Get ready to upgrade your gluten-free diet through the Celiac Disease Foundation’s first Culinary Medicine Webinar, “Enhancing the Nutritional Quality of the Gluten-Free Diet.” In this engaging session, a dynamic group of speakers including an expert physician, two seasoned dietitians, and a skilled medical chef will guide attendees through the intricacies of maintaining a well-balanced gluten-free diet. Discover practical tips, evidence-based insights, and delectable culinary techniques to enhance the nutritional value of the gluten-free diet.
Speakers
– Ritu Verma, MD: SSCD President/ Medical Director – University of Chicago Celiac Disease Center
– Vanessa Weisbrod: Chief Education & Community Engagement Officer – Celiac Disease Foundation
– Jessica Lebovits, RD, CDN: Clinical Dietitian·Columbia University Celiac Disease Center
– Sharon Weston MS, RD, CSP, LDN: Senior Clinical Nutrition Specialist – Boston Children’s Hospital
– Molly Winsten, RD: Chef, Dietitian – Freedom Bakery
Thanks everyone for joining we’re going to give people just a few minutes to log in and then we’ll get started as you’re as you’re waiting for us to get started if we could ask if you have not yet completed the pre- survey for tonight if
You could go ahead and um scan the QR code that correlates to who you are if you’re a patient or caregiver please scan the code on the left if you’re a health provider looking to claim cus for tonight’s session please scan the one on the right um we’ll ask you to do this
Again at the end with a post survey this information truly helps us learn about our programs and improve what we’re doing so we thank you in advance for filling these out and we’ll get started in just a few moments there’s a question in um in the Q&A
About a link for the QR codes um if Jennifer if you could go ahead and drop those links in the chat that would be great just give us a moment and we’ll get those links in the chat again if you’re just logging in welcome um we’re very excited for our
Inaugural culinary medicine webinar um we still have quite a few people coming in and so we’re gonna hang tight and get started in about another minute in the meantime if you could please go ahead and complete the um pre- surveys there’s one on the left for patients and
Caregivers and one on the right for health providers wishing to claim continuing education credits for tonight’s seminar um so go ahead and scan those or there’ll be a link in the chat momentarily all right those links are now in the chat so if you were looking for a link
And not a QR code they’re in the chat all right we’re going to go ahead and get started thank you everyone so much for joining tonight this is our first Innovations and culinary medicine webinar and we are so excited for all of you to join us this has been a a project
Long in the making and we are so thrilled to have such an amazing group of speakers here with us tonight to present on improving the nutritional quality of the gluten-free diet um I see there’s still lots of people coming in the room so one more time I will just
Say again um if you’ve not completed the pre- survey um please take a moment to do so I’m going to switch the slide now but the link to do um the surveys is in the chat um I have to start by saying a huge thank you to char and particularly Megan
Donnelly um from Char USA uh Megan has been a champion of nutrition education and really trying to find ways to make nutrition education accessible to everybody across the United States and across the world and so I we are extremely grateful to Megan’s vision and to her whole team at Char for helping to
Make these sessions possible so tonight is just the first there’ll be many others this year and Megan I just hope that you and your whole team know how much we truly appreciate you being a part of this yes thank you so much for having us I’m so excited to be here and
To listen to what all the speakers have to say and you know we’re so happy to support Vanessa and the celiac disease foundation for putting this together and developing such an amazing program that is so accessible across the the country so so culinary medicine and and this has
Been really interesting for me as we’ve started promoting this we’ve had so many emails come in from people saying they had no idea that culinary medicine was even a thing and we’re so excited to join tonight and so we thought that we would start by just explaining what culinary medicine is so culinary
Medicine is an evidence-based field that brings together the medical the nutrition and The Culinary knowledge to help patients in maintaining their health preventing and treating disease and so we we put together this cute little graphic of of how we envision culinary medicine working of bringing together the expert physicians in the
Field of celiac disease with the expert dietitians and skilled medical chefs and so throughout all of our culinary medicine forums um that will be available we will always have doctors dietitians and chefs who are together presenting information on the medical side of celiac disease and the latest research uh nutritional um education um
Concepts and then a chef who will be cooking and sharing uh wonderful recipes with us so we have an amazing group for tonight we have Dr Ru Verma um who is the president of the society for the study of celiac disease as well as the Director of the University of Chicago
Celiac Disease Center we have Jessica litz from the Columbia University Celiac Disease Center Sharon Weston from Boston Children’s Hospital and Molly Winston who you should all know from Freedom Bakery but also on Molly’s plate and um an amazing in addition to being a dietician and a a fabulous Chef also a professional female
Football player so lots of things to learn tonight from our amazing speakers so without further Ado I’m going to pause here and turn it over to Dr Verma thank you Vanessa thank you Megan uh this is a very exciting project that we all involved in and I have a small role
Here um so I’m going to try and share the screen and and are you able to see this Vanessa yep it looks good great thank you so what I’m going to do in the next 10 minutes at least try in the next 10 minutes is sort of give an a rapid
Overview of what is celiac disease the symptoms the diagnosis and spend a little bit of time in terms of what goes on in the gut that then affects us from a nutritional standpoint and perhaps talk a little bit about followup in Celiac disease so it’s going to be rapid
10 minutes that’s what Vanessa is assigned to me so what is celiac disease as we all may know it’s an autoimmune condition it does occur in genetically susceptible individuals so you have to have those specific genes it is extremely unique because we do know what the trigger is for for the condition and
That’s gluten we also have a test which is an autoantigen the tissue trans glutamin is and we also know that if you eliminate that gluten it does help in resolution of the disease unfortunately this is permanent this is not something that just goes away once you’ve been on
The diet for a few years or so it is quite prevalent as you can see one in 100 children it’s common in first degree relatives second degree relatives it’s also been found to be more common in females and for every want to remember this is seen in any ethnic background so
It’s not specific to just one patient population um and then the symptoms of celiac disease are extremely varied I mean obviously there are some people who don’t have any major symptoms and sometimes we only think about GI symptoms as part of celiac disease which is not true but the G GI symptoms that
We tend to see are more diarrhea poor growth abdominal pain constipation and so on and there are many other extraintestinal manifestations that are very important for all of us to remember there’s a specific rash as you can see in the picture it’s called dermatitis herpetiformis um very painful very itchy
Rash can be seen anywhere on the body not every rash is celiac disease but of course if you have a rash it should be looked at then they teeth issues bones poor growth short stature and then there are neurological symptoms with brain fog anemia where you may have more fatigue
And tiredness and sometimes none of these symptoms but you get blood work done and and you find elevated liver enzymes and so on so very important to remember that there are non-gi symptoms as well so once you have these symptoms or someone thinks that they have celiac
Disease what should one do the workup starts off initially with a blood test and this is blood test that looks at specific tissue transamin antibody as you can see they have to do a total IGA level and a TTG and that’s a screening laboratory evaluation that’s done pretty sensitive and specific though to
Remember that there are some people who have IG deficiency and in those people the TTG IG is not helpful and they are other specific antibodies that need to be done and that’s a discussion for another time and who should be tested any patients who have symptoms obviously patients who have other Associated
Diseases we do know that almost 10% of people with type 1 diabetes end up with celiac disease so not only the symptomatic people but also other Associated diseases screen for this condition and then very important to get family screening done since we talked about this is a genetic condition
