I hope you’re having a great and relaxing Summertime! I planned to skip the newsletter for June, and then a bunch of fun studies and news came out and so… here you go!

Well, this is disappointing: one promising medication, ImmunsanT seems like it’s no longer viable, after a trial showed that it was no better than placebo.

RNA changes in active Celiac disease: this may seem abstract… or sort of dry… but it’s fascinating, even if you’re not a science geek like me! Among the most interesting findings was that there are genetic differences in gene expression between people without Celiac, people with Celiac who are “treated” (on a GFD) or people with active Celiac (eating gluten). It notes “The researchers also found evidence to suggest that the risk of co-morbid autoimmune disorder may be high in active celiac disease, as pathways for type 1 diabetes, lupus and autoimmune thyroid disease also were upregulated.”

Now, that’s a big deal… and a really good reason to make sure no gluten is getting in your diet if you have Celiac.

More on g-free in restaurants… it looks like the FDA may be starting to take this seriously. This makes me so happy! I know, many years (decades?) overdue, but still.

New, and very neat research: fiber in the diet of pregnant mamas may prevent Celiac in children. But not just any fiber. Fiber from fruits and veggies, not cereals. The research also found that having moms follow a GF diet did not seem to offer protection to the babies (in moms without Celiac)

IBS and SIBO—a great podcast with the latest and greatest with Dr. Pimmentel, with updates from Digestive Disease Week 2019

IBS and a low FODMAP diet… it works. A nice overview from the Washington Post.

Why women get more autoimmune disease… it’s all about the placenta? Maybe. A new research team says so. It’s an interesting article, and we’ll see where this theory goes. If you like keeping up with research, I do try to post digestive research on my Facebook page on an ongoing basis.

Happy IBS month–with gluten-free & Kosher for Passover Easter Bunny cookies!

First, the cookies, then the research and news below.

April is IBS awareness month. I know many of you are all too aware of IBS…or IBD…or other tummy troubles. It’s no fun. I know there are tons of videos on how to make meringues cookies, and I decided to do something totally different and do a video of how to shape the meringue cookies into bunnies! They’re gluten-free, of course, and low FODMAP…a good way to track down IBS triggers for many people!  They’re pretty IBD friendly, and work well for reflux, gastroparesis…so an all-around winner. And I’ve chosen this recipe because it’s Kosher for Passover…using sugar instead of powdered sugar, which typically contains corn starch. Here’s more on Passover and the whole gluten-free connection.

These are one of my husband’s favorites, and great make-ahead cookies. I hope you love them!

Makes 80-90 bunnies. Serving size: 2 bunnies

• 4 egg whites
• 1 cup sugar
• ¼ tsp cream of tartar
• 2 tsp vanilla extract (can use almond or hazelnut)
• Pinch of salt

Sprinkles low FODMAP or Kosher for Passover (Lieber’s is the easiest to find—generally cheapest at  local stores)

Chocolate chips—I like Enjoy life minis best—super easy to get anywhere locally

Food coloring

Pastry bag with tips

Leave eggs out of the fridge for 30-45 minutes until they’re room temperature. Preheat oven to 250 degrees. Line 2 cookie sheets with parchment paper. Gather chocolate chip eyes, whiskers, pastry bag and flat tip for piping and a bowl for pink ear ‘fluff’

Separate eggs and beat with stand mixer until foamy. Add cream of tartar and salt. Whip until soft peaks form, adding in sugar a little at a time. Continue to whip until firm peaks form, 6-7 minutes total at medium-high speed. Add in vanilla right at the end.

Working quickly, add a few drops of red dye to some of the fluff for the ears. Set aside. Put ½ the rest in the pastry bag with a flat tip.

Pipe out bunnies (hop on over to the video).  Bunnies can snuggle up right next to each other but should not touch. Paint on ears, add whiskers, eyes, etc.

Bake @ 250 for 60 minutes. Turn off oven, leave in oven for 1-2 more hours (or more, if needed, until firm) undisturbed, or overnight.

