2What Is Gluten?For learning the answers, remedies and proven ways to overcome a dietary food intolerance problemDEDICATED TO…Those that have travelled the long road to living gluten free.
3The 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
4For 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 grainsWheatBarleyRyeJust avoiding grains is not enough, it is an additive in food productionGluten can be listed as dextrin on product labelsWHAT ISGLUTEN?
5For 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 proteinConditions can include:Wheat allergiesDermatitis herpetiformisCeliac diseaseWHAT ISGLUTEN?
6Most 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 dietWHAT ISGLUTEN?
7Gluten 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 ISGLUTEN?
8Gluten 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 comeCeliac disease affects more people by far than other chronic diseases like epilepsy, Crohn’s disease and Parkinson’s disease.WHAT ISGLUTEN?
9Globally, the prevalence of celiac disease is directly related to wheat consumption in each country WHAT ISGLUTEN?
10How 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 descentWHAT ISGLUTEN?
11Celiac 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 factorsGeneticsEnvironmentWHAT ISGLUTEN?
12Start 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-freeWHAT ISGLUTEN?Continued gluten ingestion increases risk of gastrointestinal cancer x
13The Mystery Behind Gluten Intolerance and Celiac Disease
14The Mystery Behind Gluten Intolerance and Celiac Disease 10% with CD have an immediate family member with diseaseIf one of identical twins has the disease, 70% of the twin has itPrimarily affects Caucasians of European descentOccasionally occurs in Middle East and IndiaRarely affects Australian Aborigines and AsiansGrain is a high proportion of diet in the most affected regionsThe Mystery Behind Gluten Intolerance and Celiac Disease
15Celiac disease affects children and adults at any age. Many develop symptoms in adulthood, while others have no symptoms at allCeliac disease is a most mis- and under-diagnosed autoimmune diseaseCeliac disease cannot be cured, symptoms only alleviatedThe Mystery Behind Gluten Intolerance and Celiac Disease
16Celiac disease symptoms and diagnosis Very difficult to diagnose because of a range from mild to severe symptoms, or from none to many symptomsCommon symptoms include:Fatigue / weaknessLow iron levels/unexplained anemiaAbdominal crampsDiarrheaGas/bloatingConstipationNauseaPoor weight gain/weight lossThe Mystery Behind Gluten Intolerance and Celiac Disease
17Celiac disease symptoms and diagnosis Less common symptoms include:Bruising easilyUlcers in the mouthInfertility and miscarriageDental problemsVitamin deficienciesMuscle cramps / spasmsBrain fog / confusionBone and joint painAny 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
18Triggers that lead to celiac disease The Mystery Behind Gluten Intolerance and Celiac Disease
19Celiac 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 / elbowsEarsShoulder bladesButtocksHairline / eyebrowsDH always occurs symmetrically and is also incurable.If diagnosed, a skin biopsy is indicated.The Mystery Behind Gluten Intolerance and Celiac Disease
20Gluten intolerance: Where it all begins Gluten intolerance: A broad term that relates to all forms of gluten sensitivityMany who are gluten sensitive will test negative for celiac diseaseThis may indicate something less than a 100% gluten-free dietGluten sensitivity can include:ConstipationDiarrheaGasBloatingGluten sensitivity can be tested by systematic removal / reintroduction of trigger foods containing glutenThe Mystery Behind Gluten Intolerance and Celiac Disease
21Wheat allergy versus gluten intolerance Wheat allergies are less common than gluten intoleranceWheat allergies are usually accompanied by other severe allergies to eggs, seafood and nutsWheat allergies are best diagnosed by skin prick testingThe Mystery Behind Gluten Intolerance and Celiac Disease
22Gluten intolerance and autism Eliminating gluten can alleviate early symptoms of autism in childrenGlobal Autism Awareness Day is April 2Prevalence of autism around the world:China: 1.1 children in 1000 have autismIndia: 1 in 250US: 1 in 88UK: 2-6 in 1000Some studies suggest food allergies caused by gluten intolerance can trigger or worsen autismGluten protein breaks down into peptides which work as a narcotic, worsening symptoms of autism in childrenThe Mystery Behind Gluten Intolerance and Celiac Disease
