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Yes, You Can Eat!
When Gluten Isn’t the Only Ingredient to Avoid
with Melinda Dennis, MS, RD, LDN
Beth Israel Deaconess Medical Center
Brought to you by Lucy’s
www.CeliacCentral.org Restoring Health … Reclaiming Lives. National Foundation for Celiac Awareness 2012. All rights reserved.
www.CeliacCentral.org Restoring Health … Reclaiming Lives.
National Foundation for Celiac Awareness 2012. All rights reserved.
www.CeliacCentral.org Restoring Health … Reclaiming Lives.
National Foundation for Celiac Awareness 2012. All rights reserved.
① A recording of each webinar will be posted along with the webinar slides within 72 hours
after the live Webinar ends. To download recorded webinars and slides, visit the Archived
Webinars page: CeliacCentral.org/webinars/archive/
① Continuing Education Credit:
• Registered Dietitians (RD) and Dietetic Technicians, Registered (DTR) are able to
participate in this live 60-minute webinar to obtain continuing education credits
regardless of this program's approval status as long as the webinar is professional in
nature. NFCA will provide a certificate as proof of participation for each webinar.
Attendees must complete the program evaluation/follow-up survey in order
to access this certificate. Program participants will receive a link to
complete the program evaluation/follow-up survey 24 hours after the close
of the webinar through an email from GoToWebinar.
• Please note that RDs and DTRs are not permitted to claim credits by viewing archived
webinars. Only those who register and attend live webinars will receive the opportunity
to obtain continuing education credits.
Three Important Reminders!
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③ In early July, NFCA community members can look for a review of the presentation in the form of
a printable guide featuring major highlights from this educational session. Please check back at
CeliacCentral.org
Three Important Reminders!
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A total of 3 webinar participants will each win a special prize pack from Lucy’s!
• Each prize pack includes a 5.5 oz. box of Lucy's newest flavors of gluten-free, vegan cookies
(made without milk, eggs, peanuts, or tree nuts!)
Ginger Snap: These snaps are made with real ginger, lemon and a tiny tad of chipotle spice.
Kids love them as much as grown-ups do.
Maple Bliss: These are crispy, crunchy, delicate, Maple Bliss. You'll think organic maple syrup
dripped right from the tree into our batter. Not too sweet. Just right!
Chocolate: These chocolate cookies have a delicate, crisp flavor. Eat them, crumble them
over frozen treats, make a pie crust with them. Have you had your chocolate today?
Also up for grabs!
Three more participants will win a copy of Melinda and Dr. Daniel A. Leffler's book:
Real Life with Celiac Disease: Troubleshooting and Thriving Gluten Free,
which was published by the AGA Press in May 2010.
Watch & Win!!
Welcome!
• Diagnosed with celiac more than 20 years ago
• Nutrition Coordinator and Research Investigator at
Celiac Center at BIDMC of Beth Israel Deaconess
Medical Center, Boston
• Former Task Group Member: Academy of Nutrition
and Dietetics’s Evidence Analysis Library for
Celiac Disease
•Coauthor: Real Life with Celiac Disease
www.RealLifewithCeliacDisease.com
•Founder and owner of www.DeleteTheWheat.com
•Founder of Healthy Villi Celiac Support Group, New
England’s largest support group
Melinda Dennis, MS, RD, LDN
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•Differentiate between celiac disease, food allergies and food intolerances
•Review FDA and USDA food labeling laws
•Review key nutrients and recommended labs
•Discuss healthy alternative foods when gluten and other food groups are
removed
•Recognize conditions such as Fructose Malabsorption and Small
Intestinal Bacterial Overgrowth
•Gather tips and resources for dining out allergen-free
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On Today’s Plate…
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•A chronic small intestinal immune-mediated
enteropathy triggered by exposure to
dietary gluten in genetically predisposed
individuals.
•1% of the population
•3 million Americans
•Lifelong avoidance of gluten
•Genetic
What is Celiac Disease? (CD)
Ludvigsson, et al. 2012
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•Adverse reaction(s) involving IgE antibodies to one or more
proteins found in the suspect food
•3-4% of adult population
•8% of the pediatric population
•Strict avoidance of the offending food(s)
•Runs in families
What is a Food Allergy?