Running in the family is very important to get the blood test done and regardless of symptoms and why is it important why do I have to be tested if I don’t have any classic symptoms I don’t have belly aches and so on so one of the most
Important things here really is that if you have celiac disease it can give you a malabsorption so you’re not absorbing all the nutrients you end up with poor growth bone issues neurological complications but more importantly it gives you at a higher risk for other autoimmune diseases so very important that the screening test
Happen and then just to go back to why is it that we think people with celiac disease have any of these nutritional abnormalities so let’s go back to the basics this is your intestinal tract doesn’t really look like this this is stretched out intestinal tract so as you
Can see I don’t know if the pointer works or not but the esophagus is right on the top so food goes down the esophagus into your stomach gets churned up into your small intestine where it gets absorbed and uh we know that in Celiac disease predominantly the inflammation is in your small intestine
In the D in duodenum and the junam so you get all this inflammation happening it affects the Villi and then the vli are not absorbing the nutrition but in normal people in all of us that what happens in the gut so in the dudum as
You can see on the left of the screen what gets absorbed you get calcium absorbed you get magnesium absorbed there’s iron there’s copper and all of these get affected whenever there’s a malabsorption so if you eat gluten it causes this damage to the lining and all
Of these elements that you see here all of these nutrients are no longer being absorbed as well and so if you think about disease process you know if your calcium is not being absorbed you can have bone disease and so on so very important to remember if there’s damage
To your small intestine all of these nutrients are not getting absorbed in your intestine so some of the diseases that happen and some of you may have it you may have heard about it with bone disease and celiac disease can be different kind of things you can either
Just have joint pains or you can actually have osteoporosis or osteopenia and why does this happen some of it is because people may have lactose intolerance so they cut down the calcium but a lot of that has to do with absorption and also some autoimmune factors which affect the bones as
Well um very interested in neurological disease so again neurological disease and celiac disease can present in so many different aspects you can have headaches brain fog anxiety and so on there are lots of theories of why people with celiac disease end up with neurological diseases and some of it may
Be because of the malabsorption so if you remember that diagram before with the stretched out intestines if you have malabsorption of folate B6 ion magnesium and copper it may be associated with neurological diseases it has been Associated that there’s some malabsorption of tryptophan and so on so
It starts making sense right so that’s a part of intestine that absorbs the iron that absorbs that vitamin it gets affected so there has to be some side effect from there obviously there are many other reasons why people can have neurological diseases and a lot of research is needed but just to remember
That vitamins can be one of the factors there as well and I mentioned ion deficiency anemia it’s probably the most common non-gi manifestation in adult studies and it’s seen in children as well again I’m a pediatric gastrologist so I definitely think about the children and we have children who are not gaining
Weight but then there are children who are gaining weight but have short stature so their height is not going so very important to remember that even if your weight is going up but your height is not you could still have Celiac de and there’s some studies done that
Almost 10% of the short children and teens may have evidence of celiac disease as well so what’s the treatment currently the only treatment we have is a gluten-free diet and as almost all of you will know that there is no wheat rye and barley you can obviously have rice
Corn potato and so on and the experts that follow me are know more about this than I do but this is sort of the treatment and the only treatment we have very important to remember that do not start a glut gluten free diet prior to full evaluation it’s so important that a
Diagnosis a correct diagnosis is made and then you start the gluten-free diet based on discussions with dietitians and your clinical team so do you think if you go on a glutenfree diet that’s all I need to do well not really because remember that stretched out intestine all those vitamins are not being
Absorbed so important that besides a gluten-free diet you’re also looking at various vitamin deficiencies that you’re getting multivitamin that that has the B vitamin B’s in it folic acid ion and so on and the experts that follow will tell you more about that but important to remember that just being on a
Gluten-free diet is not the only answer that you should have some of these vitamin deficiencies and vitamins to take along with that important to look at the calories because again you’ve been malabsorbing so you’re not absorbing the same thing with protein you’ve got to look at a balanced diet
Besides just taking a gluten-free diet so you see someone you get a diagnosis you get started on a gluten-free diet and you’re like life is good well no life is good but you’ve got to have followup so please remember the followup is important so why do we need to follow
Up right so I got a diagnosis made I’m on a gluten-free diet I’m even taking my vitamins but very important to follow up because there can be complications of celiac Dees and just looking at the damage that’s in the small bowel is not a good indicator for the extent of
Malnutrition you can have very minor damage to your doal biopsies and still have significant malnutrition so extremely important that you follow with your clinical team and the clinical team should involve a dietician a physician or nurse practitioner who is an expert in Celiac disease The dietitian to be an
Expert in celiac disease and a psychologist would be great to follow with that as well as your team but that clinical assessment is is extremely important at the time of diagnosis and ongoing as well monitoring your vitamins should be checked at the time of diagnosis and even while you’re on a
Gluten-free diet because again your vitamin absorption is not going to be right away as soon as you start with a gluten-free diet monitoring growth is important and additional symptoms sometimes you may have more diarrhea could it be because there’s some gluten going in your diet or could it be that
You have a zinc deficiency and that’s why you have diarrhea so monitoring the symptoms are important assessing for comorbid conditions a lot of children and adults who have celiac disease can also end up with thyroid disease there’s a thought that maybe there’s a deficiency in iodine and that might be a
Reason for some thyroid disease or it could be autoimmune as well so again looking with your dietitian whether you have enough of those supplements is very important in women of course I don’t see women usually who have reproductive issues but there can be women with reproductive issues because of mic
Nutrient deficiency so again followup becomes important so here we’re talking the diet is the diet is the diet and the glutenfree diet is the answer unfortunately the gluten-free diet is your disease treatment but they also the gluten-free diet currently though sh is working on it lots of foods are found to
Be high in fat low in fiber low in a lot of vitamins the gluten-free products are low in a lot of vitamins and low in a lot of minerals so very important that you continue to follow while you’re on a gruten free diet because now you want to
Make sure that you’re not at a risk for obesity for cardiovascular risk and so on a recent study done also showed that a lot of ultr processed foods that are gluten-free and if a person is not exercising enough there actually higher levels of oxidative stress and there are some pro-inflammatory cyto kindes so
It’s on the basis of Immunology as well it’s not just saying it’s high in fat and so on but the ultr processed foods have been found to be associated with some of these particular cyto kindes and this is regardless of how long someone has been on a gluten-free diet so follow
Up follow up follow up with your dietitians very important and looking at the nutrient deficiencies part of followup is also education so when children are diagnosed if someone is diagnosed at four years of age and now you are 10 or 12 years we as a clinical team need to educate you on
What is now developmentally appropriate for you if you are a person of a different ethnic background and always give an example I’m Indian and if I and I do have two children with celiac disease and if they go in and they’re seeing a dietitian or a clinical team
