Category: Newsletters

Celiac disease and fertility

News and events

Infertility is one of the hardest things for couples who want children, and Celiac disease is frequently an overlooked cause.

It’s commonly known that around 1% of the population has Celiac disease, and we often think of it as a gastrointestinal disorder. But Celiac is 4-8 times more common in women who are experiencing infertility without any other known cause.  It’s particularly tricky, because many of these women are not experiencing any of the typical Celiac tummy troubles, and most don’t even have anemia, which is often the most visible sign of Celiac.

Many doctors now suggest screening for Celiac when there isn’t another obvious cause for infertility. It’s also a much simpler and less invasive test than many of the infertility procedures. If you’re reading this, most likely Celiac is on your radar screen, but you know as well as I do that this isn’t universal. Since there’s such a genetic link involved, if you have family members who are experiencing infertility or miscarriages, or if you know people experiencing infertility, do consider passing this information along! (gently of course, to people who you think might be open to it)

What’s causing the infertility?

Well, as you know, with untreated Celiac disease, every time the mom to be eats gluten, her body attacks the small intestine, which often causes nutritional deficiencies. Obviously this makes it harder to get pregnant and to have a healthy pregnancy. The nutrients people with Celiac aren’t absorbing well are the same ones that grow babies, such as iron, vitamin D, B vitamins, zinc, magnesium, calcium, etc.

But there’s more than that. An untreated autoimmune disease even without nutrient deficiencies isn’t good for mom or baby.  The same tissue transglutaminase antibodies that doctors look at to tell if we have active Celiac disease and how we’re responding to a gluten-free diet can actually interfere with pregnancy. According to Daniel Leffler, MD, MD, director of clinical research at the Celiac Center at Beth Israel Deaconess Medical Center in Boston “It turns out that antibodies affect the placenta in negative ways. We thought they were just good diagnostic markers, but they also seem to bind to and wreak havoc on many areas of the body.”

This also means that moms-to-be will have the best chance of a healthy pregnancy if they wait 6 months or until the tTg (tissue transglutaminase) levels are back to normal and nutritional deficiencies are corrected. Because at the end of the day, the goal is not just getting pregnant, but having a happy, healthy baby.

Don’t forget dad

We tend to focus on mom, but if Dad has untreated Celiac, HE may be the cause of infertility. Vitamins A, E and zinc are critical to sperm production. And one study even showed that Dads with untreated Celiac were five times more likely to have low-birth weight babies.

Smart steps:

So-if you want to get pregnant and have Celiac disease, make sure you’ve checked with your doctor about nutritional deficiencies and your thyroid, too. People with Celiac are more likely to have autoimmune thyroid diseases, too, such as Hashimoto’s or Graves’, which often show up during and after pregnancy.

It’s also critical to make sure you’re eating a balanced diet. Most gluten-free products aren’t fortified the way regular products are, and many are both higher calorie and higher in empty, starchy carbs, too. The nutrients that are low in the diets of women with on a gluten-free diet (iron, B vitamins, calcium, fiber) are needed by both mom and baby. A Registered Dietitian can help you make sure you’re getting what you need.

For more information or for health professionals and RDs, I do have a CE course on having a healthy gluten-free pregnancy.

Coming soon: infant feeding and Celiac—I’ll post that soon, I assume I have at least 9 months!

Cheryl Harris, MPH, RD is a Registered Dietitian, Nutritionist and Certified Wellness Coach in Fairfax . Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals.  Email her or call 571-271-8742. 

• Breakfasts
• Back to School
• Events, an heirloom tomato and avocado salsa recipe & more

Breakfasts

I’m sure I’m not the only one who has been sucked into the vortex of watching the Olympics and re-emerged with back-to-school right around the corner. So it’s a perfect time to think about breakfasts.  We’ve all heard it—breakfast is the most important meal of the day, and gets us off to a good start.  We need energy to study, work, and play!  Many studies have shown improvements in concentration and learning for children who eat breakfast, and starting the day with a healthy breakfast helps adults, too.  As a dietitian, I look for breakfasts that are a good source of fiber and protein, and not too much added sugar.  There are great options from both the regular grocery store and more and more specialty products.

