Category: Newsletters

Often during the holidays, we’re traveling, with friends, relatives, in other people’s houses, and out of our typical orbit. So here’s a special holiday edition, highlighting a handful of things containing gluten.

Ferrero Rocher are a holiday classic, especially for anyone who loves chocolate and hazelnuts. But sadly, they’ve got wheat as an ingredient.

Tea: we tend to think of this as a way of opting out of potential gluten. Some Yogi teas & Celestial seasonings have barley malt as an ingredient. Yep, even flavors that sound yummy like sugar cookie sleigh ride…and seriously, who keeps the box around to read the ingredients?There can be a cross contact concern for some teas, too. And have you ever heard of Bori-cha; dàmài-chá; mugi-cha; or be?h-á-tê? all names for barley tea. Caffè d’orzo is barley coffee, which is also out.

Candy: Yes, it’s important to think beyond the normal chocolate covered cookies and wafers and all that yummy stuff. All candy needs to be rechecked, even familiar candy. There are items that are regularly gluten free, like peanut butter cups, that sometimes aren’t gluten-free in holiday shapes. Sorry. There are some available in holiday wrappers, though, so do check the list.

Nuts: You know the main table with the crackers is out, so you grab a handful of nuts, thinking that must be safe. Right? If they’re plain or dry roasted nuts, you’re good. If they’re flavored, some use wheat to make things stick, like nuts.com’s Cajun or Japanese peanuts, for example, which have wheat. This may be the case if they’re homemade, or bought. This can be particularly tricky with brands with some gluten-free and some gluten-containing products, because it’s easy to assume everything is gluten-free from a brand.

Potato chips: on your mad dash through the airport, you’re trying to grab something to eat. The only thing that looks like a potential option is a bag of potato chips. Somehow in the overwhelm you miss…the malt flavoring, especially on salt & vinegar chips. I’d absolutely recommend bringing along extra plain nuts, fruit and or bars, especially for travel.

Alcohol: You know to stay away from gluten-removed beer, and that you’re good with wine, most ciders, and hard alcohol. But there’s something else which has become more popular. Wine coolers like Mikes often have malt (and nope, it can’t be fully removed) and malt beverages are out. Bottom line, aside from distilled alcohol, if it started gluten-free and no gluten was added, you’re good. If it started with gluten, it’s a no.

Of course, the biggest issue can often be cross-contact, which is a topic for a different day.

For ideas of naturally gluten-free options see this list with a ton of options.

Wishing you a wonderful holiday season.

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach working with clients in VA, DC & MD.  She helps people with a range of digestive problems, including Celiac, IBS, Crohn’s, Colitis, gastroparesis, EDS, POTS & more. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

 

 

 

 

It’s been a while since I’ve put together studies and news from the last few months on Celiac disease & other digestive disorders. And, of course, Valentine’s day wouldn’t be complete without chocolate, so I’m linking to Chocolate banana bread here for inspiration.

Like reading studies on Celiac disease? Here’s a collection of research on gluten-contamination. Always a hot topic!

A new guide on a gluten challenge for pediatrics

Look what’s opening in Manassas—a new gluten-free bakery

New IBD guidelines, with emphasis on fiber, Mediterranean diet, etc.

Do I need a B12 supplement? A Q I hear all the time

Gut microbiome is changed in people with POTS (Postural Orthostatic Tachycardia Syndrome) & Long COVID.

Artificial sweeteners and there potential impact on the small intestine. Interesting stuff!

Speaking of supplements, this is a good resource from the DOD:

Why do women have more autoimmune disease? Gift link here:

A Mediterranean helps with so many things, but does it help with IBS? And anxiety and depression? Yes, yes, and yes.

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach working with clients in VA, DC & MD.  She helps people with a range of digestive problems, including Celiac, IBS, Crohn’s, UC, gastroparesis, EDS, POTS & more. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

April is IBS Awareness Month. And, for the 1^st time, Virginia has officially recognized it as IBS Awareness Month! Many thanks to this administration for their support, and to Pam Emmer for starting this initiative across the country.

Now, you may already be more aware of IBS than you’d like. It’s very common—approximately affecting 45 million people in the U.S. It’s a condition of gut-brain interactions with chronic change in bowel habits and abdominal discomfort. Sometimes people have IBS solo; sometimes it tags along with other conditions, like Celiac, IBD, gastroparesis, MCAS, etc.