That does not give them what they need from an Indian Cuisine standpoint I’m not going to come back to you so again talking to your dietician don’t run away from your dietitian talk to your dietitian and ask them to give you guideance Ence on ethnically appropriate gluten-free foods that will
Work for your children and for yourself and the diet and the supplements and family centered care I’m a total passionate about this that it has to be education not just for the patient their families and anyone else who’s involved in their care whether it’s grandparents uncles aunts School anything looking at
These children and adults because now we are restricting Foods we’re putting them on a gluten-free diet we need to help them we need to help improve their quality of life and coping skills a number of these children gain a lot of weight and that gets concerning a number of people develop abnormal eating
Behaviors depression and anxiety so very important to follow up with your team and have them talk to you help you improve your Quality of Life Food insecurity is a big topic and maybe that’ll be another topic for another day but again looking at covid-19 and everything else that is going on there’s
A lot of insecurity so following up looking to your team to help you is what you want to do with this so why is compliance important a lot of reasons there’s a lot of evidence to show that when children with symptomatic celiac disease adhere to a gluten-free diet it
Obviously results in resolution of their symptoms it helps them grow and growth is happening in that pediatric age group so very important it normalizes the blood work and then Studies have also shown that the quality of life in children who are on a glutenfree diet who were symptomatic improves
Significantly and in adults there is definitely an improvement in terms of higher increased cancer risk so compliance followup is extremely important and these are our references and at this point I am going to sign off hopefully I didn’t take too much more time than the 10 minutes and I’ll stop
Sharing thank you Dr we will hand it over to Sharon Weston all right thank you Dr verman thank you Vanessa I’m just GNA go ahead and share my screen all right so my objectives are to offer practical guidance on building a well-balanced gluten-free diet including sources of essential nutrients like
Fiber and vitamins and minerals and also address potential nutritional deficiencies that individuals with celiac disease May face and how to mitigate them through diet uh and then offer some kids specific tips so first off building a well-balanced gluten-free diet requires a lot of planning right to ensure that
We’re getting all of the essential nutrients that our bodies need and by following the plate model and in this case um what I’m showing here is the healthy eating plate that was developed by Harvard School of Public Health and um this is modified to show gluten-free grains uh but by following this plate
Model we can Ensure that we’re getting a balance of nutrients that are unique to each food group and remember that Foods fall into food groups based on their similarities in the type of food that they are as well as the nutrients that they provide so um you can notice that
Many of the foods falling into these food groups are all first off naturally gluten-free and also unprocessed so by eating more wholesome Foods less Ultra processed foods we can provide our bodies with more nutrients and uh this may also reduce the risk of cross-contamination so let’s just walk
Through these food groups so first off when we talk about fruits and vegetables these are going to be obviously high in vitamin C but also vitamin A and fiber um I like to think of a rainbow of colors as we’re walking through our day trying to add a fruit or a vegetable to
A meal or a snack or include it into a recipe uh which we can talk about with you know all of our culinary medicine recipes um so that we try to hit that goal of eating fruits and vegetables five or more times a day each different
Color is going to be loaded with unique phytochemicals that can help also reduce inflammation and optimize Health we also want to think about adequate protein intake protein is again as Dr Verma said essential for growth also repair of tissues remember that all of our hormones are made of protein we’re
Constantly doing protein turnover and replacing amino acids with new amino acids a lot from our dietary protein so we we need to make sure that we’re including protein-rich foods such as lean meats and fish poultry eggs tofu legumes nuts seeds in our meals and our snacks we also want to think about the
Carbohydrate part of the plate and uh so including gluten-free grains or naturally gluten-free starchy vegetables for the carbohydrate part of the plate will um will just balance out that protein and uh and so opting for gluten-free grains like quinoa or or brown rice buckwheat amaran sorghum trying a different variety of of
Gluten-free grains even gluten-free oats um can provide us with essential carbohydrates fiber vitamins and minerals and some also provide us with additional plant-based protein as well we also want to think about calcium and so dairy or dairy Alternatives can help us just provide that calcium for bone health and then healthy fats are
Going to play a crucial role in brain health also hormone production and absorption of fat soluble vitamins so including sources of healthy fats like avocados olive oil nuts seeds and even fatty fish um is a great way to improve that intake of healthy fats and then don’t forget about hydration right so
Hydrating with water is a great way to aid in digestion without adding that extra sugar that is found in Sugar sweetened beverages paired snacks is another really important concept that uh I really like to um uh get across and so this is a great way to provide a fuel to
Our bodies it acts as a bridge between two meals and it provides that more gradual rise and fall of blood sugar and it’s it’s h also great to eat our snacks mindfully which means that we’re sitting down slowing down and really savoring every bite that that we’re eating so to
Build a paired snack we’re really trying to do this combination of a vegetable or a fruit or a legume or a gluten-free whole grain and pair it with a protein or a fat so for example having a cup of baby carrots and two tablespoons of hummus or two tablespoons of ranch
Dressing um or another example would be like an apple and a tablespoon of peanut butter or it could be uh serving of gluten-free pretzels and uh some hummus or even mixing in some nuts with that but those are easy snacks that are going to provide that long sustainable source
Of food fuel um and also provide us with great nutrients gluten-free foods also can be higher in carbohydrates sugar and saturated fat content and lower in fiber and also micronutrients as compared to gluten containing counterparts so Studies have shown that both adult and pediatric patients with celiac disease
Are more at risk to have nutritional deficiencies not only only at diagnosis but also after diagnosis and this can include things like calories and protein fiber healthy fats calcium and vitamin D iron and then B vitamins like B12 folate and riboflavin the best thing to think
Of is dietary variety and so that helps us improve our average intake across the board so let’s just walk through these so first off with calories and protein we can really improve our calories and protein intake just by thinking again about balanced meals and paired snacks that balance um that balance really
Boosts nutritional intake quality variety and uh that protein sources can be added from a variety of meats and poultry and eggs and dairy as well as plant-based protein sources that would come from things like tofu nuts uh peanut butter nut Butters and even things like Ancient Grains like
Quinoa fiber is also very challenging at times to meet on the gluten-free diet and in general when we think about fiber goals for Pediatrics we start with the age plus 5 rule which means you take your age in years and you add five to kind of set an initial goal for grams
Per day and then work up to that recommended daily intake level which can vary based on age from 19 up to 38 grams per day so by gradually working up fiber intake um through adding vegetables and fruits and legumes and gluten-free whole grains s is a more realistic way to
Improve fiber intake and we also want to make sure that we’re including adequate hydration as we’re increasing our fiber intake when we think about uh healthy fats we want to kind of focus on using more plant-based fats to replace those saturated fats that come from animal
Fats or highly processed foods um and so so those plant-based fats are a great way to improve intake of healthy fats uh think of foods like nuts and seeds nut Butters avocado hummus olives um these are all great sources of plant-based fats that are also naturally gluten-free for calcium and vitamin D
These are things that go hand inand to optimize bone health and so encouraging either fortified dairy or fortified alternative Dairy milks and yogurts as part of meals and snacks is a great way to boost our intake of calcium and also vitamin D other sources of vitamin D can come from
