Dr.

Peter Osbornes Truth About Gluten

Craig Ballantyne and Dr. Peter Osborne discuss myths & facts about gluten
Listen to the recording of this call at: http://instantteleseminar.com/?eventid=28783155 Craig: Hey everybody. This is Craig Ballantyne and I am with Peter Osborne from GlutenFreeHealthSolution.com. Dr. Osborne is one of the leading experts in gluten free nutrition in the world, so we have a really excellent call today. Peter, welcome to our call. Peter: Craig: Thanks, Craig. I appreciate you having me on. Im really excited about this. This is a question we get a lot about how to eat gluten free. Youve got some very interesting information from your patient work and from studies that youve read. Why dont we start with your background, your credentials, and how you got interested in the general health field first? What was Peter like when he was growing up that got him interested in this? Peter: Well, growing up I was always to a certain extent as health conscious as a young man could be. It wasnt until I really got into weight lifting pretty heavy after high school and started studying nutrition that I really developed a passion for health. I ended up going into the Air Force and from there going on to college and majoring in Biology. Then I pursued a degree in chiropractic medicine. I was a trainer for a number of years while I was going through graduate school. I also went through an additional program and received a diplomate with the American Clinical Board of Nutrition. Im also a licensed Pastoral Medical doctor. Craig: Peter: Craig: Peter: Whereabouts are you based, Peter? Im just outside of Houston in Sugarland, Texas. Great. Sorry, I interrupted you there. What were you about to add? I started my practice about 10 years ago and thats kind of where my ventures into gluten sensitivity and diet really took a more advanced turn in treating chronically ill people. Mostly what we do is treat chronic sick people who have autoimmune disease, so I have a lot of experience in taking people who are virtually half dead, on deaths doorstep, and restoring their health and bringing them back to the real world.

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Craig:

Its a really hot topic these days. You once told a story about a young guy named Michael, a young child who seemed like he was one of the first cases that you were involved with. Can you tell us a little bit about that and how you got really focused on this gluten free nutrition? Sure. I had a young patient with juvenile rheumatoid arthritis and he was terminal, he actually was given six months to live by his doctors. It was such a severe condition he had a permanent he had a permanent stent injected into his arm because he was in and out of the hospital so frequently on IVs. The Make a Wish Foundation actually stepped in and granted him his wish because the case was so severe. When he first came to see me we did a diagnostic workup and what was interesting about Michael is he was on all these different types of medication. He was actually gluten sensitive, it came out we did some genetic testing and other tests to determine that. When we took him gluten free he almost recovered fully. He didnt quite recover fully, but he was alive again and he was no longer terminal. We later discovered that he had some other nutritional allergies that he was being chronically exposed to. Once we figured out that he was gluten sensitive and he had these other food allergies and we cleaned his diet up he came back to life. Hes now off of all of his medications. That was eight years ago, so today hes moving up into high school and hes in the band. Hes doing absolutely fabulous, hes in complete remission.

Peter:

Craig:

That is an incredible story. When you tell it in person its even more amazing because you get so fired up by it. You can see why. Like you said, he had his wish granted, thats pretty serious. So I can see why youre so passionate about the subject. Lets look at the general population and talk about what percentage of people need to be on a gluten free diet or trying gluten free diet to get rid of the many problems that they have. Maybe you can touch on the problems that a diet containing gluten can cause in people.

Peter:

Sure. Theres a list of diseases called autoimmune diseases and these are diseases when the immune system becomes confused and starts attacking the bodys own tissues. General examples would be rheumatoid arthritis or Lupus, or hypothyroidism, eczema or psoriasis. Theyve now identified even Alzheimer disease as a potential type of autoimmune

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disease. Theres only potential cause for autoimmune disease and that is primarily gluten sensitivity. So when we ask the question, What is the prevalence of autoimmune disease in the United States? we know there are 23,000,000 cases of diagnosed autoimmune disease. Its actually the number one condition in the U.S., but it gets blunted out because there are 190 different forms of autoimmune disease and doctors tend to separate them out into their different distinct names. Now, we dont do that with any other form of disease. When we talk about heart disease being one of the top killers we include all forms of heart disease in that number. When we talk about cancer killing a million people a year we include all forms of cancer in that number. But, with autoimmune disease we dont. Its one of these under-recognized disease entities in the U.S. That being said, if its that common, if there are 23,000,000 people and we know that gluten can cause and contribute to autoimmune disease then at least 23,000,000 Americans need to be looking at going on a gluten free diet, as opposed to be injected with immune drugs or given very strong anti-cancer medications to treat autoimmune diseases theyve been diagnosed with. Craig: What are some of those autoimmune diseases? Thats something that I can understand, but a lot of people wont know what that means and what falls into that category. Again, there are 190 different autoimmune diseases. One of the more commonly known ones is people with low thyroid function. Theyve gone to their doctor and the doctor and the doctor says, Your thyroid doesnt work as well as it should, thats a form of autoimmune disease. People that develop skin conditions. Theres a skin condition where we get plaques all over the skin and doctors will call that psoriasis, thats also an autoimmune disease. With autoimmune diseases what happens is the body becomes so confused, the immune system is so busy fighting the food that it doesnt have the resources to fight the rest of the environment. Then as its become hyper-vigilant, as the immune system turns on to such a strong degree it gets confused and starts attacking a persons own body.