Put cookies in a sealed container and enjoy!

News and research:

Hot off the presses: new proposed legislation would REQUIRE labeling medication for gluten. This would be a game changer.

We know Celiac and other diseases change gut permeability. But what if this could be prevented, or changed back? New research is underway.

Even more concerns about the Nima sensor. FWIW, I’m all for what Nima is supposed to do, the question is whether it does what it’s intended to.

New study shows a link between childhood antibiotics and development of Celiac. Of course, this doesn’t separate out the chicken vs egg (antibiotics vs infection)

New study suggests that Celiac disease may cause permanent changes to cells in the intestines and predispose to greater inflammation and risks

SIBO is much more common in IBD, according to a new meta analysis.The OR is higher in Crohn’s (10.9) than UC(~8) but still, it should be considered for all IBD patients, especially those with resections. https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.15133

Low FODMAP and miss garlic? You can plant garlic now and use the sprouts. They taste just like garlic and it’s as easy as sticking a piece in the ground (or a pot) and watering it. Step by step guide 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.

 Think outside the candy dish…

Happy Celiac disease Awareness Month! To celebrate, let’s talk about how to eat gluten-free and healthy. Skip down for info on the 2018 GF Expo.

Gluten-free and Healthy

Going gluten-free can be a big turning point to greater awareness and eating healthier.  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 seems to be in everything.  Or maybe after years of eating anything and staying slim, the pounds have started creeping upward, or blood pressure, blood sugar or cholesterol numbers are moving in the wrong direction.

Are you getting the nutrients you need?

Nutrition is important for everyone, but particularly for people who have food restrictions.  While a gluten-free diet is absolutely necessary for everyone with Celiac Disease, there’s an abundance of highly processed, sugary foods out in the gluten-free aisle—often even more than conventional foods.

Years ago, the Food and Drug Administration realized that many people weren’t getting enough vitamins like thiamin, riboflavin, folate and iron.  So they added a variety of nutrients to the foods supply in everyday 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 often are high in carbohydrates, but lower protein, vitamins and minerals.  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, minerals and fiber and usually more calories, too.

This is not inevitable! The good news is that that many healthy foods are naturally gluten-free, like fruits, vegetables, beans, many whole grains, nuts, seeds, and plain fish and poultry.

Also, for many people, untreated Celiac disease leads to nutrient deficiencies.  Absorption of many nutrients happens through the villi in the small intestine.  When these villi are damaged and flattened, fewer nutrients are absorbed.  Because of this, people recently diagnosed with Celiac may even need more nutrients to make up for this.  Iron, B vitamins, Vitamin D, calcium and magnesium are particularly important.

It’s awesome that there are now gluten-free brownies, donuts and beer. But just because they are 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 through the day.  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!

Here are some suggestions to make your diet healthier:

• Go for healthy fats. Increase the amount you eat of fatty fish, like salmon, trout, flounder, sole, rockfish and more.
• Calcium is key! This can be from Greek yogurt, cheese, or milk, or if you avoid dairy, choose sardines, collards or turnip greens, beans, nuts, etc.
• Switch to a GF baking blend using sorghum, garbanzo beans, almond or coconut, brown rice or other whole grains.
• Have fruit or vegetable with every meal—5-9 servings a day.  That can be as easy as an orange with breakfast, a veggie soup and a salad with lunch, dried fruit for snack and 2 servings of veggies along with dinner.
• Include legumes (i.e., dried beans and peas) with your meals regularly; increase your intake of these foods gradually to limit gas.
• Drink your water!  8 glasses a day are important to stay hydrated, especially when you increase the amount of fiber you eat.
• Include nuts and seeds several times a week, which also contain monounsaturated fats and can help control blood cholesterol levels.
• Find a way to reduce stress: acupuncture, meditation, deep breathing, talking to a friend, dancing, walking the dog, or whatever works for you. This under the umbrella of nutrition, because most people don’t reach for Brussels sprouts when they get stressed.
• Use healthy oils, like olive, avocado, etc. and eliminate trans fats.
• Limit sugar and high fructose corn syrup.
• Take care of yourself. This includes sleeping well, reducing stress, and doing things you enjoy.  You’re worth it.