Things like certain mushrooms that are cultivated under a certain type of U uh UVB rate uh of light and then um oily fish and then even just exposure to Sunshine um without a little sunscreen uh is is a great way to just boost our vitamin D intake or level I should say
Um Iron very important so so we know that iron is one of those um those high-risk uh micronutrient deficiencies for celiac disease and so focusing on fortified gluten-free cereals is a great way to just boost that iron intake as well as uh foods such as red meats or
Lentils soybeans and tofu and trying to combine an iron rich food along with a vitamin C source is also going to improve iron absorption so for example if you had lentil soup and you had sliced tomatoes with that or tomatoes were in the lentil soup that vitamin C and iron together improves that
Absorption for B vitamins we want to think about vitamin B12 folate and right ryboflavin especially uh vitamin B12 sources are naturally going to come from animal-based Foods so things like meats and eggs dairy and fish but also B12 enriched plant-based Foods so things like soy milk or oat milk that’s
Enriched will have B12 added to it good sources for folate will incre include things like green leafy vegetables things like spinach romae lettuce asparagus also things like lentils beets broccoli and then foods that are high in riboflavin are going to include things like milk and yogurt pinoa lean meats
Poultry eggs Seafood beans peas lentils nuts and seeds and also soy products so finally I think on this slide I want to make sure that I point out that working with a Celiac dietitian can also really help determine nutritional adequacy and come up with an individualized approach
You know especially if you have a picky eater or um someone that just doesn’t like a variety of foods really analyzing what they’re eating and where where the holes are in their diet is an important thing to to focus on and taking advantage of culinary medicine to try
New recipes which incorporate a variety of nutrient-rich foods in order to help optimize intake and restore nutritional deficiencies that may exist at diagnosis um but also provide adequate intake of nutrients after diagnosis is important for kids specific practical tips first thing is really to make it fun right so involving kids in the
Planning shopping and preparation of meals and snacks uh culinary medicine classes can be a super fun way to open up many new doors and uh try new foods try new recipes even from a young age and young children can help um gather ingredients they can help wash or dry
Fruits and vegetables they can help mix things and as kids get older they can carry on more independent cooking skills um that really help to Foster confidence in preparing healthy recipes on their own educating uh is also important right so teaching kids about gluten-free foods and how they relate to improving Health
But also making Foods tasty uh can really improve dietary adherence to the GL glutenfree diet and culinary medicine’s ability to educate about using food as medicine can really provide a source of empowerment to improve health um encouraging variety is another important uh point so eating a variety of foods eating a rainbow of
Colors of fruits and vegetables choosing different gluten-free grains and proteins and healthy fats and playing around with different cooking methods different spices different shapes different textures to determine different individual preferences thinking outside the wrapper is another important practical tip so homemade meals and homemade snacks made from scratch can really outweigh Ultra
Processed foods in so many ways and it doesn’t have to be complicated it can be very simple simple combinations using the balanced plate model using the paired snack concept um can just produce some very easy healthy options and then we want to think about social situations so coming up with strategy
To help kids navigate situations in school in different sporting events or family or friend Gatherings and by planning ahead and making a game plan in advance for meals and snacks can just help improve the nutritional quality of the foods that are eaten um and also minimize the risk of getting glutened
And finally seeking support So taking advantage of support groups to share and learn from others and just feel like you’re not alone and then finally I just wanted to talk a little about um just school right so tips for improving nutritional intake in school first off is to uh try to
Integrate nutrition education into the school curriculum it doesn’t have to be just in health class nutrition can can really really be embedded in all classes it can be like a simple math problem right um working with the schools to provide healthy gluten-free foods in the cafeteria and choose vendors that uh
Provide healthy gluten-free varieties that are not super high in sugar or Ultra processed also just focusing on some fun activities in schools so School Gardens are a great way to reinforce um that whole concept of nurturing nurturing a plant is just like us nurturing our bodies to improve growth
And and health and wellness uh and then extending nutrition information from school to home um is just another way that we’re really um spreading the word about health and eating uh naturally gluten-free foods into and and spreading that into the community at large and uh offering workshops Community engagement
Even like visits to local farms can really just you know again focus on using and taking advantage of those naturally gluten-free foods to just give more opportunities to eating healthfully all right I’m gonna pass it on to Jessica thank you and Jess just right before you get started for those of you
Who are asking about claiming the CME the CE credits at the towards the end of the webinar we’ll be putting the post um surveys in the chat for everyone to fill out and there will be the one for the CE credits as well as for patients so those
Are coming up thanks Vanessa all right so now that we know what we need to add to our gluten-free diet to make it nutritionally complete I’m going to talk more about practical tips for how we can make that happen so first off let’s recognize that there are several barriers to consuming
A nutritionally adequate diet there’s probably a reason we aren’t all already just doing this right why do dietitians even exist well there may be taste preferences related to gluten-free foods or Fresh Foods not everyone loves their gluten-free options we also know that the food you eat is often influenced by
Those around you often times your food choices are not solely up to you but they may be impacted by the attitudes and preferences of your friends and family additionally there may be a lack of knowledge about how to even prepare gluten-free foods or you may not feel that you have the skills to
Cook next you may not feel comfortable trying new foods or varying your diet other barriers may involve your meal patterns or settings are you eating most meals at home at a family or friend’s home or dining out or taking in food regularly food in security and availability of gluten-free foods is
Another issue that we can’t Overlook and lastly kitchen availability including limited space or appliances or even a shared kitchen can be another barrier I’m in New York City and I know not everyone has a full kitchen in their apartment others have roommates so that adds another variable to the mix but
With the help of your dietitian you can work together on strategies to reframe these barriers and make consuming a healthy diet more manageable so it all starts with meal planning setting aside time to meal plan will allow you to map out your week ahead instead of worrying about what to
Eat each day in the middle of your busy week creating a meal plan will allow you to ensure your consuming nutritious meals saving time and spending less money you’ll also have more opportunity to experiment with different foods when cooking at home start by creating a menu
Of the meals you plan to make for the week account for meals that you will be eating outside of the home and don’t forget to buy food for all of your meals that includes breakfast lunch and snacks too you want to fuel yourself throughout the day to ensure you’re energized and
Not IND producing more symptoms for yourself for example if you skip lunch you may be extra hungry for dinner and inclined to eat more and faster which may result in bloating and discomfort when putting together our menu we want to think of variety to ensure you’re getting all of the
Nutrients you need as Sharon mentioned you can aim to think of eating the rainbow this will help you to get a range of different colors in your diet because each color and each type of food will main its own unique set of nutrients consuming a vared Diet also
Helps prevent flavor fatigue making the diet more enjoyable at this point you can search for various gluten-free recipes here’s a list of some places to get inspiration from you can save your recipes so that each week you can look back through your list to help make the decision process
Easier to increase variety create a goal to try out new recipes either weekly monthly or as often as you can recipes don’t have to be complicated or challenging simply cooking a new vegetable or grain is a great first step to varying the diet once you’ve completed a recipe
