“Without bread all is misery.” (1)
This quote from William Cobbett, a British journalist, (1763?-1835) is unfortunately not true for 1 out of 100 people who have celiac or are wheat and gluten intolerant. In fact for these people, bread IS misery. I am one of those people.
I discovered that I was in fact, gluten and wheat intolerant after coming down with symptoms of Rhuematoid Athritis. I no longer worry about joint pain as long as I stay far away from anything that contains wheat or gluten (from wheat, rye or barley). This, however, is not as easy as it seems, for the food industry uses wheat flour in a majority of its products. It is also a hidden ingredient in numerous food items.
For example, let’s say that I decide to have a nice steak dinner in one of the many excellent steakhouses in Texas.
It goes without saying that I have to refuse the customary basket of hot bread, which for a bread lover like me is torture itself. But knowing that if I do not, the joints in my hands will swell up like balloons or even worse my next few hours will be spent in excruciating abdominal discomfort, I can usually pass on that tempting item fairly easily, but what about the rest of my meal?
Let’s start with the steak. First, I have to determine if it has been marinated. If the answer is yes than I need to know what was in the marinade. Many marinades are made out of soy sauce, which typically contains wheat in this country. And what about those spices used to season the steak? Flour is often added in minute particles to keep the spices from sticking together or monosodium glutamate is added as a flavor enhancer. Both, of course may be sourced from wheat. So the steak needs to come without marinade and no spices. That sounds pretty boring, right off the bat!
How about the second course of my meal, a baked potato? Harmless enough, yes, if the restaurant uses real butter…margarine, although usually wheat free, it may not be. Sour cream? Some manufacturers add flour as a stabilizer. Cheddar Cheese? Flour may be dusted across the pre-shredded cheese to keep the pieces from sticking together and is not necessarily an ingredient that is listed. Bacon? Again, it depends on the manufacturer and what ingredients are used to process it. Chives? Whew, that is safe, or at least I have never heard of it including any wheat…so my loaded baked potato becomes a very plain, possibly dry one, sprinkled with a few chives.
Salads would be safe right? Again, it depends on if the wait staff remembers to order no croutons. I have had a salad delivered with croutons after I have requested none, only to have the wait staff bring the same salad back out with the croutons removed. With no knowledge of the pain they may be inflicting, the crumbs from the croutons remain. Although the vegetables should all be safe, you still have to deal with the shredded cheese and bacon issue. And the salad dressing, well, who knows if you will find any wheat or MSG in there? I typically just order oil and vinegar to avoid the possibility of future pain.
But the salt and pepper should be ok, right? Not necessarily, again flour is used to prevent caking. Forget dessert, it’s not worth going into. You can’t even trust a child’s menu item, like ice cream. This is the life of a celiac/gluten intolerant person. Why even bother to go out to eat?
Which is why I have located just about every restaurant I can find in the state of Texas, that offers a gluten free menu. Yes, as of right now, it means that we typically visit the same chain restaurants in our area, and that can get a little boring or we eat at home most of the time. It definitely takes some of the fun and spontaneity out of life, but it’s worth it for my health and things are improving. In fact, I read recently that gluten free menu items are the number one trend in restaurants right now.
So what is celiac/gluten intolerance? Celiac disease is the most common-and one of the most under-diagnosed- hereditary autoimmune conditions in the U.S. today according to Peter H.R. Green M.D. and Rory Jones, authors of the new book Celiac Disease a Hidden Epidemic. Dr. Green is the Director of the Celiac Disease Center at Columbia University. According to their book, not only do recent studies show that celiac disease affects approximately 1 percent of the U.S. population, but that 97 percent of them are undiagnosed. (2)
Although celiac primarily attacks the small intestine, destroying the villi lining, the result of this injury can result in other medical issues from the years of inflammation and the malabsorption of minerals, vitamins, and other necessary nutrients. Currently, the average time to diagnose celiac disease correctly is nine years. By this time, patients have often developed associated autoimmune diseases, including, bone loss, anemia, malignancies and infertility to name just a few. Typically patients with one autoimmune disease are more likely to develop another as, for example, of the 2.1 million people with type 1 diabetes, 8 to 10 percent also have celiac disease. (3)
Often the associated autoimmune disease is diagnosed first because it is more obviously symptomatic, while the celiac remains silent. It is believed, though, that the celiac disease may actually develop first, pre-disposing individuals to the development of the associated autoimmune diseases. Specifically, the autoimmune diseases associated with celiac are, but not limited to, diabetes, thyroid disease, Sjogren’s syndrome, Addison’s disease, autoimmune liver disease, cardiomyopathy, alopecia areata and rheumatoid arthritis. (4)
More research may reveal other autoimmune diseases that are in fact, caused by or associated with celiac. In my case, I had symptoms of celiac for years but did not discover that wheat/gluten was in fact an issue until after I developed symptoms of rheumatoid arthritis.
In many ways, this disease is not a bad one to have. There is not a medication regimen you have to follow. The most difficult thing is to obtain the knowledge you need to insure your food quality and safety. It takes some time to learn what items are safe, not only in a restaurant setting but at the grocery store. The safest items and the healthiest will be found on the perimeters of the store. Many grocery stores have begun to offer GF foods, sometimes locating them in a special section and at other times mixed in with the regular foods. You will need to learn how to read labels and what ingredients can be hiding gluten/wheat.
There are more and more manufacturers offering products that are gluten free and taste wonderful, many with no discernible difference from your regular wheat flour foods. It is mostly a trial and error process, but the internet has made it much easier to find and order these items. Even the grocery store in my tiny town of 3000 carries bread from UDI’s and GF pizza from Amy’s. You just have to take the time to research what is available in your area.
There are times I feel sad at having to give up my favorite items or the ease with which others go through life, not having to constantly worry about accidentally ingesting a forbidden ingredient. I get tired of the irritated looks from shopkeepers or wait staff, and sometimes even friends and family members, not understanding my questions, as I attempt to navigate through the ingredient minefield of the typical restaurant. But with knowledge comes power and I believe as more and more people realize how prevalent this disease is, things will continue to improve. I know that I have seen huge changes in just the last three years I have dealt with this illness.
And one thing I know without a doubt, I no longer experience the incredible pain in the joints of my body that I did before I discovered what was at the root of my ill health. And for that, I am incredibly thankful!
(2) Green M.D., Peter H.R., Jones, Rory Celiac Disease A Hidden Epidemic New York, NY: HarperCollins Publishers; 2006, 2010 pp. 2-3
(3) Ibid. p.3
(4) Ibid. pp.149-150