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•Symptoms related to exposure to a particular food without an immune response (enzyme deficiency, food effect)
•Unknown % of people with food intolerances
•Non-celiac gluten sensitivity
• 16 million Americans
• Suggested: 1 in every 4 people
What is a Food Intolerance?
New Kid
on the block
Ludvigsson, et al. 2012
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•History of food intake
•Allergy skin tests and/or allergy blood
testing
•Removal of the allergen
•An oral challenge under direct supervision
of an allergist may be necessary.
Diagnosis of a Food Allergy
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•Rule out allergy.
•Do controlled food elimination trials or blood testing.
Diagnosis of a Food Intolerance
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Why do late-onset food allergies and intolerances develop after
going gluten-free?
• Pre-existing problems
• Injured gut lining
• Injury to immune system
Developing Allergies/Intolerances
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<1 mg of gluten (1/50th of a slice of bread) can cause significant,
sustained mucosal inflammation
Damage & Healing of Villi in Celiac Disease on
Strict Gluten-Free Diet
How do we educate our patients on how
to avoid gluten and other allergens?
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Food Allergen Labeling Consumer Protection Act, 2004:http://www.fda.gov/Food/LabelingNutrition/FoodAllergensLabeling
GuidanceComplianceRegulatoryInformation/ucm106187.htm.
U.S. Food Allergen Labeling Consumer Protection Act
2004
Applies to FDA Regulated Foods • If a food or an ingredient in a food is or contains protein from 1 of the 8 major
allergens, it must be listed:
•Contains: Wheat, Soy, Egg, Peanut, Tree nuts, Milk, Fish, Shellfish
•OR in the ingredient list: Modified food starch (wheat)
• Includes packaged foods, prepackaged foods for retail sale, dietary supplements,
infant formula, and medical foods
Proposed FDA Ruling:
<20ppm = gluten-free
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U.S. FDA Food Labeling
• The FDA does not mandate allergen labeling for oat, rye, barley,
malt, and brewer’s yeast.
• “Under the proposed FDA rule, labeling foods with the term
‘gluten-free’ continues to be voluntary.”
• Allergen advisory statements related to food processing are
voluntary and unregulated.
• i.e.: “processed in a facility that also processes wheat”
Applies to ingredients, NOT cross-contamination!
Recommendations Summary. Evidence Analysis Library. American Dietetic Association. http://www.adaevidencelibrary.com/template.cfm?template=guide_summary&key=2376. Accessed October 21, 2010.
United States Department of Agriculture (USDA)
Regulated Foods
• Allergen labeling of USDA-regulated foods (processed meat, poultry, eggs and mixed food products) is voluntary.
• USDA declares that all ingredients be listed in the ingredient list by their common or usual name which does not always indicate ingredient source.
• USDA will likely follow FDA labeling once final definition of “gluten free” is released.
Modified food
starch
Dextrin Maltodextrin
Caramel Glucose Starch
Durum flour Enriched
flour
Farina
Graham flour Plain flour Self-rising
flour
Bulgur Spelt Semolina
White flour Brewer’s
yeast (from
barley)
Triticale
Thompson. Food Labeling in the US and Canada. In Real Life with Celiac Disease. Dennis, Leffler, Eds. AGA Press, Bethesda, MD, 2010. :Labeling of USDA-
Regulated Foods. Available at http://www.glutenfreedietitian.com/articles/BLOGUSDALabelingBlog.30.pdf. Accessed October 21, 2010.