Some of the best choices:

• Greek yogurt is a great source of protein. Add in some berries and sprinkle in a spoon or two of ground flax seed or chia (Salba) to get in a little extra fiber.
• Get creative with eggs: scrambled eggs, omelets, huevos rancheros, or even hard-boiled for an inexpensive, high protein on-the-go breakfast. Add in veggies with the eggs for a more filling breakfast with more antioxidants and fiber. Three to four whole eggs weekly won’t affect cholesterol levels, and if that’s a concern, egg whites are always an option.
• Smoothies are also a great way to get in some additional fruit in your diet, and most kids enjoy them, too.  Just make sure to get some protein, from Greek yogurt, protein powder or even tofu.
• Don’t forget old standbys, like cottage cheese or ricotta cheese and fruit, organic sausages, grits, etc.
•  As far as cold cereals go, nutritionally, Crunchy Flax, Whole O’s and Mesa Sunrise are among the best options because all are great sources of whole grains and fiber.
• KIND now has Whole Grain Clusters that are tasty and some protein and fiber, too.

Looking ahead to chilly mornings, hot cereals are a great way to start the day with fiber and whole grains.  Most gluten-free grains cook up nicely as hot cereals. My personal favorite is millet, but kasha (buckwheat), quinoa flakes, amaranth, teff, etc. work well, too.  It’s easy to make a big pot and have them all week long.  . Don’t forget about certified gluten-free oatmeal, which can be found at specialty stores or online.

You can also think beyond usual breakfast foods for a change of pace.  Soups or any kind of leftovers work well, and you’re only limited by your imagination!

Events, a recipe & more:

DC Metro Celiac Organization:

Sept 22 from 2-4pm

Arlington Central Library, 1015 N Quincy St, Arlington, VA 22201

Speaker:Tony Lupo, Director of Technical Services for Neogen

Enjoy the rest of your summer and the rest of our time with much less traffic!

Harris Whole Health offers individual sessions, family sessions and group classes to help people eat healthier and feel better! Whether you are dealing with a specific health concern, or if you just want to feel and look better, Cheryl can help you achieve your goals. For an appointment with Cheryl Harris, Registered Dietitian, Nutritionist & Certified Health Coach, please click here or call 571-271-8742.

Navigating the risks of mercury.

Every week or so, I see an article on the importance of fish for good health and how we all should eat more.  Then a line or two on how people should avoid mercury because it can be so dangerous, etc.  I suspect the take-home message most people are receiving is “you should eat fish, but it’s risky.”

So let’s break it down and make it easy.  The  American Heart Association recommends 2 or more servings of fish a week, preferably fatty fish, like salmon, mackerel, herring, lake trout, sardines, etc.  Aside from heart disease, there are so many reasons why fish can be beneficial–omega 3 fatty acids are anti-inflammatory and may help with conditions from high triglycerides, rheumatoid arthritis, macular eye degeneration, high blood pressure, depression and the list just goes on.

Studies show that while mercury, PCBs, etc. are associated with health risks, the risks of NOT eating fish are higher.  In other words, the potential benefits outweigh the risk.

Fortunately, a lot of the highest omega 3 fish are low in mercury, too.

• Salmon
• Trout
• Sardines
• Anchovies
• Oysters
• Flounder

Steer clear, or limit the big fish…they’ve accumulated a lot of mercury as they’ve eaten up the little fishies.

• Shark
• King Mackerel
• Tilefish
• Swordfish

For pregnant, breastfeeding moms and little ones, those listed above should all be off the table.

Tuna is also moderately high in mercury, especially albacore tuna.  We’re best to limit tuna to 6 oz a week, or if you’re eating canned, choosing a lower mercury variety like skipjack tuna is wise.  For all you sushi aficionados, the much of the tuna used tends to come from larger fish, which are higher in mercury. Or just trade in your tuna for canned salmon, which is usually wild-caught, higher in omega 3s and lower in mercury.

My favorite new resource puts the info on omegas and mercury together nicely, so you can see how your favorite fish stacks up.  Or, if you want to calculate your mercury level for a week and see how you’re doing, check out a nifty calculator from GotMercury.org  You can crunch the numbers based on what you’re eating and your size, and that can give you a good sense of where you stand in relation to the recommended limit.  Or you can check out the FDA listing of mercury in fish.

