Know Your Status: Are You Gluten Sensitive?

food-allergies

A good number of people already know that gluten is found in various starchy carbohydrate sources. Here in the Philippines, we take pride in our carbohydrate-rich menus which are customary in every meal. However, since gluten intolerance is still not a familiar concept to many of us, we discount having gluten sensitivity when experiencing discomforts after certain meals, allergy or intolerance specifically to gluten is hardly even thought about.

Pandesal, typical Filipino gluten laden bread.
Pandesal, typical Filipino gluten laden bread.

Studies on the prevalence of gluten sensitivity or gluten allergy in the Philippines have yet to be published, though we have to be aware of the possibility that anyone of us might be part of the statistic, especially if the source of discomfort is not top-of-mind.

It is important also to differentiate between gluten intolerance and gluten allergy. Allergic reactions tend to be immediate and often severe, as opposed to intolerance, the symptoms of which are not immediately felt, could be from days to weeks, the cause of which are subtle and not readily detectable. Both are abnormal reactions to certain foods manifesting in your body in different ways. Gluten adverse reactions include skin conditions like eczema, digestive conditions like bloating, constipation, pain and diarrhea, even others seemingly unrelated to digestion, like fatigue, migraines and severe ones like seizures.

gluten-words

When adverse symptoms continue to bog you down, allergy testing and food intolerance testing would definitely help shed some light on your concerns.

Allergy Testing

A trip to the allergist would help you determine if you are susceptible to allergic reactions to specific components of a particular food, such as gluten. Some other common food allergies are caused by milk, eggs, nuts, fish or shellfish. Gluten and other food allergies can also be identified by undergoing a series of brief tests and interviews. Here in the Metro, we have quite a number of hospitals and centers that conduct tests know which food items you have to watch out for.

Quezon City

St. Luke’s Medical CenterQuezon City, ranked as one of the top hospitals in the country, offers a variety of services from asthma, drug allergies, insect allergies, and of course food allergies, to determine which substance you have an allergy to, through its St. Luke’s Allergy and Immunology Department.

It is located at 279 E Rodriguez Sr. Ave, Quezon City. They also have a branch in Bonifacio Global City: St Luke’s-Global is located at Rizal Drive cor. 32nd St. and 5th Ave., Taguig.

Makati and BGC (Bonifacio Global City)

Another center you can visit in BGC is LifeScience Center for Wellness and Preventive Medicine. Through a simple blood sampling that is analyzed using their in-house Food Detective Kit, which uses Enzyme-Linked Immunosorbent Assay (ELISA) technology, which is a plate-based assay technique designed for detecting and quantifying substances including antibodies, assisting in determining your food intolerances.

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Healthway, the mall based clinic also  offers what they term as “FIT”, short for Food Intolerance Test, which already includes a consultation with nutritionist for briefing on their FIT service and to explain the findings of the test. You can find them in Greenbelt 5, as well as other malls in Alabang, Bonificio Global City, and Quezon City.

Manila

Manila Doctors Hospital, through its Pediatric Allergology and Immunology Department also conducts tests to determine your food allergies and food intolerances. Among its Allergology Services are allergy screening, and allergy management.

MDH is located at UN Ave., Ermita Manila City

Alabang

With 30 branches nationwide, including Alabang, High Precision Diagnostics offering Food Intolerance Testing is also an option for you. The food intolerance test is simple, done through blood sampling. You can get the results of the test in two weeks.

Asian Hospital And Medical Center in Alabang also offers food intolerance and allergy testing. As with its tertiary hospital counterparts in the North, AHMC provides services for immunologic/allergic disorders, such as allergic rhinitis (hay fever), asthma, sinusitis, insect allergy, unusual vasculitis syndromes, and penicillin and other drug allergies.

AHMC is at r, 2205 Civic Drive, Filinvest Corporate City, Alabang, Muntinlupa City

With the variety of healthcare providers around, tests in determining whether you have some food intolerances is now very accessible. If you maybe suffering from any of the symptoms mentioned or you have an inkling that you could be adversely reacting to food but not completely sure, visiting your doctor and taking a food intolerance test could be well worth it. It can help improve your health and might even save your life in the long run.