The good news is that IBS does not lead to increased risk of cancer or death, but it does have a severe impact on quality of life for many people. Currently, there isn’t a cure, but there’s a lot that can be done to improve symptoms through diet, lifestyle changes, exercise, supplements, stress management, sleep, medications, and more.

Yes, for real, diet affects IBS, at least for many people. Most likely you already know this. ? Now the AGA recognizes it, too!

Great piece on IBS and stress on NPR

Can gut microbiome predict long COVID? A new study suggests this may be a thing. (preliminary data, of course, and more study needed)

An article on diet and IBD in TIME

Dr. Mark Pimentel’s new book from Cedar Sinai on SIBO is out! And they are donating profits in April to World Central Kitchen.

Gluten-free, low FODMAP meringue bunnies—Kosher for Passover, too! (video recipe), with recipe written out here

Since it’s almost Valentine’s day, I’ll be sharing a few favorite recipes below–some that you can whip up last minute! But first, a quick research run-through.

Here’s something I don’t love at all. There are concerns about gluten-free oats. Again. It’s harder to find gluten-free oats now, and there are recommendations for people who need gluten-free oats for medical reasons to choose oats certified gluten-free, preferably purity protocol. And even if you’ve checked the ones you eat, do check again, because some have change because of supply chain issues.

Interesting article on how many people who are diagnosed with IBS actually have other underlying issues, like Celiac, microscopic colitis, SIBO, carb malabsorption or pancreatic insufficiency.

For those of you with IBD, and dietitians who read the newsletter, there’s a great article on diets for Crohn’s and UC, reviewing the ones that work…and the ones that don’t.
Along similar lines, I did a 5-minute journal review of a study out in Jan 2022 on a special diet for Crohn’s called the Crohn’s disease exclusion diet. It’s been used for children in the past, and was just studied for use in adults. Tricky to do, but can be effective, and interesting to read about.

Last but not least, I’ve got a CE course for nutrition professionals on histamine intolerance. I find it such a fascinating topic, and something I’ve been seeing so much more in clients and in research lately.

Onward to the food!

My favorite things to make for my Valentine (all gluten-free, of course)

• Chocolate hazelnut torte (AKA E’s cake)
• Chocolate covered strawberries
• Chocolate banana mousse pie
• A chocolate brownie
• Chocolate Frangelico mousse on a GF shortbread crust with vanilla-hazelnut whipped cream topping (sorry…I didn’t blog the recipe)

What if you don’t like/can’t eat chocolate?

1. I’m sorry
2. I’d recommend toffee, or
3. Crustless apple pie

May is Celiac awareness month. It’s also Ehlers-Danlos awareness month. And if you’re really genetically blessed like me, you may be personally aware of the link between the two. If not, indulge me in a quick discussion of the research, because it’s too rarely discussed.

There was a 2011 paper which indicated that Celiac was much more common than expected in people with hypermobile EDS. [1] 19% had positive Celiac serology (bloodwork), and 16% agreed to a biopsy, and those 16% were confirmed to have Celiac disease. Notably, the sample size for this study was small—it was only 31 people—however, 16% is much higher than the expected prevalence of Celiac disease, which is ~1%.

2015 paper also indicated a potential link between Celiac disease and hypermobility, with found that 30% of people with Celiac met the criteria for Joint Hypermobility Syndrome (JHS), which is now known as Hypermobility Spectrum Disorder (HSD). [2]

Most recently, in 2021, a case control report looked at people with all types of EDS, and found that Celiac disease was one of the most common GI conditions associated with EDS, and the association was much stronger than in controls–with a 5.47 odds ratio. The study did not break out EDS subtypes, however. [3]

So, while the percentages and the details may still be a question, clearly there is some link between Celiac disease, EDS and Hypermobility Spectrum Disorders. And it is worth noting that while EDS is quite rare, HSD is common; 2-3% of the population.

Of course, testing is always essential before dietary changes because a proper diagnosis is critical. Other people may simply respond poorly to FODMAP content of wheat, so a much larger portion may feel better gluten free, even though they don’t have Celiac.

For more of the research on digestion and hypermobility and EDS, I do have more fun stuff on nutrition for GI issues and all things hypermobility here and for nutrition professionals, consider checking out the Digestive Disease Nutrition series, which includes a lecture from me on how hypermobility affects digestion.