Peter:

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We name the autoimmune disease based on the location. Theres a form of hepatitis or liver disease that is autoimmune in nature and can be caused by gluten. Gallbladder disease, a person thats had to have their gallbladder removed can be a form of autoimmunity. Theres a type of diabetes thats autoimmune, so patients with diabetes should be screened or checked for gluten sensitivity. Its all based on the location. Where the immune system starts attacking the body is how a doctor chooses to name the autoimmune disease. Thats why there are so many different forms. Does that clarify a little bit better? Craig: Peter: Thats fantastic. I interrupted you when you were talking about something else there? It was the statistical question of how many people in the U.S. actually have a gluten sensitivity or need to be concerned about gluten. The most recent data thats been published in scientific literature estimates that anywhere between 3 and 30% of people in the U.S. could potentially be gluten sensitive. Its a very large varying number, but its really hard to ascertain these kinds of things in research studies because when you do a general study and screen 10,000 people you cant really make the assumption that those 10,000 people are a true representation of the entire American continent. Craig: Peter: Right. Now, its not so extreme that its everybody, correct? Well, theres some really unique research thats coming out now, not so much gluten sensitivity. Gluten sensitivity is a distinct entity where when a person eats gluten they have these immune system reactions and it can trigger autoimmune disease in the individual. But, theres another component to gluten that was recently discovered by a group of doctors at the University of Maryland. What they found is that eating too much gluten, whether youre gluten sensitive or not, tends to have an effect on the intestines. It can create a condition in the intestine known as intestinal permeability, or what in common lay terms is referred to as leaky gut. What happens is little microscopic pores start forming in the gut wall and food starts leaking into the bloodstream and it creates a lot of immune problems for people.

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Whether or not that happens to everybody hasnt been disclosed, but there is some pretty good new research thats saying that happens to a lot more people than what we originally thought. Craig: Okay. Thats also very helpful. What about checking for this, how does someone go about figuring out whether theyre at that extreme that theyre gluten sensitive and they are at risk of those autoimmune diseases, or maybe thats the cause of them? Then how about just for the general population how do they know whether or not theyre eating too much gluten? The absolute best way to identify whether or not a person should be avoiding gluten is through genetic testing. Contrary to popular belief, a lot of people think that gluten sensitivity and Celiac disease are the same thing. In actuality gluten sensitivity is not a disease at all, no more than peanut allergy or an egg allergy is a disease. People that have food allergies they dont eat those foods or theyll get sick. Gluten works much in the same way. If a person is gluten sensitive and they eat gluten theyll become sick. The problem with a gluten sensitivity is it causes autoimmune disease, so it can take 30 years of exposure before an autoimmune disease develops. Thats the conundrum. So if a person says, Im healthy, I feel good, it doesnt necessarily mean theyre not gluten sensitive. It may be that as the disease is building internally it takes a certain period of time for it to actually become symptomatic in that individual where they start manifesting the symptoms of the disease to be able to get a diagnosis. For a lot of people what happens is people that are gluten sensitive will develop small symptoms at first. Its usually not really big horrendous problems at first. It might be small things that are as simple as fatigue where they just dont have energy, or brain fog where they cant think very clearly. It could be small things like irritable bowel where they have bouts of constipation or where they have a lot of loose bowel movements. Or where they get mysterious rashes popping up on the skin from time to time. Its the small subtle things. Ive had patients where their only symptom was spontaneous nose bleeding. They didnt have any other health issues, just randomly their nose would start bleeding.

