet for life, I consider it a prescription for living.

After Bette's death last week, her daughter Karol offered the following statement:

Bette embraced everyone. She believed so much in us working together and spoke often about how to make that happen. She wanted to see cohesiveness amongst the groups. She understood the power in a single voice.

To that end, Karol has asked that memorial donations be made to the American Celiac Disease Alliance, "the national federation serving, representing, and advocating on behalf of the entire celiac community." Donations can be made online; "Memorial Donation for Bette Hagman" should be entered into the Notes section. Those wishing to donate by mail may send contributions to

American Celiac Disease Alliance
c/o GIG
31214 - 124 Ave SE
Auburn WA 98092.

All donations will support the efforts of the ACDA in representing a unified voice for the celiac community. All donations are tax-deductible. ACDA is a 501c3 nonprofit organization.

Also in memory of Bette Hagman, Seamaiden of Book of Yum has started a tribute requesting that people prepare and photograph a Hagman dish for forwarding to Karol. And, over at LiveJournal, DeWinged Pixie encourages people to wear green or an otherwise appropriate article of clothing on Friday.

AMERICAN CELIAC DISEASE ALLIANCE GROWS

The Westchester Celiac Sprue Support Group and Foods by George are among the eight new members of the American Celiac Disease Alliance (ACDA), the advocacy organization announced in a press release today.

Other ACDA members associated with the greater New York metropolitan area are Gluten-Free Living and the Celiac Disease Center at Columbia University. The group's President is Beth Hillson, founder of The Gluten-Free Pantry and a Vice President of Glutino USA/Gluten-Free Pantry.

MEDSCAPE UPDATE

Two new articles on Medscape deal with celiac disease.

"Coeliac Disease: Relationship to Endocrine Autoimmunity" is a case study of a man who was treated successfully for Addison's disease and type 1 diabetes, but received a diagnosis of celiac disease after showing symptoms of fatigue and iron deficiency anemia about 15 years into his treatment for the other conditions.

An accompanying discussion identifies common celiac symptoms as malabsorption (60%), lethargy (50%), and anemia (12-22%) but notes that physical examination is often normal. It lists associated disorders as fatty liver disease, dermatitis herpetiformis, epilepsy, neuropathy, male and female infertility, Addison's disease, and type 1 diabetes. It also observes that cigarette smoking reduced the risk of celiac disease by 80%--though I'd recommend consulting with a physician before taking up smoking as a preventative therapy. The article appears in The British Journal of Diabetes and Vascular Disease (Volume 6, Number 6, 2006).

"Advances in Celiac Disease" is a multi-part summary of "recent critical research in celiac disease." I could actually use a summary of the summary, but here are three of the points that stood out for me:

Celiac disease screening among women of reproductive age could yield significant health benefits.

Primary care doctors are increasingly involved in identifying celiac disease patients.

A Finnish and Hungarian group is developing a point-of-care testing kit that would yield results within 30 minutes.

This report appears in Current Opinion in Gastroenterology (Volume 23, Number 2, 2007).

The former study put the frequency of celiac disease at 1 in 200; the latter as possibly as high as 1 in 100.

CELIACTION: CELIAC AWARENESS MONTH...PLUS FUNDING!

Quick: Which month is Celiac Awareness Month?

Beth Hillson--president of the American Celiac Disease Alliance (ACDA) and founder of The Gluten-Free Pantry--just issued the following call to action:

On February 16, 2007, Representative Nita Lowey introduced H.Con.Res. 70, which endorses May as Celiac Awareness Month, and calls for increased federal funding for celiac research.

Rep. Lowey was one of the lead sponsors of the Food Allergen Labeling and Consumer Protection Act (FALCPA) which requires food manufacturers to list the top 8 allergens on their product labels. The law also required the FDA to set rules for using the term 'gluten-free' when labeling products.

The American Celiac Disease Alliance applauds Rep. Lowey for her continued efforts to raise awareness about celiac disease, and for her support of our community.

Ask your representative to cosponsor H.Con.Res. 70. Email them directly by going to the ACDA online advocacy site www.capwiz.com/celiac and entering your zip code under "Elected Officials." Your voice will make a difference.

Thank you!

Beth Hillson
President, American Celiac Disease Alliance