Guest Blog by Max Librach of CeliAct.com

choosing GF fast food

While no one’s claiming fast food is ideal, sometimes you need to eat on the run, whether you’re traveling, out with a crowd or just short on time.

You can get a safe gluten-free meal at the drive-through, but you’ll need to be extra careful, choose your restaurant well, and ask questions.

Here are my thoughts on 10 different fast food chains, from my own experience and from what I’ve heard from others who are gluten-free. Some you won’t have in your neck of the woods, but most are well-recognized across the country.

Fast Food Options: Which Have the Best Gluten-Free Menus?

• Wendy’s has a gluten-free menu, including bunless burgers, salads, baked potatoes and chili. Some restaurants use a dedicated fryer for their fries, making them an option when you’re gluten-free. Ask your local Wendy’s to be sure that your fries are cross-contamination free.
• Hardees offers a low-carb style burger wrapped in a lettuce leaf, a breakfast bowl or salad for gluten-intolerant customers. Hardees does not use dedicated fryers, so skip the fries.
• In-and-Out Burger may be a regional chain, but it’s a favorite with lettuce-wrapped burgers and freshly cut fries. The fries are cooked in a dedicated fryer, so they’re a safe indulgence.
• Chick-Fil-A has a number of gluten-free options and one of the largest gluten-free fast food menus on the market, including a gluten-free kids’ meal with grilled nuggets, blended applesauce and a drink. The grilled chicken, grilled chicken salads and, typically, the waffle fries are safe bets.

Other Safe Alternatives with Gluten-Free Menus

• Sonic, Burger King and Arby’s all offer gluten-free meats. Have your sandwich made without a bun and skip chicken dishes and fried sides. Pair your bunless burger with a side salad, shake or hit up the kids menu for applesauce or fresh fruit.
• Many of Subway’s salads are gluten-free or can be made gluten-free. Ask that the server change his or her gloves and use fresh bins of food to reduce cross-contamination. A few Subway restaurants are testing the gluten-free market with gluten-free buns and have provided additional employee training in gluten sensitivity. This got started last year in Dallas, Portland and a few other cities to see if customers would actually buy a gluten-free sandwich. Evidently, the test was a success because Subway has just announced that they will be offering gluten-free sandwiches at all Subway locations in the state of Oregon!

Which Fast Food Options to Stay Away From

• McDonald’s offers no safe options for a gluten-free lunch on the go. Even a bunless burger isn’t necessarily safe here. A side salad, without chicken, or ice cream is the safest choice if all else fails.
• Taco Bell looks like it ought to be a pretty good choice. Looks can be deceiving. The only thing that doesn’t contain wheat on this menu is the cheesy nachos.

Keep in mind that cross-contamination is always a risk and you must assume that the employees know nothing about celiac disease and gluten intolerance. Step inside and keep an eye on your meal prep for extra safety, until you’re familiar with the policies at your favorite drive-through. Take the time to politely educate the manager and you may find that you can safely enjoy an on-the-go meal in the future.

Max Librach
Max is a co-founder of Eagle Therapeutics and has had celiac disease for over ten years. Wanting to do more for his health beyond following a gluten free diet, Max set out to research the effects of supplementation on celiac disease. Eventually, he teamed up with nutritionists, dietitians and physicians from all over the world to create CeliAct.

villi

When you first head down the road of defining a possible issue with gluten, it’s like entering a new dimension. And you also need to learn a new vocabulary to navigate that world. You’ve been lucky enough to find a doctor who is associating your potentially varied symptoms with celiac disease, and now you need to be concerned about how your lab results are being analyzed, or you may be given a mistakenly clean bill of health.

In order to achieve what physicians call the “gold standard” of a celiac disease diagnosis, an endoscopy must be done that shows histological changes, or damage, to the small bowel. The villi that line the small intestine are like what you would think of as a deep, thick, dense-pile carpet. Each of the villi can be compared to a carpet thread, contributing it’s surface area (imagine going  up one side of the thread, across the tip and down the other side) to the absorption of nutrients during digestion. However, when the villi encounter something that they cannot absorb, such as the gliadin protein in the case of celiac disease, they become damaged and show signs of decreased length, referred to as villous atrophy. Additionally, there are cellular changes, such as increased lymphocytes in the tips of the villi, that indicate inflammation. See these photos from TheFoodDoc.com to gain a better understanding of what this looks like under a microscope. So now your beautiful thick carpet of villi has worn down patches and ratty areas that make your intestinal lining look like crackled dried out mud. You may think, “Why should I care what it looks like in there, the doctor and the lab guy know what they’re doing.” But is that really the truth?

