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Happy Autumn! Here’s a quick update of news, recipes, and more.

Some neat resources from FARE to keep candies safe for trick-or-treaters—and for nibblers—with food allergies or Celiac. Another list is from Jules GF here.

But what if you choose to opt out of candy?  Nope, I don’t have a vendetta against candy, I like being inclusive, and I’m a fan of rubber duckies. This year, we’re going for ninja rubber duckies and the regular Halloween ones, but go with what works for you!

Breakfasts:

As it’s darker in the morning and there’s more temptation to stay in bed until the last second, here are some quick make-ahead breakfast recipes:

Peanut Butter Banana Muffins

Overnight oats (scroll down)

Easy Cheesy Egg Bake

Cinnamon Apple Millet

News:

I was delighted to see this article, How to maintain your social life with IBD in TIME on mental health and IBD

As part of the 2^nd annual Digestive Disease Nutrition series the 2^nd week in Nov, I’ll be presenting on Hypermobility and how it impacts digestion (including the overlap with Celiac). It’s aimed at nutrition professionals—info here.

Want to run for a cause? CDF has a Celiac Turkey Trot.

A new study showed that a low FODMAP diet can be helpful for people with Celiac who have symptoms despite staying strictly gluten-free and having healed intestines…support of an RD is key to make sure nutritional balance happens. ?

Planning ahead? Thanksgiving tips from years past here

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax, VA.  She helps people with a range of dietary issues, including Celiac Disease, digestive issues, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

Happy Summertime! Here is an updated gluten-free grab and go list for everyone who is finally traveling, and an update on gluten and digestive research below. And I’m loving all the seasonal fruit!

Starting with the biggest news:

Labeling for gluten may be on the horizon! There’s a new bill that was introduced which would require companies to label gluten (not just wheat!) on all packages. This would be huge….contact your representatives! And many thanks to Gluten-free Watchdog for the alert.

Oh, the neat new Celiac studies! This one suggests that there may be a new pill to help with cross contamination on the way—or to enable people to eat gluten…note that the study is relatively small, and short length. And for those of you thinking that a pill is not for you, I respect that! There are people with Celiac eating a gluten-free diet whose numbers have not returned to normal who will likely be hugely helped by technology like this, and same goes for people who travel for work. Here’s the same research covered in NEJM

Speaking of travel, this new dining app from Gluten dude makes gluten-free dining out easier. Restaurants are either 100% GF or actually take good precautions.

A study from the Center for Celiac Research suggests that there may be microbial changes before the development of Celiac—which hopefully may give new avenues for prevention down the line.

More about the microbiome in Celiac and RA

Ultra processed food is associated with risk of IBD–PURE study—this study links consumption of soft drinks, sweets, salty snacks, and processed meat with risk of UC and Crohn’s. Pros: it’s a big study, including people from different countries and regions, and it is a prospective study. Cons: correlation doesn’t mean causation. And nope, this still doesn’t mean the disease is your fault, but if you’ve got children at genetic risk, it’s something to consider. And as always, more study is needed.

This is a great overview of where the science is on the microbiome, which talks about everything from microbial diversity to busting many common myths.

For my fellow clinicians (or curious people) reading this, finally! IBS guidelines for pregnancy. All I can say is, it’s about time. Highlights—Low FODMAP should be adapted with an RD, soluble fiber is likely a plus, probiotics don’t have enough data.

A new randomized, controlled BMJ study shows that more dietary omega 3s may reduce migraines…

Enjoy the rest of your summer; it always goes by too fast!

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax, VA.  She helps people with a range of dietary issues, including Celiac Disease, digestive issues, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

The Farmers’ Market season has begun! Some, like Burke are open now, and I got asparagus, apples, sweet potatoes and a bunch of plants.

I love gardening, and also buying from local farmers when possible. It was a rude awakening, moving from sunny California for grad school to Northern Virginia almost 18 years ago….there were farm stands everywhere, and I was totally accustomed to easy access to fresh, beautiful food. So I’ve been gardening since to fill some of the blanks.