Footnotes

1. Danese C, Castori M, Celletti C, Amato S, Lo Russo C, Grammatico P, Camerota F. 2011. Screening for celiac disease in the joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type. Am J Med Genet Part A 155:2314–2316.
2. Fikree A, Aktar R, Grahame R, Hakim AJ, Morris JK, Knowles CH, Aziz Q. Functional gastrointestinal disorders are associated with the joint hypermobility syndrome in secondary care: a case-control study. Neurogastroenterol Motil. 2015
3. Rachel S Brooks, James Grady, Thomas W Lowder, Svetlana Blitshteyn, Prevalence of gastrointestinal, cardiovascular, autonomic and allergic manifestations in hospitalized patients with Ehlers-Danlos syndrome: a case-control study, Rheumatology, 2021.

Infant feeding study, a low FODMAP vegetarian easy dinner recipe, news, Halloween & more

New study—breastfed infants were either fed gluten early (starting 4-6 months) or after 6 months. Then they compared the rates of Celiac at 3 years. Surprisingly, the early intro of “high dose” of gluten group had lower rates of Celiac at 3 years (0%, vs 1.4%)
The study suggests that higher amounts of gluten may be the key to prevention here. They specify that this study involved an age appropriate “normal” amount of gluten—3.2 grams by 9 months—but  the paper does not provide an example of what that means in “real life”.
Longer follow up is underway…
Also: Hot off the presses—Celiac is not linked to increased risk of COVID. Phew!
And big news for many: For a long time, SIBO tests looked at 2 gasses, hydrogen and methane, but this would miss some people, because there was starting to be evidence that hydrogen sulfide was also a factor. Now labs are available can also examine this, too, and make the clinical picture clearer.
Ooh, did you hear? A bunch of Ben & Jerry’s flavors are about to be certified GF. If you happen to like ice cream. ?
Halloween on the way…
My standard Halloween suggestions here….some things may require adaptations.
From Allergic living–

• Food-Free Fun
• Treats and Candy from Allergic Living and another candy list here from Kids with Food Allergies Recipe:

Easy cheesy egg bake
We’ve still got an abundance of basil to use up this time of year, and it’s a balancing act of finding quick and easy recipes. This one takes about 5 min prep time and it’s delicious. Bonus—it’s gluten-free, vegetarian, low FODMAP, SCD friendly and adaptable for dairy-free.

Hope you’re having a healthy summertime.

A few quick updates:
Time to do the happy dance! The Gluten-Related Disorders Training for health professionals is officially out. This is an effort to train dietitians and other health professionals on Celiac, and other disorders related to gluten. It’s taken over 6 years—close to 7! But it’s done.
Module 1: Medical Aspects of Gluten-Related Disorders and Gluten-Free Dietary Treatment. Alessio Fasano, MD Tricia Thompson MS, RD
Module 2: Going Gluten-Free: Moving Clients from Diagnosis to Implementation. Mary K. Sharrett, MS, RD, Suzanne Simpson, MS RD
Module 3: Enhancing Quality of Life in Individuals on a Gluten-Free Diet. Amy Keller, MS, RD, Anne Lee, MS, RD
Module 4: Gluten-Free Diet and the Life Cycle. Cheryl Harris, MPH, RD
Module 5: Nonresponsive Celiac Disease and Developing Alternative Treatments. Melinda Dennis, MS, RD Daniel Leffler, MD

I have no vested financial interest—but I’m excited that this resource is finally available, and more RDs will be educated on Celiac.
RDs, there will likely be grants available to reimburse the cost of the trainings if you complete all the units, and I will post more info as it’s available.

• Really interesting paper on the overlap between IBD (Crohn’s and UC) and Celiac. Often people have both, and the symptoms of one are mis-attributed to the other.  
• Mint Lemonade Spritzer—my husband’s favorite thing when he’s teaching (socially distanced) martial arts outside and temps are in the 90s. Low Fodmap if you’re having one glass ?
• So many veggies. So little time! Here are a few suggestions on ways to use up all the fresh garden goodness.
• Yep, Farmer’s markets are still open–and often you can pre-order. Some info here

Long-time Celiac supporter Dr. Aline Charabaty has started a fundraiser to help those affected by the tragedy in Lebanon. If you’re inspired to help, here’s more information.

Wishing you a safe end of summer!

Harris Whole Health offers individual sessions, currently only virtually! Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, IBS, IBD and a range of tummy troubles. Let’s get you on your way to achieving your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here, email or call 571-271-8742.