We’ll go even further: Unquestionably, rice is the planet’s most important plant. It’s an ancient food staple for billions. Inexpensive, plentiful, and satiating, it appears in a wide assortment of shapes, sizes and colors and continues to inspire delicious culinary creations. Many of our most popular recipes depend on rice as a main ingredient.

That’s not to say rice doesn’t have “issues.” In 2014, Consumer Reports focused national attention on the arsenic levels in rice, which prompted the Food & Drug Administration (FDA) and the Environmental Protection Agency (EPA) to investigate. People in the gluten-free community who consume rice as their principle grain should be aware that there is some level of arsenic in certain types of rice grown in certain parts of the world. Consumers should understand how they can modify their rice consumption to address these concerns. Based on its analysis of arsenic levels in rice, Consumer Reports issued safety guidelines on November 18, 2014.

Lundberg Farms is a major producer of organic rice in the United States. Gluten Free & More published an informative interview with CEO Grant Lundberg about arsenic in rice in its June/July 2015 issue.

While we’re examining that widely asked question—Is rice gluten-free? —let’s talk about the different types of rice. There are more than 100,000 varieties! Conveniently, most fall into three main categories: long, medium and short-grain rice.

Long-grain rice: This is a classification of rice whose body is at least three times as long as it is wide. Long-grain rice generally cooks up light, fluffy and less sticky than other varieties due to higher levels of dry starch amylose. Best in: Savory dishes, salads, stir-fries, pilafs, curries, Indian, Mexican, Caribbean and Thai dishes, stuffing and fried rice.

Medium-grain rice: Typically, medium-grain rice is shorter but plumper than its long-grain kin. When cooked, this rice tends to remain moist and tender and sticks together more than long grain but less than short grain. Best in: Paella, risotto, casseroles, rice and beans, stuffing, meatloaf, rice salads, breads and desserts.

Short-grain rice: Short-grain rice has a wide, almost round body. When cooked, it tends to be quite moist and viscous due to high levels of waxy starch amylopectin. Because the grains stick together, short-grain rice is a practical choice for eating with chopsticks. Also called glutinous rice (don’t be confused–there is no gluten in it!), short-grain varieties tend to absorb less water and lose their shape during cooking. Best in: Sushi, desserts, puddings, rice balls, croquettes and risotto

Now that we’ve answered the question, “Is rice gluten-free?” are you ready to chow down on some delicious dishes? There are so many creative ways to use rice in every day cooking from Adzuki Bean Rice Burgers to Chicken Wraps with Coconut Rice, you’ll find tons of tasty recipes at GlutenFreeandMore.com.

Alicia Woodward is editor-in-chief of Gluten Free & More magazine.

Originally published in 2016, this post is regularly updated. 

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If so, remember that help is on the way. Specialists in gut disturbances are acutely aware of these symptoms and are working to lead you to a promised land free of pain and anxiety.

First step: Get a handle on the potential spectrum of celiac symptoms or gluten-influenced disorders you may be dealing with.

Studies and Research on Celiac Symptoms

At a recent Consensus Conference on Gluten Sensitivity in Oslo, a panel of 15 experts referred to these conditions as “gluten-related disorders” and proposed classifying them based on the type of immune reaction triggered by gluten: allergic, autoimmune, or immune-mediated.

The immune system responds to gluten in different ways, depending on who you are and your genetic disposition. Different organs can be affected by different types of gluten sensitivity symptoms or gluten intolerance.

In celiac disease, the small bowel is affected. In dermatitis herpetiformis, the skin is targeted, resulting in an itchy rash. Gluten ataxia impacts the brain; it’s a neurologic condition characterized by the loss of balance and coordination.

The Oslo researchers divided the gluten-related spectrum into three main categories:

• Allergic. A wheat allergy occurs when the body produces antibodies (usually IgE) in response to wheat (including gluten, the protein found in wheat). These antibodies circulate throughout the bloodstream, triggering an immune response (an allergic reaction), which occurs within minutes or up to a few hours after gluten exposure.
• Autoimmune. This includes celiac disease, dermatitis herpetiformis and gluten ataxia. In celiac disease, gluten sets off an autoimmune reaction that causes the destruction of the villi in the small intestine, interfering with the absorption of nutrients from food. Dermatitis herpetiformis is known as the skin form of celiac disease, characterized by a blistering, itchy rash. Gluten ataxia is characterized by damage to the cerebellum, resulting in difficulty with balance and coordination.
• Immune-mediated. This includes non-celiac gluten sensitivity. Non-celiac gluten sensitivity is a poorly understood entity thought to possibly have its own immune mechanisms affecting different parts of the body. Many people with non-celiac gluten sensitivity have celiac-like symptoms but have no corresponding damage to the gut. It is possible, but as yet unproven, that their immune reactions are related to involvement of the innate immune system, a primitive system that sets up barriers to repel invaders, rather than the adaptive immune system. The onset of symptoms is hours to days after gluten exposure. It must be stressed again that research is ongoing about non-celiac gluten sensitivity and that the condition remains ill defined at present.