You’ll likely feel more comfortable with these new foods and cooking skills and be more willing to try them again this will add more options to your repertoire and your meal rotation in addition you’ll have more ingredients on hand that will help you to create other new recipes it’s important to remember that
You can’t get any worse at cooking you can only get better with more practice even if you’re starting from Square One any mistakes you make will help you to learn along the way I personally was definitely not a skilled cook to start I think back on
When I first made boxed mac and cheese on my own and accidentally made it into cheese soup then as a dietitian I was required to take a cooking class in college and almost every class I pretty much failed to produce an edible version of the recipe we were supposed to
Present that day after many years I wouldn’t say I’m close to a chef but I do absolutely love cooking I cook various gluten-free recipes all the time and share them on my Instagram G free Rd I hope to inspire others to do the same there are endless resources for recipes
At every skill level whether you look online at blogs recipe websites or social media or you prefer hard copies of cookbooks or magazines I honestly don’t usually use specifically gluten-free recipes since it really is easy to switch up any recipe to make it gluten-free baking is a bit more tricky
Though but most of the flour Brands I listed have recipes on their websites using their flowers as a dietician people may think that I just inherently love healthy foods while I do love vegetables I absolutely refuse to eat them without flavor for example growing up my mother often made us plain steamed broccoli
Which would only inspire a few bites out of me once I started cooking on my own I started exploring broccoli with flavors that I enjoyed broccoli with a walnut raisin salsa with a peanut butter dressing simply with garlic and red pepper flakes a kachu Pepe version or
Parmesan and black pepper or as a SLO with almonds red onion and a lemony Mayo dressing I can’t get enough of the broccoli in these dishes figuring out what flavors you enjoy can help you to make healthy foods more appetizing and get you feeling happier to include more of these Foods
In your diet it’s important not to rule out of food just because you didn’t enjoy it one way but to explore other options that may work better for you I usually would say though that although I loved cooked broccoli raw broccoli was not for me but I recently discovered
That raw broccoli SLO I mentioned and it may be my favorite broccoli dish yet once you have your recipes picked out write down all of the ingredients you need for each recipe this will become the base of your grocery shopping list compile all these ingredients together along with your grocery needs into one
Neat list if you notice you need the same ingredient for multiple dishes see how you can consolidate them for example if two dishes call for part of an onion you may only need to buy one onion and divide it up you may want to make your list according to the layout of your
Grocery store so that you can move smoothly through the aisles I actually love using the notes app on my iPhone it allows you to make a bulleted list so as I move through the store I can check off the items I already added to my cart and
I’ll then move those to the bottom of the list only leaving the items I have left at the top until everything is checked off here’s one example of a meal plan and its shopping list sometimes you don’t want to eat the same thing 2 days
In a row or you’ll find a recipe didn’t use the entire container of one ingredient you can repurpose those ingredients or your leftovers into new meals have leftover roast chicken from Sunday night dinner use the leftover chicken for a sandwich on Monday have leftovers from taco night on Monday use
It to make a taco salad for lunch on Tuesday have extra lentil pasta from Tuesday’s dinner use the pasta for mac and cheese for lunch on Thursday you get the idea okay we have our list now we need to do the grocery shopping make sure to shop
In advance when you have more free time such as on weekends and days off I’ll often have my patients pick a day of the week and time that they want to Loosely designate for making this list and for grocery shopping I may suggest even setting a phone reminder to make sure
They don’t get too busy and forget when people are really pressed for time there are other options available some some grocery stores or services offer delivery or pickup so someone else is doing the shopping for you come prepared with your list and your shopping bags avoid shopping on an empty stomach as we
Know that when we’re hungry our eyes wander and we may want to buy a lot more than we originally planned for we made this list for a reason so we really want to stick to it aim to shop the perimeter of the store as that’s usually where all
The fresh Whole Foods will be held but of course you’ll be making purchases throughout the entire storm you’re all used to reading ingredient lists for gluten but you can also review nutrition labels for other helpful information the nutrition label will show you how many calories along with how much protein sodium fat fiber
And specific nutrients are in a product you can also see how much sugar is in an item below it you will see added sugar which refers to how much sugar was added to the product that wasn’t naturally occurring within the food but be careful you want to make sure you’re looking at
What serving size a label is referring to sometimes the amounts will represent the whole package but most of the time the serving size will only be a portion of the package and so you’ll need to figure out how much you’re actually eating and how does that compare to the
Serving size on the label you may need to do some calculations to get a more accurate estimate of how many calories and how much protein sodium fat fiber and sugar you’re taking in when you look at the ingredient label you can see what ingredients are included ingredients are
Listed on products in descending order by weight so that the first ingredient is always present in the largest amount so for example if you’re buying a chicken dinner you would really hope that the chicken would be the first ingredient and not sugar you can also look at the ingredients to see if they
Include whole grains over refined grains the fiber content will be a good good clue for this as well don’t be afraid of canned fruits or Frozen fruits or vegetables um these can be just as nutritious as their fresh counterparts and may help you to have these Foods on hand without them going
Bad once we have all of our ingredients you may decide that meal prepping is helpful to make your week easier consider preparing certain foods in bulk like a large tray of roasted vegetables or quinoa to last for several days or simply chop up certain vegetables or fruits ahead of time this could be
Helpful for healthy snacks that are all ready to go or getting a head start on certain meals you’ll be cooking later in the week cooking in bulk will help to reduce preparation time right before the actual meal when you may be busy busier after a long
Day okay so now let’s talk about when you’re dining out I highly recommend researching restaurants that have options that you’ll be happy with there’s lots of resources out there like the find me gluten-free and atlet apps consider checking out the menu ahead of time so you can be somewhat prepared
With what you want to order Sharon taught us about the balanced plate model and that still applies when dining out when you’re choosing what to order think about what will be your protein your starch and your non-starchy veggie you may want to order a side if a veggie is
Not included in your dish you can also use dining out as a great way to try new foods that you wouldn’t necessarily cook yourself just like when you go to the groc grocery store you don’t want to show up to a dinner out too hungry this may lead you to choose less nutritious
Options eat too much or eat too quickly it’s okay to have a snack before dinner so that you’re not starving by the time your food comes you can think about a hunger scale one being so hungry you could eat a horse and 10 being so stuffed you never want to eat again we
Want to try to avoid those extremes because that’s where the problems will happen try to enter each meal at a four where you’re comfortably hungry and ready to eat but not ravenous that you’ll eat too quickly and end a meal at a six when you’re comfortably full and satisfied but not overly
Stuffed on that note make sure to fuel yourself throughout the day you don’t want to just save up for this meal as this often backfires and can result in higher calorie intake and potentially more symptoms like reflux bloating abdominal pain and diarrhea listen to your hunger cues restaurant portions are often large so
If you realize that you’re becoming full or feeling like you’re at a six and if you keep going you may reach a seven eight or nine consider bringing some home for leftovers this will save you time and money and allow you to enjoy the food another time lastly and most
