Archive for the ‘Diet’ Category

 

Marissa Carter

Watch Your Waistline While on a Gluten Free Diet: Part One

September 22nd, 2009 by Marissa Carter


Marissa_Carter_Exam_Pic

When cruising the gluten free forums, it is not hard to notice that there are a few issues associated with a gluten free diet that come up a lot. One of these issues is a rapidly expanding waistline.

The problem of gluten free weight gain comes from the higher concentration of carbohydrates and sugars found in gluten free foods. One serving of gluten free corn spaghetti has 7 more grams of carbs than the “regular” counterpart. That may not seem like much in terms of numbers, but your thighs can tell the difference.

With the holiday season quickly approaching, many people are beginning to search for a sure fire way to beat the bulge. This is even more challenging when you are already searching to find the gluten free jewels in every party menu. (more…)


Jessica_Meyers_Exam_Pic

Who doesn’t love fall weather? The colors changing on the leaves, cooler weather (well, maybe we will be a couple degrees less than 100), the beginning of a new football season, the glorious Austin City Limits Music Festival, the list goes on. Some of the best tasting vegetables are also in season in the fall such as the mushrooms, oranges, lemons, cauliflower and fennel. All of the following vegetables have unique flavors and can be used in a variety of dishes. The top five are:

Mushrooms
Mushrooms are known for their immune boosting benefits in the nutrition world. They have been used for thousands of years in helping prevent cancer, boost the immune system and are also known as a great anti-aging food. There are several different types of mushrooms that are fabulous to cook with. Try grilling some beefy Portobello’s with Italian seasonings for a nice vegetarian meal this fall.

Oranges
The beloved orange; it’s one of the most popular fruits in North America. Known for the immune boosting vitamin C, oranges have many other health benefits. Oranges also have a good amount of Potassium (which helps with muscle contraction), fiber and vitamin A. Oranges are very versatile when it comes to cooking. Try this yummy recipe from celiac.com: Orange Chicken. (more…)

Cindy Swan

Is gluten free the next weight loss fad diet?

September 14th, 2009 by Cindy Swan

Cindy_Swan_Exam_Billings_MT

With increasing regularity folks are asking if they should start the “new” gluten free diet to lose weight. They’re serious. Too often eating plans designed to combat specific diseases become money making marketing machines in the form of weight loss fad diet products, usually with poor long term results.

cindy_swan_veggies Many people now see the gluten free labels in the health food section of the grocery store, the thin people reaching for them, and well, you see the fore drawn conclusion. What they don’t realize is that the thin person may have celiac disease or other autoimmune disorder, and he or she actually weighs a healthy 20 pounds more since starting a gluten free diet, putting an end to malabsorption problems. Conversely, some people do lose weight eating gluten free, not because they are using the lifestyle as a specific weight loss program, but because addressing their underlying disease resulted in improved body composition.

In the later case, weight loss may be a side benefit of removing the offending food, thus allowing the body time to heal and absorb nutrients normally. However, a gluten free lifestyle is not intended to be the next fad weight loss program. Consider two other dieting trends over the past two decades: (more…)

John Libonati

Gluten free diet cards from Glutenfreeworks.com

July 31st, 2009 by John Libonati

gluten-free-diet-card-3-images-lrge

Glutenfreeworks.com has comprehensive gluten-free diet cards that lists unsafe foods and ingredients (including hidden) broken down by categories: whole grains & cereals, flours, thickeners, sweeteners, distilled spirits, fermented, cooked products, baked products, protein polymers, brewed, germ/bran and other.

Gluten-Free Diet Cards make dining out and shopping for groceries easy. These cards are perfect for eating out at restaurants or comparing ingredient labels when shopping for groceries. No more long explanations to waiters and managers. Just hand them the card. They’ll compare the ingredients to their recipes and let you know what you can have. No more wondering if an ingredient is safe or not when shopping. Just check it against your Gluten Free Works Diet Card. (Always call the company though if you’re unsure!)

The cards are 4″ by 3 1/2″ and fold to wallet size. See what they look like here. Gluten Free Diet Cards

They cost $6.50 for 5 cards, $30 for 25 cards, or $50 for 50 cards. Shipping is included in the price.

You can also get 5 free Gluten-free diet cards when you order a copy of Recognizing Celiac Disease.

garret-children-tested-for-celiac-disease

This post answers the common question – When is the best time to introduce gluten to a child’s diet when celiac disease runs in the family?

Question:

Hi John,

I was wondering if you have any information about when to introduce a baby to gluten if there is a gluten intolerance in the family. I work with babies with special needs and I am seeing a growing need for some accurate information on this. I am sure you are not surprised.

