August 25, 2014
People with celiac disease can now have confidence in the meaning of a “gluten-free” label on foods.
The Food and Drug Administration (FDA) has issued a final rule that defines what characteristics a food has to have to bear a label that proclaims it “gluten- free.” The rule also holds foods labeled “without gluten,” “free of gluten,” and “no gluten” to the same standard.
This rule has been eagerly awaited by advocates for people with celiac disease, who face potentially life-threatening illnesses if they eat the gluten found in breads, cakes, cereals, pastas and many other foods.
As one of the criteria for using the claim “gluten-free,” FDA is setting a gluten limit of less than 20 ppm (parts per million) in foods that carry this label. This is the lowest level that can be consistently detected in foods using valid scientific analytical tools. Also, most people with celiac disease can tolerate foods with very small amounts of gluten. This level is consistent with those set by other countries and international bodies that set food safety standards.
“This standard ‘gluten-free’ definition will eliminate uncertainty about how food producers label their products and will assure people with celiac disease that foods labeled ‘gluten-free’ meet a clear standard established and enforced by FDA,” says Michael R. Taylor, J.D., deputy FDA commissioner for foods and veterinary medicine.
Andrea Levario, executive director of the American Celiac Disease Alliance, notes that there is no cure for celiac disease and the only way to manage the disease is dietary—not eating gluten. Without a legal definition of “gluten-free,” these consumers could never really be sure if their body would tolerate a food with that label, she adds.
“This is a tool that has been desperately needed,” Levario says. “It keeps food safe for this population, gives them the tools they need to manage their health, and obviously has long-term benefits for them.”
“Without proper food labeling regulation, celiac patients cannot know what the words ‘gluten free’ mean when they see them on a food label,” says Allessio Fasano, M.D., director of the Center for Celiac Research at MassGeneral Hospital for Children, visiting professor of pediatrics at Harvard Medical School and member of the American Celiac Disease Alliance.
Gluten means the proteins that occur naturally in wheat, rye, barley, and crossbreeds of these grains.
As many as 3 million people in the United States have celiac disease. It occurs when the body’s natural defense system reacts to gluten by attacking the lining of the small intestine. Without a healthy intestinal lining, the body cannot absorb the nutrients it needs. Delayed growth and nutrient deficiencies can result and may lead to conditions such as anemia (a lower than normal number of red blood cells) and osteoporosis, a disease in which bones become fragile and more likely to break. Other serious health problems may include diabetes, autoimmune thyroid disease and intestinal cancers.
Before the rule there were no federal standards or definitions for the food industry to use in labeling products “gluten-free.” An estimated 5 percent of foods currently labeled “gluten-free” contain 20 ppm or more of gluten.
In addition to limiting the unavoidable presence of gluten to less than 20 ppm, FDA will allow manufacturers to label a food “gluten-free” if the food does not contain any of the following:
- an ingredient that is any type of wheat, rye, barley, or crossbreeds of these grains
- an ingredient derived from these grains and that has not been processed to remove gluten
- an ingredient derived from these grains and that has been processed to remove gluten, if it results in the food containing 20 or more parts per million (ppm) gluten
Foods such as bottled spring water, fruits and vegetables, and eggs can also be labeled “gluten-free” if they inherently don’t have any gluten.
The regulation will be published Aug. 5, 2013 in the Federal Register, and manufacturers have one year from the publication date to bring their labels into compliance. Taylor says he believes many foods labeled “gluten free” may be able to meet the new federal definition already. However, he adds, “We encourage the food industry to come into compliance with the rule as soon as possible.”
Under the new rule, a food label that bears the claim “gluten-free,” as well as the claims “free of gluten,” “without gluten,” and “no gluten,” but fails to meet the requirements of the rule would be considered misbranded and subject to regulatory action by FDA.
Those who need to know with certainty that a food is gluten-free are heralding the arrival of this definition. “This is a huge victory for people with celiac disease,” says Levario. “In fact, that’s the understatement of the year.”
Says Taylor, “FDA’s ‘gluten-free’ definition will help people make food choices with confidence.”
August 20, 2014
Looking after your emotional health is just as important as caring for your physical health.
If your emotional health isn’t as solid as you’d like it to be, here’s the good news: just as you can improve your physical fitness by working at it, you can improve your emotional fitness, too. There are many things you can do to boost your mood, build resilience, and get more enjoyment out of life.
For example, the emotion of anger is neither good nor bad. It’s perfectly healthy and normal to feel angry when you’ve been mistreated or wronged. The feeling isn’t the problem—it’s what you do with it that makes a difference. Anger becomes a problem when it harms you or others.
There are several different types of drugs available to treat mental illnesses. Some of the most commonly used are antidepressants, anti-anxiety, anti-psychotic, mood stabilizing, and stimulant medications. These drugs carry a risk of addiction, so they are not as desirable for long-term use. Other possible side effects include drowsiness, poor concentration, and irritability.
August 14, 2014
Anyone who’s ever taken care of an infant knows that babies spit up. And spit up. And then spit up again.
It’s easy to understand why some parents and other caretakers are concerned. Is the infant getting enough nourishment? Is frequent spitting up a sign of a more serious illness? Does the baby need medicine to treat the problem?
According to Andrew E. Mulberg, M.D, a pediatrician and pediatric gastroenterologist at the Food and Drug Administration (FDA), frequent spitting up is absolutely normal in most cases and not a symptom of poor health. As long as the child is alert, reasonably content, gaining weight, and not showing other signs of illness, this is not usually a cause for concern, he says.
So what is causing the baby’s food to come back up so frequently?
In infants, the ring of muscle between the esophagus and the stomach—the lower esophageal sphincter (LES)—is not fully mature, allowing stomach contents to flow backward, Mulberg explains. In time, the LES will mature and open only when the baby swallows and will remain tightly closed the rest of the time, keeping stomach contents where they belong.
“By the time the child is 18 months of age or younger, the problem—known as gastroesophageal reflux (GER)—usually resolves itself,” Mulberg says.
In a small number of cases, a more serious condition known as GERD (gastroesophageal reflux disease) may exist. GERD also can cause excessive spitting up, but requires treatment to avoid additional health complications, such as tissue damage in the lining of the esophagus. A health care professional should be consulted immediately if a baby shows such symptoms as spitting up blood, blood in the stool, weight loss, failure to thrive including lack of weight gain and persistent coughing or wheezing, Mulberg says.
Ways to Cope With Normal Spitting Up
Once a more serious disease is ruled out by the health care professional, there are a number of things parents and other caretakers can do to help prevent babies from constantly spitting up. These include:
- Holding the baby in an upright position when feeding.
- Feeding the baby smaller portions at a time.
- Making a switch to a different formula.
“It’s understandable why new parents, especially, are worried when their child seems to be spitting up nonstop,” Mulberg says. “Generally, the parents are pretty sleep deprived, too—which doesn’t help the situation.”