23Gluten intolerance and autism “Brain fog” or confusion can worsen into pyschiatric conditions in autistic childrenCompletely eliminating gluten can result in disapperance of abnormal behavior, cognitive issues and anti-social tendencies__________Next section: How to implement a gluten-free dietThe Mystery Behind Gluten Intolerance and Celiac Disease
24The Gluten-Free Diet and Its Many Health Benefits
25All the signs point to a diet change Mild to severe gluten intolerance, celiac disease, DH and other indicate a need for a diet changeDiet changes can improve problems with:DiarrheaGasBloatingThough the switch can be difficult, the effort go gluten-free can be worth it for chronic condition sufferersThe Gluten-Free Diet and Its Many Health Benefits
26The Basis of the Gluten-Free Diet Core of the diet: Avoid any form of wheat, rye and barleyYou 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
27The Basis of the Gluten-Free Diet Factors behind the new wave of market expansionIncreasing 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
28Top 5 Benefits of a Gluten-Free Diet 1. Nutrition from a wide variety of other sourcesFlaxseeds / sesame seeds: same nutrients as wheat flourFruits & vegetables: same or more fibre than whole grains2. Gluten causes inflammationHigh-gluten grains are high in starch, causing inflammationGluten-free vegetables and fats can neutralize inflammationGluten-free foods can calm systemic inflammation related to arthritis, osteoporosis, asthma, allergies, etc.The Gluten-Free Diet and Its Many Health Benefits
29Top 5 Benefits of a Gluten-Free Diet 3. Gluten can harm jointsGluten-rich foods have amino acids found in joint tissueCan confuse immune system into attacking joints and causing long-term damage4. Gluten can cause mineral deficienciesIngestion of gluten-rich grains can inhibit vitamin and mineral absorption.Gluten-free allows for easy digestion and better absorption.5. Gluten causes gluten cravingCraving carbs or processed foods may be a gluten addictionA vicious cycle: energy boost > energy drop > then cravingsThe Gluten-Free Diet and Its Many Health Benefits
30First 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 weeksThen slowly reintroduce items, tracking foods, symptoms and reactionsIf reintroduction produces negative results a gluten-free diet may be indicated.The Gluten-Free Diet and Its Many Health Benefits
31How to Organize For Gluten Free Taking the Plunge –How to Organize For Gluten Free
32Taking the Plunge – How to Organize For Gluten Free Failure to provide for the gluten- intolerant can endanger their healthThe following strategies can be offered to those preparing food:Avoid packaged or prepared foodsCook foods from scratchAvoid cross-contamination in the kitchenBe careful with how food is presentedGo the extra mile to help a host prepare gluten-free mealsTaking the Plunge – How to Organize For Gluten Free
33Top 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
34Top 10 “Hidden” Gluten-Containing Products in A Kitchen Soups: Most commercial soups contain gluten as thickenerIce Cream: Gluten-free ice cream is available, but watch for ingredients like cookies and brownies which usually contain glutenHot Cocoa: Most instant cocoa, including Ovaltine have glutenCondiments: Most have gluten, including mayo, mustard, ketchup, sauces, etc.Taking the Plunge – How to Organize For Gluten Free
35Gluten-Free Shopping Guide Produce: Any fresh fruit, vegetable, herb and spiceMeat / Fish: Beef, poultry, fish shellfish, some cold cuts w/o additivesFrozen Foods: Frozen fruit & vegetables, gluten-free frozen waffles, ice cream and sherbetsDairy: Milk, cream, half-and-half, butter, margarine, yogurt, sour cream, cream cheese, cottage cheese, rice pudding, tapioca pudding, eggs, tofu, Jell-O, 100% fruit juicesBreakfast: Corn, rice & other gluten-free cereals, eggs, gluten-free frozen waffles and bagelsCanned Goods/Packaged Foods: Plain canned vegetables & fruits, cranberry sauce, applesauce, spaghetti sauce, gluten-free organic soups, gluten-free pastas, corn tortillas, and canned fishTaking the Plunge – How to Organize For Gluten FreeAlways read the product label
