Celiac Awareness Month–May ’22

Strawberry plantsIt’s still just barely still Celiac awareness month. So…may I recommend (request?) you do something to support the gluten-free community?

The FDA has issued draft guidance indicating that they will only consider labeling for food allergens. This is problematic on oh so many fronts. Obviously, foods foods can cause health problems via means other than allergy, and that’s well-documented. And, as many of you know, the FDA does a pretty poor job enforcing the (voluntary) labeling for gluten as is, so closing the door to changes preemptively is…well…a huge step backward for the gluten-free community at large.

This is where you all come in. Please submit your comments to the FDA. Tricia Thompson has sample comments or you can do what I did and start with her comments and add your own flavor with your own story and concerns. But PLEASE add your voice.  

Quick takes:

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.

 

IBS Awareness Month–GF Newsletter

Declaration of Recognition - April is IBS Awareness Month in Virginia

April is IBS Awareness Month. And, for the 1st time, Virginia has officially recognized it as IBS Awareness Month! Many thanks to this administration for their support, and to Pam Emmer for starting this initiative across the country.

Now, you may already be more aware of IBS than you’d like. It’s very common—approximately affecting 45 million people in the U.S. It’s a condition of gut-brain interactions with chronic change in bowel habits and abdominal discomfort. Sometimes people have IBS solo; sometimes it tags along with other conditions, like Celiac, IBD, gastroparesis, MCAS, etc.

"Poop" chocolate pudding for IBS Awareness Month

The good news is that IBS does not lead to increased risk of cancer or death, but it does have a severe impact on quality of life for many people. Currently, there isn’t a cure, but there’s a lot that can be done to improve symptoms through diet, lifestyle changes, exercise, supplements, stress management, sleep, medications, and more.

Yes, for real, diet affects IBS, at least for many people. Most likely you already know this. ? Now the AGA recognizes it, too!

Great piece on IBS and stress on NPR

Low FODMAP, gluten-free bunny meringue cookies

Can gut microbiome predict long COVID? A new study suggests this may be a thing. (preliminary data, of course, and more study needed)

An article on diet and IBD in TIME

Dr. Mark Pimentel’s new book from Cedar Sinai on SIBO is out! And they are donating profits in April to World Central Kitchen.

Gluten-free, low FODMAP meringue bunnies—Kosher for Passover, too! (video recipe), with recipe written out here

GF Valentine’s and more!

Since it’s almost Valentine’s day, I’ll be sharing a few favorite recipes below–some that you can whip up last minute! But first, a quick research run-through.

Tuxedo strawberries
Tuxedo Strawberries

Here’s something I don’t love at all. There are concerns about gluten-free oats. Again. It’s harder to find gluten-free oats now, and there are recommendations for people who need gluten-free oats for medical reasons to choose oats certified gluten-free, preferably purity protocol. And even if you’ve checked the ones you eat, do check again, because some have change because of supply chain issues.

Interesting article on how many people who are diagnosed with IBS actually have other underlying issues, like Celiac, microscopic colitis, SIBO, carb malabsorption or pancreatic insufficiency.

Table 1: Summary of different diets in inflammatory bowel disease
IBD Diets that work

For those of you with IBD, and dietitians who read the newsletter, there’s a great article on diets for Crohn’s and UC, reviewing the ones that work…and the ones that don’t.
Along similar lines, I did a 5-minute journal review of a study out in Jan 2022 on a special diet for Crohn’s called the Crohn’s disease exclusion diet. It’s been used for children in the past, and was just studied for use in adults. Tricky to do, but can be effective, and interesting to read about.

Last but not least, I’ve got a CE course for nutrition professionals on histamine intolerance. I find it such a fascinating topic, and something I’ve been seeing so much more in clients and in research lately.

Onward to the food!

My favorite things to make for my Valentine (all gluten-free, of course)

Chocolate Frangelico mousse cake
Chocolate Frangelico Mousse Cake

What if you don’t like/can’t eat chocolate?

  1. I’m sorry
  2. I’d recommend toffee, or
  3. Crustless apple pie

Celiac disease & Ehlers-Danlos: What’s the Connection?