Since we’ve moved to a more wooded area a few years ago, my garden has largely been a buffet for the deer and groundhogs. Sometimes I get a nice harvest; other times, I’m feeding the wildlife. So far, I’ve got kale, garlic, onions, herbs, strawberries, and green beans and I just put in potatoes, sweet potatoes, Thai peppers, basil and stevia, and more to come this weekend.  I’ll put them in soon anyway and hope for the best. We also have a blackberry and blueberry plant, and even grapevines. The blackberry has a ton of flowers this year (right), which hopefully means there’s lots of fruit coming my way!

Even if the critters get my veggies, there are a bunch of Farmers’ Markets and locally grown resources to give more options, and 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 or just opened.

Why go to a Farmer’s Market?

• They’re terrific for encouraging people to branch out and try new foods. There are generally a lot of samples, and everything looks so good. Works well for kids, too!
• Fresh produce and meat. Most fruits and vegetables are picked that day. Seasonal food is generally going to be more nutritionally  dense than something shipped around the globe.
• Support for local farmers and the local economy.
• 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.
• Greater variety. While Whole Foods or Wegmans may have 5 kinds of apples, it’s common to have a choice of 10+ varieties and discover new flavors that you enjoy.
• 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!

I’d be willing to bet there’s a market near you. Here’s a listing of Farmer’s Markets

• City of Alexandria Farmer’s Markets
• Fairfax county Farmer’s Markets
• Arlington Farmer’s Market
• Listing of NoVA Markets from Northern Virginia Magazine
• Nationwide listing of USDA Farmer’s Markets

Also, another great option are CSAs (Community Supported Agriculture). If that’s more your scene, there’s a nice list here.

Whether you have a nice big garden or even just an available window, it’s a great time to get growing. Even a sunny window should work for herbs like basil.

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax VA (and currently, remotely). She helps people with a range of dietary issues, including Celiac Disease and all sorts of GI disorders. Let’s get you on your way to achieving your goals and feeling great! Email or call 571-271-8742.

Happy Springtime! My favorite season, hopefully yours, too.

Okay, if you only read one thing, read this!

Did you know companies don’t need to label for gluten in meds?

There’s finally some movement on gluten in medication….and hopefully finally goes somewhere. Congressman Tim Ryan D-OH and Rep. Steve Stivers R-OH have teamed up for the Gluten in Medications Act.

If you’ve been around for a while, you know this has been problem for quite some time, with no resolution in sight. I testified for the FDA in 2011, and they listened politely. Nothing changed.

I dearly hope that this time, there’s enough bipartisan momentum. And please nudge your Congressional reps to sponsor this bill. Because this isn’t the first time this bill has been proposed, but hopefully it’ll finally go somewhere this time! Handy dandy little form to nudge your rep right here.

Other news of interest:

• French fry eaters! If you have Celiac or need to be strictly gluten-free, a new study shows with certainty that a shared frier IS often a problem. 1/4 of the fry orders would not be considered gluten-free. “It remains prudent to advise consumers with CD to avoid foods cooked in shared fryers.”
• There have been a lot of studies on diet and IBD (Crohn’s, UC). But does gluten play a role? According to a new prospective study, no, it doesn’t.

• Got fructose malabsorption? you’re in good company. Some of it is that in the US, we eat more fructose. This paper (from this month) has a good review
• Kate Scarlata has a wonderful initiative for IBS month (April) to end hunger. To learn more, or to donate, check it out.

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax, VA.  She helps people with a range of dietary issues, including Celiac Disease, digestive issues, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

Passover isn’t here until March 27th but many of the products are already appearing 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, some of the “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 is the main exception. Matzo is an unleavened bread usually made from wheat and is eaten regularly, and some products contain products with Matzo and matzo meal, which 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. Technically, imports must follow the FDA allergen labeling laws, but I can say I’ve seen many that aren’t labeled quite in the same way as the FALCPA U.S. labeling laws dictate So the label on an import may 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. Voluntary allergen labeling statements (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 4^th 2021, 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:

• Jules has some wonderful recipes
• A Passover recipe roundup
• Matzo here that looks tasty https://www.fearlessdining.com/gluten-free-matzo-dairy-free-too/
• …and here https://www.thespruceeats.com/gluten-free-oat-matzoh-cracker-recipe-1451352
• I’ve got my Kosher for Passover dessert recipes here. Remember, you’ve got to use KFP ingredients! http://www.gfgoodness.com/?p=6255
• Elana’s Pantry has an extensive roundup: https://elanaspantry.com/passover-recipes/ and another “Paleo” version here
• Gluten-Free Bay has an extensive list. It is from several years back, but it’s still a great resource.