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And, it’s about that time of year! Don’t miss the 2018 Washington DC Gluten-Free Expo and Education day, which is on June 10th! Learn more and register today at www.dcglutenfreeexpo.com

The expo sells out every year and it’s to benefit a wonderful cause–the Children’s National Medical Celiac Disease Center.

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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, GI issues, 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 and feeling great!  Email or call 571-271-8742.

Gluten-Free Springtime…almost

Spring is here. Really. Sooner or later, even if it doesn’t seem like it this week! Although the snow can be a great reminder about emergency preparedness. Do you have 3-5 days of non-perishable gluten-free foods if you need it? Because you never know…

Passover:
Passover isn’t here until March 30th but many of the products are already appearing in a wide range of 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. More here

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 7th, so mark your calendars, because the word has gotten out in gluten-free circles and the mad rush is on.

BTW, there’s always a mad rush to find the “matzo style crackers” that are GF. I saw them today at Whole Foods in Springfield…

Passover recipes are here, and thanks to Moment Magazine for sharing some of my thoughts on a gluten-free Passover, and some great recipes, too.

News & gut health roundup:

• A new article came out this month, suggesting that accidental gluten contamination may be more common than many people with Celiac realize. The study analyzes stool and urine peptides from a little under 200 adults and children with Celiac to estimate gluten consumption. Basically, what the study found is that on average, people who reported eating a gluten-free diet were eating potentially unsafe levels of gluten. That doesn’t even include people who intentionally or knowingly go off the diet. The researchers conclude that this accidental gluten may be linked to symptoms and/or intestinal damage. Unfortunately, the article does not go into the likely sources of accidental gluten. If you’re curious to read more, the abstract is here.
• The Canadian Celiac Association weighed in on the NIMA sensor. In a nutshell, their concern is that it might give people a false sense of security, and they recommend against it.
• Know someone with nerve pain related to gluten sensitivity? A new study showed that people following a strict gluten-free diet were almost 90% less likely to have nerve pain. It’s fascinating because some people assume gluten only affects the gut.
• Take a purple pill? Some studies show PPIs for reflux aren’t risk free. Everyone is going to need different treatment plans, but looking at diet and lifestyle is often a sensible starting spot.
• A new study shows that Splenda may affect gut bacteria, and this might cause increase risk for people who have relatives with IBD, or increased genetic risk.
• People taking VSL #3 for Ulcerative colitis, VSL has changed formulation in the past year, and the new strains aren’t physiologically the same as the ones that were studied for UC.
• Low FODMAP? I’ve updated my products list lately.
• Gluten-free & More Magazine covered a happy, healthy gluten-free pregnancy and shared some of my tips.
• Traveling around the world? Gluten-Free Globetrotter shared a great list of apps.

Classes:
I’m teaching a workshop on living gluten-free at City of Fairfax Regional Library on 4/22/18 from 1:30-2:30pm. It should be fun, and I hope to see some friendly faces!

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, GI issues, 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 and feeling great!  Email or call 571-271-8742.

Happy February! There’s been so much interesting news in the gluten-free world that this month’s newsletter is devoted to new research and developments of interest to the Celiac and gluten-free community.

Finally! The FDA has issued draft guidance on gluten in medications, and the comment period is open now. In short, currently there are no specific rules for labeling gluten in medications, and gluten (or wheat, more specifically) may be used as a filler or excipient without being clearly labeled. “We encourage drug manufacturers to have accurate information about their products’ gluten content available so they can respond to questions from consumers and health care professionals. Manufacturers should pay attention to possible sources of gluten in their products, consider specifications when appropriate, and consider the impact of changes in ingredient sources or formulations on gluten content.” Full statement here

Note: the FDA is proposing suggestions or recommendations for manufacturers, which means it’s not enforceable. But it is still a start! I’m glad to see it because this has been a long time coming—I presented to the FDA in 2011 and it was definitely not of interest then.

