For individuals practicing a low-carbohydrate eating style or want to try an alternative flour, can incorporating almond flour help in their wellness journey?
Almond Flour
Almond flour and almond meal are gluten-free alternatives to wheat products in certain recipes. They are made by grinding almonds and can be bought prepared or made at home with a food processor or grinder. The flour is higher in protein and lower in starch than other gluten-free flour.
Almond Flour and Almond Meal
The flour is made with blanched almonds, meaning the skin has been removed. Almond meal is made with whole or blanched almonds. The consistency for both is more like corn meal than wheat flour. They can usually be used interchangeably, although using the blanched flour will produce a more refined, less grainy result. Superfine almond flour is great for baking cakes but is difficult to make at home. It can be found at grocery stores or ordered online.
Carbohydrates and Calories
A half cup of commercially prepared flour contains about:
The glycemic index of almond flour is less than 1, which means it should have little effect on raising blood glucose levels.
The high glycemic index of whole wheat flour is 71, and rice flour is 98.
Using Almond Flour
It is recommended for making gluten-free quick bread recipes, such as gluten-free:
Muffins
Pumpkin bread
Pancakes
Some cake recipes
Individuals are recommended to start with a recipe already adapted for almond flour and then make their own. A cup of wheat flour weighs around 3 ounces, while a cup of almond flour weighs almost 4 ounces. This will make a significant difference in baked goods. The flour is beneficial for adding nutrients to foods.
Almond Meal
Almond meal can be cooked as polenta or grits such as shrimp and grits.
Cookies can be made gluten-free with almond meal.
Almond meal biscuits can be made, but pay attention to the recipe.
Almond meal can be used to bread fish and other fried foods, but it must be taken care of so as not to burn.
Almond meal is not recommended for breads that require true dough with a developed gluten structure, like wheat flour.
More eggs are needed when baking with almond meal to provide the structure gluten in flour creates.
Adapting recipes to substitute almond meal for wheat flour can be a challenge that requires plenty of trial and error.
Sensitivities
Almonds are a tree nut, one of the eight most common food allergies. (Anaphylaxis UK. 2023) While peanuts are not tree nuts, many with peanut allergies can also have an almond allergy.
Making Your Own
It can be made in a blender or food processor.
Care must be taken not to grind it too long, or it will become almond butter, which can also be used.
Add a little at a time and pulse until it is ground into meal.
Store unused flour immediately in the refrigerator or freezer because it will go rancid quickly if left out.
Almonds are shelf-stable, and almond flour is not, so it is recommended that you grind only what is needed for the recipe.
Store Bought
Most health food stores sell almond flour, and more supermarkets are stocking it as it has become a popular gluten-free product. Packaged flour and meal will also go rancid after opening and should be kept in the refrigerator or freezer after opening.
Anaphylaxis UK. (2023). Allergy Factsheets (Anaphylaxis UK A brighter future for people with serious allergies, Issue. www.anaphylaxis.org.uk/factsheets/
Atkinson, F. S., Brand-Miller, J. C., Foster-Powell, K., Buyken, A. E., & Goletzke, J. (2021). International tables of glycemic index and glycemic load values 2021: a systematic review. The American journal of clinical nutrition, 114(5), 1625–1632. doi.org/10.1093/ajcn/nqab233
Many research studies have arguably analyzed how gluten can affect the nervous system. However, people with celiac disease and non-celiac gluten sensitivity have demonstrated a variety of symptoms, ranging from headaches and brain fog to autoimmune disease. Moreover, brain health issues, such as anxiety, depression, and migraines, among others, are also common symptoms in people with gluten sensitivity or intolerance.
Gluten ataxia, a severe autoimmune disorder, affects a small percentage of the population. Evidence suggests that brain health issues, such as schizophrenia and bipolar disorder, may also be affected by gluten. In the following article, we discuss several common gluten-related brain health issues.
Brain Fog, Headaches, Migraines, Insomnia, and ADHD
Many people with brain health issues like celiac disease as well as gluten sensitivity or intolerance understand the risks of consuming gluten. But, if they do eat gluten, many people report feeling that their brains “cloud up” and they feel less efficient, even clumsy. This brain health issue, known as brain fog, requires further research studies, however, it’s another common symptom associated with celiac disease and gluten sensitivity or intolerance.
Attention deficit-hyperactivity disorder (ADHD) is yet another common brain health issue in both adults and children. Headaches and migraines are also commonly reported as celiac disease symptoms and gluten sensitivity or intolerance symptoms. These symptoms may ultimately cause insomnia.