From the Journal of Clinical Pathology, 2011 we learn that biopsies, or tissue samples taken during the endoscopy procedure, are subject to “interobserver variability”, meaning that different pathology practices may be reading biopsies differently.

Biopsies from community hospitals, university hospitals and commercial laboratories were blindly assessed by a pathologist at our institution for differences in histopathology reporting and agreement in diagnosis of CD [celiac disease] and degree of villous atrophy (VA) by κ analysis.

The results were that the agreement for primary diagnosis was very good at the university hospitals, but not nearly so good at community hospitals and commercial laboratories. Actual diagnosis differed in 25% of cases, which meant that after the cases were reviewed, there was a 20% increase in celiac disease diagnosis! Even the degree of villous atrophy, damage or blunting of the villi, was upgraded in 27% of cases. And when it came to the really subtle early stages of damage that are categorized as Marsh scores, there were complete misses at the community hospitals and commercial labs, where they only began to pick up on the details when the damage became more significant. Some labs used only basic descriptions like blunting or marked atrophy when referring to damage as opposed to providing degree of villous atrophy and IEL’s (intraepitheilial lymphocytosis) counts, or even left the information out altogether.

The intraepithelial lymphocytes are white blood cells that are part of the immune response to the proteins in food that are causing the damage. The lymphocytes rise to the surface of the lining, displacing enterocytes which are usually there, absorbing your nutrients. The IEL count may need to be analyzed in the lab through the use of a special immune chemistry stain that can make normal looking tissue reveal higher counts of lymphocytes. This can be extremely beneficial to diagnose the earliest signs of injury to the intestine, for people who already might have, with the best intentions, restricted gluten in their diets, and family members of people who have celiac disease.  Catching the disease at this early stage can greatly reduce the amount of damage to the gut.

So when you’re dealing with a celiac disease diagnosis, a university lab might be your best setting. If that’s not possible, ask your doctor about what lab he will be sending your biopsies to, and what type of standards they are using to analyze the tissue. It could make the difference between a correct diagnosis, and living with the ongoing damage of celiac disease that they are now “sure” you don’t have because the lab said so.

There’s an abundance of published research and writings to support the ancient belief that certain foods contain properties that promote love, fertility and virility. From the Mayan reverence for cacao, used to make a beverage prized for its stimulating, sustaining and euphoric qualities to countless cookbooks, websites and blogs extolling the virtues of “love” foods, the connection between food and emotions continues to endure.

Have fun experimenting with “love” foods this month and see which ones work best for you.

Almonds, which are good for your heart, are one of the oldest symbols of love and fertility. Almond essence is well documented as a favorite for pursuits of love and seduction, particularly for stimulating passion in women.

Avocado contains vitamin B6 which is said to increase male hormone production and contains potassium which aids in regulating the female thyroid gland. The Aztecs called the avocado tree a “testicle tree” because they thought the fruit hanging in pairs on the tree resembled the male organs.

Bananas, with it suggestive shape and creamy texture is considered one of the most popular aphrodisiac foods used to stimulate sexual desire and increase sexual powers. Bananas also contain potassium and B vitamins which are essential for sex hormone production.

Chili peppers get their heat from capsaicin, which stimulates nerve endings and raises our pulse. It’s also believed to release endorphins, which give our bodies a natural high.

Chocolate – in it’s purest raw form – contains a sedative, which relaxes and lowers inhibitions and a stimulant, which increases activity and the desire for physical contact. No wonder more chocolate is sold on Valentine’s Day than any other day of the year.

Ginger soothes the stomach and stimulates the circulatory system, which can increase sexual powers and desire. Enjoy ginger root raw, cooked, or crystallized – it has the same stimulating effect.

Oysters, a rich source of zinc, (needed for testosterone production) has long held a favored place on the lists of aphrodisiac food. Some oysters change their sex from male to female and back, making them a food that allows one to experience the masculine and feminine sides of love. Folklore recommends only eating oysters in the months that contain the letter R, so you’re safe this month.

Truffles with their mysterious musky aroma, have long been considered to be an aphrodisiac. Truffle salt on French fries, yeah, I’d call that sexy….
Guest Blog post by

Jordana Halpern Geist, HHC
Healthy Happy You