Peter:

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So there are a lot of little subclinical kinds of symptoms that people can manifest early in life before they develop major diseases as a result of gluten exposure. Whats recommended is that if a person has a family history of autoimmune disease, in other words if anyone in their family has any form of autoimmune disease, then it would be smart for that individual to get genetically tested to determine whether or not they have the genes for gluten sensitivity. Regardless of whether youre sick if you have the genes for gluten sensitivity and you eat gluten you will develop illness over a period of time. Some people develop illnesses earlier in life and some people it takes much longer for the illness to manifest. Craig: Peter: That genetic testing, how is that done and where does someone go and get that done? You can attempt to do it through your doctors. The problem is when we analyze genetics there are specific gene patterns that are looked for with Celiac disease. These patterns often times are recognized by most doctors, gastroenterologists, internal medicine doctors know what these genes are. Their formal names are HLADQ2 and HLADQ8 patterns. The problem is doctors stop there. There are other subsets of the same group of genes that are not HLADQ2 or HLADQ8 but that are gluten sensitive genes. In essence the doctor looks for Celiac genes, but they dont look for the other gluten sensitive genes. So if you go to your doctor and the test comes back negative it doesnt mean youre not gluten sensitive, it just means you dont have the Celiac genes. The best place to go to see whether or not you have the gluten sensitivity genes is anybody can call my office and we can get somebody set up to do genetic testing. Its very easy, its a cheek swab. Theres no invasive component to it, its just a matter of swabbing the DNA from cheek samples and then sending it out to our lab. What we do is we look for these other gene pieces that are non-Celiac gluten sensitive genes. Craig: Thats fantastic. Theres something else that you mentioned a lot of people are missing. You mentioned that most gluten free diets are still failing for a specific reason. This is where the call gets even more interesting. Tell us about that. There have been a couple of major studies done in the last 10 years where weve looked at patients who were following what we call traditional

Peter:

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gluten free diets. Traditional referring to the origin of gluten sensitivity as we know it dates back to 1952. There was a German physician who was treating children with Celiac disease and during World War II all grain was rationed, so in the hospital grain was not available for consumption. What happened to all these patients with Celiac disease is they all went into remission, they all healed. When the war ended and grain was available again they all ended up in the hospital again sick. Thats where the actual traditional definition came from, because the staple grains in Germany are wheat, barley, rye, and oats. So those are the four grains that classically or traditionally are referred to as the gluten containing grains. By botanical definition all grains have different forms of gluten. The scary part of it is when we follow patients on these traditional gluten free diets the ones that continue to eat other forms of gluten as substitutes in their diet, up to 92% of them dont heal. Were not measuring the healing by how they respond and how they feel. Were actually measuring markers of inflammation and how white blood cells infiltrate their gut and create damage. These are things that a person doesnt necessarily feel, but they can contribute to things like lymphoma and other forms of cancer, so these patients wont heal following a traditional gluten free diet. We have to redefine the traditional gluten free diet and thats kind of what Ive been trying to do for the last 10 years and were finally making some headway. Weve got some studies that have been published and the actual definition of gluten sensitivity has changed, I think, in large part based on the work that were doing here. Craig: Analogous to the fat free and low carb commercially made foods, would you say that the gluten free foods that you find in stores are really pushing the envelope? I wouldnt say that theyre lying, but are they not accurate in that theyre full of junk? Well, theyre full of junk. They certainly are full of genetically modified and highly processed, highly sugar loaded, hydrogenated fat loaded foods that are just not healthy. Even technically if they were gluten free, which many of them are not, we would say theyre not healthy. That breaks our cardinal rule of nutrition. The cardinal rule is you cant maintain or obtain good health eating food that isnt healthy. It just doesnt

Peter:

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make sense to trade one food thats destroying your health because you have gluten sensitivity for another food thats just not good for you when youre trying to heal from years of gluten induced damage. Many of these foods also contain the other types of glutens. So from a food labeling perspective you have to realize that food labeling laws in the U.S. pertaining to gluten are strictly voluntary. Theres no legal requirement to say gluten free and theres no legal definition to define what gluten free means on a food label. At least not in the U.S., that may be different in Canada. So legally you can have a product that contains lots of gluten and call it gluten free and not get in any trouble over it, although you probably would run yourself out of business. I think with the manufacturer claims of things that are gluten free its a lot of plausible deniability. A lot of the research on other forms of glutens being discovered and causing damage for people with gluten sensitivity is new. Were talking about less than 20 years. In medicine it generally takes 30 to 50 years to disseminate new information before it becomes main stream. When you have a study thats 20 years old we consider that study to be relatively new. A lot of the research on identifying new glutens and discovering new glutens has just been done in the last 20 years. A colleague of mine in Australia discovered 400 new gluten proteins last year and 40 of those were more toxic than the original glutens discovered in 1952 that we were referring to earlier. When you have new discoveries coming out this quickly and you have a food industry like the gluten free food industries thats a billion dollar a year industry and growing very quickly and not staying abreast of the current literature and research, thats where the problem becomes because theyve created an entire gluten free food market thats not really gluten free and a lot of those foods are extremely unhealthy regardless of their gluten status. Craig: Thats a great point. I heard, and Im really looking forward to your answer on this, that the way of farming in the United States has created grains that are more concentrated in gluten compared to ones in Europe. So sometimes when people go to Europe for a long time they have fewer symptoms even though theyre still eating gluten because the grains in