Want to comment on this draft guidance? https://www.regulations.gov/document?D=FDA-2017-D-6352-0002

Speaking of comment periods, the FDA petition on enforcing current gluten labeling regulations is only open until Feb 19th. More here.

A new study suggests that cardiovascular diseases and complications are more common in people with Celiac, and recommends more aggressive screening.

The debate rages on the ideal time to introduce gluten to infants. A new study shows that later introduction may raise the risk of type 1 diabetes. In a nutshell, the TEDDY study follows children at high risk of type 1 diabetes. There’s a lot of overlap here with genes for Celiac. For these infants, introduction of gluten before 4 months led to less autoimmunity than intro 4-9 months, or after 9 months. The study was prospective, which is generally a plus, but they also didn’t look at the quantity of gluten introduced, which may be relevant. Previous studies have shown the opposite of this effect, and all current guidelines recommend introducing all foods after 4 months. Hopefully further research will give us a clearer direction.

…and a podcast on children from a few weeks ago, and factors that affect risk of developing Celiac

For those of you who are low FODMAP, or just craving a sweet and delicious treat, try these Maple Spiced Nuts. They’re a long-time favorite of mine.

And a few of my favorite gluten-free Valentine’s day treats.

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, food allergies, vegetarian and vegan diets, 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. 

Now that we’ve had snow, it finally feels like December. I can’t believe how quickly the year is flying by.

For many people, the holiday season is one of the most challenging times to be gluten-free. Food is everywhere, and there’s lots of temptation. I’ve shared some of my favorite tips for a balanced and delicious holiday season.

For most of us, it’s important to keep the spirit of the season and enjoy our favorites…just with a new twist.

By now, there are recipes for just about every holiday staple imaginable. But…some of us aren’t all about mixing 5 different gluten-free flours and whipping out the xantham gum. I’ve collected a list of NATURALLY gluten-free desserts over the years—tried and true recipes that aren’t specialty cooking, but just happen to be marvelously, naturally gluten-free.

Remember, these foods are only GF if you use GF ingredients. And as always, check labels to avoid surprises. A surprising number of chocolates may contain traces of gluten, including Lindt, Ghiradelli, Godiva and many of the Trader Joe’s options. I’ve got lists of chocolates listed gluten-free here and here.

This list has a range of options, from allergy-friendly, grain-free, low FODMAP, low sugar to completely decadent options. Your call! There are enough options to choose from that you can surely find something that works for your lifestyle/food restrictions that you and your family can enjoy together.

Low FODMAP? I’ve italicized recipes that are FODMAP friendly, or easy to adapt and I’ve also put a bunch of low FODMAP recipes together here. Remember, portions matter.

• Baked apples or apple roses
• Candied orange peel (DF, EF, SF, NF)
• Caramelized bananas or Bananas Foster
• Candy canes! Dipped in (dairy free) chocolate or plain (DF, EF, NF)
• Chocolate bark (DF, EF)
• Chocolate Honey Mint Cups
• Chocolate mousse (NF)
• Christmas pudding/plum pudding
• Crème brulee (NF)
• Cheesecake-use any gf cookie crumbs for the crust, or do a crustless cheesecake (NF)
• Chocolates: make your own with a mold or buy
• Chocolate covered: strawberries, cherries, almonds, cashews, hazelnuts, etc. (can be DF or NF)
• Clementines (DF, EF, NF) Of course, they’re more festive when dipped in chocolate 😉
  
• Clementine cake (DF)
• Custard (NF)
• Dessert soufflé
• Dried fruit (DF, EF, NF)
• Divinity (DF, NF)
• Flan
• Flourless tortes (use a dairy free version of nutella to make this low FODMAP), and watch portions!
• Fondue, using chocolate and a variety of fruit and GF cookies (DF*, EF, NF)
• Fruit crisp (any gf flour or quinoa flakes for topping) (DF, EF)
• Fruit and whipped cream (EF, SF, NF)
• Fudge (EF)
• Gelato
• Hard candies (DF*, NF*)
• Hot chocolate–or hot vanilla! (EF, NF)
• Ice cream/frozen yogurt (check labels, especially for malt!)
• Jello (DF, EF, NF)