Anxiety and Depression
Research studies demonstrate that people with celiac disease experience anxiety and depression. People that don’t have celiac disease but who do have gluten sensitivity or intolerance also report experiencing anxiety and depression although the connection between the brain health issues is unknown. Researchers believe that gluten-related intestinal permeability, or leaky gut, may cause nutritional deficiencies that cause anxiety and depression.
However, that doesn’t necessarily explain why people with non-celiac gluten sensitivity or intolerance also experience anxiety and depression. Several gluten sensitivity or intolerance experts like New Zealand pediatrician Dr. Rodney Ford have hypothesized that gluten directly affects the brain and leads to the development of these brain health issues. Regardless, you’re far from being alone if you experience gluten-related anxiety and depression symptoms.
Schizophrenia and Bipolar Disorder
Many research studies suggest that gluten may be associated with two very severe brain health issues: schizophrenia and bipolar disorder. In schizophrenia, decades of research studies have shown that eliminating gluten from the diet of schizophrenics can help with the brain health issue. Research studies have ultimately demonstrated that a gluten-free diet can be beneficial for people with schizophrenia, but further research studies are needed.
In bipolar disorder, research studies have shown that people with celiac disease and gluten sensitivity or intolerance may experience the brain health issue. A research study on the levels of antibodies to gluten in the blood of people with bipolar disorder found increased levels during a manic episode.
Autoimmune Disease
When gluten consumption causes your own body to attack its own cells and tissues, you suffer from a gluten-related autoimmune disease. There are three common gluten-related autoimmune diseases: celiac disease, dermatitis herpetiformis, and gluten ataxia. In gluten ataxia, the immune system attacks the cerebellum, the region of the brain responsible for coordination. In many circumstances, the brain damage is irreversible, however, a strict gluten-free diet can help stop the progression of the autoimmune disease. Many people with gluten sensitivity or intolerance may also experience similar symptoms.
Celiac disease and gluten sensitivity or intolerance can ultimately lead to a wide variety of brain health issues and neurological diseases. However, in many circumstances, people can tremendously reduce or even resolve their gluten-related brain health issue symptoms by following a strict gluten-free diet.
Gluten intolerance or sensitivity is described as the human body’s inability to digest or break down the gluten protein found in wheat and a variety of other grains. This health issue can ultimately range from a mild or moderate intolerance or sensitivity to full-blown celiac disease, a severe autoimmune disorder related to gluten intolerance or sensitivity. Additionally, research studies have demonstrated that people with gluten intolerances or sensitivities may also develop brain health issues or neurological diseases. Talking to a naturopathic doctor or functional medicine practitioner can help determine if you have a gluten intolerance or sensitivity. Avoiding gluten altogether can ultimately help improve your overall health and wellness. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
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The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. Symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue.
The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.�
Curated by Dr. Alex Jimenez
References:
Anderson, Jane. �How Gluten Can Have a Damaging Effect on Your Brain and Nerves.� Verywell Health, Verywell Health, 20 Nov. 2019, www.verywellhealth.com/gluten-related-neurological-symptoms-and-conditions-562317.
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Neural Zoomer Plus for Neurological Disease
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention.
Food Sensitivity for the IgG & IgA Immune Response
Dr. Alex Jimenez utilizes a series of tests to help evaluate health issues associated with food sensitivities. The Food Sensitivity ZoomerTM is an array of 180 commonly consumed food antigens that offers very specific antibody-to-antigen recognition. This panel measures an individual�s IgG and IgA sensitivity to food antigens. Being able to test IgA antibodies provides additional information to foods that may be causing mucosal damage. Additionally, this test is ideal for patients who might be suffering from delayed reactions to certain foods. Utilizing an antibody-based food sensitivity test can help prioritize the necessary foods to eliminate and create a customized diet plan around the patient�s specific needs.
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900. For your convenience and review of the XYMOGEN products please review the following link. *XYMOGEN-Catalog-Download* All of the above XYMOGEN policies remain strictly in force.
Gluten Free: During a visit to my orthopedist I made a confession: �I stopped eating gluten and�this might sound a little crazy, but�a lot of my joint pain disappeared.
She smiled broadly and said, �You�re not the first person to say that.�
I stopped eating gluten because couple of friends suggested it might relieve some unexplained symptoms I was experiencing, like fatigue and mild joint pain. I had strong doubts, but my primary care doctor and I had run out of ideas (I was waiting to see a specialist), so I figured I had nothing to lose.
More recently, medical experts have begun to acknowledge the connection between gluten and joint pain described as non-pathologic (unrelated to disease).