What about sustainability and the environment, the politics and health of wild/vs. farmed, etc.?  That’s a whole different discussion!  The short answer is to check out a seafood guide, such as the one from the Monterey Bay Aquarium.

But what about the flaxseed you’re adding to your yogurt faithfully every day?  That has omega 3s, too, as does walnuts, canola oil, soy, chia seed and more.  This form of omega 3s, called ALA, does have health benefits.  However, it does not seem to have all of the same benefits as the omegas in fish.  But what about if you’re vegan or allergic to fish? There are DHA supplements available that are derived from algae.

Speaking of supplements, generally, a low dose (around 1 gram) is generally considered safe, but definitely don’t go for high dose supplements (over 3 grams) without having a chat with your doctor.

Harris Whole Health offers individual sessions, family sessions and group classes to help people eat healthier and feel better! Whether you are dealing with Celiac Disease, food allergies, picky eaters, children on the Autistic spectrum, chronic illness, or if you just want to feel and look better, Cheryl can help you achieve your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here or call 571-271-8742.

Safe Dining, G-Free Style

Especially given all of the recent fuss over the Domino’s not-truly-gluten-free pizza, one of the most common question I hear from clients is about dining out.  Is it safe?  Where can you go?  How do you KNOW they’re taking our health concerns seriously?

A good place to start is with restaurants with a gluten-free menu, or one recommended by others on a gluten-free diet.  My favorite local resource is Gluten Free Travel Site, which has a free mobile version as well. Allergy Eats also has website resources.  There are a variety of apps including Gluten-Free Registry , “Is that gluten-free” and “Find me Gluten-Free”.

For the DC Metro Area, I have to say that I personally adore the Great American Restaurants (Mike’s, Sweetwater, Silverado, etc.)  They were gluten-free friendly  long before it was trendy, and have always done a good job.  Lilit Cafe in Bethesda also has one of the most extensive gluten-free menus around.  Choices by Shawn and the new Happy Tart are also g-free gems.

When you’re traveling some place unfamiliar, you can do a google search for GF blogs, CSA chapters, or ROCK groups.   Choose restaurants more likely to have gluten-free options, like grills, sushi, East Indian and Thai.  If you can, look for a menu online or call ahead.

It’s a good idea to dine early and avoid the dinner rush so restaurants can take the time to understand and meet your needs.  When you arrive, explain your diet simply.  Explaining Celiac as an allergy is sometimes easier than a medical discussion, and it’s often better understood.  If you have a dining card, such as the ones from Triumph Dining, bring that along, too!  Once you’ve figured out a safe entree, make sure you discuss cross contamination, including:

• Requesting that staff change their gloves before handling gluten-free food.
• Insuring that staff use a separate cutting board, pans, utensils, etc.
• Only eating fried foods from a dedicated fryer
• Discussing non-obvious sources of gluten: soy sauce, cream sauces or roux, broth, marinades, etc.
• No glutenous garnishes or rolls!

Make sure that the server understands your needs.  If not, it may be necessary to speak to a manager or chef, or if your needs can’t be met, leaving is the healthiest choice.  Also, when your meal arrives, always double check with your server before you begin to eat.

Definitely discuss the diet, even if it’s a place you’ve gone before, and even at a place with a gluten-free menu.  New staff may not be well trained, and menus are ALWAYS changing!  Just because those fries were safe last time doesn’t mean they are safe today.

If you have a good experience, be sure to thank staff and leave a nice tip!  Whether your experience is good or bad, you may consider writing a letter or emailing management.  Feedback is important, and you’re helping yourself and others have a good experience in the future.

Another resource that gives much more detail on dining out safely is this article from Living Without.

Have I left out your favorite resource?  Let me know in the comments!

Stay cool and have a great summer!

Harris Whole Health offers individual sessions, family sessions and group classes to help people eat healthier and feel better! Whether you are dealing with a specific health concern, or if you just want to feel and look better, Cheryl can help you achieve your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here or call 571-271-8742.