Common Names: AVOID
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Checklist for Gluten Exposure and Cross-Contamination
Understand food labeling laws in their
country
Kitchen free of cross-contamination
Medications & Supplements Educated family, roommate, guests, friends,
schools, camps, nursing homes
Pets and Pet Food
Partner/Spouse/Kids: cross-contamination
Religious Practices/Holidays:
•Communion wafer/matzo
Bulk bins
Contaminated Grains:
• In the Field
• Transport
• Milling/Processing
• Repackaged Grains, Flours
Dining Out:
• Safe/Unsafe Ingredient Cards
• Detailed Questions
• Assertiveness
• Location Selection
Body Care Products: Nose & Mouth Salad bars
Newly introduced foods Bakeries, Pizza Parlors
Gum, mints, candy
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Malt
Marinades
Matzo
Medications
Oats*
Panko
Pasta
Play-Doh
Processed
Luncheon meats
Croutons
Dressing
Flour or cereal products
Gravies
Imitation bacon
Imitation seafood
Beer/Ale/Lager
Breading
Broth/Bouillon
Candy
Coating/Drink
mixes
Communion wafers
Contaminated
Grains
Sauces
Seasonings
Self-basting poultry
Soup bases
Stuffing
Supplements
Thickeners (Roux)
Croutons
Dressing
Flour or cereal products
Gravies
Imitation bacon
Imitation seafood
Murray, Am J Clin Nutr, 1999;
Jamatiomem, et al N Engl J Med, 1995;
Miletic et al, J Pediatr Gastroenterol Nutr, 1994
Frequently Overlooked Sources of Gluten
“Wheat-free” does not necessarily mean “gluten-free.
• Medication ingredient lists are divided into:
• Active= Safe, no gluten
• Inactive= May contain gluten
• Medications are NOT required to declare
◦ “wheat” or other allergens.
• Supplement ingredient lists are divided into:
• Supplement facts
• Ingredients
• The starch source in medicine, vitamin/mineral and
herbal supplements can be made from any number
of starches, including WHEAT.
• Supplements are required to declare “wheat”
other allergens if an ingredient.
• Supplements are NOT required to list barley, etc.
Crowe JP, Falini NP. Gluten in pharmaceutical products. Am J Health Syst Pharm. 2001;58:396-401.
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Gluten in Medications & Supplements
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Drug/Supplement Ingredient *This list is not comprehensive
Possible Botanical Source
• Unspecified starch, modified starch
• Pregelatinized starch
• Dusting powder, Flour, Gluten
• Dextrin, cyclodextrin
• Dextrates
• Maltodextrin
• May be derived from wheat starch, etc.
• Dextri-maltose
• Caramel coloring
•Barley malt may be used in manufacturing
• Sodium starch glycolate
•Usually from potato starch; may be
derived from other starches.
Adapted from Kupper C. Dietary guidelines and implementation for celiac disease. Gastroenterology 2005;128:S121-S127.
Crowe JP, Falini NP. Gluten in pharmaceutical products. Am J Health-Syst Pharm; 2001;58:396-401.
US Pharmacopeia 28th, National Formulary 23rd ed, 2005.
Handbook of Pharmaceutical Excipients, 4th ed, 2003.
Questionable Inactive Ingredients in
Medications &Supplements
You need to clarify the
source of the ingredients.
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What if our patients are avoiding more
than gluten?
How does that impact their nutrition?
Recommended Standard
Celiac Disease Labs
• CBC
• 25 OH Vitamin D
• B12
• Folate
• Osteoporosis occurs in >25% of all patients with celiac
disease
• High incidence of iron deficiency anemia in patients with
newly diagnosed celiac disease in the U.S.
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• Iron and Ferritin
• Lipids
• TSH (thyroid)
• IgA-tTG
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Iron Needed to deliver oxygen to blood and muscles. Deficiency can lead to
fatigue and decreased immunity. Produces many important
neurotransmitters.
Folate Works with Vitamin B12 to make and maintain cells, and to make DNA
and RNA, the genetic material of cells.
Vitamin B12 Needed to help make nerve cells, red blood cells, and DNA, the genetic
material of cells.
Vitamin B6 Needed to build and breakdown proteins, to build red blood cells,
maintain brain function, and for the immune system.
Vitamin D
Helps the body absorb calcium, which is needed for the normal
development and maintenance of healthy teeth and bones. It also helps
maintain proper blood levels of calcium and phosphorus. Offers anti-
cancer benefits, helps reduce inflammation, influences hormones.
Barton, et al. Gastroenterol Clin N Am 2007;36:93-108
Important Nutrients in Celiac Disease and General Health
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Calcium
Needed for bone health and many other processes throughout the body. Aids
in blood clotting, nerve function, and muscle contraction. Maintains normal
levels of blood pressure and stomach acid.
