1. WHAT IS
GLUTEN?
How Gluten Can
Harm People

2. What Is Gluten?
For learning the answers, remedies and proven ways to overcome a dietary food intolerance problem
DEDICATED TO…
Those that have travelled the long road to living gluten free.

3. The Major Difficulty With Gluten - Of Gluten Intolerance, Celiac Disease For Life and more..
Gluten is a serious health problem for many people. Many sufferers don’t realize that they are “intolerant.” Gluten Ingestion harms people and their health status.
INTRODUCTION

4. For most, a gluten-free diet is not a passing fad
For most, a gluten-free diet is not a passing fad. It must be a way of life.
Gluten is a protein found in a number of grains
Wheat
Barley
Rye
Just avoiding grains is not enough, it is an additive in food production
Gluten can be listed as dextrin on product labels
WHAT IS
GLUTEN?

5. For most, a gluten-free diet is not a passing fad
For most, a gluten-free diet is not a passing fad. It must be a way of life.
Gluten-intolerant individuals can’t digest the gluten protein
Conditions can include:
Wheat allergies
Dermatitis herpetiformis
Celiac disease
WHAT IS
GLUTEN?

6. Most associate a gluten-free diet with celiac disease.
Gluten-intolerance symptoms include diarrhea, cramping, gas, bloating, weight loss, vitamin deficiencies Discomfort from ingesting gluten comes from intestinal lining damage The only treatment is to eliminate gluten from the diet
WHAT IS
GLUTEN?

7. Gluten Intolerance Statistics
Celiac disease is hereditary.
If you have celiac disease, 4%-12% of your immediate relatives may also have the condition.
Approx 1 in 133 Americans has celiac disease (3 million people)
Gluten intolerance affects approx 1 in 100 in Australia and New Zealand.
97% of Americans may have undiagnosed celiac disease.
Celiac disease has over 300 chronic symptoms.
WHAT IS
GLUTEN?

8. Gluten Intolerance Statistics
Gluten-free foods may cost 242% more than foods with gluten.
No treatments or drugs are available to treat celiac disease.
CD sufferers dine out 80% less than before their diagnosis.
Misdiagnosis of chronic celiac disease can cost $5,000-$12,000.
Sales of gluten-free foods will reach $2 billion in years to come
Celiac disease affects more people by far than other chronic diseases like epilepsy, Crohn’s disease and Parkinson’s disease.
WHAT IS
GLUTEN?

9. Globally, the prevalence of celiac disease is directly related to wheat consumption in each country
WHAT IS
GLUTEN?

10. How celiac disease works
Celiac disease is an autoimmune disorder Gluten proteins attack the small intestine villi Prevents absorption of vital nutrients Left untreated it can seriously affect the digestive system Can ultimately lead to osteoporosis, skin rashes and anemia Highest risk demographic: Caucasion of N. European descent
WHAT IS
GLUTEN?

11. Celiac disease can be difficult to diagnose
Test for specific antibodies while gluten is in the system.
If one in three antibodies present, celiac disease confirmed through intestinal biopsy.
If confirmed a gluten-free diet is indicated.
Gluten-free diet cannot include oats due to cross-contamination.
Two specific factors
Genetics
Environment
WHAT IS
GLUTEN?

12. Start by focusing on the many foods that can be enjoyed while eliminating gluten
Fruits and veggies, coffee, eggs, potatoes, corn, nuts, beans, fish, meat, and unflavored milk. Herbs and spices are gluten-free
WHAT IS
GLUTEN?
Continued gluten ingestion increases risk of gastrointestinal cancer x

13. The Mystery Behind Gluten Intolerance and Celiac Disease

14. The Mystery Behind Gluten Intolerance and Celiac Disease
10% with CD have an immediate family member with disease
If one of identical twins has the disease, 70% of the twin has it
Primarily affects Caucasians of European descent
Occasionally occurs in Middle East and India
Rarely affects Australian Aborigines and Asians
Grain is a high proportion of diet in the most affected regions
The Mystery Behind Gluten Intolerance and Celiac Disease