The internet has been a-twitter (literally and figuratively!) with news of the new Domino’s Gluten-free pizza.  In a nutshell, the pizza itself is made with gluten-free ingredients, however, it is made in the same ovens and cut with the same equipment on the same counters…and obviously there’s a huge potential for cross contamination, because crumbs are enough to cause damage for anyone with Celiac or gluten sensitivity.

Obviously Domino’s isn’t the first company to sell gluten-free products with significant cross-contamination issues.  The unusual part here is that the National Foundation of Celiac Awareness has given Domino’s an “Amber seal”.  As per Domino’s website:

The NFCA supports Domino’s efforts to provide a Gluten Free Crust to a national audience and has given Domino’s a “Gluten Free Ingredients” rating. The NFCA granted Domino’s this rating because of our verified ingredients, consumer education approach and customer service training. This means the NFCA and Domino’s do not recommend this pizza for people with celiac disease. However, because the risk for gluten exposure is low, this product may be an option for those with mild gluten sensitivities. While the Gluten Free Crust contains no gluten ingredients, a risk of gluten exposure can occur due to the handcrafted nature of the pizza and the variety of procedures in the kitchen.

University of Maryland’s Center for Celiac Research and the Gluten Intolerance Group have spoken out loud and clear, expressing that this pizza isn’t appropriate for people with Celiac NOR people with gluten-sensitivity, and as Dr. Alessio Fasano put it in an interview yesterday on Gluten-Free Voice Blog Radio, “I’m really am distressed about Domino’s.  It’s pretty obvious that they see the opportunity and they could care less about the needs of the Celiac community, the gluten-free community.  They just want to make money…They could have done a good job, and decided not to.” GIG, a celiac disease support group that also certifies restaurants, went further and called for complete discontinuation of the Amber, and 1in133 is now circulating a petition to make this Amber designation go away.

Obviously there are many articles on the web, but the one area I haven’t is possibly the most vital. Won’t this be illegal really soon? The FDA has a gluten-free rulemaking underway, and a final rule is expected to be issued in late 2012. Rhonda Kane, a Registered Dietitian at the FDA, has been hard at work on this project. According to Ms. Kane, “Restaurants would be expected to adhere to the same gluten-free standard established by FDA as packaged foods.” As of now, one of the criteria for FDA’s proposed gluten-free standard is that a food, whose labeling is regulated by FDA, cannot contain 20 parts per million or more gluten, regardless of its source, which includes the presence of gluten due to cross-contact situations.

So where does that exactly leave Domino’s and their “gluten-free” crust?

I asked Jules Shepard, gluten-free baker extraordinaire and one of the movers behind 1in133.  “Based upon my radio interview with Alice Bast, founder and president of the National Foundation of Celiac Awareness (NFCA), and upon others of her statements regarding the testing of these Domino’s “gluten-free” pizzas, the initial tests of these pizzas showed that some of the pizzas tested above 20 ppm and some tested to below 20 ppm.”  Somehow I’m doubting that some under 20ppm is good enough to be legit when the new rules are in place.

The biggest problem is the failure of communication. Yes, Domino’s includes a disclaimer on the gluten-free claim online and in stores, but not over the phone.  And, per reports from our local celiac chapter, people are assuming that the pizza is safe because Domino’s is big chain and NFCA is very literally backing it, and people are missing the fine print.  I’m not the only one hearing it.

Says Jules: “People are eating the pizzas and suffering ill effects, and people are giving the pizza to their celiac children because they saw an NFCA seal associated with the pizza and assumed that it must be safe. I am at a loss as to why a foundation which exists to protect celiacs (the National Foundation for Celiac Awareness) would put their name anywhere near this contaminated product. It will only serve to confuse the consumers they purport to protect, and will cause people to be sickened.”

IMHO, once the FDA rules are in place, this pizza is history anyhow.  I’m hoping there’s enough support to make it vanish early–or to convince Domino’s to do the right thing and gift the gluten-free community with a  TRULY gluten-free pizza.

