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Glutenand celiac
- 1. Going Gluten-Free The whyand how of gluten-free diets
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- 3. Part 1: Glutenand Gluten Sensitivities
- 4. What is Gluten? •Gluten is a protein composite in many grains and grain-based foods.
- 5. What is agluten sensitivity?
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- 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 CeliacDiagnosed? • First, a blood test. • Then, a biopsy.
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- 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 thecure?
- 17. NO GLUTEN • Ifyou 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: GlutenSensitivities 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 toAvoid • 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 • Tonsof products these days are being made completely gluten-free. • Check out new gluten-free breads, cereals, flours, pastas, and more!
- 25. A Note AboutOats • 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 • Avoidcross-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.
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- 30. Gluten-Free Dining • Doyour homework. • Have a list of questions ready. • If it is too risky, don’t go.
- 31. The Stakes areHigh
- 32. The Stakes areHigh
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- 34. Resources • National Foundationfor Celiac Awareness: http://www.celiaccentral.org/ • Gluten Intolerance Group: http://www.gluten.net/ • Celiac Disease Foundation: http://www.celiac.org/ • Celiac Sprue Association: http://www.csaceliacs.info/
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- 36. Quick Quiz! • Glutenis 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! • Glutenis 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! • Symptomsof 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! • Symptomsof 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! • Thecure 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! • Thecure 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! • Whichof 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! • Whichof 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.
Editor's Notes
- #2 Hello and welcome to our show! Today we’re going to talk about gluten -- why people may need to eliminate it from their diets, and how to manage a gluten-free lifestyle. Oh and don’t worry, we’ll have plenty of time at the end of the presentation for any and all questions you may have about gluten and your health.
- #3 We have a lot of ground to cover today, but I promise we’ll make it as engaging as possible. Part 1 of this show is all about the basics -- the role of gluten in your body, how some bodies react differently to gluten, symptoms of gluten sensitivity, and the different types of gluten sensitivities. Part 2 of this show is all about managing food when you have a gluten sensitivity: what to avoid, warning signs of hidden gluten, and of course, how to eat in a restaurant without getting “glutened.” The third and final part of this show begins with a quiz about the first two sections (if you are offering prizes for successful answers, highlight them now). From there, we’ll offer a list of places to go in order to get more information about what we’ve discussed today. Are you ready? Let’s get started!
- #4 Let’s start with a closer look at gluten and the sensitivities it can provoke…
- #5 Gluten is a protein composite in many grains and grain-based foods. Sometimes gluten is also found in medicines, cosmetics, and even vitamin supplements.
- #6 When a person’s immune system reacts abnormally to gluten, it is called a gluten sensitivity. Basically, the body sees gluten as a threat and reacts to fight it, which can cause uncomfortable symptoms that can ultimately be dangerous for your health. Celiac disease, also known as celiac sprue or gluten sensitive enteropathy, is a form of gluten sensitivity. Gluten sensitivities are notoriously hard to diagnose. According to the Gluten Intolerance Group, gluten sensitivity is the most undiagnosed disorder in the United States. (Sources: www.celiaccentral.org, http://www.gluten.net/)
- #7 Symptoms of a gluten sensitivity can vary widely, which is one of the reasons celiac disease and other gluten sensitivities go undiagnosed, but here are a few of the most common symptoms... Abdominal pain Bloating and/or gas Constipation Diarrhea Fatty, noxious, floating, bloody, or otherwise odd stools Nausea and/or vomiting Reduced appetite
- #8 Many gluten sensitivities, especially celiac disease, involve damage to the intestines when gluten is consumed. This intestinal damage can cause other problems, which are themselves symptoms of the disease. We’ve listed a few of the most common on this slide.
- #9 Celiac disease is a condition in which parts of the small intestine are damaged by an immune reaction to gluten. Other gluten sensitivities include the symptoms of celiac disease, but don’t always include the intestinal damage. With celiac disease, those damaged sections of intestine can no longer absorb nutrients, which can lead to malnutrition and other diseases.
- #10 The bodies of people with celiac disease process gluten differently than they would if those people didn’t have celiac disease. Basically, when a person with celiac disease eats gluten, it triggers an immune response that damages the villi of the small intestine. (Source: Image from http://www.digestive.niddk.nih.gov/ddiseases/ pubs/celiac/index.aspx, accessed 11/26/12)
- #11 Did you know that 30-40% of all people in the United States carry the gene for celiac disease? Only 1-2% of those people actually have that gene activated, but it can be activated at any time.
- #12 Activating the gene for celiac disease is usually the result of an environmental trigger, like stress, trauma, getting sick, taking a certain medication, or getting a parasite.
