The year is flying by. I’m not ready for the cold weather, and our hummingbirds are still here and I’ll miss them. But what can you do. I’ve updated my GF breakfast list here, and as a bonus, here are some Gluten-free and low FODMAP Peanut Butter Banana Muffins.

There have been a lot of new papers relating to Celiac and GI health out in the last month or so. Here’s a quick round up:

There are new European guidelines for the diagnosis and management of Celiac. Now, of course, diagnosis and managing shouldn’t be your job, but, well, sometimes it is. Often doctors prefer information aimed at doctors, so feel free to print it out and bring it along with you to appointments re: initial testing, nutritional testing and follow up needed. A nice summary of them from Beyond Celiac is here.

More gluten, more risk in kids? Looks like it. A new study shows that children under 5 who are at high risk of having Celiac had a higher risk when eating larger amounts of gluten. Correlation doesn’t equal causation, but it’s the largest study so far. Dr. Fasano & co have an editorial on this article, too.

Summary: more gluten, more than a slice of bread a day raises risk in children who are genetically susceptible. BUT (and this is significant) CCR suggests that other factors must be at play as well, because countries that eat more gluten don’t have more Celiac disease. So the desire to reduce Celiac needs to be balanced with the things that promote a healthy microbiome—among other things. And, of course, stay tuned!

Think beyond the tummy troubles: undiagnosed Celiac is linked to anxiety and other behavior problems in children

A new paper outlines the factors associated with the development of IBD (Crohn’s, or CD, and Ulcerative Colitis, or UC). Of course, association doesn’t mean that these things CAUSE IBD…but still, a lot to think about, especially for kids/siblings/prevention, because of the genetic link.

Highlights:

“We identified 9 factors that increase risk of IBD: smoking (CD), urban living (CD and IBD), appendectomy (CD), tonsillectomy (CD), antibiotic exposure (IBD), oral contraceptive use (IBD), consumption of soft drinks (UC), vitamin D deficiency (IBD), and non–Helicobacter pylori–like enterohepatic Helicobacter species (IBD). We identified 7 factors that reduce risk of IBD: physical activity (CD), breastfeeding (IBD), bed sharing (CD), tea consumption (UC), high levels of folate (IBD), high levels of vitamin D (CD), and H pylori infection (CD, UC, and IBD).”
The full article is here

And one more: Titanium Dioxide. There’s nothing about that that sounds particularly delicious, but it’s in a lot of foods as a whitening agent, and it’s in a ton of supplements, too. A new rodent study shows that it shifts the microbiome in ways that may increase the risk of IBD (Crohn’s, UC) and even colon cancer.

The Annual DC Gluten-free Expo has moved from the summer to October, and will be October 6^th this year. It’s always a wonderful event for an even better cause—Children’s National Medical Celiac Center. It generally sells out, so if you’re interested, take a look.

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.

———————–

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.

———————–

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.