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Europe arent as strong and heavy, maybe perhaps genetically grown, for gluten as they are here. Is that correct? Peter: In part it is correct. There are several reasons why that happens. One is that weve hybridized a number of wheat strains to contain two to three times more gluten content than their original ancestral grains. So we have certainly more gluten exposure in the U.S. But, the other component is the dough conditioning elements that we add to the grain. If youve ever looked on a bag of flour in the grocery store it will say bromated flour. Bromein is a molecule thats added as a dough conditioner. Studies show that when you mix bromein and gluten it synergizes, kind of like those old caffeine ephedra aspirin stacks people used to take. If you take aspirin by itself, no big deal. But, when you add ephedra and you stack those three drugs together it becomes synergistic and it works even more effectively at speeding up the heart rate and getting blood going to certain vessels, etcetera. The same thing happens when you mix bromein and gluten, you get an exaggerated effect from gluten. Then third thing that has happened is the way we treat the grain. This has nothing to do with genetically manipulation, it has to do with what we add to the grain before we ever even grow it. We douse a number of these grains in hormones, the seeds themselves before they grow, so we get this additional effect and its not a gluten effect, its just a health effect thats not good for us. So people can react to grains for a number of different reasons. One of the reasons is because of gluten, but other reasons because of what they spray the grain in. There are certain funguses that will grow on our grains that some people react to that are not as prevalent in Europe, so when they go to Europe and theyre doing their travels they notice that the grain doesnt bother them as much. Craig: This has been a wonderfully terrifying call so far. Lets switch over and talk about the benefits that people will see if they go gluten free. Lets talk about the real positive stuff here. When someone does this, does everyone who has sensitivity experience these benefits? On average. Ive treated thousands of patients, so theres always that biochemical individuality from one person to the next. Obviously you cant predict that its going to be this way in everyone. On average most people

Peter:

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with gluten sensitivity notice dramatic improvements within the first two months. Some of those improvements are regulation in bowel function, because symptoms of gluten sensitivity range from diarrhea to constipation. We see some people that had diarrhea have regular bowel movements, other people have constipation have regular bowel movements in the opposite direction. We see a number of people with chronic fatigue and just generalized muscle aches and joint pains clear up. Thats probably one of the most common symptoms is joint pain, especially in athletes. What we hear overwhelmingly from athletes is, Oh, its an old injury. The question I pose is, If you get cut does it not heal or just bleed forever until you bleed to death? It kind of turns on a light bulb in their head, you dont just have an old injury that forever hurts you. Your body is very resilient and dynamic and will heal provided you give it what it needs to be capable and able to heal. When youre taking in massive amounts of gluten thats one of the areas that it loves to attack, it loves to attack cartilage and muscle tissues. So we get a lot of patients with fibromyalgia, chronic joint pain and chronic arthritic pain. Thats one of the quickest symptoms, in my experience, to see clear up. One of the other symptoms that we commonly see go away are memory issues and mental clarity issues, the brain fog, the inability to remember short term, and the inability to recall simple phrases or words. This is one of those very common side effects of being exposed to gluten that a lot of times goes undiagnosed because what do you call that? Theres not really a disease name for brain fog, so doctors just kind of dismiss it or prescribe ADHD medications to increase concentration abilities in patients without actually ascertaining the cause or origin of the brain fog, which in many cases is gluten. Craig: Peter: What about energy levels? Energy levels very commonly will improve. If thats the major complaint, energy levels often times improve. One of the reasons why is because theres a whole other realm of side effects that happen with gluten and thats the realm of micronutrient deficiency.

