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By Fred, February 8, 2010 10:00 am

We’ve talked in the past about our love of TED and how many of its big picture talks can help us frame new ways of thinking about the gluten free diet (”GFD”) and Celiac Disease (”CD”). In the video below, Bill Davenhal discusses the impact that geography has over health.

Davenhall walks through his own live, having lived in several “red zones” for health; he grew up in PA, lived in Louisville, KY, which he proclaims as “Rubbertown”, and then moved to smoggy Los Angeles.

His approach to geomedicine, as he terms it, is broad and long term. Having lived years in these places, he claims, that his physicians;

Never asked about the water put in my mouth or the food that I ingest in my stomach.

For CD, the implications might be more profound with a more tactical approach to data.  If every restaurant someone with CD visited in the past month had poor options for those on the GFD, then the probability of gluten ingestion is higher than for those who made different choices.  Davenhall makes a brief case using big time periods; the impact appears as if it might be more profound if smaller periods of time and a more detailed focus on location were made.  Think restaurants, not states and the impact on CD becomes more profound.

Davenhall closes with a quote from respected physician Jack Lord;

Geography is destiny in medicine.

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By Fred, January 28, 2010 5:38 pm

TED is a nonprofit that puts together conferences where the speakers talk about bold, challenging ideas.  At the July 2009 event, they invited Ms. Carolyn Steel, author of Hungry City, to talk about how food shapes modern cities.  It’s a fascinating presentation in which she walks through the history of modern cities, with a focus on London, and outlines how food has impacted the shape, size, and distribution of mankind.

Ms. Steel introduces the concept of a Sitopia, or “food place” - borrowing from Sir Thomas More’s Utopia, or “ideal place”, from his 16th century book.  The sitopia she describes is a place where people live in concert with, and in full knowledge of the source and impact of their food.  It flows well with the concepts of Michael Pollan, for those who have read his books as well.

She states,

[You] Can’t have it without people who think about food, who plan ahead.  We need these people, they are part of a network.  Without these kind of people we can’t have places like this [the sitopia].

Could that be what we, people who have CD, or who pursue the GFD, are?  Like it or not, we think about food a lot.  Much more than the average individual.  And we are certainly part of a network - both our own networks as we share information on food, and as part of the non-GFD communities in which we participate every day.  All our colleagues know that we are food sensitive.  We are the de facto food experts in any gathering.

Sitopia already exists in little pockets everywhere.  The trick is to join them up.

We couldn’t agree more.

We can use food as a really powerful tool to make the world better.

Thanks again, Ms. Steel - these are the kind of bold, challenging, ideas, that we like to hear.

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By Fred, January 24, 2010 4:17 pm

Ms. Blum's Book - The Poisoner's Handbook

Ms. Deborah Blum, author of The Poisoner’s Handbook; Murder and the Birth of Forensic Medicine in Jazz Age New York, penned a guest column in the Wall Street Journal this weekend.  It makes for a fascinating read, not only because of the historical implications, but also because of the science involved.

The history of poisoning is the story of an arms race between those developing poisons and those who wish to be able to determine if someone has, in fact, been poisoned.  It is painful to be on the wrong side of this arms race.

With determination, researchers do learn how to get ahead of threats and win their turn in the game. In the 19th century, for instance, after murderers turned to plant poisons, scientists redoubled their efforts to capture those alkaloids in human tissue. And in 1860, a single-minded French chemist named Jean Servais Stas figured out how to isolate nicotine, an alkaloid of the tobacco plant, from a corpse. Other plant poisons soon became more accessible, and chemists were able to offer new assistance to criminal investigations.

We’ve recently been going through many of the scientific and medical papers written in the late 1990s and early 2000s that determined safe levels of gluten, the impact of different fractions of gliadin and glutenin and the challenges of testing for gluten in food.  The similarity in the language between these papers and Ms. Blum’s is uncanny.

The arms race is between our ability to identify the components of gluten and then to understand which of those components have a negative impact on those of us with Celiac disease.  Just as Ms. Blum’s text outlines the dramatic drop in homicidal poisonings, we can look to see that the same scientific method should dramatically reduce the impact of gluten on the CD population.

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By Fred, January 11, 2010 10:41 pm

Would you like a gluten-shaker? Answer = No.