36Gluten-Free Shopping Guide Oils: Shortening, mayonnaise, gluten-free salad dressing, olive oil, canola oil, vegetable oilStarches: Rice, buckwheat, chickpeas, sunflower seeds, flax seeds, corn starch, potato starch, quinoaSnacks: Rice crackers & cakes, popcorn, cheese puffs, corn chips, some potato chips, chocolate, dried fruits, some candyBeverages: Tea, coffee, soft drinks, 100% fruit juiceCondiments: Horseradish, ketchup, some mustards, honey, pickles, vinegar (excluding malt vinegar)Nuts: Almond butter, cashew butter, peanut butter, plain nutsBaking: Salt, pepper, herbs, spices, sugar, corn meal, baking soda, baking powder, baking chocolate, cocoa, and gluten-free floursTaking the Plunge – How to Organize For Gluten FreeAlways read the product label
37How to Cook Gluten Free - Meal Preparation Hints
38What 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
39How to Cook Gluten-Free: Meal Preparation Hints BREAKFASTNutritious gluten-free alternatives:Gluten-free cerealsGluten-free muffinsGluten-free wafflesGluten-free pancake mixGluten-free trail mix or cereal barsFresh fruitEggsHow to Cook Gluten-Free: Meal Preparation Hints
40How to Cook Gluten-Free: Meal Preparation Hints LUNCHDelicious, gluten-free foods to pack for lunch:Gluten-free soupFresh fruit, yogurt, and gluten-free granolaGluten-free wrap with hummus and vegetablesDinner leftoversSandwich on gluten-free breadHow to Cook Gluten-Free: Meal Preparation Hints
41Gluten-Free Cooking 101: Basic Guidelines Know what is and isn’t safeRead all labels carefullyBuy pre-packaged gluten-free mixesUse separate cooking implements to prevent cross-contaminationUse gluten-free recipesHow to Cook Gluten-Free: Meal Preparation Hints
42How to Convert Recipes to Gluten-Free Swap out gluten-rich flourOr, omit flour altogetherAdd gluten free alternatives as substitutions for ingredientsExperiment, experiment, experimentHow to Cook Gluten-Free: Meal Preparation Hints
46Dining 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 dietWomen with celiac disease who stayed with the strictest gluten- free diet had…Improved energyReduced levels of stressReduced symptoms of depressionImproved emotional healthThe Art of Dining Out Gluten-Free
47Dining out with celiac disease: the emotional impact Dining out creates a much different experience for people with celiac disease because of diet monitoringMany are concerned about burdening hosts with dietary requestsIt’s important to continue to educate the public about everyday difficulties associated with celiac diseaseThe prescribed treatment for celiac disease shouldn’t just address the illness.The Art of Dining Out Gluten-Free
48How 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 advanceChoose safe dishes on the menu and ask questions.Remind the staff about cross-contamination.The Art of Dining Out Gluten-Free
49Gluten-free alcoholic drinks Can still enjoy some alcoholic beverages after-dinnerBeer is not allowed due to the hops and barley, which contain gluten.Recently, special gluten-free beers have been formulatedGluten-free drinks include:Brandy, cognacWine, some ciderGin, vodka, tequilaRum, SchnappsThe Art of Dining Out Gluten-Free
50Gluten-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 foodScout the food table or buffet line for gluten-free items:Plain grilled meatFresh vegetablesSalad with oil and vinegar dressingFresh fruit for dessertThe Art of Dining Out Gluten-Free
51Gluten-free tips for parties and gatherings A Holiday event probably won’t have gluten-free foodSeveral 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
52Special Guidelines for Children on a Gluten-Free Diet
53Early diagnosis of gluten intolerance or celiac disease is critical 2.5 babies / minute are born with genetics to have celiac diseaseFor 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 glutenMay be irritable, listless, have an enlarged abdomen or irregular stoolsAn older child may have symptoms like:Stunted growthPoor appetiteAnemiaSpecial Guidelines for Children on a Gluten-Free Diet
54Coping 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
55Coping 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
56Coping 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
57How 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 problemsSpecial Guidelines for Children on a Gluten-Free Diet