Importantly enjoy yourself we know that eating out with celiac disease can be stressful in itself Savor the good food and enjoy your time with others for all my patients I encourage them to increase variety with a tangible goal that may be one new food or one new
Recipe per week or per month depending on what they feel is manageable for them I’d like you to try out these goals I listed here the first is is to prepare one new gluten-free recipe it can be as simple or as complicated as you’d like and the second is to add one new
Naturally gluten-free food to your diet I’m confident that you can all reach these goals and I hope you discover new foods and exciting recipes that make the gluten-free diet more enjoyable for you thank you thank you Jessica that was fantastic all right we are going to now bring in
Molly in the kitchen for our cooking demo hi everyone this is Molly Winston msrd also known to Chef malls or on Molly’s plate is actually done in the microwave first potatoes take a lot longer to cook than any of our other ingredients that I’m going to have here so the potatoes
Actually microwave for about five minutes I’m going to get these down on our sheet right let’s those down there just babed potatoes cut in half next I’ve got my veggies I’ve got all sorts of bell peppers um yellow orange red and I also have some jalapenos if you don’t
Like spicy you can use green bell pepper or leave them out and also some sliced garlic and some red onion so I’m going to put that all in on our sheet tray I also have some cut precooked chicken sausage this is really delicious you can find all sorts of gluten-free BRS and
It’s really good for you super high in protein it just goes right on this is one sheet tray I do have this l in parment paper to keep things from sticking and I’m just going to TOS everything up with my nice clean hands hands are wonderful tools in the kitchen
I love color in my food so I love seeing the rainbow of all these colors here and the more colors you eat the more nutrients you’re getting in your food there’s all sorts of different nutrients that create different colors in food so you’re looking for that in anything
You’re making the more colors the better plus it looks really pretty um this is my sheet tray you see that it’s nice and full you have a bigger sheet tray even better but you don’t want it like overflowing everything here is pretty flattened which is great for seasoning
I’m going super super simple here I’m going to start with a drizzle of olive oil all over everything everything nice and coated olive oil is full of healthy fats super good for you for my seasoning here I’ve got garlic powder Italian seasoning and some red pepper flak if
You don’t like spicy you can just go a little chili powder here and you’ll still get lots of great flavor all of this is going on here I have one teaspoon of each this is all getting sprinkled I’m going to mix this all up here that’s all going on what I have
Here is a mix of two parts salt to one part pepp pepper I’m going to use about half of this it’s going to be about a teaspoon to a teaspoon and a half of this mixture when it comes out of the oven you can always taste test for
Seasoning but always add less than you think you need you can always add more you can’t take it out so again using my hands here I’m going to mix this all up till everything is coated in our seasoning here and also this chicken sausage is already cooked so you don’t
Need to worry you’re not touching raw meat here at all and it’s super easy too because we have very limited dishes so once everything is evenly coated there it looks beautiful and that is your sheet tray this whole thing is going to go into a 375° oven for about 20 to 25
Minutes depending on the size of your potatoes and how hot your oven actually runs and now while that’s cooking we’re going to make a quick dejon sauce to serve this way I Love interactive food so I love serving really SLE dishes with a sauce or a dressing or something just sort of
Amp up the flavor a little bit so I have a one to one ratio here of mayo to mustard is about a tablespoon and a half of each you don’t need very much here to add some olive oil to mify I’m going to add one tblspoon of red wine vinegar
Here this is going to make such a delicious bright flavor to your sauce to balance that I’m going to add about a tablespoon of honey right in here just squeeze it right in there this is also going to help thicken it just a little bit I once again have my two parts salt
To one part of pepper mixture I’m going to add about half a teaspoon of this and then I’ll taste for seasoning at the end and to emulsify this all we’re going to use a little more of our old olive oil which is so so good for you and I’m just
Going to whisk this all together and you’ll see that everything will start to emulsify mustard is a natural emulsifier so it’s going to help everything sort of Stak together and we’re not looking for stuff thick here we’re making this nice little sauce and so we’re adding all
Sorts of flavor in here is all wi should be a little bit bright a little bit sweet a little bit peppery and I just always taste for salt and pepper right here it’s perfect it doesn’t need any more this can sit in the fridge until you’re ready to have your sausage
Peppers and potato Chet tray this will thicken up a little bit as sit in the fridge as well if you wanted a bit of a thick or creamier sauce you could add in a dollop of Greek yogurt really really good for you and that’ll thicken it and
Make it a little bit creamier as well as always I check all my ingredients mustards in particular can be made sometimes with beer or wheat additives so make sure you’re checking those ingredients every time okay so we have our finished sheet tray we’ve got our our chicken sausage our potatoes
Remember we par cook those in the microwave so they would cook in time and we have all our vegetables bell peppers jalapeno peppers onions garlic and we’re going to Plate this so I love to serve this in a bowl I love anything in a bowl
I feel like it’s just really a great way to mix everything all together this serves four comfortably depending on you know the size of the people you’re feeding so you make sure you get some of everything vegetables chicken sausage potatoes so there we go some of all the good stuff
And then I just put our sauce here in a squeeze bottle so I’m just going to give this a little drizzle right across the top and then just to finish it off I have some freshly CH parsley add some freshness and some Greenery and that is it that is your finished sheet tray
Chicken sausage peppers and potatoes dish so good glutenfree dairy free this is also nutree so it’s perfect for so many diet restrictions and it is absolutely delicious you have some sweetness from the peppers and some zinc from your mustard sauce freshness of the parsley the Bell hoers also add this
Great sweetness a little bit of spikes going on great textures and it’s super balanced healthy dish so I hope you try it hey guys we’re back with Chef M from amal’s plate and we are going to make a spring inspired cob salad today we’re making a fully gluten-free and dairyfree
Recipe here with tons of nutrients tons of vegetables and of course tons of flavor so the first thing we’re going to do is we’re going to shred our lettuce now it’s obviously pretty easy to cut lettuce this is aead of ran and I love all the crunchiness and all the bright
Green Greenery in it but here’s the thing you actually want to cut down the seam of each side of the head of Roma this is going to allow you to shred the lettuce and make really nice even pieces so I’m going to take the tip of my knif
And go all the way down through that seam and I’m going to do that on all sides here and then when I cut through my lettuce I’m going to have a really really nice shred to it and the pieces will be really beautifully chopped so
I’m going to take my knife now and go all the way down through and I will get these beautiful shreds of lettuce that are so crunchy and they’re even and they’re a lot easier to eat and disperse in a salad than if you just cut immediately without cutting down through
The seam so this is going to be my base for my salad I’m going to put all of this right in here and then we are going to make our dressing and then we will assemble everything so because we are inspired by Springtime we’re going to make a super bright vibrant Green
Goddess dressing Green Goddess has a lot of different ways that you can make it we’re going to make an herb based vinegarette essentially and then we’re going to mulfy it using olive oil so and also the garlic garlic is actually also a natural muls ofier which will help it
Blend together so in my blender here I have cilantro and parsley I have most of the stems of these herbs the stems are really tasty and provide a ton of flavor and some great nutrients but they’re often cast aside because they’re not as nice for garnishing and they aren’t as a
Teasing to the eye so this is a great way to make sure you’re using up all of your produce so I’ve got those in here I also have some green onions the whites and the green parts once again I want to make sure I’m utilizing everything I’ve
