1. Going Gluten-Free The why and how of gluten-free diets

2. Today’s Agenda Part 1: What Gluten sensitivities Part 2: How Managing Food Part 3: Where Helpful Resources Review Quick Quiz

3. Part 1: Gluten and Gluten Sensitivities

4. What is Gluten? Gluten is a protein composite in many grains and grain-based foods.

5. What is a gluten sensitivity? When a person’s immune system reacts abnormally to gluten, it is called a gluten sensitivity. Celiac disease is a gluten sensitivity.

6. Symptoms Abdominal pain Bloating and/or gas Constipation Diarrhea Fatty, noxious, floating, bloody, or otherwise odd stools Nausea and/or vomiting Reduced appetite

7. Additional Symptoms Seizures Numbness in hands or feet Nosebleeds Muscle cramps Mouth ulcers Joint pain Itchy skin Hair loss Fatigue Anxiety or depression

8. Spotlight on Celiac Celiac disease is a condition in which parts of the small intestine are damaged by an immune reaction to gluten.

9. Why Intestinal Damage?

10. Surprising Celiac Stats 30-40% of all people in the U.S. carry the gene for celiac disease. Only 1-2% of those people have the gene activated.

11. Surprising Celiac Stats Activating the gene for celiac disease is usually the result of an environmental trigger. –Getting a parasite –Getting sick –Stress –Taking a certain medication –Trauma

12. How is Celiac Diagnosed? First, a blood test. Then, a biopsy.

13. But It’s Tough, Man It’s hard to get to a celiac diagnosis because the symptoms are the same as many other conditions. For every person diagnosed with celiac, 80 may be going undiagnosed.

14. But It’s Tough, Man Approximately 3 million people in the United States have celiac disease. The average time that a person waits before being diagnosed with celiac disease is 6-10 years!

15. But It’s Tough, Man The National Foundation for Celiac Awareness estimates that 18 million Americans have non-celiac gluten sensitivity.

16. So… what’s the cure?

17. NO GLUTEN If you have celiac disease, the only treatment is to go on a 100% GLUTEN- FREE diet.

18. Getting “Glutened” Diarrhea Fainting/dizziness Fever Itching/rash/hives Nausea Stomach pain Vomiting

19. Part 2: Gluten Sensitivities and Food

20. Foods to Avoid Barley Beer Bread Cereal Couscous Flour Panko Pasta Rye Spelt

21. Foods to Avoid Graham flour Kamut Malt Modified food starch Soy Sauce Vegetable protein

22. Other Things to Avoid Certain cosmetics –Particular lipsticks –A variety of shampoos –Sometimes even soaps Certain medications Certain cosmetics –Particular lipsticks –A variety of shampoos –Sometimes even soaps Certain medications Rubber or latex gloves –(often lined with flour or other grain- derived substances) Stamps and envelopes Rubber or latex gloves –(often lined with flour or other grain- derived substances) Stamps and envelopes

23. Gluten-Free Options Amaranth Beans Buckwheat Fish Fruit Meat Nuts Poultry Quinoa Rice Seeds Soy Tofu Vegetables

24. Gluten-Free Alternatives Tons of products these days are being made completely gluten-free. Check out new gluten-free breads, cereals, flours, pastas, and more!

25. A Note About Oats Oats do not contain gluten. They are often processed on machines that process foods that do contain gluten. Check labels carefully.

26. Gluten-Free Home Avoid cross-contamination –Clean anything that might have touched gluten, and clean it with soap and hot water. –Get your own cooking supplies and keep them separate.

27. Sample Meal Plan Breakfast: Fresh fruit with nonfat, plain yogurt and raw sunflower seeds. Lunch: Large green salad topped with gluten-free dressing and a grilled chicken breast. Cup of vegetable rice soup on the side.

28. Sample Meal Plan Snack: A medium apple with a tablespoon of peanut butter.

29. Dinner: Sonoran Sunset Quinoa Salad

30. Gluten-Free Dining Do your homework. Have a list of questions ready. If it is too risky, don’t go.

31. The Stakes are High Seems like a lot of fuss Stakes are high: health “Glutened”

32. The Stakes are High Gluten will damage your intestines every time, regardless of whether other symptoms are present. Only 46% of people with gluten sensitivity achieve mucosal recovery.

33. Part 3: Resources

34. Resources National Foundation for Celiac Awareness: http://www.celiaccentral.org/ http://www.celiaccentral.org Gluten Intolerance Group: http://www.gluten.net/ http://www.gluten.net Celiac Disease Foundation: http://www.celiac.org/ http://www.celiac.org Celiac Sprue Association: http://www.csaceliacs.info/ http://www.csaceliacs.info

35. Resources

36. Quick Quiz! Gluten is a protein composite found in… * Meat* Dairy * Grains* Vegetables True or false: The gene that triggers celiac disease can be activated at any time. Gluten is a protein composite found in… * Meat* Dairy * Grains* Vegetables True or false: The gene that triggers celiac disease can be activated at any time.

37. Quick Quiz! Gluten is a protein composite found in… * Meat* Dairy * Grains* Vegetables True or false: The gene that triggers celiac disease can be activated at any time. Gluten is a protein composite found in… * Meat* Dairy * Grains* Vegetables True or false: The gene that triggers celiac disease can be activated at any time.

38. Quick Quiz! Symptoms of a gluten sensitivity include… * Depression* Abdominal pain * Hives* All of the above True or false: Celiac disease involves damage to the small intestine whenever gluten is consumed. Symptoms of a gluten sensitivity include… * Depression* Abdominal pain * Hives* All of the above True or false: Celiac disease involves damage to the small intestine whenever gluten is consumed.

39. Quick Quiz! Symptoms of a gluten sensitivity include… * Depression* Abdominal pain * Hives* All of the above True or false: Celiac disease involves damage to the small intestine whenever gluten is consumed. Symptoms of a gluten sensitivity include… * Depression* Abdominal pain * Hives* All of the above True or false: Celiac disease involves damage to the small intestine whenever gluten is consumed.

40. Quick Quiz! The cure for gluten sensitivities is… * Nonexistent* Pharmaceutical * A supplement* Rare and costly True or false: 1-2% of all people in the United States carry the gene for celiac disease. The cure for gluten sensitivities is… * Nonexistent* Pharmaceutical * A supplement* Rare and costly True or false: 1-2% of all people in the United States carry the gene for celiac disease.

41. Quick Quiz! The cure for gluten sensitivities is… * Nonexistent* Pharmaceutical * A supplement* Rare and costly True or false: 1-2% of all people in the United States carry the gene for celiac disease. The cure for gluten sensitivities is… * Nonexistent* Pharmaceutical * A supplement* Rare and costly True or false: 1-2% of all people in the United States carry the gene for celiac disease.

42. Quick Quiz! Which of the following grains contains gluten? * Amaranth* Barley * Quinoa* Rice True or false: Beer contains gluten. Which of the following grains contains gluten? * Amaranth* Barley * Quinoa* Rice True or false: Beer contains gluten.

43. Quick Quiz! Which of the following grains contains gluten? * Amaranth* Barley * Quinoa* Rice True or false: Beer contains gluten. Which of the following grains contains gluten? * Amaranth* Barley * Quinoa* Rice True or false: Beer contains gluten.