Celiac Symptoms: More to the Story

Here are additional details on celiac symptoms and celiac disease:

• Dermatitis herpetiformis: A skin rash that affects 15 to 25 percent of people with celiac disease, dermatitis herpetiformis (DH) is characterized by an intensely itchy, blistering rash that may occur anywhere on the body, including limbs, trunk, groin, hands, fingers, face, scalp, and along the hairline. The rash is bilateral in nature; both knees or both arms, not just one, are usually affected. Many people with DH have none of the outward digestive symptoms of celiac disease, and only about 40 percent of them have the positive blood tests for celiac disease. But they often have the same intestinal damage as those with celiac disease.
• Gluten ataxia: Gluten ataxia is a neurologic condition characterized by the loss of balance and coordination. It can also affect fingers, hands, arms, legs, speech, and even eye movements. Typical symptoms include difficulty walking or walking with a wide gait, frequent falls, difficulty judging distances or position, visual disturbances and tremor. With gluten ataxia, damage takes place in the cerebellum, the balance center of the brain that controls coordination and complex movements like walking, speaking, and swallowing. Purkinje cells in the cerebellum, key in maintaining balance, are thought to be lost in gluten ataxia.
• Neurological disorders: Certain neurological disorders—idiopathic epilepsy (epilepsy without a known cause), ataxia (unstable gait, clumsiness), peripheral neuropathy (tingling or numbness in the hands or feet), schizophrenia, and even recurrent headaches—can be associated with celiac disease. Some syndromes, like epilepsy with calcification in the brain, are definitely linked to celiac disease.

In addition, certain psychiatric disturbances—hallucinations, depression, anxiety, suicide ideation—occur more frequently in patients with celiac disease.

Celiac disease can also present as autistic-like behaviors.

Although autism and celiac disease are distinct and unrelated entities, some autistic-like behaviors are common in celiac disease, especially in young children. A child with undiagnosed celiac disease may, in fact, appear sad, introverted, unwilling to socialize or communicate even with his or her parents, or the child may be cranky and excessively irritable.

Neurologic, psychiatric, emotional, and autistic-like manifestations have been described in celiac patients who show minimal or no GI symptoms and no damage in the small intestine.

Fortunately, all these symptoms, including depression, anxiety, and hallucinations, are likely to regress on a gluten-free diet.

Sources & Resources

For further reading, see these University Health News posts:

• “What Does ‘Gluten-Free’ Mean?“
• “Gluten Intolerance Symptoms: Is It Celiac Disease That’s Making You Ill?“
• “Celiac Disease Diet: Your Gluten-Free Planning Guide“

Originally published in 2016 and regularly updated.

The post Celiac Symptoms: Not Just Stomach Ills appeared first on University Health News.

A 1999 Italian study published in the journal Gastroenterology showed that the prevalence of other autoimmune disorders in patients with celiac disease is related to the duration of exposure to gluten. The older patients were when diagnosed with celiac disease, the greater their chances of developing other autoimmune disorders like hypothyroidism, but also—less commonly—hyperthyroidism, Addison’s disease, vitamin B12 deficiency, vitiligo (spotty loss of skin pigment), and alopecia (hair loss), among others.

Autoimmune Risks

• Type 1 diabetes: Celiac disease and type 1 diabetes are both chronic, lifelong autoimmune diseases. The two conditions have a genetic link, sharing some genes and environmental factors that may cause the immune system to attack the villi in the small intestine (in celiac disease) and beta cells in the pancreas (in type 1 diabetes). Researchers believe that celiac disease and diabetes have at least seven genes in common and there may be more.
• Other autoimmune diseases: Autoimmune disorders result when the body’s leukocytes (white blood cells), which normally fight infection, attack and destroy healthy body tissue. Celiac disease is associated with an increased prevalence of other autoimmune conditions, including multiple sclerosis, Hashimoto’s thyroiditis (which results in hypothyroidism), Graves disease (which leads to hyperthyroidism), Addison’s disease, and autoimmune hepatitis.