May is Celiac awareness month. It’s also Ehlers-Danlos awareness month. And if you’re really genetically blessed like me, you may be personally aware of the link between the two. If not, indulge me in a quick discussion of the research, because it’s too rarely discussed.

The Ehlers Danlos Society Logo

There was a 2011 paper which indicated that Celiac was much more common than expected in people with hypermobile EDS. [1] 19% had positive Celiac serology (bloodwork), and 16% agreed to a biopsy, and those 16% were confirmed to have Celiac disease. Notably, the sample size for this study was small—it was only 31 people—however, 16% is much higher than the expected prevalence of Celiac disease, which is ~1%.

2015 paper also indicated a potential link between Celiac disease and hypermobility, with found that 30% of people with Celiac met the criteria for Joint Hypermobility Syndrome (JHS), which is now known as Hypermobility Spectrum Disorder (HSD). [2]

Most recently, in 2021, a case control report looked at people with all types of EDS, and found that Celiac disease was one of the most common GI conditions associated with EDS, and the association was much stronger than in controls–with a 5.47 odds ratio. The study did not break out EDS subtypes, however. [3]

So, while the percentages and the details may still be a question, clearly there is some link between Celiac disease, EDS and Hypermobility Spectrum Disorders. And it is worth noting that while EDS is quite rare, HSD is common; 2-3% of the population.

Of course, testing is always essential before dietary changes because a proper diagnosis is critical. Other people may simply respond poorly to FODMAP content of wheat, so a much larger portion may feel better gluten free, even though they don’t have Celiac.

For more of the research on digestion and hypermobility and EDS, I do have more fun stuff on nutrition for GI issues and all things hypermobility here and for nutrition professionals, consider checking out the Digestive Disease Nutrition series, which includes a lecture from me on how hypermobility affects digestion.

Footnotes

  1. Danese C, Castori M, Celletti C, Amato S, Lo Russo C, Grammatico P, Camerota F. 2011. Screening for celiac disease in the joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type. Am J Med Genet Part A 155:2314–2316.
  2. Fikree A, Aktar R, Grahame R, Hakim AJ, Morris JK, Knowles CH, Aziz Q. Functional gastrointestinal disorders are associated with the joint hypermobility syndrome in secondary care: a case-control study. Neurogastroenterol Motil. 2015
  3. Rachel S Brooks, James Grady, Thomas W Lowder, Svetlana Blitshteyn, Prevalence of gastrointestinal, cardiovascular, autonomic and allergic manifestations in hospitalized patients with Ehlers-Danlos syndrome: a case-control study, Rheumatology, 2021.

Autumn 2020 Newsletter

Infant feeding study, a low FODMAP vegetarian easy dinner recipe, news, Halloween & more

Mini-pumpkins


New study—breastfed infants were either fed gluten early (starting 4-6 months) or after 6 months. Then they compared the rates of Celiac at 3 years. Surprisingly, the early intro of “high dose” of gluten group had lower rates of Celiac at 3 years (0%, vs 1.4%)
The study suggests that higher amounts of gluten may be the key to prevention here. They specify that this study involved an age appropriate “normal” amount of gluten—3.2 grams by 9 months—but  the paper does not provide an example of what that means in “real life”.
Longer follow up is underway…
Also: Hot off the presses—Celiac is not linked to increased risk of COVID. Phew!
And big news for many: For a long time, SIBO tests looked at 2 gasses, hydrogen and methane, but this would miss some people, because there was starting to be evidence that hydrogen sulfide was also a factor. Now labs are available can also examine this, too, and make the clinical picture clearer.
Ooh, did you hear? A bunch of Ben & Jerry’s flavors are about to be certified GF. If you happen to like ice cream. ?
Halloween on the way…
My standard Halloween suggestions here….some things may require adaptations.
From Allergic living–

Egg Bake Slice

Easy cheesy egg bake
We’ve still got an abundance of basil to use up this time of year, and it’s a balancing act of finding quick and easy recipes. This one takes about 5 min prep time and it’s delicious. Bonus—it’s gluten-free, vegetarian, low FODMAP, SCD friendly and adaptable for dairy-free.