Sources:

“Philippines.” Welcome to Ranking Web of Hospitals. Centro De Información Y Documentación (CINDOC), n.d. Web. 10 Oct. 2016.

Raneses, Katherince Grace. “Getting Tested for Food Intolerance at LifeScience.”Mucking Around Manila. N.p., 14 Nov. 2014. Web. 10 Oct. 2016.

Aventajado, Michelle. “My Food Intolerance Test – Momma ‘N Manila.” Momma N Manila. N.p., 2016. Web. 10 Oct. 2016.

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Can You Develop Celiac Disease As You Grow Older?

happy asian Family enjoy their dinner

Being that it’s nearing Father’s Day, let me just share something that is about my old man that might also be relevant to other fathers out there, as well. My dad, now in his 60s, had a check up with his doctor, and came home with a whole new diet plan. Not so unusual, he had to cut out fatty, salty food and watch his calorie intake to keep his heart’s health in check. But along with the food that he was advised to stay away from were those containing gluten. He’s never had symptoms of adverse reaction to gluten and so I had to take a second look at his not-to-eat list as. I had to wonder, can celiac disease develop later in life?

Celiac disease is an inherited case of autoimmune disorder where gluten, a protein found in some food like wheat, barley and rye, adversely affects a person’s digestive process. Some symptoms that can occur are skin conditions like eczema, digestive conditions like bloating, constipation, pain and diarrhea, even others seemingly unrelated to digestion, like fatigue, migraines and severe ones like seizures. Though in the US, according to an article published in celiac.org, only 1 out of a 100 people actually have this condition.

However, if you do not have the condition today, does that mean you are forever in the clear? According to a research published in 2010 in the Annals of Medicine, we have reason to believe that that might not be the case.

Celiac-Disease-Cvr

One of the research’s goal was to investigate if there would be any changes in prevalence of celiac disease in people over time. The research involved studying matching blood samples taken from 3,511 participants  in 1974 and then again in 1989, 15 years after. Among the subjects, the prevalence ratio rose from 1 : 501 to 1 : 219 before and after. In other words, the prevalence increased 2-fold in the test subjects over this time. The study concludes that this is due to test subjects’ loss of immunological tolerance towards adulthood.

However, adopting a new lifestyle that involves cutting anything out of your diet should be studied closely. It is always a smart thing to consult a doctor before going on a gluten-free diet.

And so my dad, not actually confirmed yet to have celiac disease still has to check his symptoms and have regular check ups with his doctor, to see if his well being will improve after following a gluten-free diet.

And just to be on the safe side, it would be best now  to look for gluten-free food to support this new diet. 

Morgan – Team GERALD.ph

References:

Klein, S. (2014, February 12). 9 Things You Should Know Before Going Gluten-Free – Celiac Disease Foundation. Retrieved June 17, 2016, from https://celiac.org/blog/2014/02/9-things-you-should-know-before-going-gluten-free/

Catassi, C. (2010, October). Natural history of celiac disease autoimmunity in a USA cohort followed since 1974. Retrieved June 17, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/20868314

Wheeler, R. (n.d.). Celiac Later in Life: Can You Become Gluten Intolerant? Retrieved June 16, 2016, from http://www.everydayhealth.com/news/developing-celiac-later-life-can-you-become-gluten-intolerant/

 

 

How do you travel Gluten-Free?

travel

Ah… the joy of travel. But only until your cravings kick in and your stomach rumbles.

If you are visiting a place for vacation, things commonly enjoyed are the sights, the fun activities,  and of course, the endless array of new delicious things to try. Even if you’re just taking a business trip, eating local food would be one of the ways you can savor the experience.

But with having celiac disease or non-celiac gluten intolerance, or just having food allergies of any kind, you already know how frustrating it is to try to relax when you don’t know where your next safe food will be coming from.

