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;
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.
Just when we thought Zach at Gluten Free Raleigh couldn’t do anymore to help those with recent CD diagnosis or those who pursue the GFD, he has topped himself. Today he’ll be presenting this petition to the City Council to increase awareness of the big eight food allergens and gluten.
Please take the time to sign up to the petition here.
This is the kind of gluten labeling every product should have.
Of all the products you must go without once following the gluten free diet (”GFD”), beer is often mentioned as one of the toughest. Beer is an essential social lubricant; it facilitates post-work business interactions, weekend football games and a simple treat after working out. Zach’s postings at Gluten Free Raleigh echo our sentiments here at Juno Nutrition. I think the world of the producers of GF Beer, with a strong affinity for Redbridge.
That being said, there’s an alcoholic beverage that is very widely available that has long been labeled GF: Woodchuck Cider. From Woodchuck’s own website (as of 10/11/2009):
Just like anybody else with CD or pursuing the GFD, the opportunity to have a beer when out for a drink is a wonderful thing; let’s not overlook businesses like Woodchuck that make naturally GF products that are widely available (now in every state except for Hawaii).
There's the gluten status, up in the top left corner.
The Czech Republic is not a friendly place to visit for those of us who pursue the gluten free diet (”GFD”). CD is not widely diagnosed. Flour is put in practically everything, and as I found out, literacy isn’t the highest even if you have a trusty “I’ve got CD and pursue the GFD cards.” (Thank you as always, to the people at www.celiactravel.com).
The search results in our Juno Nutrition food database when you look for products that are Czech. As always, we show an aggregate safety result in the Gluten Summary.
To prepare for the trip I went down to the local Czech restaurant, Klara’s, in Cary, NC. As usual, I went to visit around 2 in the afternoon, just the right time for management to still be around, but after the lunchtime rush so you can sit and talk. Klara had heard of CD and knew of the GFD for her customers, but hadn’t ever gone through her menu in detail. We spent about an hour going through each item on the menu. Klara was kind enough to tell me if which items were GF, which items would always contain gluten, and which items might be made to avoid gluten and how to ask for them.
We walked away with 66 products; 27 okay / 1 unknown / 28 avoid. It was extremely helpful and it led to my first trip to Praha and Liberec where there was no accidental gluten exposure.
Last week I had to visit Berlin to speak at Nanotech Europe. I used to enjoy travel, however the CD diagnosis has certainly made that harder. If I could avoid travel, I would. The need for travel and the need to quickly identify GF friendly locations and products, was one of the things that put the wheels in motion to start Juno Nutrition.
GF Mile High Club
Deciphering GF labeling overseas is not any easier than it is in the States. For anyone with CD who hasn’t traveled internationally, cast aside any illusions that the grass is greener elsewhere. The same challenges exist in regards to labeling conventions and clarity, throw in numerous different regulatory bodies and language issues and life gets pretty tricky. I walk out the door with at least one Lara Bar per meal knowing that I’ll have to stock up on breakfast wherever I go. On this particular trip, I left with some left over Pei Wei and Chex Mix that my wife had packed me.
Despite the woes of international traveling with the GFD, the airlines have actually gotten this part of life right! I was thrilled with the GF menu option from Continental. I’d called ahead 72 hours in advance and got a special meal - even in coach. Someone next to me asked if I could swap seats so they could sit with a friend - I held off saying “Yes” (something I would always do) in order to be sure the flight attendant could find me in the new spot. The meals weren’t anything special - but it was certainly a relief to not have to worry about getting ill prior to the trip even starting. And while the food on the trip to Berlin wasn’t that special, the return trip home was actually pretty good. They served a boiled salmon with buttered potatoes; not a low calorie meal but it was great to enjoy.
GF Ingredient List from Continental
I asked the flight attendants about the food labeling; did the flight from Newark to Berlin conform to US food labeling and the flight back to EU laws? Unfortunately, they didn’t have an answer. It was clear that the US originating flight had been packaged by a separate entity, the Berlin originating meals looked like they had been hand made and used the very dry, large-cracker-style GF bread that seems to be the default GF carbohydrate option across Europe (or at least the parts of Germany and the Czech Republic that I frequent).
Again, my thanks to Continental for making life a little easier.
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.)
Comments (0) 
