It's been eight years since I have had Arrowroot, buckwheat, corn/maize, potato flour, rice, rice bran, rice flour, sago, tapioca, soy, soy bran, or soy flour.

All are gluten free!  Yet, all are prohibited on the diet I have been following for celiac disease management, since December 2000, the Specific Carbohydrate Diet.

Why? Because they may be gluten- free but they contain starch.

Digestion of starch is effected by hydrolyzing enzymes in a complex process which depends on many factors; these include the botanical origin of starch, whether the starch is amorphous or crystalline, the source of enzymes, substrate and enzyme concentration, temperature and time, as well as the presence of other substances in the multicomponent matrix in which starch occurs naturally.

In 1951, Dr. Sydney Valentine Haas, and his son, Dr Merrill P Haas, published The Management of Celiac Disease. It remains one if the most comprehensive medical texts ever written on celiac disease

Less than a year following  launch of the book, a lone report was published in the English medical journal Lancet.  After testing only ten children, a group consisting of six faculty members of the Departments of Pharmacology, Pediatrics and Child Health at the University of Birmingham, concluded it was not the starch (carbohydrate) in the grains that so many had reported as being deleterious, but the protein gluten in wheat and rye flour that was causing celiac symptoms.

Based on this limited study, they contradicted all previous work by stating that there was no need to restrict carbohydrates. This opened the floodgates to a vast choice of food as long as wheat and rye gluten were absent.  They further advised that, "a high caloric diet may be given throughout with biscuits made from corn-flour, soy flour, or wheat starch instead of wheat flour."

Although, many patients showed remarkable clinical improvement  after following a "gluten-free" diet,  microscopic biopsy samples unearthed intestinal cells that were still definitely abnormal. There were some patients who started eating gluten with no ill effects at one time but became extremely ill at other times.

Further observation revealed how Celiac patients  could be inconsistent in their response to a gluten-free diet; the same patient could vary from time to time. Following a relapse, the patient was most often suspected of having inadvertently consumed gluten. Indeed, many patients were unclear about what constitutes "gluten" and  assumed that anything  that begins with "glut" must be gluten. (glutamic acid, glutamine, monosodium glutamate, etc.) or that gluten had been hidden in the food in spite of the fact that it did not appear on the label  (2% of ingredients do not have to be included on labels under Federal law).

It was seen that grains which contained proteins other than gluten were having deleterious effects on the digestive tract. Selected patients suffered relapses and microscopic surveillance exhibited damaged intestinal cells following ingestion of soy products. Oats and barley were seen to contain gluten-like proteins which aggravated symptoms in many celiac sufferers. Rice and other grains were indicated in additional reports as being harmful to intestinal cells.

Anecdotal documentation among 3,000 parents subscribed to Pecanbread, the support list for the autism community using the Specific Carbohydrate Diet, indicate about 80% of list members transitioned from the gluten-free casein-free diet to the Specific Carbohydrate Diet. Many have done better as a result of the change.

There are other restrictions on the Specific Carbohydrate Diet that differ from what is permitted on the gluten-free casein-free diet. In addition to the products I listed at the start.  In looking down all the lists of what the latter permits, I found many items I never even used on the Standard American Diet prior to requiring any restrictions .

Although I never have tried the gluten-free casein-free diet, I found the Specific Carbohydrate Diet very workable because so few additives are allowed in permitted foods.

It took me some time to realize the differences between starch and gluten. Both are considered harmful by Specific Carbohydrate Diet advocates ------ which is why my nutritional laundry list specifies:

"Hold the starch please."

As always, welcomes your comments (see below).