So, what to do?

Preparation is key. Take the attitude that with just a bit of time and effort, maximizing your vacation is in  your hands, and it will be well worth the effort.

happy thoughts

1 – Visit online forums, especially for gluten-free dining,  and find out which local places serve food that fits your gluten-free diet. Luckily, you’re not alone in your quest for a hassle-free vacation. You’ll be surprised at just how many people are willing to make suggestions and give useful information on where to eat and which food items to avoid at your destination. Post your questions in forums at least 2 weeks in advance so that you have time get substantial replies from fellow planners like yourself. Your trusty Facebook account is a portal to dozens of gluten-free philippines tagged groups. You may also find dedicated forums on Celiac.com.

laptop

2 –  However, if you would like to give the planning to someone else, there are resources that organize vacations and travel around the world that are especially gluten free. They reduce the worrying about the nitty gritties to a minimum. Since they specialize in gluten-free travel, they will have more options for you to choose from, and can make travel a treat, and especially if you’re travelling with your friends or family. One such company is, The Gluten Free Travel Site.

3 – Have a list of things you know are absolutely gluten-free, including food items and brands. If you are unsure of fastfood places, restaurants or even the food available at your hotel, visiting your nearest grocery store will be the next best thing. Especially, where the language barrier poses additional challenge, googling which familiar gluten-free brands are available locally will save you a lot of worry.

 

lists

 

4 – Be armed from the moment you walk out your door. Pack your own airport food.  It would make things so much easier if every bit of food with allergens is correctly labeled, but especially in the Philippines, this not the case. Airport dining is limited to only a few restaurants and gluten-free dining is not a priority. No frills flights like Cebu Pacific, only have snacks that typically contain gluten, and so it is best to come prepared. However, some flights, like international flights of Philippine Airlines do offer some comfort. PAL provides gluten-free meals in all classes, and gluten-free snacks may also be available. All special meals on airplanes must be ordered no less than 24 hours in advance. Take time to call.

 Want a first hand account of the experience? Checkout our review on an inflight gluten-free meal we have tried, on this blogpost.

airport

 

5- When you can, pack some food items that will last a few days. Order gluten-free in advance from your go-to gluten-free shops. Online shops like Gerald.ph will deliver to your home so you don’t have to go out to buy these things especially. Crackers, cookies that can last a few days in your travel pack may just save you a day of staying indoors dealing with unpleasant symptoms. Dry gluten-free pasta that is convenient enough to cook in a hotel suite or a BnB will come handy, and will save you a few bucks, as well.

lunch

6- Take gluten inhibiting supplements in your luggage. Let us rejoice as there are multiple supplements available in the market now that may protect you from the effects of accidentally ingested gluten. Though gluten-free labels in food packaging and restaurants, the experience may still feel like a game of Russian roulette.  Brands such as GlutenEase, GluteGuard and GutenDigest can be your new best friends. Though none of these are available yet in Manila, you can have these shipped via HealthPost site and get them in under 10 days. Most of these are meant to be taken with a strict adherence to a gluten-free diet, and take care of those thoughts of  pizza and pasta splurge. Take caution though as some destinations have stricter rules for supplements than others.

So? Do you think you can hack your next gluten-free vacation? We’re here with you. With these handy tips, you’ll soon find each trip less focused on where and what you can eat, and more on enjoying the experience.

Did you know MSG is Actually Gluten-Free?

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The impact of MSG on health has been debated in more than a couple medical journals and health related publications. There may be sound evidence supporting the adverse effects of MSG that may be enough reason for you to stay away from it, but having gluten is not one of them.

Why is this fact important for the gluten-free intolerant?