Both my orthopedist and primary care provider agree that my gluten-free diet is probably keeping my joint pain and other
Before you throw away your pasta and cereal in search of joint pain relief, consider these factors:
Going gluten free isn�t for everyone.�
Whole grains are a recommended part of a healthy diet. No research suggests everyone should start eating a gluten free diet. But for people experiencing painful joint inflammation, eliminating gluten and other �pro-inflammatory� foods may be one treatment approach to consider.
Food products labeled �gluten free� aren�t necessarily healthy.�
It�s almost always better to eat whole foods as opposed to processed foods that are gluten-free, but still full of sugar or saturated fats. For example, skip the gluten-free sugar cereal and make yourself a bowl of gluten-free oatmeal or a fruit smoothie for breakfast.
Eating a gluten-free diet isn�t a magic bullet.�
Adopting other healthy habits, such as making time for exercise, is essential to eliminating joint pain.
A health professional can help.It�s always a good idea to tell yourdoctor about lifestyle changes, including achange in diet. A doctor may refer you to a registered dietician who can recommend certain foods, helping ensure you get enough nutrients and fiber in your gluten-free diet.
You might experience gluten withdrawal.Many people report that their inflammatory symptoms initially got worse after starting their gluten free diet. This withdrawal stage can last days or even weeks, so you may not want to go gluten free right before a big event, like a vacation, holiday, or the start of a newjob.
No single treatment or lifestyle habit can eliminate the symptoms of arthritis, but going gluten-free may be an option worth trying as part of your overall treatment plan.
Abstract Objective: The purpose of this case report is to describe a patient with chronic, multisite muscle fasciculations who presented to a chiropractic teaching clinic and was treated with dietary modifications.
Clinical features: A 28-year-old man had muscle fasciculations of 2 years. The fasciculations began in his eye and progressed to the lips and lower extremities. In addition, he had gastrointestinal distress and fatigue. The patient was previously diagnosed as having wheat allergy at the age of 24 but was not compliant with a gluten-free diet at that time. Food sensitivity testing revealed immunoglobulin G�based sensitivity to multiple foods, including many different grains and dairy products. The working diagnosis was gluten neuropathy.
Intervention and outcome: Within 6 months of complying with dietary restrictions based on the sensitivity testing, the patient�s muscle fasciculations completely resolved. The other complaints of brain fog, fatigue, and gastrointestinal distress also improved.
Conclusions: This report describes improvement in chronic, widespread muscle fasciculations and various other systemic symptoms with dietary changes. There is strong suspicion that this case represents one of gluten neuropathy, although testing for celiac disease specifically was not performed.
Introduction:�Muscle Fasciculations
There are 3 known types of negative reactions to wheat proteins, collectively known as wheat protein reactivity: wheat allergy (WA), gluten sensitivity (GS),�and celiac disease (CD). Of the 3, only CD is known to involve autoimmune reactivity, generation of antibodies, and intestinal mucosal damage. Wheat allergy involves the release of histamine by way of immunoglobulin (Ig) E cross-linking with gluten peptides and presents within hours after ingestion of wheat proteins. Gluten sensitivity is considered to be a diagnosis of exclusion; sufferers improve symptomatically with a gluten-free diet (GFD) but do not express antibodies or IgE reactivity.1
The reported prevalence of WA is variable. Prevalence ranges from 0.4% to 9% of the population.2,3 The prevalence of GS is somewhat difficult to determine, as it does not have a standard definition and is a diagnosis of exclusion. Gluten sensitivity prevalence of 0.55% is based on National Health and Nutrition Examination Survey data from 2009 to 2010.4 In a 2011 study, a GS prevalence of 10% was reported in the US population.5 In contrast to the above 2 examples, CD is well defined. A 2012 study examining serum samples from 7798 patients in the National Health and Nutrition Examination Survey database from 2009 to 2010 found an overall prevalence of 0.71% in the United States.6
Neurologic manifestations associated with negative reactions to wheat proteins have been well documented. As early as 1908, �peripheral neuritis� was thought to be associated with CD.7 A review of all published studies on this topic from 1964 to 2000 indicated that the most common neurologic manifestations associated with GS were ataxia (35%), peripheral neuropathy (35%), and myopathy (16%). 8 Headaches, paresthesia, hyporeflexia, weakness, and vibratory sense reduction were reported to be more prevalent in CD patients vs controls.9 These same symptoms were more prevalent in CD patients who did not strictly follow a GFD vs those who were compliant with GFD.
At present, there are no case reports describing the chiropractic management of patient with gluten neuropathy. Therefore, the purpose of this case study is to describe a patient presentation of suspected gluten neuropathy and a treatment protocol using dietary modifications.