Associated Complications

• Infertility: When researchers at the Celiac Disease Center at Columbia University screened 188 women with unexplained infertility, almost 6 percent had celiac disease—a rate nearly six times higher than expected, making celiac disease an important association of unexplained infertility, according to a study published in The Journal of Reproductive Medicine in 2011.Untreated celiac disease can rob a woman’s body of nutrients, but malnourishment isn’t the only mechanism behind infertility. Antibodies to tissue transglutaminase (tTG)—one of the key markers of celiac—can have an effect on the placenta’s development.
• Osteoporosis: When celiac disease goes untreated, the small intestine is injured and can’t properly absorb nutrients, including calcium. Calcium is so critical for nerve and muscle functions—like heartbeat—that if it’s not absorbed from food, survival mechanisms take over and the body taps the bones for calcium. Over time, this leads to bone loss associated with osteoporosis. Gluten can also increase the systemic level of inflammation in the body. Inflammation causes proteins, called cytokines, and other inflammatory mediators to circulate in the blood and interfere with bone growth.
• Chromosomal disorders: Individuals with chromosomal abnormalities, such as Down syndrome, Turner syndrome and Williams syndrome, have a predisposition toward autoimmune diseases (including celiac disease), endocrine disorders, and cancers.
• Celiac disease symptoms without the celiac disease: For years, many people reported having celiac-like symptoms—abdominal pain, fatigue, foggy mind, joint pain, tingling of the extremities, even depression—but they repeatedly tested negative for celiac disease and responded positively to the gluten-free diet. Now specialists recognize that these patients may have non-celiac gluten sensitivity, a condition that is distinct from celiac disease.

How Common is Non-Celiac Gluten Sensitivity?

Studies have now demonstrated that non-celiac gluten sensitivity is a distinct medical condition that differs from celiac disease. Celiac disease is considered a subset of gluten sensitivity. Anyone with celiac disease, by definition, is gluten sensitive. However, not all gluten-sensitive people are celiacs.

Unlike celiac disease, non-celiac gluten sensitivity causes no measurable intestinal damage. Classic symptoms are gastrointestinal, such as diarrhea, bloating, or constipation. Some people report symptoms ranging from clumsiness, brain fog, and depression to ADHD or autistic-like behaviors.

Patients with non-celiac gluten sensitivity might have various reactions to gluten. In a study of 347 gluten-sensitive patients conducted by the University of Maryland, 68 percent experienced abdominal pain, 40 percent had eczema or a rash, and approximately a third reported headache, diarrhea, fatigue, or “foggy mind.” Depression, anemia, numbness in the legs, arms or fingers, and joint pain were also frequently reported.

How Is Gluten Sensitivity Diagnosed?

Currently, non-celiac gluten sensitivity is a diagnosis of exclusion; it’s diagnosed only after other conditions are ruled out. Non-celiac gluten sensitivity is not an allergic condition, is not an autoimmune reaction to gluten, does not cause any significant damage to the small intestine, and is not associated with HLA genes (as is celiac disease).

There are no genes that are currently known to be associated with non-celiac gluten sensitivity and no diagnostic markers—such as anti-gliadin antibodies, stool tests, saliva tests, or biopsy—for conclusively diagnosing the condition. (See our post “Celiac Disease: How Do You Know If You Have It?“) Non-celiac gluten sensitivity is typically determined by a positive response to the gluten-free diet. The defining element of non-celiac gluten sensitivity is feeling better when you don’t eat gluten.

For further reading, see these University Health News posts:

• “What Does ‘Gluten-Free’ Mean?“
• “Gluten Intolerance Symptoms: Is It Celiac Disease That’s Making You Ill?“
• “Celiac Disease Diet: Your Gluten-Free Planning Guide“

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Originally published in 2016, this post is regularly updated.

The post Celiac Disease Symptoms: Get Ready For Related Conditions appeared first on University Health News.

]]> https://universityhealthnews.com/daily/gluten-free-food-allergies/what-is-gluten/ Mon, 29 Jan 2018 06:00:22 +0000 https://universityhealthnews.com/?p=1254 If you’ve been experiencing unresolved gastrointestinal issues after you eat, you may have wondered if you’re experiencing gluten sensitivity symptoms. That leads you—and millions of people just like you—to beg the question: What is gluten? In a nutshell, gluten is a protein that causes some people to feel bloated, cramps, and fatigue. Their gluten sensitivity […]

The post What Is Gluten? appeared first on University Health News.