15. Celiac disease affects children and adults at any age.
Many develop symptoms in adulthood, while others have no symptoms at all
Celiac disease is a most mis- and under-diagnosed autoimmune disease
Celiac disease cannot be cured, symptoms only alleviated
The Mystery Behind Gluten Intolerance and Celiac Disease

16. Celiac disease symptoms and diagnosis
Very difficult to diagnose because of a range from mild to severe symptoms, or from none to many symptoms
Common symptoms include:
Fatigue / weakness
Low iron levels/unexplained anemia
Abdominal cramps
Diarrhea
Gas/bloating
Constipation
Nausea
Poor weight gain/weight loss
The Mystery Behind Gluten Intolerance and Celiac Disease

17. Celiac disease symptoms and diagnosis
Less common symptoms include:
Bruising easily
Ulcers in the mouth
Infertility and miscarriage
Dental problems
Vitamin deficiencies
Muscle cramps / spasms
Brain fog / confusion
Bone and joint pain
Any or all of these symptoms should be reported to a doctor.
If gluten-intolerance is detected, a gastro-enterologist will test for celiac disease.
The Mystery Behind Gluten Intolerance and Celiac Disease

18. Triggers that lead to celiac disease
The Mystery Behind Gluten Intolerance and Celiac Disease

19. Celiac disease symptoms and diagnosis
Gluten intolerance can cause the autoimmune disease dermatitis herpetiformis (DH).
DH causes a skin rash characterised by pimples or blisters.
DH is more common in men and people from Northern Europe.
DH may appear on:
Kneecaps / elbows
Ears
Shoulder blades
Buttocks
Hairline / eyebrows
DH always occurs symmetrically and is also incurable.
If diagnosed, a skin biopsy is indicated.
The Mystery Behind Gluten Intolerance and Celiac Disease

20. Gluten intolerance: Where it all begins
Gluten intolerance: A broad term that relates to all forms of gluten sensitivity
Many who are gluten sensitive will test negative for celiac disease
This may indicate something less than a 100% gluten-free diet
Gluten sensitivity can include:
Constipation
Diarrhea
Gas
Bloating
Gluten sensitivity can be tested by systematic removal / reintroduction of trigger foods containing gluten
The Mystery Behind Gluten Intolerance and Celiac Disease

21. Wheat allergy versus gluten intolerance
Wheat allergies are less common than gluten intolerance
Wheat allergies are usually accompanied by other severe allergies to eggs, seafood and nuts
Wheat allergies are best diagnosed by skin prick testing
The Mystery Behind Gluten Intolerance and Celiac Disease

22. Gluten intolerance and autism
Eliminating gluten can alleviate early symptoms of autism in children
Global Autism Awareness Day is April 2
Prevalence of autism around the world:
China: 1.1 children in 1000 have autism
India: 1 in 250
US: 1 in 88
UK: 2-6 in 1000
Some studies suggest food allergies caused by gluten intolerance can trigger or worsen autism
Gluten protein breaks down into peptides which work as a narcotic, worsening symptoms of autism in children
The Mystery Behind Gluten Intolerance and Celiac Disease

23. Gluten intolerance and autism
“Brain fog” or confusion can worsen into pyschiatric conditions in autistic children
Completely eliminating gluten can result in disapperance of abnormal behavior, cognitive issues and anti-social tendencies
__________
Next section: How to implement a gluten-free diet
The Mystery Behind Gluten Intolerance and Celiac Disease

24. The Gluten-Free Diet and Its Many Health Benefits

25. All the signs point to a diet change
Mild to severe gluten intolerance, celiac disease, DH and other indicate a need for a diet change
Diet changes can improve problems with:
Diarrhea
Gas
Bloating
Though the switch can be difficult, the effort go gluten-free can be worth it for chronic condition sufferers
The Gluten-Free Diet and Its Many Health Benefits

