National School Lunch Week: School Nutrition Consultant Talks Gluten-Free

Last August, the National Foundation for Celiac Awareness (NFCA) hosted a back-to-school webinar with Gabriela Pacheco, RD, LD, SNS, a school nutrition consultant with expertise in specialty diet accommodations. In honor of National School Lunch Week, we decided to circle back with Gabriela and get some more tips on how parents and schools can work together to provide gluten-free school lunches to celiac and gluten sensitive students.

NFCA:  What is the biggest challenge schools face in offering gluten-free options? Is it the cost? Not enough demand? Staff training?

Gabriela Pacheco (GP):  All of those challenges happen and are different in every district.

Staff training is certainly the biggest challenge.  With or without a diet prescription, the foodservice staff must understand proper label reading and handling of all foods.  This is especially challenging when a reaction to cross-contamination can have serious effects on the student.

Cost can be a challenge in some districts because the school cannot pass on the extra expense to the student.  In other words, if a student gets free, reduced, or pays full price for school meals, the school cannot charge them for the extra expense to make the special meal.

The demand “should” not be an issue. One child or 100 students should be treated the same.  However, some districts may push back if there is only one student or a few students needing the special meal. The U.S. Department of Agriculture (USDA) states that if a student has a food intolerance or allergy, the school can – but does not have to – modify meals, unless it is a life-threatening reaction such as anaphylaxis.  It all lies on the diet prescription from a certified medical authority; if the diet prescription states that meals must be modified, then the district has no choice.

With or without a diet prescription, if the school nutrition staff works with parents of students with celiac disease or non-celiac gluten sensitivity, they demonstrate support of a segment of the community by helping them improve their quality of life and concentrate on school – not stress about food.

NFCA: What are some schools meals that meet the new USDA nutrition guidelines and are gluten-free?

GP: USDA – The National School Breakfast and Lunch Program ensures that your child eats a healthy meal, including meals for children with special dietary needs.  Although a gluten-free diet limits some food options, schools can put together kid-friendly school meals. Having a diet different from that of his/her friends may cause your child to feel singled out.  Get him/her and yourself involved with cafeteria staff to go over food preferences to make him/her feel more comfortable about school meals.

School meals must meet new meal pattern requirements, which include fruits and vegetables at every meal, as well as a meat/meat alternate (protein source), legumes, fluid milk and whole grains.  Gluten-free foods include fruits, vegetables, poultry, fish, beef, nuts, eggs and more. Schools already have these onsite; however, preparation is the key. Purchasing gluten-free bread, for example, can be the only substitution the student requires to have a lunch which looks the same as his friends.  Along with a side salad, a fruit and milk, the meal is complete!

Most schools now have salad bars that contain a wide variety of items such as kidney beans, fresh fruits and vegetables, cottage cheese, and some even have the protein available there to make a complete meal.  Add milk and again, a complete meal.  The student just has to make sure to watch the salad dressings or anything else which may have been cross-contaminated.  If the student is old enough, they learn what to choose.  If still young, a teacher or cafeteria staff can help with the salad selection.

There are several manufacturers who make gluten-free items specifically for schools.  One good resource is Rich Products.  They make pizza dough and other items that will fit into the school meals and meet guidelines.

NFCA: How can schools be more welcoming to special dietary needs? Should they post the information on their website? Ask the foodservice director to speak at parents’ night?

GP: Both of those options are a great start.  The first step is to consider the needs of the student.  Second, it really takes a lot of teamwork.  The school nutrition department, the parents and the student should all be involved. Forming partnerships is key. Many districts already post carbohydrate counts/exchanges, PKU diets, etc. – why not add gluten-free options?

Keep in mind that they are not required to post gluten-free options, which is why communication is important. Asking for the menus so parents can go over it with their child and circle meals they like also helps.  The cafeteria staff can then work with the student on proper gluten-free exchanges.  This way, the meal is not so “special” and different from other students.

NFCA: What advice do you have for parents who are reluctant to contact the school about their child’s gluten-free needs? How can they approach the conversation with confidence?

GP:  The first place to go is the foodservice/nutrition director. The cafeteria staff can refer you to him/her. Parents can discuss options with the director.

If the student has a diet prescription from a medical authority, then it is especially important that the director ensures the cafeteria staff, your child’s first line of defense, is trained and understands gluten-free diet and modifications.  Even without a written medical statement, the school may provide the child with special meals, but is not required to.

Form a partnership with the cafeteria staff and offer to help choose your child’s meals.  Remember that they have to order foods from approved manufacturers, so it may be that they have to order from outside vendors to provide gluten-free options.  They cannot charge the student more for that meal, so they do have to consider the increased cost.  A parent should never hesitate approaching the nutrition department about their child’s needs, but keep in mind that there are regulations.

NFCA: What’s one thing parents can do during National School Lunch Week to advocate for gluten-free needs in the lunchroom?