]]> If you’ve been experiencing unresolved gastrointestinal issues after you eat, you may have wondered if you’re experiencing gluten sensitivity symptoms. That leads you—and millions of people just like you—to beg the question: What is gluten?

In a nutshell, gluten is a protein that causes some people to feel bloated, cramps, and fatigue. Their gluten sensitivity may lead to a diagnosis of celiac disease (more on that in a minute).

What Is Gluten? And Where is It?

Gluten is commonly found in wheat, barley, or rye—common ingredients in popular foods. You’ll find wheat in breads, other baked goods, soups, pasta, cereals, sauces, salad dressings, or roux. You’ll find barley in malt, food coloring, soups, malt vinegar, even beer. Rye is found in rye bread such as pumpernickel, rye beer and many kinds of cereals.

If you and your doctor suspect you have a gluten sensitivity, it’s easy to figure out what to avoid. But in the food world, what is gluten-free? Fortunately for people who have gluten intolerance, there are a variety of items you likely already enjoy that are naturally gluten-free. They include fruits, vegetables, meat and poultry, fish and seafood, and dairy, plus beans, legumes, and nuts.

Finding Your Diet Groove

There are lots of tasty, creative ways to enjoy a gluten-free diet—and no shortage of gluten-free recipes for all tastes and all meals. The Celiac Disease Foundation recommends things like oat bran muffins, lox and cream cheese on a gluten-free bagel, a breakfast burrito with eggs, bell peppers, avocado and olive oil. If you’re hosting a party, you can ensure your guests’ gluten intolerance symptoms are properly respected with snack items like strawberries and gluten-free goat cheese crackers, or tomato-garlic focaccia, which relies on sorghum and chopped herbs.

Bottom line: If you’re gluten-sensitive, don’t worry about finding foods you enjoy. There are lots of choice gluten-free recipes to choose from.

If you think your condition might be more serious, your doctor may suspect you’re suffering from celiac symptoms.

The first step in diagnosing celiac disease is usually a blood test to measure levels of certain auto-antibodies produced by the immune system in response to ingested gluten. As a result, it’s important to be eating a regular, gluten-containing diet when being tested for celiac disease; if you’ve been on a gluten-free diet longer than a couple of months, results may be negative—even if celiac disease is present. After that, your doctor might recommend an elimination diet to get at the root of your difficulties.

For further reading: See “Quick-Start Guide to Celiac Disease and Gluten Sensitivity.”

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Originally published 2016, this post is regularly updated.

The post What Is Gluten? appeared first on University Health News.

]]> https://universityhealthnews.com/daily/gluten-free-food-allergies/gluten-intolerance-symptoms-is-it-celiac-disease-thats-making-you-ill/ Mon, 22 Aug 2016 05:00:08 +0000 https://universityhealthnews.com/?p=1059 Maybe it started with an awareness when you were very young that certain foods—usually baked goods and pasta—left you feeling ill. Perhaps you developed a digestive intolerance later in life and you’re not sure how to handle it. Whatever the reason, you have come to the determination that you have gluten intolerance symptoms—or perhaps sensitivity […]

The post Gluten Intolerance Symptoms: Is It Celiac Disease That’s Making You Ill? appeared first on University Health News.

]]> Maybe it started with an awareness when you were very young that certain foods—usually baked goods and pasta—left you feeling ill. Perhaps you developed a digestive intolerance later in life and you’re not sure how to handle it. Whatever the reason, you have come to the determination that you have gluten intolerance symptoms—or perhaps sensitivity to other food groups including diary, soy, or nuts.

Regardless of how you got here, University Health News’s series of targeted emails and free reports will help guide you to where you are going. First, you need to understand just what’s bothering you, starting with your gluten intolerance symptoms.

Celiac disease is a genetic autoimmune disorder that occurs when the body reacts abnormally to gluten, a protein found in wheat, rye, and barley. When people with celiac disease eat foods that contain gluten, an immune-mediated toxic reaction causes damage to their small intestine and to other systems in the body. Celiac disease affects about 1 in 133 people, an estimated 3 million Americans. Approximately 85 percent of these are thought to be undiagnosed.