26. The Basis of the Gluten-Free Diet
Core of the diet: Avoid any form of wheat, rye and barley
You can continue to enjoy the foods you love.
There are many more foods to enjoy than to avoid.
Gluten-free alternatives are becoming more available in supermarkets and restaurants.
Many foods are naturally gluten-free.
For others there are gluten-free alternatives.
The Gluten-Free Diet and Its Many Health Benefits

27. The Basis of the Gluten-Free Diet
Factors behind the new wave of market expansion
Increasing diagnoses of food allergies and celiac disease.
More awareness of gluten intolerance throughout society.
Growing need for better-tasting gluten-free alternatives.
Trends for families to eat gluten-free to support loved ones.
Modern knowledge of the health benefits of gluten-free for all.
The Gluten-Free Diet and Its Many Health Benefits

28. Top 5 Benefits of a Gluten-Free Diet
1. Nutrition from a wide variety of other sources
Flaxseeds / sesame seeds: same nutrients as wheat flour
Fruits & vegetables: same or more fibre than whole grains
2. Gluten causes inflammation
High-gluten grains are high in starch, causing inflammation
Gluten-free vegetables and fats can neutralize inflammation
Gluten-free foods can calm systemic inflammation related to arthritis, osteoporosis, asthma, allergies, etc.
The Gluten-Free Diet and Its Many Health Benefits

29. Top 5 Benefits of a Gluten-Free Diet
3. Gluten can harm joints
Gluten-rich foods have amino acids found in joint tissue
Can confuse immune system into attacking joints and causing long-term damage
4. Gluten can cause mineral deficiencies
Ingestion of gluten-rich grains can inhibit vitamin and mineral absorption.
Gluten-free allows for easy digestion and better absorption.
5. Gluten causes gluten craving
Craving carbs or processed foods may be a gluten addiction
A vicious cycle: energy boost > energy drop > then cravings
The Gluten-Free Diet and Its Many Health Benefits

30. First Steps: The Initial Elimination Diet
Start out small to assess gluten intolerance with “Elimination Diet”
Elimination Diet Process:
Completely eliminate all gluten for 2-4 weeks
Then slowly reintroduce items, tracking foods, symptoms and reactions
If reintroduction produces negative results a gluten-free diet may be indicated.
The Gluten-Free Diet and Its Many Health Benefits

31. How to Organize For Gluten Free
Taking the Plunge –
How to Organize For Gluten Free

32. Taking the Plunge – How to Organize For Gluten Free
Failure to provide for the gluten- intolerant can endanger their health
The following strategies can be offered to those preparing food:
Avoid packaged or prepared foods
Cook foods from scratch
Avoid cross-contamination in the kitchen
Be careful with how food is presented
Go the extra mile to help a host prepare gluten-free meals
Taking the Plunge – How to Organize For Gluten Free

33. Top 10 “Hidden” Gluten-Containing Products in A Kitchen
Salad Dressing: Usually contains gluten unless labelled gluten-free.
Marinades: Most have gluten content or a gluten-derived ingredient.
Soy Sauce: Can contain 60% wheat filler products.
Instant Pudding: Usually produced with gluten as a thickener.
Frozen Meals: Gluten protein is used as a binding agent.
Deli Meats & Sausages: Gluten is used as a starch to bind water in production.
Taking the Plunge – How to Organize For Gluten Free

34. Top 10 “Hidden” Gluten-Containing Products in A Kitchen
Soups: Most commercial soups contain gluten as thickener
Ice Cream: Gluten-free ice cream is available, but watch for ingredients like cookies and brownies which usually contain gluten
Hot Cocoa: Most instant cocoa, including Ovaltine have gluten
Condiments: Most have gluten, including mayo, mustard, ketchup, sauces, etc.
Taking the Plunge – How to Organize For Gluten Free