I know that some research seems to be indicating a good time to try a small amount of gluten is between 4-6 months. It seems that older research said older than 6 months. Do you have any knowledge on this subject? I am very curious but hate to share inaccurate information.

I have found some information on the internet, but wanted another opinion.

Thanks for any help you may be able to offer……
Alisa W.
Celi-ACT Support Group

Alisa Weeks
Early Interventionist
Tennessee Early Intervention System

Answer:

Hi Alisa,

Regarding when to introduce children to gluten is a difficult question. There was a study that “showed” introduction at between 4 and 6 months had some benefit, but this study was poorly performed and subsequently shown to be in error.

Really, there is no proper time to introduce gluten to prevent the development of active celiac disease. Every person is different and even siblings can exhibit different symptoms. 1st degree relatives have about an 11% chance of having celiac disease, so there is an increased chance that the child will have it. (As an aside, my sister with celiac disease has two boys, 2 1/2 and 1. She won’t let either touch it because she doesn’t want to risk it.)

If the parents of an infant or young child with familial risk to celiac disease decide to risk exposure to gluten, Cleo Libonati advises not introducing gluten before the age of three.

Why three?

Children do not reliably produce antibodies before the age of three which means antibody testing could be inconclusive and misleading if symptoms arise. Suppose the child does not develop the classic presentation of diarrhea but instead atypical symptoms that mimic other disorders. The symptoms could be dismissed altogether and not considered as presentations of celiac disease.

Harm could then occur unnoticed such as development of defective tooth enamel in unerupted permanent teeth (in the gums) or neurological disorders such as epilepsy that would show up later, with or without poor growth and development. Brain development is rapid in the first year particularly so that mental, social and behavioral skills could be adversely affected.

If celiac disease testing is performed in a young child, the following should be carefully considered before determining whether a negative result is truly negative.

• Children under the age of 2 years do not produce tissue transglutaminase (tTG) antibodies, therefore the best time to begin measuring antibodies is after children reach age 2 to 3 years.

• In clinical practice tTG lacks the reported sensitivity. Specificity is reported between 95% and 99% in adults, falling to 73% in children at the recommended cut-off value of 20 IU.3 tTG is reported to be less reliable in early stage celiac disease without villous atrophy, the elderly, children under 3 years of age, smokers and advanced celiac disease.

• In screening relatives of patients with celiac disease, evidence showing discordance in testing suggests that both tTG and EMA should be used to avoid false negative results.

• EMA is reported less reliable in early stage celiac disease without villous atrophy, the elderly, children under 3 years of age, smokers and advanced celiac disease.

• EMA positivity with normal biopsy was found to be a very early predictor for later overt celiac disease, and necessitates further follow-up, especially if the child is AGA-positive and there is a family history of celiac disease.

• A substantial proportion of patients with true celiac disease are EMA negative.

• AGA testing had 100% sensitivity for diagnosis in children less than 18 years of age with iron deficiency anemia compared to EMA sensitivity of 81.8% in the same study.

In any case, the mother must watch the child for symptoms of nutrient deficiencies after the introduction of dietary gluten – whenever (if) she starts him or her. Children under the age of two seem to present with classic signs of failure to thrive, diarrhea, however, after that age atypical symptoms become predominant. Use Recognizing Celiac Disease to identify changes in behavior, growth, skin, hair, eyes, intelligence – anything at all – because that age period is a critical time in growth and development of the body and the mind.

Here are two videos about a child who presented with atypical symptoms at age 3 months, whose mother knew she had celiac disease but was told her children could not have it because it was so rare…and even if they did, she would recognize it because the kids would have the same symptoms she did: diarrhea, weight loss, and fatigue. Her son had neurological symptoms only, disturbing schizophrenic-like episodes and you will see it was a miracle that he was diagnosed at all. You may recognize his symptoms in other children you know who you never suspected of having celiac disease. These videos are a real eye-opener and exactly why people need Recognizing Celiac Disease – so they can determine whether symptoms are related to celiac disease and the causes when they are. It is very likely that many children are being affected just as this little boy was…it is far less likely that the events that led to his diagnosis will happen for them.

Part 1 – Celiac Disease Manifesting as a Mental Aberration in a Baby

Part 2 – Celiac Disease Manifesting as a Mental Aberration in a Baby

References:

Cleo J. Libonati. Recognizing Celiac Disease, Fort Washington, PA, USA: GFW Publishing, 2007. www.recognizingceliacdisease.com

Abrams JA, Diamond B, Rotterdam H, Green PH. Seronegative celiac disease: increased prevalence with lesser degrees of villous atrophy. Dig Dis Sci. Apr 2004;49(4):546-50.