Case Report
A 28-year-old man presented to a chiropractic teaching clinic with complaints of constant muscle fasciculations of 2 years� duration. The muscle fasciculations originally started in the left eye and remained there for about 6 months. The patient then noticed that the fasciculations began to move to other areas of his body. They first moved into the right eye, followed by the lips,�and then to the calves, quadriceps, and gluteus muscles. The twitching would sometimes occur in a single muscle or may involve all of the above muscles simultaneously. Along with the twitches, he reports a constant �buzzing� or �crawling� feeling in his legs. There was no point during the day or night when the twitches ceased.
The patient originally attributed the muscle twitching to caffeine intake (20 oz of coffee a day) and stress from school. The patient denies the use of illicit drugs, tobacco, or any prescription medication but does drink alcohol (mainly beer) in moderation. The patient ate a diet high in meats, fruits, vegetables, and pasta. Eight months after the initial fasciculations began, the patient began to experience gastrointestinal (GI) distress. Symptoms included constipation and bloating after meals. He also began to experience what he describes as �brain fog,� a lack of concentration, and a general feeling of fatigue. The patient noticed that when the muscle fasciculations were at their worst, his GI symptoms correspondingly worsened. At this point, the patient put himself on a strict GFD; and within 2 months, the symptoms began to alleviate but never completely ceased. The GI symptoms improved, but he still experienced bloating. The patient�s diet consisted mostly of meats, fruit, vegetables, gluten-free grains, eggs, and dairy.
At the age of 24, the patient was diagnosed with WA after seeing his physician for allergies. Serum testing revealed elevated IgE antibodies against wheat, and the patient was advised to adhere to a strict GFD. The patient admits to not following a GFD until his fasciculations peaked in December 2011. In July of 2012, blood work was evaluated for levels of creatine kinase, creatine kinase�MB, and lactate dehydrogenase to investigate possible muscle breakdown. All values were within normal limits. In September of 2012, the patient under- went food allergy testing once again (US Biotek, Seattle, WA). Severely elevated IgG antibody levels were found against cow�s milk, whey, chicken egg white, duck egg white, chicken egg yolk, duck egg yolk, barley, wheat gliadin, wheat gluten, rye, spelt, and whole wheat (Table 1). Given the results of the food allergy panel, the patient was recommended to remove this list of foods from his diet. Within 6 months of complying with the dietary changes, the patient�s muscle fasciculations completely resolved. The patient also experienced much less GI distress, fatigue, and lack of concentration.
Discussion
The authors could not find any published case studies related to a presentation such as the one�described here. We believe this is a unique presentation of wheat protein reactivity and thereby represents a contribution to the body of knowledge in this field.
This case illustrates an unusual presentation of a widespread sensorimotor neuropathy that seemed to respond to dietary changes. Although this presentation is consistent with gluten neuropathy, a diagnosis of CD was not investigated. Given the patient had both GI and neurologic symptoms, the likelihood of gluten neuropathy is very high.
There are 3 forms of wheat protein reactivity. Because there was confirmation of WA and GS, it was decided that testing for CD was unnecessary. The treatment for all 3 forms is identical: GFD.
The pathophysiology of gluten neuropathy is a topic that needs further investigation. Most authors agree it involves an immunologic mechanism, possibly a direct or indirect neurotoxic effect of antigliadin anti- bodies. 9,10 Briani et al 11 found antibodies against ganglionic and/or muscle acetylcholine receptors in 6 of 70 CD patients. Alaedini et al12 found anti-ganglioside antibody positivity in 6 of 27 CD patients and proposed that the presence of these antibodies may be linked to gluten neuropathy.
It should also be noted that both dairy and eggs showed high responses on the food sensitivity panel. After reviewing the literature, no studies could be located linking either food with neuromuscular symp- toms consistent with the ones presented here. There- fore, it is unlikely that a food other than gluten was responsible for the muscle fasciculations described in this case. The other symptoms described (fatigue, brain fog, GI distress) certainly may be associated with any number of food allergies/sensitivities.
Limitations
One limitation in this case is the failure to confirm CD. All symptoms and responses to dietary change point to this as a likely possibility, but we cannot confirm this diagnosis. It is also possible that the�symptomatic response was not due directly to dietary change but some other unknown variable. Sensitivity to foods other than gluten was documented, including reactions to dairy and eggs. These food sensitivities may have contributed to some of the symptoms present in this case. As is the nature of case reports, these results cannot necessarily be generalized to other patients with similar symptoms.
Conclusion:�Muscle Fasciculations
This report describes improvement in chronic, widespread muscle fasciculations and various other systemic symptoms with dietary change. There is strong suspicion that this case represents one of gluten neuropathy, although testing for CD specifically was not performed.