GP: Parents can form a partnership with the food and nutrition department to send out a newsletter or a side note on the month’s menu regarding children with celiac disease and non-celiac gluten sensitivity, and how the department can help with modifications. School administrators can also benefit from this, as they don’t always understand regulations.

For more articles on this topic, visit NFCA’s Gluten-Free Resources for National School Lunch Week 2012

FNCE 2012: NFCA’s Gluten-Free Workshop for Dietitians

After pulling long hours leading up to Appetite for Awareness last month, you’d think our staff at the National Foundation for Celiac Awareness (NFCA) would take some time to wind down. Not the case.

NFCA Director of Development Kim prepped our gluten-free flour blends.

We immediately went full throttle on our next activity, which was hosting a Gluten-Free Culinary Workshop leading up to the Food & Nutrition Conference & Expo (FNCE), an annual meeting for food and nutrition professionals run by the Academy of Nutrition and Dietetics (formerly the American Dietetic Association). Planning had already been underway for months, and all the pieces were in place:

• A Gluten-Free Baking Workshop with Chef Richard Coppedge, CMB, author of Gluten-Free Baking with The Culinary Institute of America (CIA) and a professor at CIA.
• The Ancient Grains Challenge, featuring a “Chopped” style cook-off between teams of dietitians.
• Educational sessions, including “Current Understandings of Gluten-Related Disorders” and “Case Studies: Living with Celiac Disease,” led by NFCA’s Alice Bast and Beckee Moreland, respectively.

I eagerly volunteered to help out and take photos and video at the workshop. (A chance to spend some one-on-one time with dietitians and top chefs? Please, I’m there.) So, bright and early last Saturday morning, I pulled up with a car full of goody bags and made my way up to the Academic Bistro at Drexel University.

The dietitians took home these goody bags full of gluten-free treats!

Even with all the details our VP Jennifer had provided, I still wasn’t prepared for how active this day would be. After spending the first few hours mixing huge batches of gluten-free flour blends and setting up our impressive ‘pantry’ of ingredients and fresh produce, it was time to step back and put the dietitians to work.

Our participants were from the Food & Culinary Professionals Dietary Practice Group (FCP DGP), a subgroup of the Academy. They already had a basic understanding of gluten-free food and cooking, but they came eager to learn even more. I think had just as much fun watching them as they did participating.

Gluten-Free Baking Workshop

Our baking workshop started off with an introductory lesson from Chef Coppedge. It was clear that he’s an experienced teacher, as his presentation was brief, yet informative. He brought good energy to the room and gave us a few chuckles as he talked. My favorite tip: Use seltzer water to make your dough lighter and fluffier, but don’t leave it overnight or it will over-ferment and deflate upon cooking.

Chef Coppedge helped the dietitians as they baked gluten-free goodies.

Then it was time to hit the kitchen. The dietitians whipped up gluten-free goodies like jalapeno & cheese muffins, spritz cookies and – my favorite – peanut butter and chocolate cupcakes. The hard part was figuring out which of the four gluten-free flour blends to use for each recipe. While the dietitians were mixing and measuring, Chef Coppedge was there offering quick tips. Best of all, they got to bring home a sample of what they baked. And the smells? Heavenly.

Yum!

Ancient Grains Challenge

Across the hallway, our participants had to think on their feet as we presented them with pre-cooked gluten-free grains (amaranth, buckwheat and quinoa) and challenged them to make a fresh and healthy meal. For the additional ingredients, we had an impressive display of fresh fruits, vegetables and herbs, plus sauces, broths, beans and more, to complete their dishes.

So much fresh produce!

To determine the winner, we recruited a diverse panel of judges:

• Alice Bast, Founder and President of NFCA.
• Chef Garrett Berdan, RD, a registered dietitian and chef who is part of the White House’s Chefs Move to Schools program.
• Chef Charles Ziccardi, Assistant Teaching Professor of Culinary Arts at the Goodwin College of Professional Studies at Drexel University.

NFCA Board Chair Dorothy Binswanger even stopped by to assist with the judging – a deliciously good decision, as it turned out.

The judges had some tough decisions to make.

The Ancient Grains Challenge went above and beyond our expectations. The dietitians were incredibly imaginative and resourceful, and their dishes had wonderful flavors. Among the finished plates, there were breakfast/dessert porridge with berries and a touch of orange zest; homemade soup with a side of bean salad; and ‘croutons’ made out of gluten-free grains and flax seed.

The dietitians didn’t skimp on presentation.

To make the challenge even more realistic, some of the ingredients on the table were not guaranteed to be gluten-free, such as a broth that wasn’t labeled gluten-free and some premade sauces that required verification with the manufacturer before using. For the most part, the dietitians were cautious about choosing ingredients that were clearly gluten-free. On a few occasions, they asked about questionable ingredients, which became a teaching lesson as our VP Jennifer walked them through the process to verify the ingredient. When in doubt, they left it out.

Lunchtime! A generous gluten-free spread from our sponsor, Dietz & Watson.

