THAT’S THE WAY THE COOKIE CRUMBLES Read Online Free Page A

absorption. And you know what? The FTC would not object, because scientific evidence would back him up.

For Some, a Diet Goes against the Grain
    Just ask people what they worry about most in their food supply and they’ll round up the usual suspects. Their thoughts will drift to nitrites, sulfites, food colors, artificial sweeteners, monosodium glutamate, or genetically modified organisms. Yet we are far more likely to be harmed by a commonly occurring natural component in food than by any of these. Gluten, a protein found in wheat, barley, rye, and — to some extent — oats, can provoke health problems in a significant percentage of the population. Celiac disease, as gluten intolerance is usually called, may be much more common than we think.

    Dr. Samuel Gee of Britain was the first to provide a clinical description of the disease. In 1888, he painted a disturbing picture of young children with bloated stomachs, chronic diarrhea, and stunted growth. Dr. Gee thought that the condition could have a dietary connection, so he put his young patients, for some strange reason, on a regimen of oyster juice. This proved to be useless. Willem K. Dicke, a Dutch physician, finally got onto the right track when he made an astute observation during World War II. The German army had tried to starve the Dutch into submission by blocking shipments of food to Holland, including wheat. Potatoes and locally grown vegetables became staples, even among hospital patients, and Dicke noted that his celiac patients improved dramatically. Moreover, in the absence of wheat and grain flours, no new cases of celiac occurred.
    By 1950, Dicke had figured out what was going on. Gluten, a water-insoluble protein found in wheat, was the problem. As later research showed, the immune systems of celiac patients mistake a particular component of gluten, namely gliadin, for a dangerous invader, and they mount an antibody attack against it. This triggers the release of molecules called cytokines, which in turn wreak havoc upon the villi — the tiny, fingerlike projections that line the surface of the small intestine. The villi are critical in providing the large surface area needed for the absorption of nutrients from the intestine into the bloodstream.
    In celiac disease, the villi become inflamed and markedly shortened, and their rate of nutrient absorption is effectively reduced. This has several consequences. Nonabsorbed food components have to be eliminated, and this often results in diarrhea. Bloating can also occur when bacteria in the gut metabolize some of these components and produce gas. But the greatest worry for the celiac disease sufferer is loss of nutrients. Protein, fat, iron, calcium, and vitamin absorption can drop dramatically, and this results in weight loss and a plethora of complications. Luckily, if the disease is recognized and a gluten-free diet initiated, the patient can lead a normal life.
    Diagnosis of celiac disease involves the physician taking a biopsy sample from the duodenum, the uppermost section of the small intestine, via a gastroscope passed down through the patient’s mouth. Microscopic analysis shows the damaged villi. Recently, blood tests have also become available. One of these screens for the presence of antigliadin antibodies, but it is not foolproof. Only about half the patients with positive results actually show damaged villi upon biopsy. The antitissue transglutaminase test (anti-tTG) is a much better diagnostic tool, but it is available only in specialized labs.
    There is a great deal of interest in these tests because of their potential value in identifying celiac cases and perhaps even in screening the population. Celiac disease, which has a genetic component, does not necessarily begin immediately after gluten is first introduced into the diet. The onset of disease can occur at any age. In adults, the symptoms are usually much less dramatic than they are in young children. The first signs are often