Got some garlic cloves I also have a jalapeno in here I left everything in it because I love spice but if you don’t want Spice you can either take the seeds out or you can leave the um jalapeno out Al together that is totally fine so I am
Going to add in a splash of vinegar you could also use lemon or lime juice here this is about half a cup and then I’m going to do the same thing with the olive oil but I’m going to stream this in as I’m blending on low speed to help
A mify it of course we’re going through that beautiful vibrant green color as well because it is a green bonus after all as everything starts to blend you can start to bring your speed up slowly so again you want everything to emulsify here and you’ll see that those ures get
Broken down and they start do more SCP thing of the olive oil screen in now at this point you have a great texture of your dressing it’s a little bit creamy it’s super bright but we’re going to add some salt and pepper too this is two parts salt to one part
Pepper this is really to taste here you can always add more you can’t really take it out so I’m going to add a good pinch of my salt and pepper mixture here and I’m going to stream in about another 1/4 cup of olive oil to help finish the
Dressing you can see that’s becoming really creamy and that’s because the multiplication process is happening as you’re screaming in the olive oil I’m going one more blit to make sure everything’s really mix this one’s going to be at a bit of a higher speed and there is your finished Green
Goddess I’m going to put this into a mason jar and I’m going to give it a little bit of a taste test you always want to taste test things like dressings and sauces because you want to make sure that they’re properly seasoned so there is our gorgeous dressing this will also
Keep in the fridge which is a great thing to have on hand for veggies salads Etc I’m going to take a little taste just to check it for seasoning it’s perfect it’s vibrant it’s bright it’s super green and it’s going to really add so much flavor to our
Salad so now it’s time to assemble our salad going with this theme of spray and all sorts of great flavors we’re gonna vary a little bit from a classic cob so we’re going to add in a few things we’re going to add in some roasted asparagus some beautiful green peas and we’re
Going to add in some Julian radish as well it’s going to add great Crunch and test and texture so we have our shredded lettuce here as our base I’m going to go with some tricolored Tomatoes I always make sure to cut baby tomatoes in half I
Don’t love them whole I don’t love the look of them in a salad and I also think they’re much easier to eat when they’re cut in half so those go in we have just some diced cucumber this is an English cucumber those are the ones with the origes they’re a little bit crunchier
And a little bit less water content thanut traditional cucumber which means you can really use the whole thing in a salad and it adds great texture and crunch to anything you’re making that’s going in next I have some hardboiled egg very traditional in any cob salad and also it’s really good for
You so we have lots of protein we have some good fats coming in here I just ordered these but if you prefer these to be chopped you can do that as well these are just hardboiled there’s no softness to the yolk or anything like that just a
Classic hardboiled egg so we’re going to put those right next to our Tomatoes here and this is one of the reasons too I didn’t put too much lettuce in the salad because you have so much other stuff going on I hate when salads don’t have a ton going on they get sort of
Boring or outd by the lettuce there’s so much going on in here when it comes to textural contrast color and ber and variation of flavors so right in the middle I’m going to do our main protein which is our shrimp I just did this with some garlic and parsley I roasted in the
Oven for about 10 to 12 minutes at 375° olive oil garlic parsley salt and pepper super super easy these are going to go right in the middle here because they’re sort of like the star of the show they’re your main protein next I have a little bit of bacon it’s
Traditional in a cob I rendered it down it’s just a little bit and just a little bit goes a long way here I’m going to scooch this right in between my tomatoes and cucumber next I’ve got everything on this beautiful platter so I’ve got my
Green peas I try to alter colors as I’m going so the cucumber is green so maybe I don’t want to do green right next to the Cucumber I’m going to do my green peas next to my egg and then the radish can go in between uh the peas and the
Asparagus next I’m going to go in with my roasted asparagus this was just roasted in the oven at the same time as the shrimp olive oil a little bit of lemon juice salt and pepper let’s get that in here and I just cut these once
They came out of the oven I included the tops and the bottoms if you only prefer the tops that’s fine you do not have to use the bottoms it is not an absolute necessity next I have some pickled onions these are super easy to make it’s so much flavor and the most beautiful
Color all I did was take one large red onion I cut it up pretty thinly filled the Mason jar and then I did a one to one ratio of vinegar and water plus salt pepper garlic powder and you put them in the microwave for about 2 minutes and
Let them cool and you have the most beautiful vibrant pickled onions so they can go on any salad they great topper for eggs they’re a great topper for anything you have really any Savory meal they go so well the last thing I have is some avocado again very traditional in
Aob salad I’m going to put that right here this is just sliced up really nicely I’m just going to take that out here put it right here on my salad the last thing to do when you’re ready to eat is to dress your salad I’m just going to drizzle this right across the
Top and then you can toss it you could also serve this dressing on the side and let people take their salad what they want and let them dress it themselves I’m just going to take this beautiful Green Goddess and I’m just going to drizzle right across and that is your
Finished spring inspired Green Goddess com hope try thank you so much Molly that was so awesome so everyone this is Molly we need to switch slides hi everyone this um so now I’m gonna ask all of the panelists to please come back to the screen um we are going to go ahead and
Answer some questions I know we’re running right at time now but we do want to make sure we get to some of the questions um from today before we get there I just want to mention um that we have the two post surveys up on the screen now for health providers who are
Wishing to claim continuing education credits for today’s seminar um please go ahead and um scan that QR code on the rightand side that is how we will be able to submit your credits um and get your transcript posted if you’re a patient or a caregiver if you could
Please complete the survey on the right side of the screen um that would be wonderful for us to get your feedback on today’s seminar I’m also going to put both of these links in the chat for those of you who are um using your digital device and cannot scan a um a
Code right now so these were all absolutely amazing presentations and we have so many questions that have come in we have over a hundred that have been live plus over 200 that were pre-submitted so I want to start um with a question that was asked many many
Times about ways to make make the gluten-free diet more affordable but also increasing nutritional value um there were a number of questions regarding um food insecurity not being able to get free meals at school and so how do you all work with patient families that need access to food that’s less
Expensive I can start um so uh at Boston Children’s we actually are lucky enough to have um a a food pantry that’s associated with the hospital and so patients um are screened with the hunger Vital Signs and a screening tool and then um if they test positive for uh food insecurity then um
They’re really referred to um our social work team and um and they get access to the food pantry which has gluten-free foods that they can get um in their packages every week uh and that’s that’s just one way that we we um uh provide food and then we also have um cooking
Classes culinary medicine cooking classes that are offered every month um by Zoom that are free and go over free um recipes and um and these are all uh really um affordable and easy to make and um simple and so uh so that’s just um some options that we that we try to
Encourage great so there was a question um I saw another presentation from a medical provider that said that zero gluten in food is impossible can any of our dietitians ex elaborate on this and help us understand what this means that could have that could have
Been us so um you know we don’t tell patients that the goal is a zero gluten diet otherwise you’d probably be in a bubble and never leaving your home um even gluten free products don’t have zero gluten in them they are something that is label gluten-free is tested to
Be below 20 parts per million or a concentration of gluten that’s deemed acceptable for somebody with celiac disease so most of the time that’s not going to be zero so maybe water has zero gluten in it but even like a gluten-free bread you know the sh products which are