No, we don’t want a gluten shaker on your table.  That would be a bad, unused, item.  However, in reading two articles today from the New York Times and Wall Street Journal on efforts to curb the use of salt in foods, we see a template that could be applied to the food industry’s use of gluten.

Per Ilan Brat and Maurice Tamman’s well-researched article, “Food Makers Quietly Cut Back on Salt: Companies Find Consumers Respond Better When Sodium-Reduction Isn’t Emphasized on Labels”, “Salt is an inexpensive ingredient that enhances sweetness and diminishes bitterness in flavors. It keeps packaged foods fresh longer, plumps up canned vegetables and helps hold together hot dogs.” For anyone with CD or who pursues the GFD, these words sound familiar. Salt is an inexpensive ingredient, like gluten. Salt enhances the product, in the same way gluten enhances the chewiness and texture of foods. Salt is important in extending shelf-life, and we are all well familiar with the challenges of keeping GF food products edible without the assistance of refrigeration.

Salt is a mineral.  Gluten is plant derived.  Salt has merited its own book and has arguably driven the course of world history. Grains, the wheat, rye and barley, which produce gluten, made the fertile crescent and agriculture changed humanity’s course.

The articles make great points; (i) consumers expect low-salt products to taste worse, but are okay with it if phased in, (ii) general health improves by reducing salt to minimal levels, (iii) everyone wins with salt added only where necessary, (iv) there is increasing awareness at the policy level about the negative impacts of too much salt being used for the general population.

For the gluten-avoidance community to catch up with the salt-avoidance community we need better quantification of the negative impacts of gluten.  We see the beginnings of that for those with CD in insurance-related studies, but we will benefit from other studies of other specialty diet populations.

In closing, we highlight an excerpt from the WSJ article with salt modified to [gluten] - think about what it would mean:

Consumers’ prejudices about reduced-salt [gluten] products and taste are also complicating food-makers’ efforts.

In one 2007 test in Holland, Unilever found that consumers expected to like one powdered-soup mix purported to be lower in salt [gluten] less than another, even though they were actually identical, says Mr. Balentine, of Unilever.

“Once you start saying you’ve taken salt down [gluten out], it’s basically equal to, ‘It’s not going to taste good,”‘ he says.

New technology is driving many salt [gluten] reductions by helping maintain the saltiness [texture] of products with less sodium [no gluten]. Some companies are deploying new meaty-tasting compounds that boost saltiness flavor without sodium [gluten] or cooling agents that make the tongue taste salt [texture] better. Others are using materials that smell salty [have the same texture] without having any sodium [gluten], says Mr. Eilerman, of Givaudan.

It makes for a nice read, doesn’t it?

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By Fred, January 5, 2010 7:45 am

What would be the impact of eating these items?

Spectrums are everywhere, from the classic visible light spectrum of ROY G BIV (or his Russian cousin, VIB G YOR), to the progression from birth to death, gradual changes and their delineations provide useful frameworks for understanding how things work.

There is an obvious spectrum of the impact consuming an item could have on an individual.  On one side we have severe negative reactions, and on the other, we have extremely positive reactions.  In the middle we have neutral events.  Our focus here is on the impact on an individual, not on an entire population.  The spectrum has five clear values:

• Strong Negative: If the item ingested kills the individual, it is a poison.
• Weak Negative: If the item harms the individual, it is a toxin or allergen.
• Neutral: If the item has no impact, it is a non-actor.
• Weak Positive: If the item sustains the individual, then it is a food.
• Strong Positive: If the item improves the individual, it is a medicine.

From a severity standpoint, gluten is somewhere between the weak and strong negative for those with CD.  For those with some kind of wheat anaphylaxis, it is clearly a poison.  For the population at large, it is somewhere between neutral and weak positive.  While this framework for thinking about gluten is focused on individuals, it is a first step in exploring the impact of gluten on a population.

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By Fred, January 4, 2010 7:21 am

A recent New York Times article discussed the adventures of a pair of students from Manhattan’s Trinity School as they collected DNA samples for analysis by Dr. Mark Stoeckle of Rockefeller University.

The most fascinating mention in the article was that one in six (11 out of 66 to be precise) of the typical household food items were mislabeled, ”including sheep’s milk cheese that was in fact made of cow’s milk, venison dog treats that were made of beef and sturgeon caviar that was actually Mississippi paddlefish.”

Because of the differences between animal cell structure and those of plants, DNA barcoding, as discussed in the article, still is a long way away from being helpful in our efforts to identify wheat, barley and rye to avoid gluten.