Magnesium Needed for normal muscle and nerve function, to keep heart rhythm steady,
to support the immune system, and for bone health. Also used in the proper
functioning of over 300 enzymes in the body.
Zinc
Needed for immune function, improving of brain function (including memory),
in the synthesis of insulin, growth and development, and wound healing.
Vitamin K
Necessary for blood clotting. Some studies suggest that it helps promote
strong bones.
Vitamin A
Needed for vision, bone growth, cell division, reproduction, and the immune
system.
Vitamin E Necessary to protect cells from damaging effects of free radicals that can
contribute to cardiovascular disease and cancer; supports immune function.
Important Nutrients in Celiac Disease and General Health
Barton, et al. Gastroenterol Clin N Am 2007;36:93-108
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Food Nutrients Alternatives
Peanut
• Protein, healthy fat (vitamin E), folate,
niacin, fiber, copper.
• Other tree nuts, sunflower seed
butter
Milk/Dairy
• Calcium, vitamin D, protein, phosphorus. • Soy milk, hemp milk, almond milk,
rice milk, potato milk, hazelnut, coconut,
flax milk, sunflower milk (all labeled
gluten-free)*
Wheat
• Protein, iron, B vitamins, fiber,
antioxidants, calcium, phosphorus, zinc.
• Amaranth, brown rice, buckwheat,
millet, quinoa, sorghum, wild rice, black
rice, oats (all labeled gluten free)
Soy
• Nutritionally complete protein, fiber, iron,
naturally-occurring ALA omega-3 fatty
acids.
• Gluten-free vegetarian burgers, dried
beans, peas, lentils, dairy products,
seeds (flax), nuts
* Low/no protein in most
Amaranth
• Annual herb/broad leafed plant
• “Super food” for warriors 8,000 years ago
• More iron than most grains
• Combine with other gluten-free flours to make pancakes, flatbreads
• Very good in dark colored baked products, such as:
• Dark bread, chocolate cake and with spices
• Toasted bran flour:
•Cookies, quick breads
• Blend with almond flour in light colored mild flavored baked goods
• Honorable Mention:
• Protein, fiber, calcium, iron, magnesium
• Phosphorus, potassium, zinc, lysine (amino acid), B vitamins
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• Is a fruit and is related to rhubarb
• Groats:
• Kernels stripped of outer coating, crushed
• Kasha:
• Roasted groats
• Unroasted:
• Poultry stuffing, cream of buckwheat
• Flour:
• Pancake mix, bread, muffins, “soba” noodles
• Cook with:
• Onions, chicken broth, maple syrup, egg, milk
• Use for:
• pie crusts, breakfast bars, side dish, pilaf, casseroles, thickener
• Honorable Mention:
• Protein, magnesium, zinc, phosphorus, potassium, niacin, riboflavin
• B6, fiber, iron, cholesterol and blood pressure lowering properties
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www.birkettmills.com
Buckwheat
• Is a cereal grass
• Native to Ethiopia
• 100 grains = 1 wheat kernel
• Nutty, molasses-like flavor
• Combine 25-50% teff with other flours
• Use as:
• Hot cereal, scones, pancakes, pie crust
• Veggie burger (seeds, beans, tofu, garlic, herbs, onions)
• porridge, polenta, thickener, enjera
• Honorable Mention:
• Fiber, protein
• CALCIUM, IRON
• Magnesium, thiamin, zinc
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www.teffco.com www.Bob’s Red Mill
Teff
whole green pea flour
chickpea flour
split green pea flour
whole yellow pea flour
pea bran meal
pea fiber
Slide courtesy of Shelley Case; www.glutenfreediet.ca
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Pulse Flours, Brans and Fibre Milled in Portage la Prairie, MB, Canada
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Chickpea
(Garbanzo
Bean) Flour
Yellow Pea
Flour
White Rice
Flour
Tapioca
Starch
Cornstarch Potato
Starch
Protein (g) 25.7 24.7 9.4 0 0.3 0.2
Fiber (g) 20.9 20.6 3.8 0 1.2 0
Carbohydrate (g) 73 71 127 119 117 158
Iron (mg) 6.8
5.4 0.6 0 0.6 2.9
Calcium (mg) 92 90 16 0 3 19
Zinc (mg) 3.5 3.9 1.3 0 0.1 N/A
Magnesium (mg) 169 144 55 0 4 N/A
Thiamin (mg) 0.70 0.73 0.22 0 0 0
Riboflavin (mg) 0.16 0.15 0.03 0 0 0
Folate (mcg) 334 15 55 0 0 N/A
Pulse Power (1cup)
* Chart excerpted from Gluten-Free Diet: A Comprehensive Resource Guide by Shelley Case, RD
** Pulse flours analyzed by Silliker Canada June 2010
• Naturally gluten-free grains, flours,
and products made from them may be
contaminated with wheat, barley or rye.