35. Gluten-Free Shopping Guide
Produce: Any fresh fruit, vegetable, herb and spice
Meat / Fish: Beef, poultry, fish shellfish, some cold cuts w/o additives
Frozen Foods: Frozen fruit & vegetables, gluten-free frozen waffles, ice cream and sherbets
Dairy: Milk, cream, half-and-half, butter, margarine, yogurt, sour cream, cream cheese, cottage cheese, rice pudding, tapioca pudding, eggs, tofu, Jell-O, 100% fruit juices
Breakfast: Corn, rice & other gluten-free cereals, eggs, gluten-free frozen waffles and bagels
Canned Goods/Packaged Foods: Plain canned vegetables & fruits, cranberry sauce, applesauce, spaghetti sauce, gluten-free organic soups, gluten-free pastas, corn tortillas, and canned fish
Taking the Plunge – How to Organize For Gluten Free
Always read the product label

36. Gluten-Free Shopping Guide
Oils: Shortening, mayonnaise, gluten-free salad dressing, olive oil, canola oil, vegetable oil
Starches: Rice, buckwheat, chickpeas, sunflower seeds, flax seeds, corn starch, potato starch, quinoa
Snacks: Rice crackers & cakes, popcorn, cheese puffs, corn chips, some potato chips, chocolate, dried fruits, some candy
Beverages: Tea, coffee, soft drinks, 100% fruit juice
Condiments: Horseradish, ketchup, some mustards, honey, pickles, vinegar (excluding malt vinegar)
Nuts: Almond butter, cashew butter, peanut butter, plain nuts
Baking: Salt, pepper, herbs, spices, sugar, corn meal, baking soda, baking powder, baking chocolate, cocoa, and gluten-free flours
Taking the Plunge – How to Organize For Gluten Free
Always read the product label

37. How to Cook Gluten Free - Meal Preparation Hints

38. What NOT to do when cooking gluten-free
DON’T use the same cooking materials and utensils.
DON’T forget to separate your gluten-free cooking ingredients.
DON’T forget to read labels carefully.
DON’T think that cooking will eliminate trace amounts of gluten.
DON’T double dip.
How to Cook Gluten-Free: Meal Preparation Hints

39. How to Cook Gluten-Free: Meal Preparation Hints
BREAKFAST
Nutritious gluten-free alternatives:
Gluten-free cereals
Gluten-free muffins
Gluten-free waffles
Gluten-free pancake mix
Gluten-free trail mix or cereal bars
Fresh fruit
Eggs
How to Cook Gluten-Free: Meal Preparation Hints

40. How to Cook Gluten-Free: Meal Preparation Hints
LUNCH
Delicious, gluten-free foods to pack for lunch:
Gluten-free soup
Fresh fruit, yogurt, and gluten-free granola
Gluten-free wrap with hummus and vegetables
Dinner leftovers
Sandwich on gluten-free bread
How to Cook Gluten-Free: Meal Preparation Hints

41. Gluten-Free Cooking 101: Basic Guidelines
Know what is and isn’t safe
Read all labels carefully
Buy pre-packaged gluten-free mixes
Use separate cooking implements to prevent cross-contamination
Use gluten-free recipes
How to Cook Gluten-Free: Meal Preparation Hints

42. How to Convert Recipes to Gluten-Free
Swap out gluten-rich flour
Or, omit flour altogether
Add gluten free alternatives as substitutions for ingredients
Experiment, experiment, experiment
How to Cook Gluten-Free: Meal Preparation Hints

43. The Basic Gluten-Free Substitution Chart
Sandwich bread  Corn tortillas
Crackers  Brown rice tortillas
Bread crumbs  Crushed gluten-free cereal or gluten-free oats
Pizza crust  Mashed potatoes
Flour tortillas  Corn tortillas
Flour tortillas  Lettuce wraps
Pancakes  Cornmeal cakes
Cake frosting  Meringue
Yogurt with granola  Yogurt with nuts
Croutons  Nuts
How to Cook Gluten-Free: Meal Preparation Hints