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What that means is when gluten damages the intestine it hinders the bodys ability to absorb vitamins and minerals from the food that we eat. Probably three of the most common nutritional deficiencies linked to gluten sensitivity are vitamin B12, iron, and zinc. All three of those nutrients (vitamins and minerals) cause anemia. When youre deficient in those nutrients you develop anemia, and anemia medically is defined as a lack of oxygen, not getting enough oxygen supply to the tissues. That causes fatigue and shortness of breath. A person might climb stairs and have to catch up and catch their breath because they dont get enough oxygen. A lot of times energy levels improve because when we take gluten out of the diet were not longer inhibiting the absorption of these nutrients and the body starts becoming nourished again. Craig: What happens when the average person, who is not gluten sensitive so they have done the tests and theyre not gluten sensitive, but as you mentioned before someone who may be eating a lot of gluten, what happens when they go to zero? Do they notice a lot of benefits as well? Id say that probably the biggest change we see in somebody who just goes on a gluten free diet is weight loss. Okay. From a common sense perspective youve got How do we fatten up a farm animal? I dont know if any of your listeners are farmers, but the quickest to fatten up a farm animal is to feed them a bunch of grain. Its no different in humans. The quickest way to fatten up a human is to feed them a bunch of grain. Gluten does this, but there are also compounds in grain, like amylopectin is found in wheat, and these compounds are two to three times, sometimes four times more potent than just pure sugar cane at causing an insulin variation or an insulin spike. Hormonally speaking, when you drive up insulin you drive up storage of fat, the body starts storing more fat. This is one of the big side effects we see in somebody who maybe theyre not gluten sensitive and theyre just going on the diet to try to lose weight. We see them take that insulin spike out and then their body starts saying, Hey, we dont have to store all this, were going to start burning this fat as fuel. And so we see a lot of weight loss.

Peter: Craig: Peter:

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Craig:

Do you also see your clients reducing their calorie intake by switching to gluten free foods and the nutrition that you give them? Its probably going to be lower calorie foods or less calorie dense foods, but also theyre not going to be hungry after theyve eaten the food because theyre not going to have those insulin spikes. Is that something you see as well? Absolutely. When a person is used to eating grain, grain is very high in calories and very low in nutrients and there are also compounds within grain. These compounds bind to minerals and inhibit mineral absorption. So what happens when a person eats a lot of grain is they become mineral deficient. When minerals like magnesium are low that turns on the hunger mechanism and makes that person want to eat more, even though theyve eaten more calories theyre still hungry and they want to eat more. When we take that grain out we see the insulin levels come down, but we also see the nutrient density of the foods improve. When youre eating more meats, fruits and vegetables, as opposed to a bunch of sandwiches, pastas, or heavy carbohydrate loaded foods, youre going to get less calories but more nutrients in the food. The more nutrients you have per calorie the less stimulating your hunger mechanism becomes, so you become more satisfied with smaller amounts of calories. Me, Im 170 pounds and I cross-fit very regularly, I try to stay in pretty good shape, and on most days I wont eat over 1,400 calories, but I still maintain that 170 pounds. The average recommendation for somebody at 170 pounds is going to be somewhere around 2,200 to 2,400 calories a day. Im almost 1,000 calories under that because the quality of my food and the nutrient density of my food is so great that my body becomes more efficient.

Peter:

Craig: Peter: Craig:

And then your high energy all day long too, right? Yes. I know from hanging around you. I was going to ask you just in terms of the average persons diet who is not gluten sensitive, whats considered a lot of gluten? We talked a little bit earlier when you said if someone is eating a lot of gluten they might have problems. Do you have ranges of what is considered a lot of gluten? Is it two pieces of bread, is it four pieces of bread per day? Is it four pieces of bread, plus a bowl of cereal?

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Peter: Craig:

I would say a lot of gluten is two servings or more a day. A serving being half a bagel, one piece of bread, half cup of cereal, or a half cup of pasta. Thats obviously a very easy amount for most people get. At breakfast some people probably are getting four servings. When I think back to the Food Guide and the pictures that they put up for us of the cereal plus toast. People that arent thinking about this and are getting grains are getting a lot of gluten. Right? Absolutely. Another thing that I read about, and Im not an expert like you on this certainly and this is kind of a pitfall for people who are trying to do gluten free diets. Ive heard that theres a lot of hidden forms of gluten in sauce, condiments, and all sorts of things that people might get at a restaurant or might be eating out of their own fridge that they just dont realize is a problem. Hidden gluten is probably one of the areas that people with gluten sensitivity have the biggest problem with. Think about it. If you go to a restaurant it could be as simple as you ordered the salad and maybe the salad dressing is thickened with wheat starch. Maybe you ordered a cup of soup and they thickened it with wheat starch or some other grain based starch. Ketchup often times will contain grain based thickeners. Mayonnaise can contain grain based thickeners. It becomes a problem if you dont read your labels. You have to become accustomed to reading labels to rule out whether or not theres gluten present. Often times you can get cross-contamination, which is a little bit different than the hidden gluten. Hidden gluten is in there and you dont really think about it, you dont read your label, and you end up getting it because you didnt think about it. Cross-contamination is when you go out to eat somewhere and maybe you tell the 16 year old restaurant waiter you need it gluten free and he doesnt quite understand it, but he shakes his head as if he does and brings you something. Maybe it was soy sauce that they cooked your steak in and he didnt think it had any wheat in it or any other grain in it, but it did. Thats what we would call cross-contamination. Maybe they used the same cooking surface to cook your food that somebody elses food was cooked in or maybe they shared the same oil where they had a chicken fried steak battered in wheat and then they put