• Whenever possible it is best to choose
labeled gluten-free versions of these
products.
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Celiac Disease Toolkit. American Dietetic Association. Chicago, IL, 2011; 7. Thompson T, Lee AR, Grace T. J Am Diet Assoc. 2010;110:937-940.
Important to remember…
Individuals with egg allergy should also avoid eggs from duck, turkey, goose, quail, etc., as
these are known to be cross-reactive with chicken egg.
Avoid foods that contain eggs or any of these ingredients:
•Albumin (also spelled albumen)
•Egg (dried, powdered, solids, white, yolk)
•Eggnog
•Lysozyme
•Mayonnaise
•Meringue (meringue powder)
•Ovalbumin
•Surimi
Egg is sometimes found in the following:
• Baked goods
• Egg substitutes
• Lecithin
• Macaroni
• Marzipan
• Marshmallows
• Nougat
• Pasta
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http://www.foodallergy.org/page/egg1
In addition to FDA labeling, teach:
• 1 tsp. baking powder, 1 T. liquid, 1 T.
vinegar.
• 1 tsp. yeast dissolved in 1/4 cup warm
water.
• 1 1/2 T. water, 1 1/2 T. oil, 1 tsp.
baking powder.
• 1 packet gelatin, 2 T. warm water. Do
not mix until ready to use.
• 1 T. ground flax seed in 3 T. water;
whisk; wait 3 minutes.
These substitutes work well when baking
from scratch and substituting 1 to 3
eggs.
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Substitutions
A Few Companies that Cater to Special Diets…
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Tips for Safer Dining Out
• Know the gluten-free diet
• Know the restaurant
• Identify yourself to the wait staff
• Ask specific questions (and ask again!)
• When in doubt, go simple
• Do not accept mistakes
• Do your homework before you go
• Try to go early or late
• Say thank you!
• Tip well
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Real Life with Celiac Disease, AGA Press, 2010.
• Cooler with milk & juice
• Picnic supplies for lunches:
• Gluten-free deli meat
• Cheese or rice cheese sticks
• Carrot sticks
• Plain chips
• Lunch in restaurants:
• Salads - question salad dressings or bring your own!
• Dinner in restaurants:
• Ask for manager
• Use restaurant cards
• Remember to use:
• GPS portable systems, AAA maps & itineraries
• Mapquest.com or Google maps
Rinehart, Janet Y. Traveling the World Gluten Free.
Traveling by Car
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•Call ahead to check on nearby eateries
•Check with local support groups
•Book a room with a kitchenette
•Reserve a mini-fridge
•Ask the hotel to hold food for you
Staying In Hotels
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• Less food available onboard or at pit stops
• Pre-order gluten-free meal in advance
• Check and double check
• Think airport security:
•No knives
•No liquids or peanut butter, yogurt
• Prepare for delays and layovers
• Pack non-smelly, easy to carry food:
•Alpine Aire: freeze dried
•Thai Kitchen
•Go Picnic
Traveling by Air, Bus or Train
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Dried fruit/trail mix
Fresh fruit, veggies
Plain nuts
Dried cereal in bags
Tuna fish in pouch
Freeze-dried food
Energy bars
Oral supplements (Ensure®, Boost®)
Candy (in moderation)
Yogurt smoothies with ice
Pre-toasted bread
Pretzels
Chips
Cookies, muffins
Crackers, rice/corn cakes
Soups
Packaged entrees
Peanut butter
Dried pasta
Soy sauce, condiments
*Don’t forget: Can opener, extra baggies, ice packs, containers
Gluten-Free (and Allergy-Friendly) Food to Go:
Choose Labeled Gluten-Free Products
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Print Resources
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AAAAI.org
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More Resources
FAAN.org
GREAT Kitchens Training: CeliacLearning.com
Indana-Allergynetwork.org
GIG Gluten Free Food Service: Gluten.net
“My 3-year old has gluten and milk sensitivity.”
