I just finished two new ‘Ask the Dietitian’ answers for the National Celiac Association. The links to those are below.
I just finished two new ‘Ask the Dietitian’ answers for the National Celiac Association. The links to those are below.
I’m excited to let you be among the first to know about the release of a new book for individuals with gluten-related disorders, dietitians, and clinicians published in conjunction with the Gastroenterology Clinics of North America. The book’s chief editors are Benjamin Lebwohl, MD, MS and Peter H.R. Green, MD. Alan L. Buchman, MD, MSPH, FACN, FACG, FACP, AGAF was the consulting editor. The work was a major collaboration between more than 30 experts from many adult and pediatric celiac centers in the United States and around the world.
The book is a compilation of the latest facts about celiac disease, including who it is most likely to affect, the changing presentation of celiac disease, and our understanding of why and how it affects individuals. For those with celiac disease or loved ones with celiac disease, this book provides a detailed description of the current dietary treatment, standards for follow up care, usefulness of new real-time dietary adherence assessment tools, and future non-dietary therapies on the horizon to treat celiac disease. Other articles address areas on the frontier of celiac disease research, including the rise in its incidence in Asia, our understanding of the interaction between celiac disease and the microbiome, and breakthroughs in the diagnosis and treatment of refractory celiac diseases. Our current understanding of nonceliac gluten sensitivity is also touched upon.
Anne R. Lee, EdD, RDN, LD, Tara McCarthy, MS, RDN, and I collaborated on the “Nutritional Considerations of the Gluten-Free Diet” chapter in the book. This section addresses the vital importance of seeing a registered dietitian for initial and ongoing education about the gluten-free diet (GFD). Celiac specializing dietitians play a crucial role in mitigating health risks, ensuring appropriate nutritional content in the diet, providing ongoing updates related to the diet and labeling-related regulatory changes, and aiding in providing social and emotional guidance related to improving the patient’s quality of life. This chapter also discusses the causes of nonresponsive celiac disease including gluten exposure, small intestinal bacterial overgrowth, irritable bowel syndrome, lactose intolerance, microscopic colitis, food allergies, eating disorders, disaccharide deficiency, and refractory celiac disease.
The book is available now electronically through Amazon (via Kindle) or a print version can be pre-ordered through Amazon for release in April here: https://www.amazon.com/Celiac-Disease-Gastroenterology-Clinics-America-dp-0323655238/dp/0323655238/ref=mt_hardcover?_encoding=UTF8&me=&qid=1552958239
Individual articles/chapters from the book are available for purchase here: https://www.sciencedirect.com/journal/gastroenterology-clinics-of-north-america/vol/48/issue/1
Finally, for those with university library access, each chapter can be downloaded separately.
Written by Julie Bradley on behalf of Melinda Dennis, MS, RDN, LD
Livestream and regular registration now open!
Harvard Medical School Celiac Research Program and the National Celiac Association announce their 3rd annual celiac/gluten sensitivity conference.
Nov 10-11, 2018 in Norwood, MA.
17 leading expert speakers, 3 delicious gluten-free meals and over >30 vendors.
For patients and providers.
CEUs for RDs and RNs.
• The Landscape of Celiac Drug Development
• Then and Now: Adult/Pediatric Management of Celiac Disease
• Using the Microbiome to Prevent and Predict Celiac Disease
• Gluten-free Family Dynamics: Is There a Happy Ending?
• Psychological Health and Celiac Disease
• Non-Celiac Gluten Sensitivity
• Nutrition and Diet: New Findings
• A Closer Look at our Gut-Brain Cross-Talk
• Cooking Demo: It’s Not Rocket Science – Just Eat Real Food!
• ……..and a very special Clinician’s Debate by Dr. Ciaran Kelly and Dr. Alessio Fasano
Registration for either or both days:
Please join us!
Harvard Medical School Celiac Research Program and National Celiac Association present
Facing Facts about Celiac Disease and Gluten Sensitivity
When: Saturday, November 10 and Sunday, November 11, 2018
Where: Four Points by Sheraton, Norwood, MA
Presenters: 18 experts in gluten-related disorders from the Celiac Center at Beth Israel Deaconess Medical Center, Celiac Disease Program at Boston Children’s Hospital and Center for Celiac Research and Treatment at Mass General Hospital and our affiliates
Melinda Dennis will be speaking at 2:15pm on Reading the Fine Print: Deciphering the Gluten-Free Nutrition Label. She’ll be sharing the podium
with Dietitian Tricia Thompson who is speaking on Facial Misbranding of Gluten-Free Foods.
