~by Regan Jones, RD
This time last weekend I was preparing with Healthy Aperture co-founder Janet Helm and Liz Weiss of the Meal Makeover Moms to lead an all-day workshop on Food Photography to a group of dietitians at the Academy of Nutrition and Dietetics 2013 Food & Nutrition Conference & Expo or “FNCE”. (If you’re not an RD or familiar with FNCE, it is the mother of all nutrition and food conferences and a yearly must-attend for many of in our profession.) It was a phenomenal session and a wonderful reminder to me about how many RDs are now inspired to do exactly what it is that we focus on here at Healthy Aperture - visually celebrate how appetizing healthy eating can be.
The following day was no less inspiring as Janet and I once again took to the stage to share this message, this time accompanied by my dear friend and colleague, Holley Grainger.
I spoke on food photography and Holley, on video. And let me tell you, I walked away from there ready to launch a YouTube channel immediately (which is ironic considering I only have two recent videos of me on camera that are not on VHS tapes!) Holley is SO motivating when it comes to the online video space (If you’ve never seen her in action, check these out.) Who knows if I’ll follow through in 2014, but I can tell you that I certainly want to try.
But Monday was the day when I finally got a chance to put down the mic and enjoy all that FNCE had to offer. I walked the expo floor looking for new products and emerging food trends.
I attended educational sessions onsite (...a must after sneaking offsite on Sunday for a quick lunch at Houston original Ninfa's and a wonderful visit with some dear friends.)
But the most insightful part of the day came from the media briefing “The Gluten-Free Trend: Past, Present and Future presented by Academy sponsor SOYJOY®,” which featured Rachel Begun, MS, RD as the speaker.
Being the founding editor of Healthy Aperture, I’ve seen A LOT written on blogs about gluten free - gluten free living, gluten free cooking, gluten free food trends and sometimes, gluten free jokes.
And let’s be honest. That’s what “gluten free” has become to many people - even in my own profession. While most RDs accept that “celiac disease” is not a joke, this notion that there are people living without celiac disease, but who are in some way “gluten sensitive” is often dismissed as a fad and not taken seriously.
Rachel’s session changed that whole way of thinking for me and here’s why it should for you too.
It used to be (certainly when I was in graduate school) that we thought of an immune response to gluten as an on/off - yes/no proposition. We also thought the negative response to gluten was solely confined to the GI system. I recall very little about celiac disease as a student, other than knowing it was rare and likely not a patient population I would encounter often.
Fast forward to 2003 when Fasano published his groundbreaking study that established the prevalence of celiac as one in 133 people in the U.S. (nearly 100 times greater than previous estimates), and you can see why the conversation around gluten began to grow louder.
This is not, however, a post about celiac disease specifically. I believe (or hope) that it’s widely accepted that celiac is a very real and serious disease that’s much more prevalent than we used to think. And luckily, the diagnosis for celiac - while not without its own struggles - is one that is progressing as doctors implement antibody testing and intestinal biopsies.
But this notion of “gluten sensitivity” for which jokes like these are made...
...isn’t so well understood and isn't experiencing the same improvement in diagnosis, even if it is a very real health concern.
What I learned from Rachel’s talk was that there are three primary reactions to gluten: celiac disease, wheat allergy and non-celiac gluten sensitivity. Ultimately, there is no clear definition for Non-Celiac Gluten Sensitivity (NCGS), nor are there any definitive clinical tests. This is - I believe - what makes it so hard for many in our profession to acknowledge it as a real condition or disease state. In essence, the diagnosis comes as one of observation and exclusion - meaning that as gluten is eliminated from the diet (ideally under the supervision of an MD and RD), if symptoms resolve there may be enough support for a diagnosis. This is not something many in the medical field are comfortable with... it's a bit vague and seemingly complex to assess.
But that doesn't mean it's not real.
What types of symptoms are we talking about? Interestingly, not the digestive ones characteristic of celiac disease. Instead, conditions like early on-set osteoporosis, anemia, neurological disorders, infertility and even rheumatoid arthritis, to name a few.
The delicate balance comes, though, in realizing that not all of these conditions can be tied back to gluten sensitivity as the fall-back self-diagnosis, nor is everyone reading this blog and shopping next to you at the supermarket gluten sensitive.
But it does raise questions about Who is gluten sensitive? Why are they? And most importantly, What can we do as professionals to help support a healthy diet for those living gluten free?
The food industry is clearly doing their part. Manufacturers are rapidly bringing gluten-free foods to the marketplace (the upside to any "fad" is that the almighty consumer dollar helps drive product introduction.) And fortunately, just this August the Food and Drug Administration issued a final ruling on the standards by which a food can actually be labeled as "gluten free."
But healthfully living gluten free isn't just about grabbing a box of pretzels stamped with a gluten free symbol. And that's where I believe Healthy Aperture comes into play. If there’s one category that gets plenty of fuel here each day, it’s our offering of gluten free recipes and the Gluten Free Kitchen feature on the blog. Any RD will tell you that healthy gluten free diet isn’t centered on GF bagels and muffins. It's important to encourage everyone to base their diet on fruits and vegetables, milk group foods and lean proteins, including the person living gluten free.
The next time you find yourself talking with someone about living gluten free, realize it’s not a joke. If they haven’t consulted a medical professional for a diagnosis, encourage them to do so. If they’ve been diagnosed, offer them support and certainly encourage them to explore all the wonderful ways to cook and eat gluten free.
What about you? Do you take gluten sensitivity seriously? Did you attend FNCE? What did you learn?