  

• Macaroons
• Mango with sticky rice (DF, EF, NF)
• Marshmallows (DF, NF)
• Marzipan (some say glucose derived from wheat, so beware)
• Meringue cookies (DF, SF, NF)
• Mint Chocolate Egg cream (DF, EF, SF, NF) and low FODMAP
• Nut or seed brittle (DF*, EF)
• Panna Cotta (EF)
• Pavlova (meringue cake) (DF)
• Peanut butter cookies  or a nut free, use sunbutter (DF)
  
• Peanut Butter Fudge (DF, EF, SF)
• Poached pears (DF, EF, SF, NF)
• Popcorn clusters or caramel corn (EF)
• Popcorn cake (EF)

  

• Pralines<–this version is dairy free (EF)
• Pumpkin seeds (DF, EF, SF, NF)
• Pudding
• Pudding pie with almond or cookie crumble crust
• Rice pudding ( EF, NF)
• Rice krispie bars using puffed rice (EF)
• Roasted chestnuts. (DF, EF, SF) Not quite dessert, but an amazingly seasonal yummy snack.
• Sorbet (DF, EF)
• Toffee (EF)
• Truffles (EF)
• Watermelon (DF, SF, EF, NF)
• Zabaglione

Italicized=low fodmap or easy to adapt, dairy free (DF), egg free (EF) and soy free (SF), NF (nut free) *=check labels

The Washington Post even has a 2017 “Cookie Generator” with a gluten-free option. Of course, you need to make sure the ingredients are be mindful of cross contamination, etc. but this is an easy way to keep traditions without venturing into specialty flours and unfamiliar territory.

My personal favorites? My Bittersweet Chestnut Fudge and my Vegan Pralines.

And for my low FODMAP friends, here’s a round-up of low FODMAP holiday desserts. Just watch the portion sizes.

Oh, right, and there’s holiday food, too. I’ve got a G-Free Turkey and Ham list.

More recipes from around the web:

• A roundup from the Food Network of Holiday Favorites
• A roundup of  gluten-free favorites on GFE & Gluten-free Homemaker
• Holiday appetizers from Gluten-Free Easily
• Gluten and grain free options from Genius Kitchen
• The Dec 2017 issue of Simply Gluten-Free  is online and in stores. It has many beautiful recipes!
• Cookies & desserts from Elana’s Pantry
• 25 Christmas cookies from Only Taste Matters
• 20 Gluten-Free recipes from The Kitchn
• Jules Shepard hosts a g-free cookie swap, where you can get a ton of ideas, or enter to win prizes. Or you can just ogle the pictures. 😉
•  50 gluten-free & grain free holiday desserts from Gormande
• G-Free Kid has a PDF of holiday favorites
• Some Paleo Christmas treats from Paleo Parents
• Gluten Free Girl and the Chef has a great selection of cookies
• A gargantuan Home for the Holidays from GFE and many  others
• Simply Sugar and Gluten Free Christmas recipes
• 25 days of Christmas from Gluten Free Easily
• Celiac Family’s Favorites
• Gluten and Dairy free Holiday tips from Gluten Free Goddess
• Christmas Cookie Roundup (from my cookie exchange)
• Christmas cookie roundup from Ginger Lemon Girl & I’d also recommend her GF 101 Cooking e-book!

Wishing you a peaceful & joyful season!

‘Tis the season of excess. Here are my favorite tips for keeping it balanced:

We’ve just made it through T-day recipes and Christmas candy is all over at work and play. It’s easy to feel like our main form of exercise is usually moving the fork from the plate to our mouths. Here are some ways to enjoy the spirit of the season and favorite holiday foods, while staying healthy, too.

…and if you’re gluten-free, I’ve got more suggestions here for making the holidays work with ease.

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, food allergies, vegetarian and vegan diets, 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.