Brian Anderson DC, CCN, MPHa,?, Adam Pitsinger DCb
Attending Clinician, National University of Health Sciences, Lombard, IL Chiropractor, Private Practice, Polaris, OH
Acknowledgment
This case report is submitted as partial fulfillment of the requirements for the degree of Master of Science in Advanced Clinical Practice in the Lincoln College of Post-professional, Graduate, and Continuing Education at the National University of Health Sciences.
Funding Sources and Conflicts of Interest
No funding sources or conflicts of interest were reported for this study.
References:
1. Sapone A, Bai J, Ciacci C, et al. Spectrum of gluten-related
disorders: consensus on new nomenclature and classification.
BMC Med 2012;10:13.
2. Matricardi PM, Bockelbrink A, Beyer K, et al. Primary versus
secondary immunoglobulin E sensitization to soy and wheat in
the Multi-Centre Allergy Study cohort. Clin Exp Allergy
2008;38:493�500.
3. Vierk KA, Koehler KM, Fein SB, Street DA. Prevalence of
self-reported food allergy in American adults and use of food
labels. J Allergy Clin Immunol 2007;119:1504�10.
4. DiGiacomo DV. Prevalence and characteristics of non-celiac
gluten sensitivity in the United States: results from the
continuous National Health and Nutrition Examination Survey
2009-2010. Presented at: the 2012 American College of
Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las
Vegas.; 2012.
5. Sapone A, Lammers KM, Casolaro V. Divergence of gut
permeability and mucosal immune gene expression in two
gluten-associated conditions: celiac disease and gluten sensitivity.
BMC Med 2011;9:23.
6. Rubio-Tapia A, Ludvigsson JF, Brantner TL, Murray JA,
Everhart JE. The prevalence of celiac disease in the United
States. Am J Gastroenterol 2012 Oct;107(10):1538�44.
7. Hadjivassiliou M, Grunewald RA, Davies-Jones GAB. Gluten
sensitivity as a neurological illness. J Neurol Neurosurg
Psychiatr 2002;72:560�3.
8. Hadjivassiliou M, Chattopadhyay A, Grunewald R, et al.
Myopathy associated with gluten sensitivity. Muscle Nerve
2007;35:443�50.
9. Cicarelli G, Della Rocca G, Amboni C, et al. Clinical and
neurological abnormalities in adult celiac disease. Neurol Sci
2003;24:311�7.
10. Hadjivassiliou M, Grunewald RA, Kandler RH. Neuropathy
associated with gluten sensitivity. J Neurol Neurosurg
Psychiatry 2006;77:1262�6.
11. Briani C, Doria A, Ruggero S, et al. Antibodies to muscle and
ganglionic acetylcholine receptors in celiac disease. Autoimmunity
2008;41(1):100�4.
12. Alaedini A, Green PH, Sander HW, et al. Ganglioside reactive
antibodies in the neuropathy associated with celiac disease.
J Neuroimmunol 2002;127(1�2):145�8.
Gluten-free dominates the free-from category, especially the baking mix subcategory. Gluten-free product sales in 2015 grew nearly 10 percent to $25 billion, according to SPINS data.
“Gluten-free is growing,” notes Michelle Lorge, VP of marketing for Chicago-based Simple Mills. “Just in general, I would say that we are seeing the whole allergen-free world growing. What we found was that the allergen-free world is growing not just for people with allergies. Folks are realizing some of this element of bioindividuality and the fact that they’ve got sensitivities. Those sensitivities can be very different depending on the person because we’re all unique human beings; while they’re not necessarily truly �diagnosed’ with an issue, they know that they don’t feel their best, either physically or mentally, with certain food items.”
Clean and Simple
The free-from category has expanded well beyond gluten-free. “Customers are looking for clean labels completely across the board,” says Joe Hanni, president of PS Seasoning & Spices, Iron Ridge, Wis.
Lorge agrees that consumers want simple, hence, the name of her company Simple Mills. They want ingredient lists with words they can pronounce and can be found in their own pantries, she notes.
“There’s this whole group that is just looking for a cleaner product,” agrees Kasey Moss, senior brand director for Enjoy Life Foods, Chicago. “They don’t want all the fillers and the gums and all of the other ingredients that you find in a lot of mixes on those markets.” Instead, they turn to the free-from category to find the clean ingredient list.
For example, Simple Mills’ Banana Muffin & Bread Mix’s ingredient list only contains seven ingredients: almond flour, banana, organic coconut sugar, arrowroot, organic coconut flour, baking soda and sea salt.
In terms of clean label, consumers are looking further than just the flour used. “It’s beyond just gluten-free; they want non-GMO. They want all of that without giving up any type of function or flavorability,” Hanni says, crediting the company’s R&D department with formulating gluten-free flours that form the basis of the baking mixes and gives them all the function and flavor of traditional flour.