Super safe for celiac patients oftentimes they’re probably not going to have zero this really comes into play in terms of just the natural environment harvesting manufacturing practices but these tiny amounts should be fine for most patients and you know the the studies that have been done have showed
That this amount really should be okay and still induce healing and still allow you to be healthy on on a gluten-free diet with celiac disease thank you Dr Verma does one accidental gluten exposure lead to nutrient deficiencies no that’s the short answer does not great so there are probably two
Dozen questions on oats and I don’t want to give it all away tonight because actually our next culinary medicine webinar is is titled to eat or not to eat the talking about oats um but since there are so many questions coming in I don’t want all these people to feel
Ignored so can our dietitians just briefly touch on your approach to counseling patients with celiac disease on oats I can start and then Jessica you can add um so oats are tricky right because oats should be gluten-free but because of the way that they’re um cultivated they’re contaminated unless they’re gluten-free
Oats and then even when we look at gluten-free oats there’s two ways that manufacturers can produce glutenfree oats one is uh the Purity protocol and one is the mechanical Optical sorting method and um both should produce a final product that’s less than 20 parts per million the products are tested um
Like Jessica said to be less than 20 parts per million um but even with that said um there’s still a part of Oats that can still be um challenging to tolerate just because there’s another protein in oats called aanin and um and for uh some patients that have celic
Disease that Avan and protein can be a troublemaker um and so so if you are eating gluten-free oats and you don’t feel good and your TTG levels are not coming down then talk to your dietician your GI provider and um and and individually come up with a plan that
May remove gluten-free oats for a period of time um and then revisit that yeah I’ll give a very short answer on that um basically the rule of thumb for us is that GL all oats that you’re going to eat with celiac disease should be labeled gluten-free or any oat
Product but at the end of the day it’s really individualized and you should work with your dietitians and your doctors to determine whether oats are okay for you because it’s going to determine it’s going to be based off of your symptoms your antibodies your healing your preferences so many other
Factors that Megan and I have actually worked out an algorithm for dietitians and practitioners to use to kind of figure out when it is right um and the frequency you know how often are you actually eating them are you eating them once a year we’re probably not going to
Care nearly as much if you’re eating them every day so um you know once a year is not as much of an issue as eating every day Dr just like to add I would just like to add on those oats controversy that one should not be afraid I think it should
Not it’s not a no no it’s something that has to be discussed but it’s got good nutritional value so um I think that discussion should be there with your team and it’s not a food product that you should say no to right away Dr Verma how long is too long for a
Child antibody levels to go down after being diagnosed with celiac disease and when should a parent worry so I think it depends on how high the first antibody is so you know every time you get the blood work done it should be lower than the previous one um
So that’s rule of thumb a if it’s getting lower than the previous time your antibodies you’re in a good place and for some people it can take two years some two and a half three years to totally normalize um and that’s okay okay so long as everything else is fine the
Numbers continue to go down each time uh and the symptoms and growth and everything else is fine um focusing on the numbers is good but maybe not overly hypervigilant about those numbers so each time it goes down you’re in a good place great why do some people with celiac disease still experience symptoms
Even though they are on a strict gluten-free diet I’ll say from a physician standpoint there are so many other reasons why people can have symptoms so um looking at the gluten-free diet you know there were a lot of questions going on about beans and things like that even
In people who don’t have celiac disease if you eat a lot of beans at one time there’s a lot of products in there that generate a lot of gas so you can have symptoms because of a particular fiber is good but you have too much fiber at
One time it’s going to generate gas and symptoms so look at the food products you’re eating then there are things like intolerances there lactose intolerance and so on um you could be constipated not uncommon if you’re not getting the right balanced diet that you all learned today from culinary medicine but if
You’re not doing that you don’t have enough fiber um gastroparesis there’s a lot of reasons that you can so again it becomes important to have that discussion with your team and not immediately think it has to be gluten or a food that I should take out of my
Diet so there are a few questions about other grains um specifically quinoa and then um some other questions about lentils that are labeled glutenfree but being told by um providers not to eat them because of cross contact UM is this true how do they know what to believe in
When it comes to things like quinoa and lentils I think if it says glutenfree uh it’s fine go ahead and have it but Sharon and Jessica yeah I mean I think that um that especially with grains you know trying to focus on certified gluten-free might be a better way to move towards towards
Just Grains um just because there’s a a higher ramped up level of testing um and and you can find gluten-free lentils and and and gluten-free certify gluten-free products like that now so um so that might be you know a smarter way to go if you feel especially like you’re
Not feeling good when you’re eating um things that don’t say certified glutenfree or gluten-free for for legumes yeah I would say that with grains generally I recommend grains and grain B based products to just have a gluten-free label so you know that they’re being tested quinoa and rice are
Not usually grown on the same Fields with wheat so it may be you know that those like a pure version of that could potentially be okay lentils oftentimes I don’t see it with a gluten-free label but you know if there aren’t any other Gluten ingredients and you’re rinsing it
And you’re checking for any you know extraneous uh you know particles you probably should be okay as well and I’m very much going to generalize this last question because there were about 40 very specific questions on supplements and so I’m going to generalize this to should all Celiac patients be taking supplements
And how do they know what the right ones are so my group recently just published guidelines for micronutrients for celiac disease and we had come to a consensus that not all patients with Celiac disase have to take a multivitamin um or necessarily nutrient supplementation um I think it really
Depends on the case how low are the levels um if you just got diagnosed your levels are only slightly low and then you’re going to go on a gluten-free diet you’re going to heal and you’re meeting with dietitians you’re getting all the nutrients out of your diet you may not
Need it but if you if your levels are quite low we really need to boost that up we may recommend a multivitamin or specific nutrient supplementation again depending on how many are low and what those levels are great thank you I think it’s important to have things checked out
Rather than just um taking all the supplements that are out there and I think it really goes back to Dr verma’s you know conclusion is followup is really important follow up with your physician follow up with your dietician and make sure that you’re asking these questions because it does vary by
Individual so listen to to Dr Verma and make those follow-up appointments if you haven’t already for this year so we are already a little bit over time and we thank you all for sticking with us um one last reminder to please complete the post surveys for health providers
Claiming cus you must complete the survey in order for us to process your transcript and as I mentioned our next kinary medicine webinar is on oats to eat or not to eat oats and the gluten-free diet will be on Wednesday April 24th at 12:00 p.m. eastern time
Again that is accredited for CEUs for Physicians and dietitians and to all of the nurses psychologists and social workers watching we have seen your comments and your please for CE credits for you and we will work on that um for future seminars we promise so thank you
Again to to all of our speakers Dr Verma Jessica Sharon and Megan and of course our amazing Chef Molly and huge thank you again to sh for for making this series possible thank you all for joining and we’ll hopefully see you again in April good night everyone
1 Comment
Is it chrome or celiac
I have Amos and poor iron saturation of ,,,7