• Negative for celiac; negative for allergies
• Rash, vomiting, diarrhea with gluten
• Diarrhea, rectal sores with dairy
• Doctor says, despite tests, still allergic to gluten and milk
• Assuming the testing was reliable…what are the possibilities?
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You ask, We answer.
① Intolerance with/without allergy
② Dermatitis Herpetiformis
③ Eosinophilic esophagitis
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You ask, We answer.
Assuming the testing was reliable…what are the possibilities?
• No money for doctor’s visit
• Multiple loose bowels, painful gas, bloated and huge, bubbling stomach
• Tried over the counter gas relief
• What foods should I eliminate?
• Testing is needed.
“I have wheat/gluten/various food allergies.”
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You ask, We answer.
Other Food
Intolerances
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• What is it?
• Poor digestion of a large sugar molecule found in some fruits, honey, high fructose corn syrup, etc.
• Fermented by bacteria in the colon
• What are the symptoms?
• Excess gas/bloating, cramping, diarrhea
• Who gets it?
• Common in IBS, increasingly seen in celiac disease
• Testing with the Hydrogen Breath Test:
• Tests ability to digest fructose
• Baseline breath (hydrogen and methane)
• Measurements every 30 mins x 2.5 hours
• Watch for strong rise in either gas
• Nothing by mouth midnight before test
Shepherd S, Gibson P. Fructose malabsorption and symptoms of IBS: guidelines for effective dietary management. J Am Diet Assoc. 2006;106:1631-1639
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Fructose Malabsoprtion
Fermentable oligo-, di-, and monosaccharides & polyols
• Fructose: Honey, certain fruits, high fructose corn syrup
• Lactose: Milk products
• Fructans: Wheat, onion family, artichoke
• Galactans: Peas, soybeans, lentils, dried beans
• Sugar Alcohols: Artificial sweeteners, sorbitol, xylitol, isomalt, prunes, cherries
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The Larger Picture: The Low FODMAP Diet
CHOOSE AVOID
• Pineapple, strawberry
• Blueberry, raspberry, lemon, lime
• Honeydew melon
• Banana, rhubarb, orange, kiwi,
grapes, grapefruit, cranberry, tangelo
•Prunes, pear, cherry, peach, plum
• Apple, applesauce, apple juice, pear juice
• Grapes, mango, date, figs, apricot
• Nectarine, dried fruit
Sugar Sources on the Low FODMAP Diet
CHOOSE AVOID
• Sucrose (table sugar), corn syrup
• Evaporated cane juice, jam or jelly
• Agave, honey
• High Fructose Corn Syrup
• Maple syrup, syrup, stevia • Sugar alcohols
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• What is it?
• Abnormally high bacterial populations in the UPPER bowel
• What are the symptoms?
• Gas, bloating, cramps, weight loss, diarrhea, nausea
• Who gets it?
• Seen in celiac disease (in absence of obvious gluten exposure)
• Diabetes, Crohn’s, IBS, scleroderma, diverticula, gastroparesis or any intestinal dysmotility syndrome
• Fistulas, chronic pancreatitis, abdominal pain, diarrhea, weight loss, macrocytic anemia, etc.
• What are the implications?
• Can lead to carbohydrate, protein and fat malabsorption, inflammation and toxin production
• Can cause persistent damage to villi, vitamin deficiencies and increase in tTG levels
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Small Intestinal Bacterial Overgrowth (SIBO)
Ghousal et al, 2004
Tursi et al, 2003
Leffler et al, 2007
•Get a clinical evaluation and testing!