Educational Sessions

While the hands-on activities proved to be learning opportunities, NFCA’s workshop also balanced those active moments with some thoughtful discussions. The morning session on gluten-related disorders prompted good questions from the audience, and the dietitians left with a better understanding of the disease spectrum.

Alice’s morning session focused on gluten-related disorders.

In Beckee’s session, the dietitians discussed a variety of perspectives and scenarios related to gluten-free needs. There was an 8-year-old with celiac disease struggling with her school lunch program; a 19-year-old newly diagnosed and figuring out how to eat gluten-free at college; and a chef who was catering a gluten-free event. The case studies sparked plenty of “A-ha” moments as the dietitians worked through these real-life applications.

Beckee presented three case studies about gluten-free needs.

So, to make a long story short, it was a winning day for all involved. My favorite part was chatting with the chefs and dietitians during and in-between each session. It always amazes me how a group can have similar interests and skills, yet put them to use in such a variety of ways.

Thanks to Wegmans for sponsoring our gluten-free workshop!

Bravo to the dietitians for putting in an A+ effort at our Gluten-Free Culinary Workshop. We hope to “see” you again during our upcoming webinar on October 31!

- Cheryl

For more photos from the workshop, visit NFCA’s Facebook page.

Spring Travels: Around the World with Celiac Experts and Dietitians

In my last post, I described where the first half of my spring travels took me – Orlando, Manhattan and Washington, DC. Now, I’m going to fill you in on an international trip and other domestic travels!

It was an honor to share findings from NFCA’s collaborative study with the Celiac Center at Beth Israel Deaconess Medical Center (BIDMC) and Lankenau Institute for Medical Research (LIMR), “The Use of Disease Symptoms Checklist in Self-Initiated Diagnoses of Celiac Disease and Non-Celiac Gluten Sensitivity,” as a poster presentation at an International Meeting on Coeliac Disease in Florence, Italy this past March.

Together, NFCA, BIDMC and LIMR aimed to understand the diagnostic experiences of patients who use the web, specifically NFCA’s Celiac Disease Symptoms Checklist, to prompt a self-initiated diagnosis of celiac disease or non-celiac gluten sensitivity. NFCA’s Celiac Disease Symptoms Checklist was designed to be a patient education tool that drives awareness of celiac-associated symptoms and conditions. Our ultimate goal was (and remains to be) that patients would use this tool to start a conversation about celiac disease with their healthcare providers. As a result, the Checklist provides the ample opportunity to study health behavior. You can learn more about the study, including the ability to view the poster itself, by heading over to NFCA’s Research News feed.

Of course, I realize that most people don’t have the opportunity to travel to Italy for work. What can I say, I’m a lucky girl and I know it.

For those of you who don’t know, I studied abroad in Florence during my junior year of college (pre-celiac days), so I know the city quite well. It was my first return trip since 2006 and the experience wasn’t anything short of awesome! Between attending presentations from some of the finest celiac experts in the world and enjoying gluten-free pasta and pizza in the country from where pizza and pasta hail, it was wonderful.

What’s more, Alice and I were beyond impressed with how the Italian foodservice industry understood celiac disease and handled gluten-free menu options. Here’s an example: more than once we were turned away from a restaurant who knew what gluten-free required, but were honest about not being able to control cross-contamination. The restaurateurs and servers understood that the gluten-free diet is a form of medical nutrition therapy and not the latest fad diet.

Vegetable pizza with spicy olive oil for lunch.

Case in point number two: On my last night in Florence I visited one of my favorite gelato spots, Festival Del Gelato, for an after-dinner treat. After suggesting that I pick a different flavor because of the risk of cross-contamination (chocolate hazelnut is popular!), the clerk asked if I would like a gluten-free cone instead of the normal cup and proceeded to grab an individually wrapped cone from a rack. How fun!

My second favorite flavor, gelato di riso or rice pudding, on a gluten-free cone.

After Italy, my next stop was Little Rock, AR. Talk about night and day, huh?

In an effort to raise awareness of celiac disease and non-celiac gluten sensitivity among Arkansas dietitians practicing in the long-term care, foodservice and clinical settings, NFCA partnered with the Arkansas Dietetic Association (ArDA) and the Arkansas Dietetics in Health Care Communities (ArDHCC) to participate in their 2012 Annual Meeting & Expo.

After spending many months coordinating educational lectures, preparing a delicious gluten-free food sampling and organizing materials for the exhibit hall, I traveled to Little Rock where I spent 3 days. It was great to finally meet the ArDA and ArDHCC team with whom I had spent countless hours emailing and talking via the phone. I also had the pleasure of spending some time with Anne Lee, MSEd, RD, LD, Schar USA’s Director of Nutritional Services, and Dr. Lucy Gibney, President and CEO of Lucy’s, a GREAT Business Association Member. You can read more about my experience in Arkansas here.

Gluten-free food at the ArDA and ArDHCC meeting.