Search for Flavor
Consumers also are looking for more flavor than is just imparted from the flour. “We’re seeing customers looking for more interesting flavors in the baking mixes, not just baking flours,” Hanni says.
PS Seasoning & Spices has introduced a gourmet line of pancake mixes that includes flavors like Cookies & Cream, Fudge Brownie and Salted Caramel. “They’re looking for great, unique fusion flavors. They’re looking for free-from labeling and again, all of this without losing any type of functionality and/or without compromising any of the flavor as well,” Hanni notes. Retailers need to be aware that consumers are looking to recreate that gourmet experience in their kitchen, he says, and they want products that will make it easy to do so.
“Consumers want to be outside the norm,” he says. “One of the biggest pushes we’re seeing that retailers really need to pay attention to is that [consumers] don’t want a standard pancake. They want to try and make some these different baking items a fun, flavorful experience.”
Enjoy Life has taken a different approach to meet consumers’ growing demand for unique flavors. The company deliberately keeps its mixes’ flavor profile neutral and uses digital marketing to show customers how they can customize the end product to any flavor profile they want. For example, the company’s website offers a simple recipe to make a Cherry Coffee Cake Bread that uses Enjoy Life Foods Pizza Crust Baking Mix and consumers simply have to add sugar, vanilla, cherry preserves, flour and oil to create a completely unique and flavorful product.
Importance of Flour
Simple Mills also is looking for its ingredients to maximize nutrient density. “A lot of allergen-free products, especially in the baking world, are made with white rice or potato starch base devoid of all nutrients,” Lorge says. The company uses almond flour because it imparts all of the nutritional benefits of almonds, which have more nutrients than other tree nuts and are a good source of fiber, high in protein and naturally cholesterol free.
Enjoy Life Foods shies away from the nut flours that many manufacturers may turn to formulate gluten-free or other gluten-free products because nuts are one of the top eight allergens (milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans) and has instead found teff flour to be an on-trend ingredient that works well in its baking mixes. Probiotics is another on-trend ingredient the company has incorporated to make the mixes as attractive as possible to all consumers.
“We took trends that you hear about maybe outside of baking mixes and put them into our mixes to create an all-encompassing product for multiple consumers, not just those with food allergies,” notes Moss.
Beyond Gluten
Simple Mills products are naturally gluten-free, which helps with the clean label aspect that consumers are looking for, due to the ingredients it chooses to use, but its products are also grain-free, soy-free, dairy-free and corn-free. “We know that a lot of our consumers have issues with these elements,” Lorge says. “Not everybody has issues with all of them, but we just generally try to avoid them because we are seeing increases across the board with these ingredients.”
She notes that grain-free in general is a growing trend, some of which could be due to the increasing interest in the Paleo diet. For example, Simple Mills avoids using rice flour because rice is technically a grain and people can have sensitivity to rice. Sales of grain-free foods grew 242 percent in the past year to account for $44 million in sales, she says, adding “While it still pales in comparison to gluten-free, it is definitely a growing trend we are seeing.”
What’s next in the free-from baking mix category? Hanni notes that plant-based diets continue to be on the rise, which will continue to push dairy out of diets as well as more consumers looking to avoid soy. Also, sales of free-from products will continue to grow as the price of the items continues to go down as manufacturers figure out how to make them more cost-efficiently.
Moss also thinks dairy may be the next big food item that consumers will look to eliminate as well as more consumers who do not suffer from food allergies seeking out the free-from products as a way to find the clean labels they want in order to eat more healthfully.
“In general, consumers are becoming a lot more aware,” Moss notes. “It’s an opportunity for retailers to really offer an alternative to consumers that are wanting to explore a newer, cleaner product.”
New Products
Sweet Potato Pancake & Waffle Mix
Birch Benders’ Sweet Potato Pancake & Waffle Mix features the exclusive seasonal flavor of sweet potatoes. Real sweet potatoes are blended with vanilla, brown sugar and buttermilk to bring flavor to a traditional holiday favorite while only requiring consumers to add water. The mix is made with all natural, non-GMO ingredients, contains no trans fat and is cholesterol-free. SRP: 4.99 Birch Bender, Denver, 303-658-9271 ext. 104, www.birchbenders.com
Cinnamon Sugar Muffin Mix
Among Friends Baking Mixes introduces Francie’s Make It Your Own Cinnamon Sugar Muffin Mix made with Vietnamese cinnamon spice � a perfect snack or breakfast to go. The new muffin mix is gluten-free and made with high-quality whole grain flours that offer superior flavor, texture and nutrition. All of the brand’s mixes are free of high glycemic fillers and gums like tapioca starch and xanthan gum. Other products available include Cora’s Honey Cornbread, Papa Tom’s Perfect Pancake and Alec’s Awesomely Fudgy Brownie mix. Among Friends LLC, Ann Arbor, Mich., 202-276-1909, www.amongfriendsbakingmixes.com
Peripheral neuropathy is a condition which occurs due to nerve damage in the arms, legs, hands and feet. Common symptoms include pain, tingling and burning sensations and numbness.