Specialists now confirm that another portion of the population is affected by non-celiac gluten sensitivity. Individuals with gluten sensitivity experience symptoms similar to celiac disease but without the autoimmune reaction or the intestinal damage.

Although awareness of celiac disease in this country is increasing, at least one study reports that it can still take up to 11 years for some to be diagnosed. This may be due to the fact that celiac disease can present with a wide range of subtle to serious symptoms—from migraines to seizures, from diarrhea to dementia.

Also delaying diagnosis is the fact that many doctors still don’t think to suspect gluten sensitivity unless a patient has obvious gastro-intestinal complaints. Yet recent studies indicate only 30 percent of the people with gluten sensitivity have classic GI symptoms.

Celiac disease is a lifelong condition that cannot be outgrown. It is often present without obvious symptoms. If left untreated by the gluten-free diet, it continues to cause (more or less “silently”) intestinal damage and can lead to the development of conditions such as osteoporosis, infertility, and chronic anemia, as well as other related autoimmune disorders and even certain types of cancer.

Older Adults and Celiac Disease

Celiac disease was once considered a childhood condition that could be outgrown. Medical experts now know that celiac disease is a lifelong disorder that doesn’t occur just in childhood. New studies suggest it’s possible to develop celiac disease quite late in life.

When researchers from Finland screened a large group of adults over age 55 for celiac disease in 2002 and then again in 2005, they detected several new cases during the three-year interval. The gluten intolerance symptoms that subjects experienced revealed that the disorder can develop even in the elderly.

Similar results were reported in a study conducted in the United States by the University of Maryland Center for Celiac Research. The research revealed that as people in the study aged, the incidence of celiac disease increased.

Still unanswered is why a person would develop celiac disease at age 60, 70, 80, or even 90. There are theories on triggers, like changes in the intestinal bacteria, but these theories are not yet proven.

While younger patients are often able to experience intestinal healing quickly on a gluten-free diet, it may take longer for older adults. The dramatic turnarounds in health sometimes seen after diagnosis and adherence to the gluten-free diet—feeling like a new person overnight—aren’t typical for those diagnosed at an older age. The intestines simply heal more quickly in those who are younger. Little children may heal in weeks or months while older adults may take years to recover and some may not ever get fully back to normal.



How does celiac disease affect us? As the chart here shows, it can wreak havoc on everything from the mouth to joint pain to intestinal and stomach issues to skin problems.

Celiac Triggers

As with all autoimmune diseases, celiac disease is thought to involve a complex interaction of genetic and environmental factors. Thus far, two genetic markers—HLA-DQ2 and HLA-DQ8—have been associated with the condition. Ninety-nine percent of those with celiac disease have one of these genetic markers. (Note that many people who don’t have celiac disease also have these markers.)

Researchers are actively trying to identify other genes that are also implicated in the onset of celiac disease, and the list of genes is growing every year. It is thought, however, that their role is minor compared with the HLA-DQ2 and HLA-DQ8 markers.

Besides gluten, additional environmental factors may contribute to the onset of celiac disease. A particular event can activate, or “turn on,” the condition. Sometimes celiac disease is triggered—or becomes active for the first time—after stressful events, like surgery, pregnancy, childbirth, viral infection, or severe emotional stress.

Infection may be a substantial trigger for celiac disease. Over the years, infections have been studied in connection with the onset of a variety of autoimmune conditions, including type 1 diabetes and rheumatoid arthritis.

When a report in medical literature noted the symptomatic onset of celiac disease following a confirmed case of Campylobacter jejuni enteritis (traveler’s diarrhea), it was among the first to suggest that an environmental factor other than gluten—in this case, an infection—could be important to the onset of symptomatic celiac disease.

A large, earlier study of children with genetic markers for celiac disease linked repeated rotavirus infections (one of the most common causes of childhood diarrhea) with an increased risk of developing celiac disease later in life. More recently, it has become clear that the risk for developing celiac disease is increased by any type of recurring infections during early infancy.

Just how an infection might precipitate celiac disease or celiac symptoms is unclear, however. One theory is that repeated infections chronically stimulate the immune system, which may, in turn, trigger an autoimmune reaction in genetically susceptible people. Another theory is that a mechanism known as molecular mimicry is to blame. Here, a foreign protein, such as an infectious bacteria or virus, tricks the body into attacking its own cells.

Click here for our guide on tests and screenings for people with celiac disease and gluten intolerance symptoms. It’s free to registered users at University Health News.

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Originally published in May 2016 and updated.

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