Just two days after returning from Arkansas I made my way north to Boston to attend a presentation by Claudia Dolphin, a graduate student from Emerson College’s Master’s in Health Communication program, on a research project titled, “Screening for Health: Attitudes and Beliefs of Non-Participants in Disease Testing.” As an alum of Emerson’s Health Communications program, which is in collaboration with Tufts School of Medicine, I was honored to serve as a co-preceptor to Claudia over the past 6 months as she completed her Applied Learning Experience (ALE) project, the equivalent to a Master’s thesis. Here’s another twist to the story: the other preceptor providing guidance to Claudia was my own preceptor from my grad school days – Dan Leffler, MD, MS, the Director of Clinical Research at the Celiac Center at BIDMC in Boston. It has been pretty neat experiencing things come full circle.

Anyway, back to the presentation…

Claudia’s ALE project focused on conducting research on the perceptions of celiac disease among families where a member has been medically diagnosed. Her research sought to uncover the attitudes and beliefs of at-risk family members who have not been tested for the disease.

You may have noticed recruitment notices for research participants this past March and April and wondered what would become of the research. Well, now you know! Together with BIDMC, we are currently gearing up to implement Claudia’s work on CeliacCentral.org and into NFCA and BIDMC programming. Check back soon for an update on how you can help persuade your family members to take getting tested for celiac disease seriously.

In late May, my business travels ended with a trip out to sunny San Diego to attend Digestive Disease Week 2012, otherwise known as DDW, the world’s largest gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

The view from our hotel at Digestive Disease Week 2012.

Many of you may have trouble staying awake just reading this meeting’s subject matter, but as a self-proclaimed nerd, it’s the one conference I look forward to each year. In addition to learning the latest and greatest research, it’s always a pleasure to catch up with the field’s different thought leaders, many of whom are members of NFCA’s Scientific/Medical Advisory Board. In addition to attending the lectures, DDW attendees also have the opportunity to visit the poster sessions in the exhibit hall and even speak with the study’s researchers if they happen to be standing at their poster. Each day, the posters are changed to reflect a new topic. Saturday, May 19^th was designated for celiac disease.

Here are a few highlights from this year’s conference:

• Dr. Sveta Shah from BIDMC presented findings from the Boston group’s study “Celiac Disease Has Higher Treatment Burden Than Common Medical Conditions.” A notable conclusion included that “despite high treatment burden, celiac disease patients reported high disease specific health state.” As a result, Dr. Shah and her colleagues suggest that, “the burden of following the gluten-free diet may be a reason why adherence is limited and argues for the need for adjunctive therapies.” I personally think that this an important finding given what seems to be continually emerging research on the importance that quality of life plays in celiac disease management.
• Using data of 7,798 persons observed from the National Health and Nutrition Examination Survey (NHANES) 2009-2010, Jinjuvadia et al. discovered that an estimated 1 in 111 individuals in the U.S. population has celiac disease. The group also noted that celiac was more common among men than women. While the disease prevalence is certainly not “new” news, I thought their method was an interesting way to capture celiac disease in the U.S. And, given that we currently believe more females are diagnosed than males, I found their other discovery to be interesting, too.
• In the world of celiac disease, we are programmed to believe that gluten is evil. Judging by the work of a group of researchers led by Dr. Schuppan (the scientist who led the way in identifying tTG as the celiac disease autoantigen), gluten may not be the only “evil” protein involved. On Saturday the 19^th, Alice and I had the privilege of meeting Dr. Zevallos, lead author of the abstract “Isolation of Alpha-Amylase/Trypsin Inhibitors From Various Plants and Their Ability to Activate Innate Immunity in Celiac Disease.” Zevallos explained that they recently identified non-gluten components of wheat, the family of alpha-amylase/trypsin inhibitors (ATIs), as powerful activators of innate immunity. This time, they took it one step further and defined three classes of grains, including naturally gluten-free grains, and their substitutes according to their ability to fuel innate immunity activity. Stay tuned for more details as their research continues.
• The North American Society for the Study of Celiac Disease (NASSCD), the U.S. national society of medical, scientific and allied health professionals in the field of celiac disease, held its first General Assembly meeting during DDW. Although I wasn’t able to participate since I’m not a clinician, I attended the reception following the meeting and can attest to the establishment being an exciting development. The new group will provide leadership in advancing the fields of celiac disease and gluten-related disorders by fostering research and by promoting excellence in clinical care, including diagnosis and treatment of patients with these conditions. It’s the first time that the U.S. thought leaders have come together to form a clinical and research focused collaboration.

- Kristin

Spring Recap: Traveling for Celiac Disease Education and Advocacy

This past spring was jam packed with business travels. There were times when I felt as if my “out of office” auto response would be up forever! So, it’s safe to say that I have good reason for being MIA on the staff blog. Let me backtrack so I can keep everyone in the loop.

Starting in February, Alice and I traveled to Orlando to participate in the American College of Preventive Medicine’s (ACPM) 2012 annual meeting. When we weren’t exhibiting at NFCA’s booth, where we explained the importance of patients not going gluten-free before being tested for celiac disease and clarified that yes, gluten sensitivity is real, we sat in on lectures from leading preventive medicine experts like Dr. Mark Hyman and learned how media outlets determine what news gets covered.