Peter: Craig:

Peter:

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your french-fries or something in the same oil. Not that those things are healthy, but everybody is going to deviate from their diet and have a cheat day, I certainly understand that. When you run the risk in eating out is that cross-contamination. Craig: That brings up a question here. How much gluten is needed to cause somebody issues? You mentioned just even cooking in the same pan or something. So if somebody is gluten sensitive, even something as small as that or a tablespoon of salad dressing, is that enough to cause them trouble? If so, how long does it take for them to get healthy again after even a small relapse like that? The studies that have been done on minimal exposure for damage give us a value somewhere around 20 parts per million, which is equivalent to one drop of water in a gallon of water. Thats a whole lot of exposure to create an inflammatory reaction or to create damage. Now, theres certainly a dose response. The more that a person consumes, obviously the more damage is going to occur. Ive had autoimmune patients that would not heal unless they controlled every aspect and component of their food. They were not able to really eat out, because they were that sensitive. Were not seeing that extreme sensitivity in everyone. But, research tells us that 20 parts per million is enough to do damage and detriment. Craig: Peter: Craig: Peter: And then those particular cases, those people had to go hard core, for lack of a better word, eating at home for two months to figure this out? Right, to get it really figured out to where they were not perpetually poisoning themselves. That is unfortunate. Have we covered everything in terms of the hidden sources there? Is there anything else you want to say on that? I think the biggest thing is just read the label carefully. If youve got a diagnosis of gluten sensitivity really read the label. Its just not worth it. You ask yourself why youre going gluten free in the first place and probably somewhere in that answer is, I want to be healthier. Then you have to really start asking yourself, If Ive got to read a label thats 20 words long and half the terms I cant pronounce without a biochemistry degree, how healthy is that really for me anyway?

Peter:

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Regardless, read those labels very carefully because thats where youre going to find a lot of that hidden gluten. It can be literally in anything. You can get hidden gluten by licking an envelope or a stamp where they use a gluten adhesive. Craig: Peter: Craig: Peter: Wow. It can come on things that are not even edible. With that, theres hardly going to be any foods that are in a box that are gluten free, right? Some examples of gluten free foods that are relatively safe One of the recipes I like to make is a spaghetti squash and pull it out using the squash as spaghetti. Then well make ground beef and add a spaghetti sauce to it. You can buy spaghetti sauce in a jar, theres a brand I buy that has tomato, olive oil, carrots, onions and garlic. All those names you know what they are, you can pronounce them, theres no hidden or added ingredients. I feel relatively safe with things like that. If youre buying something thats canned or jarred it can be very safe, just read that label. If you dont read labels already, youll be surprised at what you see when you do start reading labels how much stuff is in there that you didnt even think about. Craig: Perfect. So someone has learned that theyre gluten sensitive or maybe theyre not, they havent learned that for sure yet, but they want to move over to a gluten free diet. Lets talk about how you would get somebody to change. Would you have them go cold turkey, would you have them just eliminate all gluten right off the bat? How does someone make that transition, what do you have people do? I think you have to judge the character of the person. Its like anything else. Some people can quit smoking cold turkey, some people have to wean and use crutches. I think to be successful you have to do go with what works for the person and follow up and monitor and help them to keep them on that proverbial wagon. Lets say youre taking somebody who is used to eating cereal for breakfast, pasta for lunch, and a sandwich at dinner. What you may start them on is a slow wean where theyre trying to remove the three major foods the bread, the pasta, the cereal but not worrying so much about

Peter:

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the smaller cross-contaminations, not worrying about so much about the ingredients in absolutely everything. Theres a transition. When you go gluten free theres a learning curve. Its like learning algebra, you dont go home and all of a sudden you know algebra because you practiced it one night. Its learning, its experiencing, its gaining the wisdom as youre going gluten free. Ive even see patients that were gluten free veterans that had been gluten free for several months and got accidental exposure because they made a mistake they just hadnt experienced or known about yet. I think you just have to take into consideration the individual nature of the person. Are they a cold turkey person or are they the kind that need to wean? The success depends on their willingness to not be paralyzed by overanalyzing or being overwhelmed initially by the diet. Craig: Okay. What do you have in terms of tips, what do you tell people to focus on first or to choose in emergency situations where theyre in a convenience store and theyre starving? Maybe a couple of real top tips that tend to work for a lot of people that you might have to share. Yes. If youre in a tight fix and youre really hungry one thing is nuts. Nuts are really easy, theyre filling, because of the fat content theyre going to give you good satiety, your appetite is going to be reduced as a result of eating them, and theyre pretty much available anywhere. Pistachios or cashews, almonds or pecans, whatever you can get a hold of, provided that theyre not glazed in honey thats dusted in wheat flour or something like that. Again, reading the label applies. But, you can generally find quick and easy things in a convenience store or in an airport lobby, or in a grocery store when somebody is traveling and theyre really new to it one of the simplest things to do is go through the produce section and pick up some fruit and some hand vegetables like carrot sticks or broccoli. Those are all really simple easy things to do as youre making that transition. Where the problem is if youre used to buying your food and eating out and youre really sensitive you can really mess up your progress by going in somewhere and getting cross-contamination.

Peter:

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Craig:

Im just going to go back to one of the grains. One thats really popular these days is quinoa. Where does it stand in terms of containing gluten? A lot of people will claim that something like that is gluten free. It is technically, but its not. Quinoa is a seed. Grain is defined as the seed of grass. We have different varieties of grass and they sprout their seeds and thats what we define as grain. Quinoa is a type of seed, but not so much of a grass. But, theres a kind of gluten called prolamine and quinoa has a lot of prolamine in it, which tends to irritate people with gluten sensitivity. A lot of people go to quinoa pasta as a substitute and they end up not getting better. Again, we have to consider why were going gluten free in the first place. The other component to this is that there was a study published just last year, they did a study where they pulled the products off of grocery store shelves at random, these products were supposed to be gluten free. They were inherently gluten free, like quinoa or almond flour, these types of things. They analyzed them for gluten content, they sent them out to a lab and they analyzed them for gluten. They found that 41% of these products had enough gluten in them to do damage. Quinoa was one of them. So when it comes to quinoa I say word of caution, youre running a risk by using it if youre gluten sensitive and you havent validated or verified that your source that youre getting it from is a 100% gluten facility. There are versions and brands out there where they focus on only producing this one particular food product, whereas a lot of companies will produce wheat in their facility, peanuts in their facility, all kinds of different things, so theres that risk for cross-contamination. But, if you have a dedicated facility then you can tend to trust that a little bit more.

Peter:

Craig:

Okay. Again its a matter of looking for the label and seeing that. Certainly a lot of foods processed at companies where they also do nuts will put that in their labels, hopefully some of these companies will put that they also process wheat. Will they put that on their labels too or is that something that youre going to have to learn by trial and error? In the U.S. there are certain allergies that you absolutely have to put on a food label. If a product may contain wheat, dairy, soy, or peanuts, then it will be on the label. If it says this product was processed in a facility that

Peter:

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also processes wheat, that would be a warning for you that maybe thats cross-contamination. Craig: So if someone has a gluten sensitivity they have to treat it like a mother would treat the food of a child who has a peanut allergy? Its that serious and theres absolutely no exceptions, were looking at the labels, were scrutinizing them that seriously. Thats my advice. A peanut allergy can kill a child by creating an anaphylactic reaction. Although we dont typically see anaphylaxis with gluten, the problem is gluten does insidious damage over time. By the time a person is sick enough to get a diagnosis theyve created 20 or 30 years worth of damage. To me, I would rather have an acute peanut allergy than a gluten sensitivity that went unrecognized. At least with an acute allergy reaction you can identify it and remove it from the diet. Does that make sense? Craig: Absolutely. A couple more things. What weve talked about in terms of foods that are gluten free sounds pretty straightforward, but it sounds people are going to be giving up a lot of their favorite meals. Im sure that a guy like you has put together or come across some really great recipes. Are there opportunities for people to enjoy different versions of their favorite foods when theyre going gluten free? Absolutely. Im actually gluten sensitive, so some of my favorite foods are recipes that wife has created as a result of not being able to do things like pizza, not being able to eat things like spaghetti or sandwiches. Well do fajita wraps, you can use coconut wraps, you can use butter leaf lettuce as a wrap. One of the best pizzas Ive ever had has a meat crust as opposed to a dough based crust. There are a number of foods that traditionally people grow up on that they love, that they want to experience and continue to experience, that you can get ideas for or create recipes for that are going to be just as good, if not better than their gluten containing counterparts. Craig: Excellent. Last thing. Why dont you just tell us what you tend to eat in a day so that people can have a good idea of what the doctor eats on his gluten free diet? Okay. Every week we take grass fed beef and buffalo and we patty it up with different seasonings and spices into about one-eighth pound little