This type of neuropathy can be caused by a variety of factors, such as diabetes, chemotherapy, statin medications, disc herniation and trauma from an injury, toxic metal exposure, chronic alcohol consumption and vitamin deficiencies. Recent research studies, however, have associated peripheral nerve damage to gluten sensitivity and celiac disease.
Celiac disease is an autoimmune disorder that generally affects the individual’s digestive tract. When a person with celiac disease consumes gluten, it can cause damage to the small intestine, interfering with the body’s natural nutrient absorption function. In a majority of cases, this inability to properly absorb nutrients can alter growth, weaken bones and even damage peripheral nerves, leading to neuropathy.
According to the Celiac Foundation, in the United States alone, 2.5 million Americans are undiagnosed and at an increased risk of experiencing serious health complications. Celiac disease affects approximately 1 out of every 100 people throughout the world. If the disorder is left untreated for an extended period of time, the affected individual can develop issues like type 1 diabetes, multiple sclerosis, dermatitis herpetiformis, anemia, osteoporosis, infertility, miscarriage, neurological conditions such as epilepsy, migraines, short stature, intestinal cancers, and now nerve damage. A new research study published in the Journal of the American Medical Association Neurology has found that celiac disease patients are at an increased risk of suffering nerve damage.
�It�s quite a high figure, compared to many other outcomes in celiac disease,� the study�s co-author Dr. Jonas Ludvigsson, a pediatrician and professor at Karolinska Institutet in Sweden, said in a statement. �There is a real association between celiac disease and neuropathy. And we have precise risk estimates in a way we haven�t had before,� concluded Dr. Ludvigsson.
Swedish researchers also studied medical records between 1969 and 2008 from over 28,000 patients with celiac disease and compared them with the results of 139,000 people who were never diagnosed with the autoimmune disorder. Those individuals with celiac disease were found to be 2.5 times more likely to develop some form of neuropathy. In addition, gluten sensitivity in people without the disorder can also cause them to experience symptoms, such as tingling sensations and numbness.
In another research study, researchers screened 215 patients with peripheral neuropathy. A total of 140 of these patients were diagnosed with idiopathic neuropathy, meaning there was no medical reason behind their peripheral neuropathy. Also, the researchers tested those 140 people for antibodies to gluten utilizing two celiac disease blood tests: the AGA-IgA and the AGA-IgG test. While these tests are believed to not be very specific to celiac disease, they can detect whether the body perceives gluten as an invader and if it is generating antibodies to defend itself against the protein found in�wheat, rye, spelt, kamut and barley. About 34 percent of those tested, exactly 47 people had high antibodies to gluten in one or both of those tests, compared with a 12 percent rate�of high antibodies to gluten in the overall population.
The researchers also performed endoscopies and biopsies on those people in the research study who were suspected to have celiac disease and established that 9 percent of those in the unexplained neuropathy group actually had celiac disease. The celiac disease genes, HLA-DQ2 and HLA-DQ8, were discovered in 80 percent of all patients with peripheral neuropathy.
Peripheral Neuropathy: Key Symptom of Celiac, Gluten Sensitivity
According to research studies conducted by the University of Chicago Celiac Disease Center, peripheral neuropathy is one of the most prevalent non-digestive symptoms of celiac disease and gluten sensitivities. As a matter of fact, patients with celiac disease may often experience no noticeable gastrointestinal symptoms but they may display peripheral neuropathy and other neurological symptoms.
Researchers evaluated the medical records of over 28,000 patients with celiac disease, following up with all the study participants after 10 years to check if they had developed nerve damage. They concluded that those with celiac disease had an increased risk of developing nerve damage over a period of time as compared to the control population.
Gluten Sensitivity Causes Nerve Damage
Peripheral neuropathy and other neurological symptoms, such as brain fog and migraines, can more frequently manifest in people with non-celiac gluten sensitivity, stated Harvard Medical School’s Dr. Alessio Fasano, one of the lead researchers in the field of gluten sensitivity. Dr. Fasano explained that up to 30 percent of individuals diagnosed with gluten sensitivity experienced neurological symptoms, a much larger percentage than people with neurological symptoms due to celiac disease experienced.