NFCA’s booth at ACPM 2012

After that, it was back to the Northeast for another round of conferences. Cheryl joined me in attending Columbia University’s Intestinal Immune-Based Inflammatory Diseases Symposium where we snacked on fresh rolls from Free Bread Inc. (a personal new favorite!). The Celiac Disease Center at Columbia University continually organizes meetings that are educational and fun, allowing for the providers and patients to mingle. And, of course, it’s always a pleasure catching up with experts like Dr. Jonas Ludvigsson. You can read a recap of Cheryl’s experience and catch an interview I held with Dr. Ludvigsson after we parted ways in March.

Special note: While listening to some of the world’s finest celiac experts discuss topics such as the emergence of non-celiac gluten sensitivity and the role of the PillCam in the diagnosis and management of celiac disease, I learned the exciting news that an abstract from the NFCA was accepted for a poster presentation at the International Meeting on Coeliac Disease, Mastering the Coeliac Condition: From Medicine to Social Sciences and Food Technology. After months collaborating with the Celiac Center at Beth Israel Deaconess Medical Center and the Lankenau Institute for Medical Research on the data collection and analysis of the study “The Use of Disease Symptoms Checklist in Self-Initiated Diagnoses of Celiac Disease and Non-Celiac Gluten Sensitivity,” it was great to hear that our work would be recognized. (And judging from the theme of this post, if you think that my spring travels also involved a trip to Florence, Italy, you are correct. Watch out for my recap later this week).

Our Awareness All-Star fundraiser Jack Simpson and his mom Cheryl Lynne joined us at the DDNC Public Policy Forum.

The very next morning after returning from NYC, I hopped on a train to Washington, DC, to meet up with Alice and participate in the Digestive Disease National Coalition’s (DDNC) 2012 Public Policy Forum. This was my second time joining in the annual meeting where patients, industry representatives, healthcare providers, lawmakers and their legislative staff come together for two days of educational programs, legislative updates and advocacy training. Each year, the Digestive Disease National Coalition (DDNC) briefs participants from around the country on Federal healthcare legislation and policy and provide the opportunity to educate Members of Congress on issues of concern to the digestive disease community. In essence, it provides an opportunity to see the government in action.

This year, our colleagues from The Children’s Hospital of Philadelphia’s Center for Celiac Disease joined the Public Policy Form. It was great to have NFCA Scientific/Medical Advisory Board Member Dr. Ritu Verma and Patricia A. Bierly, CRNP, on hand to share the clinical perspective of celiac disease with legislators.

Stay tuned for more tales from my spring travels, including:

• Mastering the Coeliac Condition: From Medicine to Social Sciences and Food Technology in Florence, Italy
• Arkansas Dietetic Association’s (ArDA) Annual Meeting and Expo and the Long-Term Care Seminar in Little Rock, AR
• Research presentation from graduate student of Emerson College’s Health Communications program in Boston, MA
• 2012 Digestive Disease Week in San Diego, CA

- Kristin

5 NFCA Webinars to Watch Right Now (Plus 1 on the Way)

You’ve learned the basics of gluten-free, and now you’re ready to learn more information. Well, you can read until you’re blue in the face, but there’s another, more engaging way to get those facts and tidbits you’re looking for: Webinars.

In case you didn’t know, NFCA hosts a monthly webinar series, with topics ranging from everyday food choices to gluten-free holiday prep. The webinars are free, and we always post the recording and slides in our archive, so you can go back and listen again and again. Here are 5 webinars you can find in our archive right now.

1. Food as Medicine for Celiac Disease: Nutrition Beyond the Gluten-Free Diet

In this webinar, NFCA Scientific/Medical Advisory Board Member Rachel Begun, MS, RD, offers practical advice on how to incorporate foods into our diet that heal the body and can even prevent disease. Pay close attention to her tips on combining different foods, like leafy greens and citrus, to improve absorption of nutrients.

Watch this Webinar

2. Maintaining a Healthy Weight While Eating Gluten-Free: The Importance of Mindful Eating and Physical Activity

How often do you eat because you’re stressed? Or tired? Or bored? Dietitian and local celiac support group founder Amy Jones, MS, RD, LD, reveals some of the habits that contribute to weight gain, especially when following a gluten-free lifestyle. (Did you really eat that many cookies before you went gluten-free?) We bet you’ll have an “A-ha!” moment listening to this.

Watch this Webinar

3. Top 10 Ways to Get Gluten-Free Kids to Eat Healthy

This webinar is designed for dietitians who counsel families affected by gluten-related disorders, but there are plenty of tips anyone can use. EA Stewart, BS, MBA, RD, walks you through the best ways to set up a gluten-free kitchen, plan meals with your kids and foster good eating habits by putting healthy options within reach.