Peter:

Peter:

Peter:

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patties. We make about 40 to 60 of these things and we put them in the freezer. For breakfast Ill take a couple of them out and Ill put them in a pan with a little bit of water and put a lid on it and let those simmer. It takes about 15 minutes to cook. Aside from that Ill have a piece of fruit and maybe a handful of almonds. I like bananas, berries, apples, so just depends on whats available and in season. I like fresh fruit, so if I can get something fresh and organic and in season thats what Im typically going to go for. Right now blueberries are in season, so Im going to eat blueberries every day that I can because a few months from now were not going to be getting them. For lunch today I went home. My wife cooked a really good dinner last night, she took a whole chicken and put it in the Crockpot and slow cooked it. Were in Texas, so salsa verde is something that is kind of popular here, its like a green salsa made out of green pepper. She just took some of those chili peppers and she made this salsa and just marinated that and slow cooked it. That was what I had for lunch today and thats what I also had for dinner last night. We also had a big pile of salad, I like to use mixed greens and green chard. On our salads well thinly slice some strawberries, maybe sprinkle some sunflower seeds. Instead of a dressing I just squirt fresh lemon or lime juice and olive oil on my salad, that gives it enough texture and taste to satisfy me. To me its actually a lot better than the salad dressings you can buy in the store. For dinner, I told you I had the same thing for dinner and lunch yesterday and today. Prior to that for dinner my wife made a meatloaf and instead of using any kind of grain to thicken the meatloaf she used sliced up cabbage, sliced up carrots, and some almond meal and egg to hold the meatloaf together, and then of course garlic and onions. She just put tomato paste over the top of that and baked it and that was what we had for dinner the night before. There are a lot of classic recipes that you can have that you probably are already eating, you just create them in a gluten free way, create them in a way where youre not going to have all the different grains. Craig: Fantastic. This is awesome, Peter. I really appreciate this. I know everyone listening is really going to appreciate the clarification on such a hot topic and the exact details coming from an expert like yourself. Thank

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you very much. Is there anything else you want to add here on our first call? Peter: I think that if somebody is contemplating going gluten free the best thing that they can do is really to get an answer definitively if you cannot afford genetic testing is to just do a trial gluten free diet. Just commit to it for a month and, proverbially speaking, the proof is always in the pudding. If you feel tremendously better does it really matter whether youre gluten sensitive or not? Changing the diet made you feel better, so go with it. Theres an old saying, Nothing tastes so good as it feels to be thin. Well, I changed that statement to say, Nothing tastes so good as it feels to be healthy. When youre healthy youre more functional, you can do more, you can enjoy life more. Youre more awake and more alert to the things in the world that matter. So many people focus food, theres another old saying of food equals love. We all grew up with people baking and making us foods that were probably not great for us, but out of love they were doing that. So weve created a culture in the U.S. that is very food centric. I just say look at it differently, switch in your mind. Just turn that switch and say, Im not going to look at food as a necessity for happiness, Im going to look at health as a necessity for happiness. Craig: Thats a good way of thinking. One last thing there that you mentioned. If someone was going to try the gluten free diet they should give it a full four weeks, right? Its not a week thing, its not a two week thing. Even if, like you said, if the diet just makes you feel healthy or not, it should be a full month and you should really give it a shot like that. Most doctors and most experts say even longer, really six months, because you have a percentage of people who go gluten free who wont respond in the first month. It really can sometimes take up to six months. For those of your listeners who give it a month and notice a difference, I think a large percentage of them would feel that way even if they just did give it a month. Craig: Thats great, really helpful information. Peter, thank you very much. Again, your website is GlutenFreeHealthSolution.com. If somebody did want to go through and actually get testing, whats the website for your office that they would contact?

Peter:

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Peter:

My office and my clinic is TownCenterWellness.com. They can call my office and ask for Diana, Debbie, Patricia, or Casey and theyll direct them in the right direction to get tested. Its very simple, you dont have to be a patient in my office to come in if you dont want to actually visit a doctor and you just want to have an answer. Genetic testing is as easy as sending you an envelope with cheek swabs that we can send to the DNA lab. Great. TownCenterWellness.com. Thanks, Peter, for being on the call. We really appreciate it and we look forward to hearing from you again. I know were going to get lots of questions and we also want to go more in depth with you and get more advanced gluten free information, so well be back on another call soon. Thanks everybody for listening, this was another fantastic call. This is Craig Ballantyne and well talk to you soon. Bye everyone.

Craig:

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