According to Dr. Fasano, gluten sensitivity has the potential to develop in far more people than celiac disease. He estimates that approximately 6 to 7 percent of the United States population may have a gluten sensitivity, meaning that about 20 million Americans could be sensitive to gluten. Symptoms of gluten sensitivity can include: digestive issues; headaches; rashes; eczema-like skin symptoms; brain fog; fatigue; and peripheral neuropathy. “Almost one-third of those I’ve diagnosed as gluten sensitive report brain fog and headaches as symptoms,’ stated Dr. Alessio Fasano.
Dr. Ford, a pediatrician in Christchurch, New Zealand and author of The Gluten Syndrome, stated that he believes the percentage of people who are gluten-sensitive could potentially be between 30 and 50 percent.
“There are so many people who are sick,” he says. “At least 10 percent are gluten-sensitive and it’s probably more like 30 percent. I was sticking my neck out years ago when I said at least 10 percent of the population is gluten-sensitive. My medical colleagues were saying that gluten sensitivity didn’t exist. We’ll probably find that it’s more than 50 percent when we finally settle on a number.”
Dr. Fine, a gastroenterologist who founded and directs the gluten sensitivity testing service Enterolab, agrees that gluten sensitivity could possibly affect approximately half of the population.
An increased percentage or people in the United States have additionally been diagnosed with other types of autoimmune disorders, irritable bowel syndrome, chronic headaches and/or microscopic colitis, placing these Americans at a higher risk of developing gluten sensitivity. Approximately 60 to 65 percent of people with those conditions test positive for gluten sensitivity. Meanwhile, approximately 20 to 25 percent of people with no symptoms are diagnosed with gluten sensitivity.
�When we did the math, we came up with the number that about one in two individuals are gluten-sensitive,� Dr. Fine stated.
Peripheral Neuropathy Can Resolve with Gluten Sensitivity
Another research study published in 2010 on the journal of Neurology demonstrated that a gluten-free diet could stabilize neuropathy and its symptoms in many of the patients diagnosed with peripheral neuropathy, among others in the study.
More so recently over the past years, gluten has been demonstrated to develop an autoimmune antibody response to nerve cells, the myelin sheat, or protective coating around the nerves, as well as in receptor sites on cells which connect neurotransmitters, the chemicals which allow the nerves to transmit important information and communicate. It has also been discovered that gluten can contribute to the breakdown of the blood brain barrier. This allows chemical toxins to leak into the blood supply of the brain itself.
Furthermore, gluten sensitivity has been determined to also damage the gut, interrupting the proper absorption of vitamins and minerals, such as vitamins B1 and B12. Gluten sensitivity has also been associated with the following neurologic conditions:
In conclusion, if you’ve been diagnosed with celiac disease or gluten sensitivity or if you haven’t been diagnosed with these complications but you suspect you may have them, following a gluten-free diet can be fundamental towards the overall health and wellness of your nerves and gastrointestinal tract. If you are unsure, feel free to follow the “Gluten Free for 3” challenge. Go completely gluten free for just 3 days and keep a journal log of how you feel and sleep during those 3 days. If you feel better, chances are, you are gluten sensitive.�
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
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There are 3 known types of negative reactions to wheat proteins, collectively known as wheat protein reactivity: wheat allergy (WA), gluten sensitivity (GS),�and celiac disease (CD). Of the 3, only CD is known to involve autoimmune reactivity, generation of antibodies, and intestinal mucosal damage. Wheat allergy involves the release of histamine by way of immunoglobulin (Ig) E cross-linking with gluten peptides and presents within hours after ingestion of wheat proteins. Gluten sensitivity is considered to be a diagnosis of exclusion; sufferers improve symptomatically with a gluten-free diet (GFD) but do not express antibodies or IgE reactivity.1
A 28-year-old man presented to a chiropractic teaching clinic with complaints of constant muscle fasciculations of 2 years� duration. The muscle fasciculations originally started in the left eye and remained there for about 6 months. The patient then noticed that the fasciculations began to move to other areas of his body. They first moved into the right eye, followed by the lips,�and then to the calves, quadriceps, and gluteus muscles. The twitching would sometimes occur in a single muscle or may involve all of the above muscles simultaneously. Along with the twitches, he reports a constant �buzzing� or �crawling� feeling in his legs. There was no point during the day or night when the twitches ceased.
Discussion
The authors could not find any published case studies related to a presentation such as the one�described here. We believe this is a unique presentation of wheat protein reactivity and thereby represents a contribution to the body of knowledge in this field.
This report describes improvement in chronic, widespread muscle fasciculations and various other systemic symptoms with dietary change. There is strong suspicion that this case represents one of
