Arizona Advanced Medicine Clinic

Gluten Free

Grains have an addictive lure. The components stimulate the narcotic centers of the human brain.

No wonder food manufacturers put wheat everywhere. The offending element is the protein gluten, a primary ingredient in wheat flours.

Gluten can hide in licorice candy, imitation bacon, processed luncheon meats, soy sauce, drugs and over-the-counter medications - even communion wafers.

People are becoming increasingly sensitive to gluten. Eating it may trigger a host of symptoms including irritability, headache, difficulty concentrating, fatigue, and increased appetite. It may even go as far as producing difficulty with balance (called "gluten ataxia") and even a picture resembling multiple sclerosis.1

Gluten sensitivity in children can be hard to identify at first because the issue may simply appear to be only a vague collage of unrelated symptoms: attention deficit disorder, chronic earaches, stomach cramps, alternating diarrhea and constipation, bloated abdomen, joint pain, fatigue or just being small for their age.

When gluten sensitivity goes untreated, malnutrition develops, and the chronic inflammation may lead eventually to various autoimmune and neurological disorders.

Gluten can trigger an increasingly common auto-immune disorder called Celiac Disease in which the villi (tiny surface folds) of the small intestine become inflamed, thickened, and finally flattened to the point they can no longer absorb nutrients. This disease is characterized by the presence of serum antibodies to various proteins including endomysium, reticulin, gliadin, and tissue transglutaminase.2 Antibodies to neuronal tissue have been identified in patients with gluten sensitivity.3

Celiac disease prevents the body from absorbing nutrients properly. There are no longer as many functioning “holes in the sieve” for nutrients to get through to the blood stream. Even after the villi in the small intestine are described as being “back to normal,” there remains the potential of some nutrients being absorbed at lower levels.

According to Dr. Kenneth Fine, an intestinal researcher at Entero Labs, as many as 40% of Americans may have the gene for gluten sensitivity. That means as many as 1 in 4 Americans may have some delayed allergic reaction to gluten.

The good news is that much of the damage to the gut surface can usually be reversed by following a gluten-free diet. The other good news, for breakfast lovers, is that oats do not contain gluten, as long as they are processed in a plant which does not also process wheat.4,5

Welcome to the gluten free diet, or GF for short.

A GF diet is considered medically imperative for people with Celiac Disease or dermatitis herpetiformis, a gluten induced skin sensitivity rash. Some people choose to go GF because they find it helps with Autism or Attention Deficit Hyperactivity Disorder (ADD, AD/HD). There is also considerable evidence that gluten is associated with illnesses as diverse as rheumatoid arthritis6, epilepsy7, odd neurologic symptoms8, autoimmune diseases including diabetes1, systemic lupus erythematosus9, migraine headaches and white matter abnormalities of the brain10, thyroiditis.11

Your favorite foods can be prepared without gluten. Bakeries are popping up that specialize in GF lasagna, cookies, muffins, and more. You can even find GF soaps and personal cosmetics.

Children with autism often need the “casein-free, gluten-free” diet, which involves elimination of gluten and all foods containing the protein casein in pasteurized milk. The Autism Network for Dietary Intervention (ANDI) provides information and support to families who wish to follow this diet. We prescribe this diet to these children in our clinic, and help their parents negotiate the obstacles of shopping, reading labels, well-meaning teachers, friends and family members who think that gluten-free is right next door to child abuse.

What contributes to the need for GF diets? For one thing, the government dietary guidelines that recommend several servings of grains every day. Not good advice.

All grains can cause nutritional deficiencies, since they are all incomplete proteins. As we eat more and more grain products we tend to eliminate other nutritional meats, fruits, and vegetables. Think how kids, if given the chance at the dinner table, will fill up on bread, French fries, chips. This emphasis leads to inadequate growth because of a reduction of protein and amino acids.

Another tip: don't make wheat cereals the first solid food you feed a baby. This practice contributes to wheat allergies. Make pureed veggies the first meal.

In the meantime, if a GF diet is for someone in your family, take comfort in the fact the GF food makers have come a long way, baby.

Below is our list of eateries which we know to be GF literate as of January, 2009.

The restaurant business is subject to change, so call ahead to verify.

Consumer Beware: When you eat out, remember you run the risk of cross-contamination from the grill, airborne particles, utensils, and more. There is no guarantee restaurants will make the same thing the same way each time; verify with your server. And product manufacturers sometimes change their ingredients without advising the public.