Many thanks to Ms. Rhonda Kane and Ms. Jules Shepard for allowing me to quote them.  If it’s not in quotes, the views reflected in this article are mine alone and do not reflect the views of the FDA, Ms. Kane, Ms. Shepard, organizational boards I serve on or any other entities.

News:

It’s been a fun month for me!

• I was named “Emerging Dietetics Leader of the Year for 2012” by the Virginia Dietetics Association

I was featured in a few articles from the Washingtonian Well Being Blog:

• Can Going Gluten-free Help You Lose Weight? See my response in the April 12th, 2012

• Is Shake Shack your guilty pleasure? Best and worst burgers and Hot dogs at Shake Shack
• Tastier than conditioner any day: Top foods to eat for healthy hair

Something Yummy in Season:

In some ways, it was a rude awakening, moving from sunny California for grad school to Northern Virginia.  One of the first things that struck me was the difference in fruits and vegetables.  The year-round gardens and Farmers’ Markets had me utterly spoiled.  I took my very first trip to a local grocery store and stared blankly at the veggies and a friendly employee asked if he could help me find something.  And before I could think clearly, I blurted out, “Sure!  Where are there Farmers’ Markets near here?”  I don’t think that was what he was anticipating, but he was kind enough to let me know of one up the road.

Fortunately, the number of markets has only grown for the last decade. We’ve got a bunch of markets nearby, and they’re about to open, so get ready!

Benefits of shopping at the Farmer’s Market

• Fresh produce and meat-most fruits and vegetables are picked that day
• Support for local farmers
• Few or fewer pesticides on fruits and vegetables. A plum shipped from Chile need a lot of pesticides to keep it lovely even after traveling thousands of miles.
• Better taste! There’s nothing that compares to the taste of a freshly picked tomato, peach, or apple.
• The “manufacturer” is usually right in front of you, so if you have questions about how something is made or grown, just ask!

Also, another great option are CSAs (Community Supported Agriculture)

Harris Whole Health offers individual sessions, family sessions and group classes to help people eat healthier and feel better! Whether you are dealing with a specific health concern, or if you just want to feel and look better, Cheryl can help you achieve your goals. For an appointment with Cheryl Harris, Registered Dietitian and Nutritionist, please click here or call 571-271-8742.

Gluten-free Passover foods:

Passover isn’t here until April 7th (or technically, the evening of April 6th), but many of the products are already starting to appear in grocery stores. Not all Passover foods are gluten-free, but many are, and there’s a much wider selection than usual at the grocery store. This can be a good time to stock up on GF cakes and mixes, cookies, macaroons, “bread” crumbs and supplies like potato starch. As an added bonus for people with multiple restrictions, most Kosher for Passover products contain no corn or soy products, either.

In a nutshell, the basic rule of foods for Passover is no leavened foods, which eliminates normal breads, cakes etc. Matzo, (an unleavened bread usually made from wheat) is eaten, and some products contain products Matzo and matzo meal, (also potentially listed as cake meal or farfel). However, many products don’t contain gluten. Or, if you find products labeled “non-gebrok or gebroktz or grebrochts” (or another spelling variation) they’re non-grain containing and therefore have no gluten-containing ingredients. Often Kosher for Passover products and cakes are made of potato flour or nut meals rather than wheat or glutinous grains.

As always in the gluten-free world, read labels carefully. “Kosher” and “Kosher for Passover” are two different things entirely. Kosher for Passover foods will be labeled “May be used for Passover” or have a symbol that says OUP. I have often seen “regular” Kosher foods in the Passover section at grocery stores, so please do check the labels very carefully.

Keep in mind that many Passover foods are imported from other countries, and imports should be, but often not labeled quite in the same way as the FALCPA U.S. labeling laws dictate (the flip side is that a claim of “gluten free” is more meaningful in Europe or Israel) So a label will still say matzo, but may not say “wheat” explicitly or have the disclaimer stating that it contains wheat.

Most Kosher for Passover products will have to adhere to strict standards for cross contamination from a religious perspective, but again, buyer beware and no guarantees. Voluntary allergen labeling (AKA “Made in a factory” claims) are still not regulated.

From a gluten-free perspective, possibly the best part of Passover is AFTER Passover, when all of the great gluten-free goodies are on sale! Passover ends April 14th, so mark your calendars, because the word has gotten out in gluten-free circles and the mad rush is on.

