Author: Cheryl Harris

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

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

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

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

Calcium:

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

Iron:

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

Fiber:

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

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

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

Quick takes:

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

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

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

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

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

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

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

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

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

Notably–

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I hope you do, too.

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

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

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

Contamination/news/lots of recipes

Before we get into seasonal goodness, I’d like to highlight a wonderful video from Gluten-free Watchdog which is well worth your time! If you aren’t already a member, I also  encourage you to join. Below are highlights of the video, but I absolutely recommend you to watch it in full for many of the details around gluten testing:

Of 4% of foods tested are out of compliance—which means 96% are compliant.

THIS IS STILL TOO HIGH!

The problematic foods are often grain-based foods–

• 79% problem foods are grains
• Of the problem foods, 45% are oat products

For oat products, choose only purity protocol oats. These are going to be the safest options.

Careful of lentils—they often have cross contamination. Look for ones that are purity protocol. New brands are out there, such as Avena foods, and keep your eyes open for new ones.

New problem—facial misbranding.

Facial misbranding=products marked GF, but aren’t.

This is why we need to always read products carefully.

If there are problems, they must be reported to the FDA!

Again, the full link is here: https://www.glutenfreewatchdog.org/news/lessons-learned-from-16-years-of-testing-food-for-gluten/

More news:

Kate Scarlata has a great overview of where oats fit for a GFD

A wonderful upcoming webinar on mental health on a gluten-free diet on Dec 17^th (free!)

Crohn’s and Colitis foundation has devoted their whole issue to diet and IBD this month. I’d recommend reading the whole thing, actually, if it’s a topic of interest. But if time is limited, I think the 2nd (Kelly Issokson’s) encapsulates the current understanding particularly well.

Holidays are here:

On an entirely different note, I always share holiday recipes. Here’s a list of naturally gluten-free recipes, which includes many of our favorites.

A new one I’ll be adding to the list—Strawberry meringue tarts.

And here’s a list of low FODMAP holiday recipes. Remember, they are only low FODMAP if you’re eating the recommended maximum portions.

The holidays will be different for most of us this year. Now, this is my 14th year posting on a gluten-free Thanksgiving,  I’m used to things looking different. But this is a different different. And I’m not quite sure how each of us are going to navigate the challenges of a smaller, socially distant or outdoor feast. It’s new for all of us, and I haven’t quite figured out how we plan to mini-size the meal.

There are some tips here in the Washington post (not all gluten-free, of course) and on Livestrong

GF Jules has some info on how to shrink a typical feast and make it gluten-free. We made Jules’ pull apart rolls last year, and they were delicious!

And if you plan to order in, some gluten-free options are here….and Epicured just published a 25% off code EPICUREDBLKFRI for gluten-free and low FODMAP meals (nope, none of these are sponsored, just sharing what might be of interest)

My traditional Thanksgiving ideas are here, if you are looking for ideas and recipes to get you started.

So here’s to you and the ones around you having a safe, happy and healthy holiday, where ever it takes you or wherever it finds you. This current situation may be uncomfortable, but it is temporary—your health and the health of the ones you love is a longer-term proposition.

ps–have some extra time and want to watch a great conference on Celiac? Canadian Celiac Association’s conference was recorded just this weekend and is available here…all 6 hours with lots of experts.

pps–surely you’ve heard about the new GF oreos that will be arriving in January 2021? A handful of Ben and Jerry’s flavors are certified GF, too. Nope, neither are known for their major health benefits, but for many, they are a nostalgic favorites. Re: oreos, many details about ingredients and production are still TBD.

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