• 3 delicious gluten-free meals
• Numerous gluten-free vendors
• Free Parking is available
• CEUs for dietitians and nurses
Go to www.nationalceliac.org to register
Record breaking wildfires followed by devastating mudslides caused tremendous loss and sorrow for thousands of people in Southern California this past fall and winter. As you well know, Northern California and other areas of the United States have also been particularly hard hit by natural disasters this past year; the Gluten-Free Disaster Relief Task Force was founded in the fall of 2017 in response. For everyone affected, the impact is one that remains long after the initial tragedy has passed. I think first of those who struggle during these times with the added challenge of finding gluten-free food. Fortunately, there is always something we can do to show we care.
I met the phenomenal, experienced staff of the Unity Shoppe, the lead case management site for the Montecito/Ventura/Santa Barbara disaster recovery when I visited Santa Barbara this Jan/Feb* and volunteered in their kitchen preparing produce for their welcoming grocery area. Currently, 20 staff and 1400 volunteers are trying to serve 18,000 people. Unity directors tell me that they are always in need of gluten-free products and that this recent double disaster has amplified that need and the number of gluten-free visitors.
Gluten-free clients often don’t come to standard food banks or resource centers expecting to find gluten-free products. The Unity Shoppe has a powerful network of 300 affiliated partners in the community and can spread the word that more gluten-free products will be available with the help of donations.
You can earmark a financial donation directly to the Unity Shoppe’s Gluten-Free Fund. The money will be designated specifically for gluten-free shelf staple products that are in great need by gluten-free consumers in this expected 2-5 year long-term recovery effort.
To Donate: http://www.unityshoppe.org/ways-to-give/
Click on the Disaster Support Fund donate button
IMPORTANT! Be sure to write in the section “Add special instructions to the seller” that you want the money to be used for the purchase of gluten-free supplies.
Questions? Please contact Nicola Harrington of The Gluten-Free Food Bank at the National Celiac Association: Phone: 1-888-4-CELIAC
If you know of Los Angeles–based food banks or resource centers that accept financial donations specifically for gluten-free food, please email Nicola.
Thank you for helping these communities as they heal!
*I grew up in the rain/ mudslide area and going home to visit and lend a small hand was a powerful experience for me.
Tricia Thompson of Gluten Free Watchdog, LLC, is working hard to convince the Food and Drug Administration to increase their surveillance, investigation, and enforcement of gluten-free food products that have been mislabeled (facial misbranding) under the Gluten-Free Labeling Law. The Center for Science in the Public Interest has recently added its positive input. To read CSPI’s comment, go to https://www.regulations.gov/docket?D=FDA-2017-P-5118 and click on view all comments; then search under CSPI.
Please join us in taking time to comment on this important issue that affects the safety of all of us who must follow a gluten-free diet. Click on the url above and then click on “Comment Now.” Under “Category,” there are various options including Individual Consumer and Health Professional.
Gluten-Free Labeling: Are Growth Media Containing Wheat, Barley, and Rye Falling through the Cracks?
- an article by Tricia Thompson, Melinda Dennis and Luke Emerson
“Bacteria, mold, yeast, and enzymes produced by bacteria are used in a variety of products, including probiotics and digestive enzymes. These microorganisms may be grown on media that may include ingredients derived from gluten-containing grain (ie, wheat, barley, and rye).
Some concern has been expressed in the celiac disease community that the use of gluten-derived/gluten-containing growth media may result in residual gluten protein fragments remaining in products containing microorganisms such as bacteria and mold.” [excerpt from our paper]
Read on to hear about a past study that also raised concern about growth media, results of recent testing of probiotics using both gluten-containing growth media and gluten-free growth media, and where we stand with regulations regarding labeling of allergens and gluten used in growth media. We also address where labeling laws are unclear about which ingredients meet the definition of “gluten free” for these products. Learn what questions consumers can ask manufacturers to get clearer answers regarding ingredients and gluten testing methods.