Lurz E, Scheidegger U, Spalinger J, Schöni M, Schibli S. Clinical presentation of celiac disease and the diagnosic accuracy of serologic markers in children. Eur J Pediatr. Oct 2008. Epub.

Donaldson MR, Book LS, Leiferman KM, Zone JJ, Neuhausen SL. Strongly positive tissue transglutaminase antibodies are assodciated with Marsh 3 histopathology in adult and pediatric celiac disease. J Clin Gastroenterol. Mar 2008:42(3):256-60.

Donaldson MR, Firth SD, Wimpee H, et al. Correlation of duodenal histology with tissue transglutaminase and endomysial antibody levels in pediatric celiac diasese. Clin Gastroenterol Hepatol. May 2007;5(5):567-73.

Esteve M, Rosinach M, Fernández-Bañares F, et al. Spectrum of gluten-sensitive enteropathy in first degree relatives of patients with celiac disease: clinical relevance of lymphocytic enteritis. Gut. Dec 2006;55(12):1739-45.

Sanders DS, Hurlstone DP, McAlindon ME, et al. Antibody negative celiac disease presenting in elderly people – an easily missed diagnosis. BMJ. Apr 2005; 330(7494):775-776.

Utiyama SR, Nass FR, Kotze LM, Nisihara RM, Ambrosio AR, Messias-Reason IT. Serological screening of relatives of celiac disease patients: antiendomysium antibodies, anti-tissue transglutaminase antibodies or both? Arq Gastroenterol. Apr-Jun 2007;44(2):156-61.

Boger CP, Thomas PW, Nicholas DS, Surgenor SL, Snook JA. Determinants of endomysial antibody status in untreated celiac disease. Eur J Gastroenterol Hepatol. Oct 2007; 19(10):890-5.

Grodzinsky E, Fälth-Magnusson K, Högberg L, Jansson G, Laurin P, Stenhammar L. IgA endomysium antibodies – an early predictor for celiac disease in children without villous atrophy. Acta paediatr. Jul 2008;97(7):972-6.

Shah VH, Rotterdam H, Kotler DP, Fasano A, Green PH. All that scallops is not celiac disease. Gastrointest Endosc. Jun 2000;51(6):717-20.

By John Libonati

Commonly asked questions on nutrition and Celiac Disease, answered by Melinda Dennis, MS, RD, of the Celiac Disease Center at Beth Israel Deaconess Medical Center. Ms. Dennis has herself had Celiac Disease for more than 17 years.

Q. What is it like for a person you see who is newly diagnosed with Celiac Disease?
A. The gluten-free diet requires more preparation, taking food with you when you travel, making sure that you are safe in dining-out situations or when you are visiting with family or friends. So for some, it is very simple and straight forward and they are already experimenting with new grains like amaranth, buckwheat, millet, sorghum, and teff. But some people are completely unfamiliar with these grains and it is a bit more of a stretch for them. Many people just eat on the run these days and this really makes it challenging.
Others are in complete denial. Perhaps they were having no symptoms but this was discovered through a blood test and they think – do I really need to change my life? Those are the people who, understandably, ask “how much can I get away with?” So there are all different types of people. But more and more people are coming into the clinic well educated about this because of the good information on the web. That’s a big change from about seven or so years ago when there were very few resources.
 

Q. There are many gluten-free foods on the market now. Does this make it easier for those diagnosed with Celiac Disease?
A. Yes. But it’s important to stress that the gluten-free diet isn’t just about what we need to take out of our meals, it’s about making sure the foods you do choose have lots of nutrients. Rice, corn and potatoes have a really high glycemic index, and they don’t have a lot of fiber. They can create food cravings. They can lead to weight gain and they are not nutritionally dense. So when we think of Celiac Disease, we think – how can we make up for the fact that we don’t have a very high protein wheat product any longer? What can we substitute and what would be superior? That’s when we work on educating about other grains that are healthier and have plenty of vitamins and minerals. Several of the gluten-free foods are now fortified with B vitamins, iron and trace minerals, and you can check the labels to make sure.
 

Q. It’s great there are more gluten-free options, but even reading the labels don’t always help. What items have hidden gluten?
A. Lots of things you wouldn’t expect contain gluten. Toothpaste can have gluten; you have to be careful to wash your hands carefully after feeding your dog because chow usually contains gluten. Dental pumice that is used to polish your teeth may contain gluten. Soy sauce, gravies and marinades are suspect. Even communion wafers. Patients need to be educated on all of this, because consistent exposure to gluten will lead to increased damage to the small intestine.
 