Watch this Webinar

4. Nutrition and Training for the Gluten-Free Athlete

NFCA Athlete for Awareness Peter Bronski leads this webinar about the best ways to fuel your body with a well-balanced gluten-free diet. Pete explains what to eat before, during and after an athletic activity, then answers actual training questions from the audience.

Watch this Webinar

5. The Importance of School Nurse Education and How-To Strategies for Parents of Gluten-Free Kids

Summer vacation is just starting, but now is a great time to brush up on what you’ll need to review with school nurses, administrators and teachers in the fall. Nina Spitzer, President of CDF’s Greater Phoenix Chapter, outlines the 504 plan and who you’ll need on your child’s School Team. Bonus! Get a list of recipes for yummy gluten-free lunches.

Watch this Webinar

Coming Up…

Our next live webinar will take place on June 20, 2012 at 2 p.m. ET/11 a.m. PT. The topic will be “Yes, You Can Eat! When Gluten Isn’t the Only Ingredient You Avoid.” The webinar will feature NFCA’s Answers from a Dietitian blogger Melinda Dennis, MS, RD, LDN. Sponsored by Lucy’s.

Register for this Webinar

5 Things I Learned from NFCA’s Getting Started Guide

One of NFCA’s most valuable resources is our Getting Started Guide – a 24-page booklet filled with information for those newly diagnosed with celiac disease or non-celiac gluten sensitivity. It lists gluten-free alternatives, sources of hidden gluten, tips for cooking and dining out, and contact information for support groups and celiac disease centers.

When I started at NFCA, I didn’t know much about celiac disease. Here are 5 things I learned thanks to the Getting Started Guide.

1. Take baby steps.

The gluten-free diet can seem overwhelming, especially when you try to jump in with an overly complex recipe. Instead, start with a few basics. As the Guide says:

“A first and simple step is to look for dishes that need very little customization, perhaps just the substitution of one gluten-free ingredient for one that is not gluten-free. For example, make macaroni and cheese or baked ziti with rice, corn, or lentil pasta, or prepare enchiladas with corn tortillas instead of the wheat flour variety.”

NFCA’s Getting Started Guide

2. Don’t skip out on your doctor.

Follow-up visits are critical to ensure you are healing and not accidentally ingesting gluten.

“To make sure your gluten-free diet is successful, schedule annual exams and take the celiac antibody test when directed by your doctor. If your blood test comes back normal, it will confirm that you are maintaining a completely gluten-free diet,” the Guide says.

3. Cup for Cup conversions.

Baking with gluten-free flours isn’t as easy as using a box mix (which, thankfully, include gluten-free versions). Fortunately, the Getting Started Guide has a cheat sheet. Page 12 lists conversions for replacing wheat flour with a gluten-free alternative. For example, use ½ cup of almond flour for every 1 cup of wheat flour. Sorghum flour, on the other hand, swaps 1-for-1.

4. Those “weird” health issues could be related to celiac.

Dental enamel defects. Pale mouth sores. Fatigue. They don’t always get the spotlight, but they are signs of celiac disease. The Guide has an abbreviated list of symptoms (there are more than 300, after all). You may find yourself having an “A-ha” moment after reading them over.

5. Generic and brand name drugs can differ.

Yes, but how is this relevant. Well, there are things called excipients (binders) used in medications that can sometimes contain gluten. In some cases, a brand-name drug may be gluten-free, but its generic counterpart may not be. So, it’s important to always check with the manufacturer to ensure a medication is gluten-free. Find more details in the Getting Started Guide.

Where can you find this Getting Started Guide? It’s available for download 24/7 on NFCA’s Printable Guides page. Just scroll to the section called Restoring Health. In fact, all of the Printable Guides you find on that page can be helpful in your gluten-free lifestyle – and they’re all free!

Is there a topic you’d like us to cover in a Printable Guide? Leave your suggestions in the comments below.

- Cheryl

Gluten-Free on the Road: GREAT Kitchens in Michigan and Minnesota

Every day, new restaurants are going online and completing NFCA’s GREAT Kitchens training and educating their staff about serving gluten-free to people who depend on verified ingredients, gluten-free protocol, and a celiac savvy waitstaff. They’re learning why it’s important to greet special diet guests with confidence and know how to answer questions to build trust. Owners and managers across the country are hearing about GREAT Kitchens at their local restaurant association and American Chef Federation meetings, through U.S. Foods distributors, and of course, the celiac community.  Thanks for your help!

GREAT training is better than “good enough,” and I’ve had the pleasure to see firsthand the result of GREAT training while traveling for business and pleasure. I can’t tell you how excited I get when I know I’m going to a city where GREAT Kitchens exist, and I can be a secret diner to check out the effects of GREAT training.  There are hints of GREATness that stand out in GREAT Kitchens. Check out some of my travel spots and their outstanding service:

W.O.W. – East Lansing, MI

I ended up in East Lansing, MI, in October 2010, to speak at a local health food store for their Celiac Awareness campaign. On my way back to Detroit, where I would be speaking the next day, I stopped in to meet Steve Pollard at Guido’s pizza parlor in Okemos, MI, just outside of East Lansing. Steve was one of our first GREAT Kitchens, and his staff is well-trained in gluten-free protocol.