A summary of the article:
Here’s a brief reflection on some of the concerns of going gluten-free without a medical diagnosis to support it. The U. S. News and World report article pays particular attention to the apparent rise in parents choosing to put their children on the gluten-free diet.
A task force of hospital celiac centers, nonprofit organizations and community leaders is facilitating gluten-free product donations and gluten-free/allergy-friendly designated monetary donations to food banks in areas affected by the hurricanes. To learn how you can help please visit:
And today’s email update from Tricia Thompson of Gluten Free Watchdog
September 14, 2017
Hurricane Irma: We are in touch with someone on the ground in St. Croix. She is trying to help us figure out how to get gluten-free food to the shelters in St. Thomas. However, her communications with St. Thomas have been spotty at best. According to her emails, the damage suffered in St. Thomas and St. John is catastrophic. Shelters are open in St. Thomas. There are shelters in St. John but she doesn’t know how they fared. Many folks are staying with friends and family. “If someone has a house that's mostly intact, just needs a tarp, they will be keeping friends and family.” Food and supplies are getting to the islands via boat or military helicopters/planes. We will keep the community posted.
Thank you for caring. We truly are a remarkably supportive community.
Why is amaranth called a pseudo cereal and not a grain?
Amaranth (species: Amaranthus) belongs to a different plant species than your typical “true” cereal grains, such as sorghum and oats. But it has a very similar nutrient profile that we’ll look at in a minute. A tall plant with tiny edible seeds (only 1 millimeter across) and broad green leaves,* it’s been used for centuries in traditional diets around the world in much the same way as true cereal grains have. Where in the world? Just about any place with a temperate climate which includes Africa, India and Nepal, non-native regions such as China, Russia, Thailand, Nigeria, Mexico, parts of South America AND even in the U.S. where I read that it grows in Iowa, Nebraska, Missouri, North Dakota and New York.
But that’s not all. Last month I saw beautiful amaranth plants growing in the community garden at City Natives in Mattapan, MA, a property of the Trustees of Reservations. Here’s a shout out to a great organization I volunteer with that protects land in MA and encourages local and sustainable food production.
Why is amaranth so great?
There are SO many reasons. People following the gluten-free diet need wholesome nutritious gluten-free grains to take the place of wheat that we used to eat. We also need to avoid an overreliance on the more refined corn, rice, potato and tapioca starch-based foods on the market. PLUS, whole grains, such as amaranth, can help reduce the risks of heart disease, certain types of cancer, and type 2 diabetes, and may also help in weight management.
If you tolerate gluten-free grains and you need more fiber, iron, calcium and vitamins to round out your diet, consider amaranth. While you’re at it, check out teff, sorghum, quinoa, buckwheat and millet, too. It’s one simple way to meet the guidelines for consuming at least one half of your grains each day as whole grains, a recommendation from the US Department of Agriculture’s Dietary Guidelines for Americans and the Whole Grain Council.
Detailed information on the gluten-free grains can be found here: http://www.bidmc.org/Centers-and-Departments/Departments/Digestive-Disease-Center/Services/Celiac-Center/CeliacNow/NUTRAGFD/FBR/Level-2.aspx
More Reasons to Try Amaranth
• A protein powerhouse (13-14% protein!!), more than
• A COMPLETE protein, containing all essential amino
acids, including lysine
• High in fiber, calcium, iron, magnesium, phosphorus,
potassium, zinc, and B vitamins
• Easily digested, allowing your body to make use of its
rich source of vitamins and minerals
• Some early data showing its promise as a cholesterol
Even more reasons to try amaranth and links to recipes are here:
What do you do with amaranth?
In our gluten-free community, those familiar with amaranth typically use it as a flour in gluten-free baked goods. Carol Fenster, well-known author of multiple gluten-free cookbooks (www.carolfenster.com), uses it most often in cakes, cookies, bars and the occasional pancake to boost the nutritional content of the food. She finds the taste nutty, pleasant, and not too strong and I agree.
Other ways to use amaranth seeds (we’ll call them grains from here on):
Need FUN RECIPES to try amaranth?
Kristine Kidd, former food editor of Bon Appetit and gluten-free cookbook author, concocted a yummy Maple, Hazelnut, Amaranth Granola recipe - it’s a unique and tasty way to add this remarkable grain into your diet.