44. The Basic Gluten-Free Substitution Chart
All-purpose flour  Gluten-free flour
Wheat flour  Almond flour
Lasagna noodles  Sliced eggplant
Couscous  Steamed chopped cauliflower
Couscous  Quinoa
Pasta  Rice noodles
Pasta  Spaghetti squash
Bagels  Rice cakes
Roux  Potatoes
Pie crust  Gluten-free cookie dough
How to Cook Gluten-Free: Meal Preparation Hints

45. The Art of Dining Out Gluten-Free

46. Dining out with celiac disease: the emotional impact
Women with celiac disease are more likely to exhibit disordered eating and depression due to a gluten-free diet
Women with celiac disease who stayed with the strictest gluten- free diet had…
Improved energy
Reduced levels of stress
Reduced symptoms of depression
Improved emotional health
The Art of Dining Out Gluten-Free

47. Dining out with celiac disease: the emotional impact
Dining out creates a much different experience for people with celiac disease because of diet monitoring
Many are concerned about burdening hosts with dietary requests
It’s important to continue to educate the public about everyday difficulties associated with celiac disease
The prescribed treatment for celiac disease shouldn’t just address the illness.
The Art of Dining Out Gluten-Free

48. How to eat out on a gluten-free diet
Eating at a restaurant may now be confusing and nerve-racking trying to choose menu items for this diet.
Many restaurants now offer special menus for diners with gluten intolerance and celiac disease.
Eat a balanced snack before going out to eat.
Study the venues menu in advance.
Tell the house Maitre Di about gluten free diet in advance
Choose safe dishes on the menu and ask questions.
Remind the staff about cross-contamination.
The Art of Dining Out Gluten-Free

49. Gluten-free alcoholic drinks
Can still enjoy some alcoholic beverages after-dinner
Beer is not allowed due to the hops and barley, which contain gluten.
Recently, special gluten-free beers have been formulated
Gluten-free drinks include:
Brandy, cognac
Wine, some cider
Gin, vodka, tequila
Rum, Schnapps
The Art of Dining Out Gluten-Free

50. Gluten-free tips for parties and gatherings
It may be difficult to request gluten-free if a party has a set menu.
At a party with a catered menu, bring along gluten free food
Scout the food table or buffet line for gluten-free items:
Plain grilled meat
Fresh vegetables
Salad with oil and vinegar dressing
Fresh fruit for dessert
The Art of Dining Out Gluten-Free

51. Gluten-free tips for parties and gatherings
A Holiday event probably won’t have gluten-free food
Several steps to take to avoid inconveniencing a host:
Bring a prepared dish.
Call the caterer in advance.
Eat before everyone goes out.
Cheating on this diet can cause permanent damage.
The Art of Dining Out Gluten-Free

52. Special Guidelines for Children on a Gluten-Free Diet

53. Early diagnosis of gluten intolerance or celiac disease is critical
2.5 babies / minute are born with genetics to have celiac disease
For children who are at risk the age of diagnosis is critical.
When a first degree blood relative has celiac disease, there is about a 5% chance that a child also has the condition.
Recognizing celiac disease in young children:
May refuse to eat or fail to gain weight after eating gluten
May be irritable, listless, have an enlarged abdomen or irregular stools
An older child may have symptoms like:
Stunted growth
Poor appetite
Anemia
Special Guidelines for Children on a Gluten-Free Diet

54. Coping with celiac disease at school
Speak to a counselor, teacher and the school nurse immediately.
To simplify the process, get a doctor’s note that explains your child’s celiac disease or gluten intolerance.
Teach your child to be independent in managing their condition.
Some school cafeterias may have gluten-free menu options.
Special Guidelines for Children on a Gluten-Free Diet

55. Coping with celiac disease: The teen years
If diagnosed as a child, transition into teen years should be easy.
Discuss situations where they may feel out-of-place with their diet.
Teens need to understand that they won’t outgrow celiac disease.
Occasional cheating is not okay.
Make gluten-free eating fun by having the right snacks on hand and learning good gluten-free recipes.
Special Guidelines for Children on a Gluten-Free Diet