Gluten-free and amazing!

The pizza? Well, it is simply amazing. Soft, tender crust handmade crust with perfectly placed toppings made me teary to think that Steve was serving these sweet pies daily to the lucky East Lansing folks.  Now almost 18 months later, Steve’s moved his gluten-free operation next door. W.O. W. ( With Out Wheat) deli and bakery has fantastic gluten-free breads, sandwiches, rolls, pizzas and dessert.  GREAT progress!

Beckee and Steve from Guido's/W.O.W.

Hint of GREATness #1 – Taste has not been compromised by gluten-free status.

Pizza Luce – Minneapolis, MN

Staying in Minneapolis for a wedding weekend in September gave me the opportunity to taste a bit of the Mini-Apple’s famous pizza spot, Pizza Luce. Pizza Luce has 5 locations in Minnesota that are all GREAT trained. At the downtown location, the servers were gluten-free informed and the gluten-free options on their menu extensive.

One of Pizza Luce's yummy gluten-free pies

Confession…I ate there twice and could have placed an order for the road. What is it about eating in a restaurant that you know has GREAT status, and all will be well with the tummy? It’s seems you have to try everything that’s offered and more. As the director of GREAT, I know what’s supposed to happen when a dining establishment takes training seriously.

Hint of GREATness #2 – The waitstaff welcomes you with a gluten-free menu, say they’ve been trained, and can answer ingredient questions with ease.

More spots and hints in my future blogs!

-Beckee

See the full list of GREAT Kitchens in the U.S. at www.CeliacCentral.org/kitchens

It’s Spring! Time for a Health Fair!

New Year’s Day may be the time for making resolutions, but the breath of spring in the air makes all of us want to live healthier lives as we get ready to be outdoors more and more. Enter, the health fair!

Two weeks ago, I had the pleasure of participating in two such events, each one targeting a very specific audience.

Sunday, March 25, brought the annual “Education Day” at The Children’s Hospital of Philadelphia (CHOP). Called Growing up with Celiac: A Forum for Parents and Children, this information-packed event was organized by Dr. Ritu Verma, pediatric gastroenterologist and Section Chief of CHOP’s Gastroenterology and Nutrition group. Dr. Verma leads the Center for Celiac Disease at CHOP and also serves as a very active member of NFCA’s Scientific/Medical Advisory Board.  This lady wears many very important hats!

Dr. Ritu Verma

The conference covered a wide range o f topics ranging from ‘The Genetics of Celiac Disease,’ with Curt Lind of CHOP, to ‘Celiac + Social Media,’ with Priyanka Chugh, and ‘Bone Health in Children with Celiac Disease,’ with Babette Semel, PhD.

Welcome to Education Day!

Our own Alice Bast spoke about a topic that is grabbing national attention as students struggle with the gluten-free diet in school and on college campuses. In ‘Gluten-Free Goes to School,’ Alice outlined the perils and some solutions for this important facet of a student’s daily life.

By the way, there was loads of delicious gluten-free food provided as samples by vendors and also for a plentiful breakfast and lunch.

A big thanks to NFCA volunteer Sarah Terley, who passed out information to parents and kids coming to our table.

Sarah Terley, Kristin Voorhees, Alice Bast

Thanks to the discerning palate of my associate, Kristin Voorhees, we ended the day with a delightful meal at Garces Trading Company at 1111 Locust Street in Philadelphia.  The Garces Restaurant Group has completed NFCA’s GREAT Kitchens program and, as a result, we were confident that the gluten-free items on the menu really were produced in a safe manner.  Very reassuring. Anne Lee of Schar USA joined us as we enjoyed a delicious gluten-free meal, including fabulous desserts. The quite decadent Chocolat is to die for!

Garces Trading Company

On Saturday, I joined the group at a free Men’s Health Fair at The First Pentecostal Church in Lambertville, NJ. Organized by Jonathan Bridges, a church member and owner of Wallingford Farms, this preventive health collaboration between the church community and healthcare service providers offered lectures plus screening for a variety of the basics: hypertension, hyperglycemia, BMI and more.  Many thanks to Karen Dalrymple and Donna Sawka of the Greater Philadelphia Area Celiac Support Group for coming out to spread the word about celiac disease, gluten-related disorders and the gluten-free diet.

So…great weather, interesting information, delicious food…an all around GREAT experience!

- Nancy

Attending a Celiac Disease Patient Conference: Part 1

Earlier this month, I had the opportunity to attend the Intestinal Immune-Based Inflammatory Diseases Symposium at Columbia University. It was a joint event presented by Columbia’s Celiac Disease Center and the Jill Roberts Center for Inflammatory Bowel Disease at Weill Cornell Medical College. I was there for the Patient Program, but it also included a CME track for physicians, dietitians and other healthcare providers.

Yes, these are gluten-free. I'll get to that in a bit.