Gluten Free Summer Fun

Hope you’re having a healthy summertime.

Green Beans from garden
Garden Green Beans

A few quick updates:
Time to do the happy dance! The Gluten-Related Disorders Training for health professionals is officially out. This is an effort to train dietitians and other health professionals on Celiac, and other disorders related to gluten. It’s taken over 6 years—close to 7! But it’s done.
Module 1: Medical Aspects of Gluten-Related Disorders and Gluten-Free Dietary Treatment. Alessio Fasano, MD Tricia Thompson MS, RD
Module 2: Going Gluten-Free: Moving Clients from Diagnosis to Implementation. Mary K. Sharrett, MS, RD, Suzanne Simpson, MS RD
Module 3: Enhancing Quality of Life in Individuals on a Gluten-Free Diet. Amy Keller, MS, RD, Anne Lee, MS, RD
Module 4: Gluten-Free Diet and the Life Cycle. Cheryl Harris, MPH, RD
Module 5: Nonresponsive Celiac Disease and Developing Alternative Treatments. Melinda Dennis, MS, RD Daniel Leffler, MD

I have no vested financial interest—but I’m excited that this resource is finally available, and more RDs will be educated on Celiac.
RDs, there will likely be grants available to reimburse the cost of the trainings if you complete all the units, and I will post more info as it’s available.

Long-time Celiac supporter Dr. Aline Charabaty has started a fundraiser to help those affected by the tragedy in Lebanon. If you’re inspired to help, here’s more information.

Wishing you a safe end of summer!

Harris Whole Health offers individual sessions, currently only virtually! Cheryl works with people to feel and look 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.

G-Free Summer

Strawberries

Just a few studies and thoughts for summertime.

OMG strawberries! And the birds haven’t gotten them yet. Yum!

Strawberries
Home garden strawberries

If you are tempted to get out and growing, it’s the perfect time to plant tomatoes, peppers, basil, cucumbers…

And SOME Farmers’ Markets are opening, or partially opened, so do look if you enjoy them.

A new study suggests that probiotics may lead to a breakthrough in treatment for a gluten-free diet. Specifically, people with Celiac have lower levels of bifidobacteria, which tends to be linked to good health. But before you head to the supplement aisle, this research is still really early yet, so stay tuned.

FDA allows food substitutions because of COVID. ….and there’s concern that there may be slip ups that may lead to gluten added to foods accidentally, because substitutions are allowed. Gluten-free Watchdog has comments here. This is also a concern for people with food allergies. It’s a good idea to stick with brands you know and trust, and know do a good job, and when in doubt, check with manufacturers.

Celiac… and cookware? Maybe. A new study indicates that chemical exposures in pesticides, nonstick cookware, etc. is linked to higher levels of Celiac. This is only a pilot, but it’s interesting data for understanding triggers and prevention.

The National Celiac 5K is virtual…so for all you runners who want to get out there, May 30th is the date!

Children’s National DC is holding their Expo virtually this year on June 14th. Details here: Gluten-Free Education day

A PSA for local businesses with g-free menus—if you’re ordering take out, try to order from the small, locally owned places. Most are really struggling! The large chains will likely make it through this, but if you want your favorite places to be around in a few years, make sure you make the effort to order in and buy gift cards if that’s in your budget.

Wishing you all a happy and healthy summer,

Cheryl

Harris Whole Health offers individual sessions, currently only virtually! Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, IBS, and a range of tummy troubles,  promoting great health and “whole foods” eating. 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.

Sprouting Garlic (low FODMAP)

garlic-4
Sprouted garlic

I originally created this post at the start of the pandemic (remember back then?), which was before Monash tested garlic scapes. Good news is that they are low FODMAP at 6 TBSP per meal. They’re yellow at 1/2 cup, but, quite frankly, while I love garlic, I can’t imagine using that much at once!