Recognize that especially in the Philippines, MSG is everywhere. The fact that flavor enhancers like Maggi Savor and Ajinomoto are pantry staples is just one of the signs. Typical restaurants that put flavor first will use some form of flavor enhancer that contains MSG. We really have to ask if we’re putting ourselves at risk if we need to stay away from gluten, but find MSG stealthily appearing in most food items we buy.

aji-brands-retail-ajinomoto
Photo credit: Ajimoto.com.ph

If the absence of umami is driving you crazy (well, not crazy, just that it’s not exactly convenient to be paranoid about all food items), know this: MSG is actually gluten-free.

msg structure

Aside from sounding similar, glutamate and gluten are actually two different substances. First, monosodium glutamate (MSG) is a sodium salt of glutamic acid, an amino acid that is present in all protein containing food like cheese, and meat. It occurs naturally in some food, and is commonly used as a flavor enhancer, and responsible for the umami that can more descriptively termed as a savory, brothy or meaty taste.  Gluten, on the other hand, is a protein that is found in wheat, barley and rye.

MSG is  made primarily through fermentation using various sugars and starches, such as sugar cane, beet sugar, corn starch and tapioca starch as starting materials (http://www.glutamate.org), wheat and rye actually not being on the list.

knorr
Sinigang, a Filipino dish typically MSG flavored. Photo credit: Knorr.com.ph

Why the talk first and foremost of MSG (monosodium glutamate) being linked to gluten?

A source of controversy is that glutamic acid was first isolated in the year 1866 from wheat promain gliadin, and in 1909 MSG was isolated from wheat flour. This was the primary source of MSG until the 1960s when other methods of deriving MSG were developed, including chemical synthesis and fermentation process.

Other sources since then have been used, which no longer use wheat.

So, if you are staying away from gluten, it can be a big burden off your chest to know that MSG is one less thing you have to worry when you have gluten sensitivity. 

Looking for gluten-free food? Visit: http://shop.gerald.ph/gluten-free

Sources:

Celiac.org https://celiac.org/blog/faq/what-is-gluten/

Sano, Chiaki. History of Glutamate Production. The American Journal of Clinical Nutrition. 2009;90:728S-732S. Available at: http://www.ajcn.org/content/90/3/728S.full

Thompson, Tricia, MS, RD. Monosodium Glutamate! . Gluten Free Dietitian. 2011. Available at http://www.glutenfreedietitian.com/monosodium-glutamate/

 

What’s up with Grains?

glutenfree grains

A common assumption (and paranoia) for the gluten intolerant is that any food that is made with grains is laced with our enemy gluten. But let’s clarify. Not all grains contain gluten, but these are the culprits: wheat, barley, and rye, also triticale which is a hybrid of wheat and rye.

Another interesting fact is that pure wheatgrass and barley grass are actually gluten-free. What we’re concerned about is the gluten in the seeds. However, most find it less risky to simply stay away from byproduct of these grains altogether, as they may be contaminated during harvest and manufacturing.

There are actually plenty of other grains that are gluten-free. It’s the reason why there are still breads, desserts and even pizza and pasta out there as alternatives for those staying away from gluten.

 

corn

Corn for example is gluten-free, and it is one which is very readily available here in the Philippines in different forms and varieties: sweet corn, white corn, yellow corn. You can buy them fresh on the cob, frozen or canned in kernels, the white bloated addictive version binatog, served with coconut shavings (also gluten-free–getting the craving, yet?) and of course, popcorn.

filipino food

Rice  and potato that a typical Pinoy consumes in pounds per day thankfully, is also gluten-free (so worry not as your pure potato fries, and unli-rice food tripping is safe. 😉 ) If you’re not on the prowl for extra ordinary food adventure, the typical meal of rice plus viand, won’t actually be such a hassle. 

tahoSoy is also gluten-free and soy made product if in pure form (without extenders) are safe such as tofu (you can enjoy your tokwa’t baboy guilt-free) and warm and sweet dessert-breakfast taho.  Though, since gluten might be a cross-contaminant in the harvest, transport and storage of soy as most is grown in wheat farms, it is best to still be cautious with this item. 

Here are some more samples of gluten-free grains to help when faced with such a dilemma.