And here are yummy breakfast pancakes from Carol Fenster.
The simplest way to cook amaranth
Measure the grains. Rinse them thoroughly in cold water, strain them, and remove any dirt or debris. Measure the water and bring it to a boil, add grains, bring to a boil again, then reduce heat and simmer, covered tightly, stirring occasionally for ~15-20 minutes (time varies with different recipes and chefs). Drain, rinse, add salt (if desired) and eat. Most whole grains are slightly chewy when cooked. The Whole Grains Council recommends 6 cups of water per one cup of amaranth since the liquid thickens so much while cooking. Whole Foods Market suggests 3 cups of water per one cup of amaranth. Experiment!
A useful note when baking
Since amaranth absorbs water very easily, it can quickly become gummy. That’s why you always see amaranth in combination with other gluten-free flours, starches, and gums when baking. Paying close attention to the amounts and mixtures of flours is really important. Blended together properly, they can mimic the same consistency of gluten.
Where do you buy it?
Here are a few suggestions:
www.amazon.com (only purchase if labeled gluten-free)
www.bobsredmill.com (only purchase if labeled gluten-free)
www.mygerbs.com (all product lines are top 11 allergen-free, including gluten-free)
http://www.nuts.com (choose from the on-line gluten free section)
Or… a tip from Carol Fenster: Keep whole-grain amaranth in the refrigerator to grind into flour in your coffee/spice grinder, when needed.
It’s all in the label!
Wherever you buy your grain, be sure the package is labeled gluten-free. A 2010 study by Thompson, Lee, and Grace showed mean gluten levels above 20ppm in seven of 22 (32%) samples of inherently gluten-free grains, seeds, and flours NOT labeled gluten-free. The summary can be found here: http://www.glutenfreedietitian.com/contamination-of-naturally-guten-free-grains/
And the pub med abstract here: http://www.ncbi.nlm.nih.gov/pubmed/20497786
Here’s a 2009 blog from Tricia Thompson’s site that reminds us of the historical perspective on labeling of gluten-free grains.
Storage Tips (from www.nuts.com)
Store amaranth in a tightly sealed container, such as a glass jar with a rubber sealed lid. Keep it in a cool, dark, dry location or in the refrigerator. Avoid storing it near the stove, oven or dishwasher. If stored properly, amaranth can have a shelf life of up to one year.
Enjoy your amaranth!
*Amaranth leaves are nutritious and contain high levels of beta-carotene and lutein (both great for eye health). I have no experience cooking with them yet – but I will!
Disclosures: Carol Fenster and Kristine Kidd have sent me cookbooks in the past as give-aways at my retreats. MyGerbs was a 2015-2016 sponsor of my wellness retreat. Bob's Red Mill has sent samples in the past to my workshops or retreats.
USDA Dietary Guidelines, 2015
USDA National Nutrient Database: https://ndb.nal.usda.gov/ndb/foods/show/6474?manu=&fgcd=
Fiber and the Gluten-Free Grains: http://www.bidmc.org/Centers-and-Departments/Departments/Digestive-Disease-Center/Services/Celiac-Center/CeliacNow/NUTRAGFD/FBR/Level-2.aspx.
Thompson, T., M. Dennis, L. A. Higgins, A. R. Lee, and M. K. Sharrett. Gluten-free diet survey: Are Americans with coeliac disease consuming recommended amounts of fibre, iron, calcium and grain foods?" J Hum Nutr Diet, 2005;18(3):163-169.
“I’m on the gluten-free diet and I still feel unwell.” This is a common scenario among my patients with celiac disease and non-celiac gluten sensitivity. Symptoms can include (but are not limited to) gas, bloating, cramping, abdominal pain, loose stool, diarrhea, constipation, abnormal stool patterns, fatigue, headaches, nausea, and the list goes on. So, let’s explore what might be causing these persistent symptoms.Read More
Hi! I'm Melinda Dennis, MS, RDN specializing in gluten related disorders. After my own diagnosis in 1992, I became a registered dietitian and created Delete the Wheat to teach the gluten-free diet and lifestyle to others. Join me at Delete The Wheat to learn and implement crucial knowledge about gluten-related disorders and other special diets. I will be sharing inventive ways to remain healthy, happy, and gluten-free!