Creating mechanisms by which consumers can double check manufacturer’s statements about food contents creates interesting dynamics in any setting. As such mechanisms become more socially acceptable and a fact of life for complex supply chains, such as the food industry, they will benefit those of us who pursue specialty diets.

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By Fred, December 13, 2009 10:08 pm

[UPDATE 12/15/2009 4:30 PM: We received feedback from the EZ Gluten manufacturer. We were informed that the EZ Gluten reading of high is not a clear indicator of > 200 ppm. A 'High' reading is simply a relative indicator, and the only clear ppm reading from the test is the < 10 ppm of a low reading. 'High' may indicate higher or lower than 200 ppm.  Further, the 3rd party test that was used was not the 'AOAC approved' test; rather it was a modification of the AOAC OMA 991.19 that has been modified to go down to 5 ppm.  As a point of transparency, our errors are left in with strikethrough.]

Five (5) different products which had a ‘Gluten Free’ product claim from Great Specialty Products, a physical and online seller of GF products, show high levels of gluten based on seven (7) different gluten tests.  Six were over the counter test kits, one was sent off to a 3rd party lab for independent confirmation.  We purchased two products, a white-bread loaf, and a sourdough loaf from Great Specialty Products - a website (greatspecialtyproducts [dot] com), and formerly a physical store, based in North Carolina.  Both samples, when evaluated with an EZ Gluten Kit, showed ‘High Gluten’ (photos and details below).  We were present for two other samples (a dinner roll and another white-bread loaf) when other EZ-Gluten Kits were run and showed ‘High Gluten’.  Two others shared results which were not run in our presence, which both showed high gluten.  For an EZ-Gluten kit, a reading of ‘High Gluten‘ indicates 200 ppm or more.

One of these six samples was sent to a 3rd party lab for independent testing, it too found ‘High’ levels of gluten.  For the [3rd party] AOAC approved test, High levels of gluten meant 80 ppm or more.  As of this writing, seven (7) different tests show products from Great Specialty Products to be high in gluten as defined by the relevant test.

EZ Gluten has shown 'High Gluten' on 6 Great Specialty Products breads.

A summary of the results are listed below:

• White Loaf / Delivered 12.7 / Tested 12.10 / EZGluten EZG90529-9 / Result = High Gluten, >200 ppm (JN)
• Sourdough Loaf / Delivered 12.7 / Tested 12.10 / EZGluten EZG90529-9 / Result = High Gluten, >200 ppm (JN)
• French Dinner Rolls / Delivered 12.3 / Tested 12.5 / EZGluten EZG90529-9 / Result = High Gluten, >200 ppm (JN)
• Sourdough Loaf / Delivered 11.25 / Tested 12.3 / EZGluten EZG90529-9 / Result = High Gluten, >200 ppm
• Flour Tortilla / Delivered 11.25 / Tested 12.3 / EZGluten EZG90529-9 / Result = High Gluten, >200 ppm
• Multi-Grain Bread / Delivered 11.25 / Tested 12.3 / EZGluten EZG90529-9 / Result = High Gluten, >200 ppm
• French Dinner Rolls / Delivered 12.3 / Tested 12.10 / 3rd Party AOAC Quantitative Gluten ELISA / Result = High Gluten, >80 ppm (JN)

We believe the likelihood of contamination of these samples since delivery is very low; they were handled by individuals with CD or by establishments that are well-versed in GF food preparation.  Chain-of-custody for each of these samples has been recorded.  For the four samples marked (JN), we have retained frozen representatives.  All users of the EZ Gluten kits were experienced in their use and photos of their use have been retained.

Product Delivery

The products were delivered door-to-door, but had no labeling, nor an ingredient list. We called a Food Compliance Officer at the North Carolina Department of Agriculture and Consumer Services (”NCDA&CS”), who stated that if such a delivery had occurred, it would be a violation of North Carolina State Law.  NCDA&CS further stated that the same laws would be applied to an online retailer as would those that applied to a physical store.  North Carolina law also supports Federal law in relation to following GMP and allergen labeling.