- #13 So, how is celiac disease diagnosed? The first step is usually a blood test to see if particular antibodies are present in the bloodstream. There are generally 2 types of these antibodies -- anti-endomysium antibodies (EMA) or antitissue transglutaminase antibodies (tTGA). If those antibodies are detected, the next step is to do a biopsy of the small intestine. This biopsy looks for flattened villi in the small intestine. Only if those villi are flattened can a doctor offer an official diagnosis of celiac disease. (Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001280/)
- #14 It’s hard to get to a celiac diagnosis because the symptoms are the same as many other conditions, like Crohn’s disease, depression, intestinal infections, irritable bowel syndrome, and lactose sensitivity, among others. According to the Gluten Intolerance Group, “For every 1 person diagnosed with gluten intolerance, 80 people are undiagnosed.” The National Foundation for Celiac Awareness asserts, “It is estimated that 85% of Americans who have celiac disease are undiagnosed or misdiagnosed with other conditions.” (Sources: http://www.gluten.net/, http://www.celiaccentral.org/celiac-disease/facts-and-figures/)
- #15 The National Foundation for Celiac Awareness is full of facts and figures about celiac disease. According to their research, approximately 3 million people in the United States have celiac disease, and the average time that a person waits before being diagnosed with celiac disease is 6-10 years! (Source: http://www.celiaccentral.org/celiac-disease/facts-and-figures/)
- #16 The National Foundation for Celiac Awareness estimates that 18 million Americans have non-celiac gluten sensitivity.
- #17 So, what’s the cure for celiac disease and other gluten sensitivities?
- #18 Sadly, there is no cure for celiac disease or other gluten sensitivities. However, that does not mean that there is no treatment. If you have celiac disease, you must go on a gluten-free diet. People with celiac disease can lead healthful lives by eliminating all traces of gluten from their diets. It helps to work with a registered dietitian to develop a new food plan & explore gluten sources. With time, your intestines will even begin to repair themselves. You MUST be scrupulously careful about avoiding gluten in all forms in order for this to happen.
- #19 People with celiac disease and other gluten sensitivities refer to accidentally consuming gluten as “getting glutened” or having a “celiac attack.” Symptoms of getting “glutened” can be quite severe and could even last for days. They include… Diarrhea Fainting/dizziness Fever Itching/rash/hives Nausea Stomach pain Vomiting With all this vomiting/diarrhea, dehydration can be a serious concern, so if you do get “glutened,” be sure to drink liquids when you can stand it.
- #20 Well, now that we’ve looked at the basics of gluten and gluten sensitivities, let’s take things to the next level and discuss living with a gluten sensitivity. In this section, we’ll focus on gluten-filled foods to avoid and other options to choose instead. There’s a wide variety of wonderful alternatives to foods with gluten, and we’re here to show you the ropes.
- #21 With celiac disease or any other gluten sensitivity, avoiding gluten is key. You will find gluten in products like… Barley Beer Bread Cereal Couscous Flour Pasta Rye Spelt
- #22 Sometimes gluten is hiding out in products where you wouldn’t expect it. Check out the list of less well-known gluten sources --they include… Graham flour Kamut Malt Modified food starch Soy Sauce Vegetable protein
- #23 Not all gluten that you could ingest comes from food. For example, did you know that the glue for stamps and envelopes contains gluten? Certain cosmetics and medications do too! Ask your pharmacist about the possibility of gluten in your medications, and check out Celiac Central’s guide to finding hidden gluten (http://www.celiaccentral.org/Resources/Gluten-in-Medications/111/).
- #24 Whew! That seems like an exhaustive list, but actually there are lots of products out there that are perfectly safe to eat and 100% gluten-free. After all, fruits, vegetables, and most protein foods -- like meat, poultry and fish -- do not contain gluten. Here are some of our favorite foods that you can still eat while avoiding all that gluten… Amaranth Beans Buckwheat Fish Fruit Meat Nuts Poultry Quinoa Rice Seeds Soy Tofu Vegetables
- #25 More and more products these days are being made without gluten. Check out new gluten-free breads, cereals, flours, pastas, and more!
- #26 Oats do not contain gluten. However, they are often processed on machines that also process foods that do contain gluten, which is all the exposure that some people need in order to get “glutened.” Check labels carefully and only select oats or oat products that have been processed on machinery that is not at risk of cross-contamination.
- #27 With all these great gluten-free alternatives, making your home a safe, gluten-free place is much easier than it used to be. However, you still have to be very thoughtful as you eliminate all traces of gluten from your home. If you live with people who are not cutting gluten from their diets, it’s important to avoid cross-contamination. This means that you should get all the cooking utensils you need -- think cutting boards, saucepans, etc -- and keep them COMPLETELY SEPARATE from all the other cooking supplies in your kitchen. If you’re sharing supplies, wash everything that may have touched gluten. Wash it thoroughly with soap and hot water. Simply brushing visible crumbs off the cutting board is not enough. If you have family members who might, say, dip their crumb-covered knife back in the peanut butter jar, then guess what? You need your own peanut butter jar. I know this sounds really high maintenance, but gluten can wreak havoc on your system if you have celiac disease. It’s just not worth it to skip the precautions and then get “glutened.”