I had been to conferences before, but never one that focused specifically on celiac disease. Needless to say, I was stoked to meet people who are just as excited to talk about gluten-related disorders as we are.

First up, I’m covering the scene: The People and The Food. Watch for my next post, when I get down to the nitty-gritty: The Education.

The People

As someone who spends more than 8 hours a day in front of a computer, it was a treat to get some face-to-face time with patients and healthcare providers. Breakfast, lunch and dinner afforded us plenty of time for chit chat, and I met a wonderful group of people.

There was Patty McG, a spunky teacher who was diagnosed with celiac disease late in life. She was so full of energy, so inquisitive at sessions and so hilarious at mealtime – a thrill to be around.

Our new friends: Andrea and Allie!

Then there were Andrea and Alexandra, a mother-daughter duo who flew in from Ohio for an appointment at Columbia’s Celiac Disease Center, then stuck around a few extra days for the patient conference. Alex is a senior in high school and was preparing for a 2-week trip to Spain. Kristin and I immediately offered some travel resources to help her stay gluten-free while abroad. They were thrilled to hear about the new Gluten-Free in College section on our website. We’re sure Allie will be a well prepared gluten-free student come move-in day.

Next, I met Jonas Ludvigsson, MD, PhD, a renowned celiac disease researcher from Sweden who is doing research at the Mayo Clinic on a Fulbright Scholarship. I’ve posted a number of his studies on our Research News feed, so it was an honor to spend some one-on-one time with him. Plus, he’s a hoot. (He also wrote a guest post for NFCA back in November.)

Finally, there was Barbara Halpern, a long-time champion of NFCA. Barbara is a practicing dietitian in not one, not two, but three states. She even does nutrition counseling via Skype, so she’s never far out of reach. She leads a local celiac support group, and she’s done wonders to promote our Primary Care CME to physicians.

The Food

What’s a celiac disease conference without delicious gluten-free food? Each day, we enjoyed a lavish spread at each meal, including a seemingly endless supply of gluten-free rolls from Free Bread Inc. These rolls were a huge hit with gluten-free and gluten eaters alike. They were warm and hard on the outside, moist and doughy on the inside. Flavors included the Jalaa!, with cheddar cheese, buttermilk, and jalapeno, and our favorite, the MOXY, with gluten-free oats and seeds, molasses and agave nectar. It wasn’t uncommon for someone to eat two or three rolls in one sitting. (Attendees came from far and wide, so they were stocking up while they could.)

This salmon filet was HUGE!

To balance out all that bread, we filled our plates with dishes like salmon, roasted vegetables, chicken with a Dijon sauce, and cold gluten-free pasta salad from the buffet. I have never seen salmon filets as big or beautiful as they ones they served. They were so fresh and tasty, I barely used the sauce.

Gluten-free pasta salad.

For dessert, there was gluten-free cheesecake – plain and chocolate – and fresh fruit. The cheesecakes were light and creamy, not like the dense cheesecakes I’ve had in the past. And who doesn’t like fruit?

Stay tuned for my follow-up post, including some key takeaways from the sessions.

- Cheryl

Gluten-Free Products at Expo West 2012: New Snacks, Better Nutrition

Last weekend, Alice and I went to Natural Products Expo West in Anaheim, CA. It was a blast!

Let’s start with the magic of Disney: their chefs are a delight, and the 8:40 p.m. nightly fireworks were icing on the gluten-free cake.

Speaking of cake, gluten-free sales continue to boom. At the Expo, we learned that Mintel projects the market to reach between $8.5 and $9.9 billion by the end of 2013. Mintel, along with market research firm SPINS, stated unequivocally what we all know – that gluten-free is a long-term industry trend that is here to stay, not a short-term fad that will fade into distant memory.

As far as products go, we saw the continued abundance of gluten-free salty snacks, including several lentil-based crackers. We previewed Rudi’s new tortilla, which didn’t crack or break when rolled or folded, and we spent Thursday evening with the team from Rudi’s and Charter Baking, including their CEO Jane Miller.

We saw the emergence of stronger nutritional profiles at Expo West this year. Schar’s new Gluten-Free Multigrain Ciabatta Parbaked Rolls are delicious and satisfying. And Lucy’s has developed a brownie bite free of most major allergens. Also free of all 8 allergens was Enjoy Life’s individually-wrapped packs of trail mix, providing easy-to-grab fiber and protein from a flavorful blend of seeds.

After an endless day of sampling chips, pizza, cookies and bars, I was especially excited to eat some actual veggies. Thank you to Kettle Cuisine for their delicious array of savory soups (I love the Roasted Vegetable) and Thai Kitchen, for their curried vegetable stir-fry with fresh pea pods and peppers. Yummy.

I spent the plane ride home reading the story of Bob Moore (of Bob’s Red Mill), whose inspirational act of generosity caught our attention when he gave the company to his employees on his 81^st birthday. “These folks helped me build the company up,” Bob told me. “How could I do anything else?”

- Jennifer