Other favorite gluten-free recipe sites for Passover? Let me know in the comments section on my website.

Lately, Whole Foods has stocked a gluten-free Matzah, and the brand is Yehuda, so keep your eyes peeled! You can also get it on Amazon. It’s not technically matza because it’s not made of oats, but it’s “Matzo style squares”. There are also many more Kosher markets, such as Kosher Mart in Rockville. Some local grocery stores also have a great selection.

 

 

It’s National Nutrition Month, so it’s a good time to touch on the cornerstones of a gluten-free diet to make sure you’re getting the nutrients needed for health.

Are you getting the nutrients you need on a gluten free diet?

When people start off on a gluten free diet, step one is figuring a way to take out all the gluten, and get adjusted to this new way of living and eating.  But as life starts to ease back to normal, it’s important to take the second step and eat a diet with all of the nutrients you need to feel better, allow your intestines to heal, and live well.

Years ago, studies showed that many people weren’t getting enough iron and B vitamins, so the US government decided to fortify our breads, cereals, etc.  However, GF foods are considered specialty foods, and there are no laws about enrichment. Many GF foods are not fortified, so it’s not surprising that researchers have found that on average, people on a gluten free diet are eating less of these key nutrients than general population.   People on a gluten free diet also seem to be eating less calcium, fiber and grains than recommended, especially among women.

Calcium:

Calcium is particularly important to people with Celiac disease, since osteoporosis often occurs due to intestinal damage from CD, which can cause malabsorption of calcium and Vitamin D.  Also, many people with Celiac disease avoid dairy due to lactose intolerance.   In a study of people on a GF diet, less than a third of the women ate the recommended amounts of calcium, although most men did get the amounts recommended. When people start off on a gluten free diet, step one is figuring a way to take out all the gluten, and get adjusted to this new way of living and eating.  But as life starts to ease back to normal, it’s important to take the second step and eat a diet with all of the nutrients you need to feel better, allow your intestines to heal, and live well.

Iron:

A survey of people on a gluten free diet found that less than half of women are getting recommended amounts of iron.  This is particularly important, since many people with Celiac disease are anemic before going gluten free due to the constant intestinal damage and irritation.  Anemia often causes fatigue, weakness and poor concentration.   Liver and organ meats are great sources of iron, but there are a variety of foods and ways of combining foods with vitamin C that can help raise iron levels, too.

Fiber:

Most Americans are getting less fiber than recommended, and getting enough fiber can be even more challenging on a gluten free diet, since many high fiber cereals, breads and bars are off limits.   Fiber is best known for its help keeping people regular, but it is important in helping lower risk of heart disease and diabetes, too.

So what’s a gluten free gal (or guy) to do?

• Take a (gluten free!) multivitamin
• Choose fortified gluten free products
• If you avoid dairy products, find other calcium fortified beverages and other high calcium foods
• Make sure you’re getting your Celiac serology (blood test) done yearly, and other #s, like vitamin D, iron, B12, folate, thyroid, etc. done every few years or as needed to avoid deficiencies.
• Make sure you’re getting enough fiber!  Veggies, fruits, beans, flaxseed, and whole grain GF foods are a great source of fiber.
• Consider speaking to a dietitian to help you trouble shoot and make sure you’re getting what you need.

Quick takes:

• Wow! There is now a Congressional Caucus to address Celiac disease! This is huge news. CDF is taking the lead, and if you’re interested, you may want to stay informed on news.

• Curious about oats? GF Jules has a great post and infographic that breaks it down.

• I’m doing a presentation for the Metro DC EDS Association on Digestion and Hypermobility and EDS on March 15th. If you have EDS or HSD and you’d like to attend, email me for more information.

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax, VA.  She helps people with a range of dietary issues, including Celiac Disease, digestive issues, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

Many of you know that I love research! There are so many neat digestive health studies on Celiac disease, IBD and more.

But before we get there, here are some gluten-free Valentine’s day recipes from GF Jules.

I’ve also posted one of my long-time favorites: Chocolate Banana Bread, which is low FODMAP and gluten-free.

Here’s a quick research roundup for your reading enjoyment, and I wanted highlight a webinar from the Center for Celiac Research has a webinar that looks great (free!!) on the emotional burden of juggling multiple autoimmune illnesses on Feb 11^th. Register here.