Whether you’re low FODMAP and avoiding garlic, or looking for a fun DIY experiment to entertain yourself, or looking for something to entertain your kids, hopefully you can get your hands on garlic and some dirt, because that’s all you’ll need for this little experiment. This is perfect weather for sprouting it outside in Virginia right now.

The good news is that you can sprout garlic pretty quickly and use the shoots the same way you might use scallion tops. It’s easy to do now, even if you don’t have a lot of space or light.

Love garlic? You’re not alone. For many of my clients on a low FODMAP diet, missing garlic is the biggest complaint. Sure, there are scallions and chives, and garlic infused oil, but…there’s nothing like the real thing!

I sprouted these in a few weeks in a tiny pot on my shady patio, so if it works there…it’s likely to work in any pot during Autumn, Spring or Summer.

Preparing the plant will only take a few minutes.

Take a large clove of garlic with the peel still on it.

garlic-1

Put it in the soil with the pointy end up, and then cover with just ½ inch of soil

garlic-2

Water…and watch!

garlic-3

This is at 3 weeks.

garlic-4

Let me know how it goes for you. And if you actually want to grow garlic bulbs itself and not just the shoots, you want to plant it deeper, generally 1.5 inches.

Harris Whole Health offers individual sessions, currently only virtually! Cheryl works with people to feel and look their best with a range of specialties, including Celiac Disease, IBS, and a range of tummy troubles,  promoting great health and “whole foods” eating. 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.

G-free Things I Love

chocolate almond cup

Things I love…and things I don’t

Chocolate almond cup
Chocolate almond cup

Hope you’re having a cozy Wintertime.

Here are a few interesting studies, and a quick and yummy gluten-free AND low FODMAP dessert you can make in 5 minutes. Yep, 5 minutes!!! It’s a chocolate almond cup for two. And then what I don’t love, and how you can make your voice heard.

tuxedo strawberries
Tuxedo Strawberries

And if quick, easy and delicious isn’t your thing, here are other Valentine’s day recipes I love to make.

Fun—SELF magazine shared my favorite book on relationship with food. Any guesses? It’s a great list they’ve put together.

Research:

Where in the world is the most Celiac? Here’s the most current research. What’s new/interesting? Celiac is more common in women than men. Interestingly, this study showed it was least common in South America, followed by Africa, North America, Asia, Europe and Oceania (includes Australia). This indicates that Celiac seems to be more common in Asia than in years past.

Trace amounts of gluten are common, even among people who believe they are strictly gluten-free. This is a small study…but caught my eye, especially as there’s been a push for ways for people to be less vigilant. Unfortunately, that doesn’t seem to be the case.

Menal health is an issue “without a doubt” for people with IBD. It’s hard, physically and emotionally! This matches what I see.

And now for what I DON’T like

General Mills is considering a new “Gluten Friendly” claim:*Gluten friendly in this context means items manufactured without gluten-containing ingredients. General Mills does not claim these items meet FDA requirements for “gluten-free” because of the possibility for cross-contamination with gluten, including due to shared cooking and prep areas in kitchens.

My take: OMG no. Gluten and I are not friends. The FDA defined gluten-free for a reason. The GF is recognizable and understood to mean gluten-free. They are being deliberately misleading.

Worse, these products are designed for food service—think hospitals, long-term care facilities, etc. These are often captive audiences, who believe they are getting gluten-free foods. As mentioned in the research above, many people are getting more gluten than they can safely tolerate already.

I know you’ve heard this rant from me before, but it’s upsetting. While I have no problem with people eating gluten-free because they just feel better, I worry about people who need to be strictly gluten-free for medical reasons. The underlying problem here is that even if you choose not to eat General Mills foods, if a big company decides to do this, and gets away with it, it will pave the way for others to do the same.

Fortunately, Gluten-free Watchdog is collecting comments, because this line is still in the “proposed” phase. Please send your comments along. This is when you want to make your voice heard.

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

Happy G-Free Holidays

Christmas Meringues!

Something for everyone!

More recipes from around the web:

Wishing you a peaceful & joyful season!

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, 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.

 

Top