Back when you really couldn’t get GF prepared foods in the regular grocery store, this was a much bigger deal. But it’s still nicer to have an expanded selection, and nicest of all is AFTER Passover, when all of the products are on sale!

For people who DO celebrate the actual holiday of Passover, not just the gluten-free food, here are some great recipes and information:

• Elana’s Pantry has an extensive roundup: http://www.elanaspantry.com/passover-round-up/
• Kids with Food Allergies put out a booklet on Passover with food restrictions.

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DC Area Metro Celiac Organization
Next Meeting Date: Saturday, March 17, 2012, 2:00–4:00 pm

SPEAKER: Dr. Sean Hurley of Digestive Disease Physicians

TOPIC: “I am gluten free but still have symptoms, what do I do now?”

Location: Bethesda Public Library
7400 Arlington Road, Bethesda, MD
www.montgomerycountymd.gov/apps/libraries/branchinfo/be.asp

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Fun stuff from Feb:

• Delighted to be honored as one of Washingtonian’s 6 Best Gluten-Free Bloggers
• See my thoughts on Web MD on Seven Signs You’re Getting Bad Nutrition Advice

Cheryl Harris, MPH, RD is a Registered Dietitian, Nutritionist and Certified Wellness Coach in Fairfax & Alexandria, VA. I work with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals.  Email me or call 571-271-8742. 

In honor of Valentine’s day, here are some of the things I <heart> in the gluten-free and Celiac world!

• First things first: About.com’s Gluten-Free Valentine’s Day Candy List
• Hungry for a new gluten-free breakfast cereal?  Shelley Case has a great listing of nutritional values of different cereals.
• I profiled a variety of heart-and-Celiac friendly blogs in my Jan Newsletter.
• I rarely advertise products, but made an exception because I think this is one many people will enjoy.  I hear so many complaints of people who are looking for more variety and bored with the usual gluten-free suspects.

• I had the pleasure of reviewing quite a few books last year.  I was very surprised that the one that got the most use was “Gluten-Free in Five Minutes” by Roben Ryberg.  I’m a bit of a food snob and not a fan of microwaves.  That being said, I really appreciate being able to make a little g-free cake for my favorite husband in just a few minutes.
• Love to read everything you can on celiac disease?  My favorite book on the science along with Celiac is Real Life with Celiac disease by Melinda Dennis and David Leffler.

Celiac Webinars: New Project that makes my heart flutter:

I’m very excited about my new Celiac Webinar Series for Dietitians, nutritionists and health professionals.  They’re they’re research focused and aimed at health professionals, but anyone is welcome to take them, and CEUs available for RDs/DTRs.

Topics include:

• Celiac Disease: What every RD Should Know
• Gluten Free and Healthy
• Gluten Sensitivity
• A Happy, Healthy Pregnancy and Baby
• To sign up and for more info, see http://dietitiancentral.com/ceu/course_list.cfm

Love my newsletters?  You can now subscribe in a reader, too, and leave comments on my blog.

Cheryl Harris, MPH, RD is a Registered Dietitian, Nutritionist and Certified Wellness Coach in Fairfax & Alexandria, VA. I work with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals.  Email me or call 571-271-8742. 

Many of us see the New Year as a great time to make changes and improve our health.  It’s a good time to look at your diet and lifestyle, and see what you can do to look and feel your best.

Going gluten-free can be a big turning point to eating healthier.  Many people are amazed to realize the impact that diet has on how they feel!  All of a sudden, people need to start reading labels, and many begin to wonder why there are all of these ingredients they can’t pronounce and why high fructose corn syrup and red dye # whatever seems to be in everything.  Or maybe after years of eating anything and staying slim, the pounds have started creeping upward.  No matter what your reason, let this be the year you improve your diet.

Are you getting the nutrients you need?