•Treatment: Antibiotics
•Consult a dietitian:
•Balanced, healthy diet; limit FODMAPs
•Vitamins/minerals
•Probiotics
•Modest fiber and adequate fluid
•Spacing meals through the day
Diet for IBS and SIBO. Specialists in Gastroenterology. www.gidoctor.net/diet-ibs-sibo.php; Scarlata K. Today’s Dietitian, April 2011,13(4):46.
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SIBO Diagnosis & Treatment
•Most people with Oral Allergy Syndrome are allergic to one or more
pollens
•What is it?
• Body mistakes one protein for another
• Local and mild reaction in general
• Heat destroys the proteins (except NUTS)
•What to do:
• See an allergist.
• Solution: Cook/Avoid/Get allergy shots.
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Oral Allergy Syndrome
POLLENS CROSS- REACTIVE FRUITS/ VEGETABLES
Birch Pollen • Peach, Apple, Plum, Cherry, Apricot, Strawberry, Pear
• Almond, Hazelnut, Potato, Carrot, Celery
Grass Pollen •Tomato, Melon, Watermelon
Mugwort (weeds) •Apple, Celery, Carrot, Peanut, Kiwi
Ragweed Pollen • Banana, Melon, Honey, Cucumber, Zucchini
• Watermelon, Chamomile
*If allergic to one of the pollens, avoid the related fruits and vegetables IF
symptoms arise from eating them.
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Cross-Reactivity
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Plan Ahead! • Select some celiac-friendly restaurants in
advance of your trip:
• www.Allergyeats.com
• www.CeliacCentral.org/Kitchens
• www.glutenfreerestaurants.org
• [email protected] (archives)
• www.celiacchicks.com
• www.glutenfreepassport.com
• www.gluten.net
• www.glutenfreemenus.net
• www.gfregistry.com
• Copy restaurant cards in different
languages:
• www.celiactravel.com/restaurant-cards.html
• www.livingwithout.com
• www.csaceliacs.org
• www.triumphdining.com
• Pack foods that travel well.
• Carry a doctor’s note for
overseas trips
• Accept that travel is more
costly and not as healthy.
• American Celiac Disease Alliance: www.americanceliac.org
• Canadian Celiac Association: www.celiac.ca
• Celiac Disease Foundation: www.celiac.org
• Celiac Sprue Association: www.csaceliacs.org
• Evidence Analysis Library Celiac Toolkit (for dietitians): www.adaevidencelibrary.com
• Gluten Intolerance Group of North America: www.gluten.net
• IBS – Free at Last!: www.ibsfree.net
• National Foundation for Celiac Awareness:
• CeliacCentral.org
• CeliacCentral.org/Kids
• CeliacCentral.org/Gluten-Free-Food
• National Institutes of Health: http//:digestive.niddk.nih.gov/ddiseases/pubs/celiac
• Other websites:
• www.glutenfreedietitian.com
• www.celiac.com
www.CeliacCentral.org Restoring Health … Reclaiming Lives.
National Foundation for Celiac Awareness 2012. All rights reserved.
Celiac Disease, Food Allergy & Food Intolerance Resources
www.CeliacNow.org
Coming Summer 2012
From:
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National Foundation for Celiac Awareness 2012. All rights reserved.
Healthy Focus on Food!
More organic food
More home grown food
Less processed food
Less label reading
Advocacy
Social events are also about people
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National Foundation for Celiac Awareness 2012. All rights reserved.
Thanks to Lucy’s!
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www.drlucys.com
http://www.youtube.com/user/drlucys
•Gluten Free
•Vegan
•No Peanuts, No Tree Nuts
•Dedicated Bakery
•Ingredients Tested
•Og Trans Fat
•Omg Cholesterol
•Non-GMO
•All Natural
Save The Date!
Thursday, July 26th at 8:30pm Eastern/5:30pm Pacific
"Setting the Record Straight:
Dispelling Gluten-Free Manufacturing and Production Myths”
Tricia Thompson, MS, RD; The Gluten-Free Dietitian, Nutrition Consultant
Celiac Disease, Founder Gluten Free Watchdog, LLC
CeliacCentral.org/webinars/schedule/
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Thank you!
Questions? Comments? Feedback?
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