New study on screening children for Celiac shows that Celiac is more common in people without classic risk factors.

Notably–

• only 30% had “classic” symptoms, i.e. digestive discomfort
• only 10% had a family history of Celiac

Most would not have been caught by current typical practices for screening for Celiac. This calls into question whether mass screening is appropriate.

New study on patients with autoimmune issues who get COVID–the conclusion:

“Patients with AICID are not at increased risk of severe COVID?19 with the exception of those on corticosteroids. These data suggest that patients with AICID should continue on biologic and nonbiologic immunosuppression but limit steroids during the COVID?19 pandemic.”

Translation–patients with Celiac, autoimmune thyroid, IBD, psoriasis, etc. don’t seem to be at increased risk of COVID if they don’t have other risk factors like steroid use.

A low FODMAP diet helps with IBS D (with diarrhea)—moreso than traditional diet advice for diarrhea.

IBD (Crohn’s, UC)—here’s a quick roundup from the recent Crohn’s and Colitis Foundation Conference:

• One looked at SCD vs modified SCD vs a normal diet. Both versions of the SCD were helpful…and on average, no major difference between the two.
• Another diet that was discussed was the Crohn’s disease exclusion diet, or CDED, which was shown to be more helpful than EEN, AKA Exclusive Enteral Nutrition, or only formula, especially when looking long term. This is significant, since EEN has been seen as the gold standard in the past.
• Another study looked at the Mediterranean diet and SCD and in people with mild to moderate Crohn’s. They defined Mediterranean diet as having lots of fruits, vegetables, nuts, and grains; moderate fish, poultry, and wine; and limited red and processed meats and sweets.

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax, VA.  She helps adults with a range of dietary issues, including Celiac Disease, digestive issues, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.

Happy New Year…here’s to a happy, healthy 2021.

Let’s start off with the most common question I’ve heard in the last month re: recommendations for adults. VACCINES!

Yes, if you have Celiac, you can get the vaccine– there aren’t reasons for concern. Here’s a statement from SSCD. “There is no evidence to suggest that people with Celiac disease would be more prone to an adverse effect of vaccination.”

FWIW, the same guidance exists for those of you reading this with IBD: get the vaccine! “The bottom line, she said, is that ‘it’s much safer to get a vaccine than it is to take your chances of getting COVID-19.'”

Or, if reading a Tweetorial is more your thing, here’s a good one:

If you’ve got IBS, there’s no specific guidance, but the best bet is the same: get vaccinated!

Worried because you have food allergies? (not allergies to vaccines/vaccine components). That shouldn’t be a problem. Really. “People with common allergies to medications, foods, inhalants, insects, and latex are probably no more likely than the general public to have an allergic reaction to the mRNA COVID-19 vaccines”. MCAS may be a different story, though, and there’s inadequate research, so do speak to your doctor.

Oh, and the other question I get. Given that I, personally, have a ton of autoimmune diseases and food intolerances, am I going to get the vaccine?

YES!!! Yes I am. YES! As soon as I can.

I hope you do, too.

As always, do check in with your health care team…

• For those interested in Crohn’s and UC, there’s a patient education event online on Jan 30^th
• For GI RDs/colleagues–this is a wonderful article on GI disorders an eating disorders. The crossover is huge and significant, and affects the whole range of GI disorders, from Celiac to IBD to IBS and GERD. Eating disorders and disordered eating isn’t only weight loss–sometimes it’s fear of food. If this speaks to you as a patient, give it to your doctor.
• For my RD colleagues or GIs, fantastic article from Kate Scarlata, MPH, RDN and Emily Haller, MS, RDN on the value of RDs to a GI practice
• Healthier gluten free habits webinar with the wonderful Melinda Dennis, MS, RD…more info here
• New year, new healthy habits? I hope so! I recorded a short mindfulness meditation video of awareness of senses. It’s a nice way to pause and take a break.  

Cheryl Harris, MPH, RD is a Registered Dietitian Nutritionist and Certified Wellcoach in Fairfax, VA.  She helps adults with a range of dietary issues, including Celiac Disease, digestive issues, preventing diseases and “whole foods” eating. Let’s get you on your way to achieving your goals and feeling great!  Email or call 571-271-8742.