Nutrition is important for everyone, but particularly for people who have food restrictions.  Years ago, the Food and Drug Administration realized that many people weren’t getting enough vitamins like folate, several other B vitamins, iron and calcium.  So they added a variety of nutrients to the foods supply in every day foods like flour, bread, pasta, cereal, etc.  However, gluten-free breads and cereals are considered specialty products, and very few are enriched with these vitamins.  Not only that, but many gluten-free breads are filled with things like tapioca, potato and cornstarch to give a light texture, and these foods have very few nutrients.  So when people switch from eating regular packaged foods to eating gluten-free processed foods, they don’t realize that they’re actually eating a lot fewer vitamins and minerals, a lot less fiber and usually more calories, too.  Not only that, but many people with Celiac disease may be deficient in many vitamins, such as B vitamins, vitamin D, Calcium and iron because they have not been absorbing foods well for years, and may need more than the average person while they are healing.

And, as we well know, gluten-free does not automatically mean good for you!  Often in the beginning, people want to try anything that’s gluten-free, and are just focusing on getting by.  The focus is on finding replacements for old favorites and learning all of the new rules.  That is definitely a great short-term strategy but it’s only the first step!  The good news is that that many healthy foods are naturally gluten-free, like fruits, veggies, beans, many whole grains, nuts, seeds, and plain fish and poultry.

Here are some suggestions to make your diet healthier:

• Add beans back to your diet.  They’re a great source of fiber, calcium, and iron, and super yummy in a winter soup.
• Have fruit or vegetable with every meal—5-9 a day.  That can be as easy as an orange with breakfast, a salad with lunch, dried fruit for snack and 2 servings of veggies along with dinner.
• Make sure you’re getting your omega 3s. Salmon, trout, flounder, sole, etc. are great options, and flax, chia, walnuts and hemp are vegetarian options.
• Choose whole grains, rather than refined. Wild rice, quinoa, teff, etc. are more nutrient dense than white rice.  Try a whole grain hot cereal, wild rice with dinner, or even quinoa pasta.
• Drink your water!  6-8 glasses a day are important to stay hydrated.
• Find a way to reduce stress: acupuncture, meditation, deep breathing, talking to a friend, dancing, playing with the dog, whatever works for you.  I’ve listed this under nutrition because most people don’t reach for Brussels sprouts when they get stressed.

Healthy Websites:

Here are some websites with many gluten-free recipes featuring simple, good, real food!  Whether you’re “just” gluten-free or you’re dairy-free, grain-free, vegan or whatever other way of eating has worked for you and your family, the list blow should have you covered

•  Bob’s Red Mill features many gluten-free and whole grain recipes.  Search under “gluten-free” http://www.bobsredmill.com/recipe/
• Dr. Weil has great healthy recipes listed.  Most (not all) are GF http://www.drweil.com/drw/ecs/common/recipe.html
• Diet, Dessert and Dogs: Gluten-free? (check!) dairy-free? (check!) vegan (check!) delicious (check!) Ricki’s recipes are wonderful , no matter your food restrictions, and many are grain-free as well.  She also has a variety of e-books on her website.
• Elana’s Pantry: Curious about almond flour?  Elana’s pantry should be your first stop!  She also has a lot of wonderful veggie recipes and tips for children, too. http://www.elanaspantry.com/
• Ginger Lemon Girl: Most of the newer recipes are paleo friendly, most of the older ones are decadent, but all are gluten-free http://gingerlemongirl.blogspot.com/
• Gluten-free Goodness: my blog, which is gluten, dairy, egg, corn, soy and usually sugar free.  Most of the time the recipes are healthy. http://gfgoodness.com/
• Gluten-free For Good. Great gluten-free and healthy recipes and information on healthy foods, too. 
•  Health-e-Recipes from AICR (American Institute for Cancer Research). You can sign up for newsletters on their site, and you get weekly recipes in your inbox. Many (not all) are gluten-free and dairy free. Many are quick and simple, use seasonal ingredients, and feature a lot of veggies.
• Kalyn’s Kitchen: Perfect if you’re on South Beach, but wonderful if you’re not, too!  Many food recipes (not just desserts) and many, but not all are gluten-free.  http://www.kalynskitchen.com/
• Simply Sugar and Gluten Free—Amy’s website and cookbook have a lot of wonderful options. http://simplysugarandglutenfree.com/
• The Spunky Coconut: Kelly’s recipes often include beans and veggies in unusual, but tasty ways.  Many are grain-free and allergen friendly, all are gluten-free. http://www.thespunkycoconut.com/
• The W.H.O.L.E Gang—Allergen friendly recipes for the family (all gluten free) http://www.thewholegang.org/blog/
• Whole Life Nutrition Kitchen http://www.nourishingmeals.com/ Gluten-free, healthy whole food based meals
•  World’s Healthiest Foods: Good, basic healthy recipes.  Most are gluten-free, but you can check off the foods you want to avoid for a recipe search.  http://whfoods.com/
• 101 Cookbooks: Some are GF, some aren’t. There are many great soup and vegetarian recipes, and many feature veggies and whole grains. http://www.101cookbooks.com/