Alberto Italian Restaurant
7171 East Cave Creek Road, Ste S, Cave Creek
480-488-5800
Has gluten-free pasta dishes.

Bamboo Club
Locations in Phoenix, Scottsdale, & Tempe
www.thebambooclub.com

Barrio Cafe
2814 North 16th Street, Phoenix
Most items on menu happen to be GF and they know what gluten is.
www.barriocafe.com/barriocafe.html

Basis New American Restaurant
410 East Thunderbird Road, Phoenix
602-843-3689

Bombay Spice Grill
10810 North Tatum Boulevard, Phoenix
602-795-0020
www.bombayspice.com

Carrabba’s Italian Grill
Six locations in the Valley
See www.carrabbas.com

Eden’s Grill
13843 North Tatum Boulevard, Phoenix
NE corner of Thunderbird & Tatum
Middle Eastern cuisine, most items on menu happen to be GF
602-996-5149
www.edensgrill.com

Gluten-Free Creations Bakery
Best Little Bistro
2940 East Thomas Road, Phoenix
602-522-0659
www.glutenfreecreations.com
A totally gluten-free wheat-free bakery 1 mile east of hwy 52 & Thomas, behind Midas

Golden Wok
4651 East Cactus Road, Phoenix
602-953-9390

Havana Café (3 locations)
www.havanacafe-az.com
4225 East Camelback Road, Phoenix
602-952-1991

6245 East Bell Road, Phoenix
480-991-1496

4232 East Chandler Boulevard, Ahwatukee
480-704-260

La Stalla Cucina Rustica
60 West Buffalo, Chandler
480-855-9990
Has gluten-free pasta
www.lastallacr.com

Lon’s at The Hermosa Inn
5532 North Palo Cristi, Paradise Valley
Especially helpful to call ahead
800-241-1210
www.lons.com

Octagon Café
12645 North Saguaro Blvd, Ste 1, Fountain Hills
480-816-8806
www.octagoncafe.com
Serve GF sandwiches and a selection of GF and non-GF sweeter items.

Old Spaghetti Factory
1418 North Central Avenue, Phoenix
602-257-0380
www.osf.com

Outback Steakhouse
Various locations
See www.outback.com

The Persian Room
17040 North Scottsdale Road, Phoenix
480-614-1414

PF Chang’s China Bistro
Various locations
See www.pfchangs.com

Pei Wei’s
Various locations
See www.peiwei.com

Pizza Picazzo’s
www.pizzapicazzo.com
Locations in Sedona, Tempe, and Phoenix. Offers gluten-free pizza menu.

Pugzie’s
4700 North 16th Street, Phoenix
602-279-3577
www.pugzies.com
Serving gluten-free sandwiches, muffins, cookies, dressings, and soups. The owner is gluten-free!

Z Tejas Grill
www.ztejas.com
Locations in Phoenix, Scottsdale, Tempe, Chandler

5 Hardman CM, Garrioch JJ et al. Absence of toxicity of oats in patients with dermatitis herpetiformis. NEJM 337;26:1884-87 (Dec 25, 1997).

6 Hafström I, Ringertz B et al. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology 40:1175-79 (2001).

7 Pratesi R, Modelli IC et al. Celiac disease and epilepsy: favorable outcome in a child with difficult to control seizures. Acta Neurol Scand 108;4:290 (Oct 2003).

8 Haddad L, Amsterdam A et al. Celiac disease presenting as a paraneoplastic syndrome in a patient with synchronous endometrial and ovarian cancers. Gynecol Oncol. 2005 May;97(2):704-6.

9 Hadjivassiliou M, Sanders DS et al. Gluten sensitivity masquerading as systemic lupus erythematosus. Ann Rheum Dis 2004;63;1501-1503.

10 Hadjivassiliou M, Grunewald RA et al. Headache and CNS white matter abnormalities associated with gluten sensitivity. Neurology. 2001 Feb 13;56(3):385-8.

11 Volta U, Ravaglia G et al. Coeliac Disease in Patients with Autoimmune Thyroiditis. Digestion 64;1:61-65 (2001).

12 Hope BT, Nagarkar D et al. Long-term upregulation of protein kinase A and adenylate cyclase levels in human smokers. J Neurosci. 2007 Feb 21;27(8):1964-72.

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