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The people of Kota Kinabalu love to eat. We are very enthusiastic when it comes to food because ultimately, all of us are foodies at heart.

With the increasing number of restaurants popping up every now and then, it exposes us to a variety of different foods from numerous regions all around the world. The cuisine that can be found in this city ranges from Mexican dishes to even Hungarian dishes. And thus, due to this occurrence, our diet has slowly been changed.

While we still eat local and traditional food, there are many choices available that lead us to modify the food we consume. This brings us to the topic of GLUTEN.

Carla Modugno, who is an Italian native, has been working in Sabah for the past 8 years. Before arriving in Malaysia, she frequently suffered from fatigue, diarrhoea and nausea. She had been feeling sick and weak so often since she was a child.

“For as long as I can remember, I was always ill. When I was about 20, I had to spend a month in the hospital because my body crashed. My immune system was weak and the main problem was that my body couldn’t absorb iron. Doctors did a lot of examinations on me, looking for a reason why.” said Carla.

“I kept trying different medications but none of them seemed to be helping with my iron absorption. At one point, a doctor almost guessed the reason behind it as he suggested me to avoid as much as I could to eat pizza, pasta and bread while taking my iron supplement.”

The overwhelming sickness Carla was experiencing immensely took a toll on her health. There was a time when she was working in Australia, her body grew skinnier even though she was eating very excessively. Her friends were alarmed to see a drastic change in her physically.

“Everyone knew it would be impossible for me to weigh that little with my eating habits” said Carla.

She continued, “When I came to Sabah, miraculously I was feeling slightly better than I did in Australia, then I thought to myself, this is the place for me to live. But unfortunately, it did not last. After some time my health started to deteriorate again. I was fighting to be stronger and healthier until my body couldn’t stand it anymore.”

Carla then went back to Italy for her annual health screening and had an appointment with a personal doctor where she described her symptoms as diarrhoea, weakness, depression and brain fog or confusion. Her doctor informed her that she may have an illness related to gluten. In addition to the routine blood tests, she also did a specific blood test for gliadin antibodies called tTg-IgA tests. Carla explained that if someone is tested positive for this test, your physician will recommend a biopsy of your small intestine to confirm the diagnosis of a disease called CELIAC.

“There are three types in which you can be affected by gluten – allergy, intolerance and disease. Upon hearing the outcome of my tests, I was apathetic at first because they mentioned a disease I have not heard of before. My doctor told me that I have celiac disease.” said Carla.

Celiac disease is a genetic disorder that affects approximately 1% of the population, with up to 10% of the population experiencing some gluten sensitivity. A study has even showed that about 95% people in the USA have not been diagnosed with the disease. It mostly affects people of European descent, but recent studies show that it also affects Hispanic, Black and Asian population as well. This disease makes people highly sensitive towards gluten; food that contains wheat, rye and barley has gluten, therefore celiacs must avoid eating them as there is no cure yet.

The many common symptoms of Celiac disease found in children are abdominal bloating and pain, chronic diarrhoea, vomiting, constipation, weight loss, pale/foul-smelling/fatty stool, weight loss, fatigue, irritability and behavioural issues, dental enamel defects of the permanent teeth, delayed growth and puberty, short stature, failure to thrive and also having ADHD (Attention Deficit Hyperactivity Disorder).

As for adults, the common symptoms are bone or joint pain, arthritis, osteoporosis, depression or anxiety, seizures or migraines, unexplained iron-deficiency anaemia, fatigue, missed menstrual periods, infertility or recurrent miscarriage, tingling numbness in the hands and feet, canker sores inside the mouth, and an itchy skin rash called dermatitis herpetiformis.

“Being Italian, I cannot eat the type of food that I have been eating and cooking my whole life because of the celiac disease. After studying more about this, it finally made sense why in my younger years I was having a hard time focusing. The times where I was abnormally sick unlike my peers, I understood the reason behind it now; I have been eating food that contained gluten for a long time”.

According to Carla, gluten is a big factor in causing sickness such as dementia, cancer and Parkinson’s disease. Research suggests it could be related to the autism syndrome. A local Sabahan teacher is aware that gluten free diets may help autistic children, as Carla says. She had requested Carla’s help to promote awareness of gluten free diets to the families with children that has autism syndrome as it can improve the performances of the children.

“Gluten affects the brain. That’s why the gluten free diet is proven to be an autistic treatment.” says Carla.

Following the gluten free diet has given Carla all nutrition that a body needs, and it started to make her feel better. Much of the local food we have here is mostly gluten free, with the exception of soya sauce, oyster sauce, flavourings and chicken/fish stock. Food that contains additives or preservatives are not gluten free. Rice, corn, tapioca, buckwheat, brown rice flour, rice noodles, potatoes, all vegetables, all fruits, fish and meat are examples of gluten free foods.

However, Carla’s life with celiac in Sabah wasn’t one without hardships.

“There is not much awareness towards celiac disease here in Malaysia yet. I faced difficulties in adjusting myself here with my health condition. There is a stigma of speaking about a sickness; it’s hard to make people understand that I simply cannot eat food with gluten and food that is contaminated with gluten. Even in the tiniest amount, I cannot eat food that has been in contact with gluten in any way.” says Carla.

“You cannot see my disease, but it doesn’t mean that I won’t get sick. When eating at a restaurant here, I have tried to explain why my food has to be prepared in a certain way. I have asked the restaurants to wash their utensils thoroughly and also to not include certain ingredients. But they think I’m just fussy, when I’m really not. If the food had gluten by mistake, it will cost me my health, and I will fall get very sick.”

“Asians have changed their diet. Eight years ago, there were not as many bakeries as you see now. Unfortunately, the blood test to check whether gluten affects you is currently unavailable in Malaysia. We cannot ignore this situation as the rest of the world has taken many actions to aid people like me.”

The gluten free diet, as Carla states, is not at all hard to accomplish. Even though she still struggles with some health issues, her health improved because of the diet. You can still eat the food you normally eat while being in this diet, the only important thing is to know how to cook gluten-free.

Carla concluded with, “In Italy and many other Western countries, there are restaurants certified as gluten free. Many gluten-free products have been made, products that you can find in Kota Kinabalu now. In Italy, we can still enjoy eating good pizza, pasta and bread which are gluten free. I attended a cooking course to become certified in specialized gluten free cooking. Now she has been using all of her grandmother’s teaching in a gluten free diet.”

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