The Gluten-Free Debate: A Baker’s Friend or a Consumer’s Villain?
Probing gluten and celiac disease
Bryan Tarnowski Photograph
It may be gluten-free, but it isn’t French bread. It won’t hold a fried shrimp poor boy. If that’s French bread, I don’t have celiac disease,” says Annette Bentley, president for life of the American Celiac Society as we were listening to a food vendor’s pitch from Lafayette. Bentley, an animated dynamo, didn’t like what she saw. We were at The Big Easy Gluten/Allergen-Free Expo held at the New Orleans Healing Center on St. Claude Avenue last October.
“I was diagnosed with celiac disease when I was 33 years old,” says Bentley. “I had extreme bloating and looked nine months pregnant even though my weight had dropped to 67 pounds. The first doctor I went to told me I had the six-month flu. Then I saw Dr. Murrel Kaplan. May he rest in peace. He made the diagnosis and saved my life.”
Kaplan was one of New Orleans’ most preeminent internists in the second half of the 20th century. He practiced gastroenterology in the Touro area when the most important tool of a gastroenterologist was cerebral power augmented by listening to patients and taking detailed medical histories. The toys of this specialty came later: long endoscopes with fiberoptic lighting to illuminate and look into dark passages of the gastrointestinal tract previously inaccessible except for surgery or autopsy.
Symptoms of classic celiac disease occur in children: loss of appetite, diarrhea, vomiting, bloating, weight loss and impaired growth. Common adult symptoms are more vague: abdominal cramping, bloating sensations, excessive gas and irritable bowel-like complaints, such as diarrhea or constipation, or both. Often these digestive symptoms are obscured by multiple other problems including anxiety, depression, fatigue, infertility, mouth ulcers, tingling sensations and even peculiar rashes.
Celiac disease is an autoimmune disorder of the small intestine. The lymphoid rich tissue lining our guts is part of the body’s defense system against harmful invaders. Some folks have a genetic makeup that labels gluten as an enemy. Gluten throws their immune systems into overdrive, producing abnormal antibodies. These reactive molecules, called autoantibodies, poke small holes into the intestinal lining, stripping away the essential villous layer.
Important clues about celiac disease surfaced during World War II. A German blockade in Holland combined with severe winter weather caused a widespread famine. Flour was in short supply. A pediatrician who treated a large number of children with chronic diarrhea and failure to thrive noted that the children under his care actually improved under these adverse conditions. When the war ended, hospitals were the first to get imported bread. Many of the children, whose bowel disease had actually improved during the famine, immediately got worse. The Dutch pediatrician proposed a link between gluten in wheat and his young patients with celiac disease. His subsequent research proved that link.
For most adults, the onset of celiac disease is rarely sudden and dramatic as with children. Classic early symptoms are vague bloat and diarrhea. Over time, the early non-specific symptoms of celiac disease become more protean, fueled by malabsorption of all sorts of important nutrients and vitamins. For those with lesser degrees of gluten sensitivity, the progression of signs and symptoms is more diverse and can include weight gain.
Bentley told me how Kaplan first suspected her lactose deficiency around 1962. She actually did improve with steroids and by avoiding all baked foods containing milk or milk products. She had turned into a real pasta hound when Kaplan called her excitedly one day after returning from a national conference. He had heard a presentation on adults with gluten allergy, a disorder previously associated mostly with children.
“He told me ‘I think you have a gluten problem. My library is your library. Every book on my shelf is yours for the taking.’ I read them all and have been on a gluten-free diet ever since,” says Bentley.
Kelly Boffone held court at another nearby booth. The night before she delighted patrons at the Louisiana SPCA Howling Success gala with samples of her pastry skills right up there with chef organizer Greg Picolo. Boffone owns and operates The PeaceBaker, a gluten-free source of pastry delights on Veterans Boulevard across from Lafreniere Park in Metairie. I met her at the gala. She enticed me into trying one of her erupting chocolate volcano cupcakes, warning me about a second too late that my tie was at risk.
It was worth the spot as she also was the one who told me about the Big Easy gluten-free Expo happening the next day.
“All my products are gluten- and dairy-free with local ingredients when possible. No cross-contamination in my kitchen. My idea is to offer relaxing and tasty food; food that’s easy on everybody’s stomach, peaceful food. Thus the name PeaceBaker. We have three small tables where you can eat in, but we’re mostly takeout. The most popular is Cookie Sammie, a double chocolate cookie sandwich with a core of banana buttercream made from soy,” says Boffone, a professionally trained chef who slung the dough at some of the city’s more famous eateries before she decided to “bring it back to the basics.”
“Oh my God, I love it. I have been living in New Orleans for 10 years, and have never even tasted gumbo,” said an attendee whom I overheard at another booth. I scurried over to investigate. An attractive 30-something young lady was talking to Kristie Buford, who turned her own celiac disease into a business at YourWayCuisines.com.
“I had asthma for 15 years along with bloating, constant diarrhea and stomach cramps before blood tests showed I had celiac disease. Once I got on a gluten-free diet, my asthma subsided tremendously. My goal is to bring Cajun-style food to the gluten-free community,” said Buford as she handed out samples of a gumbo even ya mamma would die for, based on a rice flour roux. I had to agree with the virgin gumbo taster. Buford’s gumbo was broth-based and the perfect color. It was not only delicious, but it tasted good, too.
Back to the French bread, Bentley had a point. The squatty 10-inch long loaf of bread, about 4 inches wide and 1 inch high, was as heavy as a brickbat. The thin, well-tattooed promoter of gluten-free French bread from Lafayette shrugged and rolled his eyes as Bentley continued to pound him. She has been president of her organization for 37 years. In spite of its national sounding name, I suspect she’s more of a local than national voice for people with gluten concerns.
A Google search provides the names of more gluten-free local and national organizations. My recommendation for folks looking for more information on celiac disease and its variants is the National Institutes of Health website (NIH.gov) that lists all the national heavy hitting groups. These include the American Celiac Disease Alliance, Celiac Sprue Association, Gluten Intolerance Group of North America and National Foundation for Celiac Awareness.