– tapioca

– quinoa

– beans

– flax

– chia

– nut flours

– gluten-free oats

– sorghum

– millet

– buckwheat groats (aka kasha)

– arrowroot

– amaranth

– teff

– yucca

You may also visit the complete list from Celiac.org here.

Have some of your own tips you would like to share to help with the gluten-free diet?

Leave some in the comments! 🙂

How do you shop for a gluten-free diet in Filipino grocery stores?

A woman shopping in a grocery store

Proper food labeling regulations by the Bureau of Food and Drugs require indicating common allergens in food. However, rules specific to gluten have not been properly defined as of late. As a result, hunting down gluten will take a bit of legwork in the Philippines.

To start, let’s get to know the culprit:  Gluten is a type of protein found in wheat, rye, and barley. So, as a basic rule,  you would need to develop the habit of checking the back labels of items to make sure gluten is not found anywhere in the ingredients of the food you are buying.

You also have to watch out for stealth gluten, which are not as easy to spot. One example is malt. Malt is commonly made from barley and is mostly in items such as energy drinks, for its energy giving properties, and to enhance flavor and color (So, you’d know that malt drinks, such as Milo chocolate drink, are out.) Another thing is hydrolyzed vegetable protein, which can be a term used for hydrolyzed wheat protein, that is used as a flavor enhancer in processed food like soups, gravies, and some meat products like hotdogs.  

To further guide you in your shopping, here are some common grocery items  that you’d need to be more careful about when following the gluten-free diet:

Breads

tastybread

Say bye bye to breads as you know it, as common breads on the shelves and even in your bakery are made of wheat such as white bread and whole wheat bread. But then you can say hello to a wide variety of alternatives which use other types of flour, such as brown and white rice flour, and cassava starch. Breads like these are safe and available in gluten-free specialty shops, and online at GERALD.ph.

Breakfast Cereals and Oats

cerealbowl

Breakfast cereals also should be studied carefully. Read the back label since some that are not even made of wheat such as corn or rice cereals may have malt in their ingredients.

Oats on the other hand are not related to the varieties of grains you need to watch out for. Studies have also suggest that commonly, oats in its pure form are safe for those with gluten-intolerance. Although, household brands such as Quaker Oats state their products may not be completely gluten-free due to manufacturing cross-contamination. So, if you’d want to be on the safe side, better to research brands and see if any of them fit the gluten-free bill.

Pizza & Pasta

Lots of pastas are commonly made of wheat. But thankfully, like bread, alternatives are available that use other gluten-free ingredients such as brown rice. You can find gluten-free penne and spaghetti to use as substitute for your favorite pasta dishes. A great recipe to try can be found here.  

Yes, unfortunately pizza is also another casualty when going gluten-free, as your classic pizza doughs are made of wheat. But before you decide to start cutting yourself, hold that thought! There are gluten-free pizzas available, and you can also play arround with gluten-free pizza toppings on gluten-free crust to make your own pizza, also available on GERALD.ph

Alcohol

You can still clink a glass in a gluten-free diet. Just choose wine instead of beer or whiskey that are normally made of malted wheat.

Snacks and Desserts

cakes

Usual sweets like cakes and cookies are also out when following a gluten-free diet. But keep on scouting the grocery aisles as there are countless other options for snacks like corn chips, or rice cakes that are waiting for you. But if you cannot let go of the cookie and cake craving, there are gluten-free options that do not use wheat, rye or barley and are as good as any other gluten laced dessert.

If you want to be a little more carefully in your shopping, also consider that some packaged snacks like packaged nuts may be subject to cross-contamination since packaging lines are commonly dusted with common wheat flour. Better to opt for those that still come in shells.

It may seem at first that taking out gluten is taking over your whole grocery check list. Do take comfort in the fact that most items are naturally gluten free such as eggs, unprocessed meats, fruits, vegetables, all-natural cheeses and dairy, and other starches such as potato and rice.

To further help you, you can also visit WebMDs list of hidden sources of Gluten to arm  you in your next grocery shopping.

References: WebMD, About.com, QuakerOat.com