- #28 Going gluten-free is hard work, but that doesn’t meant that it can’t also be fun. In fact, some people choose to go on gluten-free diets simply because they want to. Whatever your reasons, here is a sample of a single gluten-free day. Breakfast: Fresh fruit with nonfat, plain yogurt and raw sunflower seeds. Lunch: Large green salad with tomatoes, bell peppers, carrots, and cucumbers, topped with gluten-free dressing and a grilled chicken breast. Add a cup of vegetable soup -- but make sure it isn’t thickened with anything that contains gluten -- on the side.
- #29 Snack: A medium apple with a tablespoon of peanut butter. Dinner: Sonoran Sunset Quinoa Salad -- recipe to follow.
- #30 This tasty dish is a nutritional powerhouse and comes together in a snap. Recipe here: http://foodandhealth.com/fnce-story-1-gluten-free-workshop/
- #31 Whew! That was a lot of discussion about how you can go gluten-free at home, but how about dining out? Gluten-free dining can be pretty fraught. Check up on restaurants before you go and find out which ones are good at offering truly gluten-free options. Some restaurants have earned gluten-free credentials, while others simply know what to look for in order to safely make a gluten-free dish. Sometimes it’s helpful to make a list of questions for your servers to ask the kitchen. Things like -- Did I order anything that is breaded? Is this food thickened with wheat flour? Etc etc etc. If you have been repeatedly “glutened” at a particular restaurant, or if the staff is unwilling to address your situation, it would probably be wise to skip it and stick to places that are more accommodating.
- #32 This can seem like a lot of fuss. But the stakes are high -- your health is on the line. Remember the symptoms of getting “glutened?” People can be sick for days with terrible nausea, vomiting, diarrhea, and itchy rashes, among other things.
- #33 So, here’s the deal with your small intestine. It can and will heal itself, but only in the complete absence of gluten. If gluten gets into your system, it will hurt your intestines again -- assuming that your sensitivity does, in fact, involve intestinal damage, which many do -- even if there are no symptoms of getting “glutened.” Only 46% of people with gluten sensitivities achieve mucosal recovery. It’s important to stay the course and join that group, for the sake of your health.
- #34 We have covered a lot of vital information today. Are you ready to test your knowledge? Here we go! The first place to start is your grocery store – there are many gluten free products in grocery stores and in the Whole Foods Stores.
- #35 A gluten sensitivity can make life more complex. It’s important to remember that you are not alone. Now, more than ever, there are tons of wonderful resources and communities that all support a life without gluten. Check out the sites on this slide for tons of tools that you can use to live a gluten-free life. Now, does anyone have any questions about gluten sensitivities, celiac disease, or gluten? (Leave this slide up during the question and answer session).
- #36 Visit amazon.com for great baking books. And the Whole Food Store and many grocery stores carry gluten free products and baking mixes.
- #37 Gluten is a protein composite usually found in which of the following foods? * Meat* Dairy * Grains* Vegetables True or false: The gene that triggers celiac disease can be activated at any time.
- #38 The answers are… Gluten is a protein composite found in grains. and True, the gene that triggers celiac disease can be activated at any time.
- #39 Symptoms of a gluten sensitivity include which of the following? * Depression* Abdominal pain * Hives* All of the above True or false: Celiac disease involves damage to the small intestine whenever gluten is consumed.
- #40 The answers are… Symptoms of a gluten sensitivity include all of the above: depression, abdominal pain, and hives. That’s why it is so hard to get an accurate diagnosis -- there are over 300 symptoms of gluten sensitivities, and many mimic symptoms for other conditions. The answer to the second question is true. Celiac disease does involve damage to the small intestine whenever gluten is consumed.
- #41 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 The answers are…. The cure for gluten sensitivities is nonexistent. That does not mean that people with gluten sensitivities are powerless. For a bonus point, who can tell me what people who have gluten sensitivities should do? (The answer, of course, should be along the lines of scrupulously avoiding gluten). The answer to the second question is false. 30-40% of all people in the U.S. have the gene for celiac disease, but only 1-2% of those people have the gene activated.
- #43 Which of the following grains contains gluten? * Amaranth* Barley * Quinoa* Rice True or false: Beer contains gluten.
- #44 All right, here are the answers… Barley is the only food on that list that contains gluten. Amaranth, quinoa, and rice are all naturally gluten-free! And it’s true, beer does contain gluten. However, there are currently some gluten-free beers on the market that are safe for people with gluten sensitivities.