Re-Packaged Desserts

In past weeks, Great Specialty Products had an area on their site titled, “Gluten Free Specialty Desserts.”  Two desserts from this area had been delivered to a customer with the original wrappers from the primary manufacturer, an un-associated private-label food manufacturer.  When the original manufacturer was called, they stated that their products were not gluten free.  Website photos from the non-gluten free photos were being used to promote the Great Specialty Products desserts, again the Great Specialty Products were represented with a Gluten Free product claim.  The original manufacturer immediately set about correcting the situation.  It appears that this portion of the site has now been removed, an archive of the page can be found here.

Notification

Prior to this post Great Specialty Products was informed that based on the results we had received that their products contain gluten.  We attempted to ask questions about ingredients and the source of their product claims.

Final Comments

Several products from Great Specialty Products have been to have high levels of gluten in contrast to their product claims of 'Gluten Free.'

As someone with CD on the GFD, I am immensely grateful to any group that makes GF products.  We recognize that kits have their weaknesses, that suppliers may provide ingredients that are out of spec, and that accidents do happen.  We routinely run EZ Gluten kits when it is difficult to tell if ingredients have gluten or not.  The kits were run in this instance after the products were delivered unlabeled without an ingredient list.

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By Fred, December 5, 2009 5:45 pm

Sushi is being identified through genetic means

The WSJ just published a great article on the use of DNA ‘barcodes’ for speciation of food products.  Unfortunately, species identification is much simpler in animals than it is in plants.   While the methods employed are not immediately valuable, they do show that clear identification of food products and their components continues to grow as a societal issue.

The article, reported by Robert Lee Hotz, outlines how rapid genetic sequencing is increasingly being used to identify animals for food, environmental and other reasons.  He focuses on a recent test of 68 samples from 31 sushi restaurants in New York and Denver (why would you eat Sushi in Denver?) which found that restaurant patrons weren’t always getting what they ordered.  Lower cost, endangered, and even potentially dangerous fish species were served in their place.

A similar survey in Canada of 18 sushi restaurants found that half the orders were mislabeled.  A 2004 study by the University of North Carolina estimated that 3/4 of all snapper sold in the US was mislabeled.

This also matters for food labeling and species conservation.  Current guidelines restrict the label Grouper to 33 species of fish.

This has profound implications for all of us who are concerned about the presenece of gluten, or other foods, in our diets.  We are not alone.  Almost as important as the health, safety and species conservation aspects of this article is the fact that there are clear economic implications.  It matters what people eat; there is money to be had for those who pay attention.

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By Fred, September 9, 2009 7:30 am

Terms and abbreviations matter, especially for CD and the GFD

We’ve spent a lot of time lately reading the scientific and medical literature around Celiac Disease (“CD”) and ways to improve conformance to specialized diets, particularly the Gluten Free Diet (“GFD”). We’ve always used GF to denote Gluten Free, however, we were pleased to see how widely these abbreviations were used across continents and scientific fields.

It’s essential to use consistent and precise language in everything we do here at Juno Nutrition because of all of the different fields and disciplines we work with. There are a lot of complex things in pursuing the GFD, the least we can do is use a common set of abbreviations.  Terms like CD and GFD dominate the scientific and medical research literature that weighs on our health; we should do our best as a community to exercise the same consistency.

“If language is not correct, then what is said is not what is meant; if what is said is not what is meant, then what must be done remains undone; if this remains undone, morals and art will deteriorate; if justice goes astray, the people will stand about in helpless confusion. Hence there must be no arbitrariness in what is said. This matters above everything.”

From The Analects of Confucius, Book 13, Verse 3 (James R. Ware, translated in 1980.)

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By Fred, July 17, 2009 7:31 am

The New Scientist had a great article on the accuracy of calorie counts in food labels written by Mr. Bijal Trevedi. Labels matter. Any issue about items like calories, arguably the most important number on the label, provide huge guidance in how we can expect the gluten labeling to work for those of us with Celiac disease.

Here are a few great quotes;

“Yet according to a small band of researchers, using the information on food labels to estimate calorie intake could be a very bad idea. They argue that calorie estimates on food labels are based on flawed and outdated science, and provide misleading information on how much energy your body will actually get from a food.”

“”Food texture might be as important a factor for preventing obesity as taste or food nutrients,” Oka and his colleagues concluded (Journal of Dental Research, vol 82, p 491).”

Again, here at Juno Nutrition we are 100% focused on ensuring that the food information that people pursuing a gluten free diet use is as accurate as possible. We should look at these issues with calories and try to understand how they will map to our own issues with Gluten.