IS GLUTEN FREE For ME?

1. Kathy Egan, RDN/LDN National Nutrition Month March 2014 IS GLUTEN FREE For ME? ANSWERS TO YOUR QUESTIONS

2. GLUTEN FREE IS EVERYWHERE! What’s all the fuss? It’s confusing Trendy – does that make it wrong?

3. I’m not going to tell you what to do • There are enough people trying to do that already.

4. LEARNING OBJECTIVES • Describe & define gluten • Understand gluten vs. food allergy • Become more comfortable making diet choices

5. What is gluten? • A Protein found in: • Wheat • Barley • Rye • Oats, by contact

6. Gluten related disorders • Celiac Disease (Celiac Sprue) • Auto immune response • The body attacks itself • Mass General Hospital - What is celiac disease? • Gluten Sensitive Enteropathy(GSE) • (a.k.a. non celiac gluten sensitivity) • Damages intestines, but in a different way • Gluten Intolerance • causes discomfort, but doesn’t do damage

7. Gluten is not an allergen • Food allergy - immune response • Food is as an invader • Histamine reaction is typical • To learn more about food allergies: • FARE - Food Allergy Research & Education

8. “gluten free” defined by fda • Manufactured foods - less than 20ppm • 20 parts per million = 20/1,000,000 or .002% • Example - ½ teaspoon flour in 220 pounds sugar

9. Top food allergens • 90% of all food allergy reactions- • Peanuts, tree nuts, milk, egg, wheat, soy, fish, shellfish (sesame seed) • FALCPA • Food Allergy Consumer Protection Act of 2004 • Allergens must listed be in plain language • About Food Allergies

10. Is gluten bad? YES, if you have: Otherwise…. NO Gluten is just one of many proteins found in common foods. (It is possible to have a wheat allergy, but that’s different.) • Celiac disease • Gluten Intolerance • Gluten Sensitive Enterapathy (GSE)

11. FEELing BETTER WITHOUT GLUTEN? By avoiding gluten, you may consume: • GREATER VARIETY • HEALTHIER CARB FOODS • FEWER PROCESSED FOODS • LESS SUGAR, SALT & FAT • MORE FRUITS & VEGETABLES • ALL OF THESE HABITS WILL MAKE YOU FEEL BETTER

12. Other causes? • Out of balance gut flora • Stress, emotional issues • Irritable bowel syndrome • Crohn’s Disease • Colitis • Chronic Fatigue Syndrome • Lyme disease • Fibromyalgia • Poor diet • Poor sleep

13. Diet concerns • Regular flour is enriched with vitamins • Whole wheat is a good source of fiber • Glutenous grains contain protein, iron & calcium • GF flour is primarily white rice flour • Low in fiber, vitamins, minerals & protein • Higher calorie foods • Short article in New York Times - "Before Going Gluten- Free - Make Sure It's Necessary"

14. just go gluten free? • It’s expensive • Uncertainty about real issue • Can mask other physical or emotional issues • Rise in orthorexia – preoccupation with “healthy” foods • Interferes with social life & enjoyment of food

15. IS gluten free healthier? YES NO GF cookies, cakes, breads, crackers, pretzels Made with rice flour – less fiber and nutrients Often higher in sugar and fat to improve flavor & texture Usually higher in calories • Brown rice, quinoa, sweet potato, butternut squash • Plain fruits and vegetables • Meats, fish & poultry that are not breaded or fried • Simple nuts & seeds

16. Stomach enzymes adapt • If you stop eating a food for a long time, you body will make less of the enzymes needed to digest that food. • Gives a “false positive” for intolerance when you start eating that food again. • nih.gov/ PubMed

17. What if …………? • If you suspect you may have celiac disease or be gluten intolerant…. • It is very important that you KEEP EATING gluten containing foods. • A simple blood test can give your doctor important information, but only if you are still consuming gluten.

18. Talk to your doctor It’s the best place to start

19. Questions? • kegan@holycross.edu • to request copy of this presentation. • Thank you!