Q. Do most patients eventually adopt a healthy, gluten-free diet?
A. Most patients, even those who have a hard time with the diagnosis, do learn how to eat well. From my own experience, I feel it was actually a blessing to be diagnosed. It changed my life for the better. It empowered me to make the right decisions, to eat well—actually better than I had ever eaten before. I travel more now and experiment with tasty foods, more ethnic food, as well. So it’s a good thing to have a diagnosis—and learn the best ways to take care of your body and be healthy.

Above content provided by Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.
Source: http://www.thebostonchannel.com:80/bethisrael-old/17014446/detail.html

————————
“””Author Information: John Libonati, Philadelphia, PA
Publisher, Glutenfreeworks.com.
Editor & Publisher, Recognizing Celiac Disease.
John can be reached by e-mail here.”””

John Libonati

Everyone on a Gluten Free Diet?

May 15th, 2008 by John Libonati

The below article by Nadine Grzeskowiak is a good explanation of why the gluten-free diet can work for anyone and everyone and pitfalls of the celiac tests.  Medical experts speak of the gluten-free diet as if it is something strange, yet most unprocessed foods you cook yourself are naturally gluten free.  All meats, seafood, fruits, vegetables, nuts, legumes, dairy (unless gluten was added to them), corn, rice and other grains,(besides wheat, barley, rye or oats), naturally do not contain harmful gluten.  Wheat, barley, rye and oats don’t contain any nutrients you cannot get in other foods, so what is the big deal with not eating them?Nadine’s article is excellent.  The only thing I would add is if you do eliminate the gluten grains of wheat, barley, rye and oats and feel better within two weeks, get yourself tested for celiac disease.  A positive diagnosis makes dealing with healthcare providers much easier.  That said, if it comes back negative but you feel better being gluten-free then eliminate gluten from your diet and be healthy.You can find Nadine’s blog article at http://glutenfreern.com:80/everyone-on-a-gluten-free-diet/-John Libonati, Editor Glutenfreeworks.com
john.libonati@glutenfreeworks.com

Discussion | | Nadine Grzeskowiak | May 13, 2008

I have thought for a long time about this very question.  Who would suggest such a thing?  I would.  The main reason I would dare to make such a statement is because we have been so negligent in recognizing and treating people with celiac disease.  Not a day goes by that I don’t hear about or speak to someone directly who has suffered needlessly for years.  The other main point I want to make is that NONE of the currently available testing is 100%.  The blood tests and endoscopic biopsies are great tools if they are positive.  If they are negative, I have heard of too many people tell me ‘I don’t have celiac disease, my blood test/biopsy was negative’.  This is a major cause for concern to me.  Both of these tests do not confirm you don’t have, or will never develop celiac disease.  First, neither test is 100% reliable.  Second, both tests are simply a snapshot of right now.  I have also seen test results that are clearly positive for celiac disease, but read as negative by a medical provider that does not understand what the results mean.  The genetic testing is great and it is my first choice when testing people.  The test is a cheek swab, I get results in one week and it is covered by most insurances.  I utilize Kimball Genetics in Denver, Colorado,  www.kimballgenetics.com.  I have run into this scenerio in the past week: a 12 year old on a gluten free diet for several months, a remarkable recovery from many symptoms while on the gluten free diet, and yet, she tests negative for DQ2 and DQ8.  Is she at risk for celiac disease if she eats gluten?  Are there other genes that could be looked at?  I am gathering more data on this because nothing is black and white with gluten intolerance, there are many grey areas.  Other than, of course, the need to be on a strict gluten free diet for the rest of your life if you have celiac disease.  Not much grey there. 

So, this leads me back to the original question: everyone on a gluten free diet?  In my perfect world, the answer would be a resounding YES!  If people would simply try the gluten free diet for a month, most, if not all of those people will feel better.  It remains simply a diet change.  Change your diet and feel better, doesn’t that sound appealing.  To some yes, and to others, not really. Not without the proof that they need to change their long held diet and lifestyle habits.  It also sounds quite un-American to say ‘I can’t eat wheat, barley, rye and oats’, by extension, bread, pies, cakes, beer and pizza.  My most recent convert to a gluten free diet, said to me, “You know I don’t even miss the bread anymore, it doesn’t even appeal to me, I feel so much better on the gluten free food”.  This is a woman who has had symptoms for most of her 76 years and I had a hard time convincing her to try the gluten free diet for a month.  She is convinced now.  I can tell many stories with the same happy ending.  I can also tell you that most men have a harder time changing anything, let alone their diet, than women.  Trust me, I am a nurse and I have no reason to lie to you.  Try it.  Go gluten free for a month and contact me with your results.  GO!