I have other recipe & sites listed at http://www.harriswholehealth.com/recipes/  And, of course, there are more websites and resources popping up every day! Do you have a favorite healthy recipe site that isn’t listed?  Email me and let me know.

Meetings:

DC Celiacs:

Next Meeting Date: Saturday, January 7, 2012, 2:00–4:00 pm

Meeting Topic: A panel discussion on “Eating Healthy While Being Gluten-Free.”

Location: Tenley-Friendship Neighborhood Library (DC)
4450 Wisconsin Ave. N.W. (at Albemarle St), across the street from Tenley metro stop.

Cheryl Harris, MPH, RD, LD is a Registered Dietitian, Nutritionist and Certified Wellness Coach in Fairfax & Alexandria, VA. Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals.  Email her or call 571-271-8742. 

Gluten in Medications:

We know that most packaged foods on the grocery shelf in the U.S. will follow FDA labeling, at least for ingredients containing wheat. However, this is not the case for medications, and finding accurate and timely information is much more challenging.

Standard prescription labels include only the active ingredients. So if your doctor writes you a prescription for penicillin, the bottle would say x mg of penicillin. It won’t say what anything about any fillers, binders, coatings, excipients, etc. although these substances are a part of most medications. These can, of course, include wheat and barley.

The PDR (Physician’s Desk Reference) often has a list of ingredients but these are tremendously hard to decipher, and most don’t give a source for ingredients. This information requires calling the manufacturer, and waiting an answer from companies. Ideally, get support from a doctor’s office or pharmacist. Many drug companies will not answer consumer inquiries directly. Generally name-brand drugs do have a consistent list of ingredients, but with generics, different fillers are used at different times, depending on cost at a particular moment in time. So one batch may have cornstarch, the next may have wheat starch, and so on. And, of course, a the name-brand may be gluten-free, but that does not necessarily mean anything about the generic drug.

As a dietitian and someone who has had to make those calls for myself and others, I feel like this is a potentially dangerous and unfair system. People who need medications immediately often do not have the time, energy or mental clarity to make a variety of phone calls and wait for answers. It’s important that steps be taken for longer term changes in policy to ensure the safety of people who need to strictly avoid gluten.

For the meanwhile,

• Check into all of the medications and supplements you take.
• When possible have a knowledgeable doctor or pharmacist call and make inquiries, as this may be a faster route to get information.
• As with any inquiries, do probe further because even health professionals vary in their knowledge and understanding of Celiac Disease and gluten. (I have had pharmacists say to me that they don’t see “gluten” listed as an ingredient, so it must be safe).
• It may also be necessary for your doctor to specifically order name-brand drugs in certain cases to ensure they are safe for people with Celiac Disease.
• If you have other food sensitivities/allergies and cannot get answers or safe medications, a compounding pharmacy may be a great option, as they make medications from scratch. In the DC metro area, that includes the Alexandria Medical Arts Pharmacy in VA and Village Green in DC.

There are a few free resources out there that can help, like www.glutenfreedrugs.com.  However, ingredients in medications can always change, so these lists can best be seen as a starting point.

Also, NFCA is dong a survey on gluten in medications through Feb 28, 2012

Harris Whole Health offers individual sessions, family sessions and group classes to help people eat healthier and feel better! Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, food allergies, pregnancy, breastfeeding, vegetarian and vegan diets, preventing diseases and “whole foods” eating. 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.