56. Coping with celiac disease: The college years
You need to prepare for them being largely on their own.
More colleges are accommodating students with gluten-intolerance and celiac disease.
College counselors can advise if the school caters to students with food sensitivities.
A doctor’s diagnosis or medical report can be helpful.
This time of transition is another opportunity to learn celiac disease does not go into remission.
Special Guidelines for Children on a Gluten-Free Diet

57. How to raise a gluten-free child
Focus on the foods that a child can eat.
Ask the child to help you plan meals.
Try new foods with a child.
Rearrange the kitchen to take away temptation.
Plan in advance to bring gluten-free classroom treats.
Establishing these principles from an early age will it easier for a child to avoid gluten and minimize short and long-term problems
Special Guidelines for Children on a Gluten-Free Diet

58. Further resources are found at www.what-is-gluten.info.
COPYRIGHT
Disclaimer:
All the information, techniques, skills and concepts contained in this presentation are as a guide and an assist to general education only. Nothing herein is recommended, neither as an individual’s nor a groups’ direct advice. The intent is to offer a variety of information to provide a wider range of knowledge in education, recognizing that we have widely diverse circumstances and viewpoints. Should anyone choose to make use of the information contained herein, this is their decision, and the contributors (and their companies), authors and publishers do not assume any responsibilities whatsoever under any condition or circumstance. It is recommended that the viewer obtain their own independent advice and consult a medical practitioner experienced with gluten, gluten intolerance, celiac disease, etc.
This presentation is available internationally across all countries and borders for use as an education assist in general. The publisher does not warrant suitability unto any education authority or any desired outcome for education across all countries and borders accordingly. The end user has determined, under the end user individuals own merit and knowledge, the decision to using this presentation is as a display medium and general assistant only.
Transmission is permitted in this format for visual display presentation. All rights reserved. No part of this presentation may be altered, reproduced, stored in a retrieval system, or transmitted in any other form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission from the publisher.
Further resources are found at
First Edition Copyright © 2012 Steven Wilkinson.
Sources:
1. National Institutes of Health, Univ. of Chicago Celiac Disease Center
2. "Making sense of celiac disease with clues to a cure." Medill Reports. N.p., n.d. Web. 28 Mar
3. Integration of Genetic and Immunological Insights into a Model of Celiac Disease Pathogenesis. Annual Review of Immunology. Vol. 29:
4. Nutrients 2010, 2(1), 16-34; doi: /nu
5. "What is the Global Incidence of Autism? | Early Signs of Autism In Babies and Children." Early Signs Of Autism & Autism Information. N.p., n.d. Web. 29 Mar
6. "What to Feed a Vegan (and others)." N.p., n.d. Web. 29 Mar
7. "Gluten Ingredient Shopping Guide." N.p., n.d. Web. 5 Apr
8. "Printable Gluten-free Celiac Grocery List ". Printable Grocery Lists. N.p., n.d. Web. 3 Apr
9. Penn State (2011, December 27). Women with celiac disease suffer from depression, disordered eating, study finds. Science Daily.
10. ALDERMAN, LESLEY. "Patient Money - The Expense of Eating With Celiac Disease - NYTimes.com." The New York Times - Breaking News, World News & Multimedia. N.p., n.d. Web. 9 Apr
11. "English Celiac / Coeliac Gluten-free Restaurant Card." N.p., n.d. Web. 12 Apr
12. "Facts & Statistics About Celiac Disease." Celiac Disease & Gluten Free Diet Resources. N.p., n.d. Web. 12 Apr
13. "Celiac Disease in Children." Welcome to Celiacs. N.p., n.d. Web. 12 Apr
14. "Where Food Ranks: Getting to Know the Glycemic Index Chart." N.p., n.d. Web. 13 Apr
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