Posts tagged ‘gluten’
5 Tips for Talking to Your Child About Celiac Disease & the Gluten-Free Diet
[Kathleen Reale runs BeFreeForMe.com, a website that offers coupons, samples and information for those with celiac disease and food allergies. In addition to having celiac disease, Kathleen also has family members with food allergies. We asked her for advice on breaking it down for the little ones.]
When you first discover your child has celiac disease, it can seem overwhelming. What foods to buy? How to cook? How to correspond with schools, camps and other social situations? But most importantly, how do you communicate with your child on what celiac disease is and how to navigate the gluten-free diet.
Following are a few tips and tricks to make gluten-free journey easier to navigate…and will help you and your child find a positive, optimistic way to better health and wellness.
1. Help Your Child Understand the Gluten-Free Diet
Depending on your child’s age, it is important that they understand the gluten-free diet and why they need to be on it. For younger children, start with the basics of the diet and expand upon the information depending on the child’s age. Encourage your child to ask questions. Need a springboard to get the conversation started? Check out some of the fantastic books in the resource section below!
2. Keep a Positive Attitude
Being on a gluten-free diet is not the end of the world. But for a child, it can seem devastating. Help your child stay focused on what the diet allows, rather than what it does not. Bring your child grocery shopping and allow them to select gluten-free foods they will enjoy. Encourage them to explore new foods, help with cooking, and even start their own garden. Getting children involved in growing, selecting and preparing their foods creates a sense of ownership and pride in the foods they can eat.
Remember also to keep a positive attitude yourself. Kids will pick up on your cues and the approaches you take. Start by being “positively prepared.” Some examples are researching gluten-free options before dining out or keeping frozen gluten-free pizzas and cupcakes on hand at all times. This shows your child that eating out, pizza with friends, and birthday parties are easy and simple.
3. Empower your Child
Your first instinct is to protect your child at all times. But depending on your child’s age, they may be in social situations that require them to take responsibility for the food they eat and their own health. Make sure that your child understands what “safe foods” are, how to read labels, and know that they can always call you for help in navigating their diet.
4. Role-Play Potential Situations
Talk to your child about potential situations that may arise that require them to address being on a gluten-free diet. Talking to your child about these situations, and problem solve them together. How should your child respond to a grandparent that says “just one” non gluten-free cookie is fine to eat, or what tactics will be used when your child is invited to a pizza party? This will equip your child to deal with some circumstances they may encounter. Most importantly, make sure your child understands that it is OK to persistently, but politely, say NO to gluten.
5. Some Resources to Help You and Your Child
Following are some resources to help you and your child start your gluten-free journey:
Books for younger children
- Mommy, What is Celiac Disease?, by Katie Chalmers
- Gluten-Free Friends: An Activity Book For Kids, By Nancy Patin Falini, RD
- Gluten-Free Kids: Raising Happy, Healthy Children with Celiac Disease, and Other Conditions, by Danna Korn
- Eating Gluten-Free with Emily: A Story for Children with Celiac Disease, by Bonnie Kruszca
Books for pre-adolescents
- The Gluten-free Kid. A Celiac Disease Survival Guide, by Melissa London
Also, make sure you check out Kids Central on the National Foundation for Celiac Awareness website for tons of support, information and tools for your gluten-free child. All the subjects are addressed in kid-friendly terminology. Some topics covered are the basics – such as what is celiac or what is gluten-free, as well some fantastic pointers on living a gluten-free diet from a child’s perspective including explaining celiac disease and the gluten-free diet to friends, or pep-talks from other gluten-free kids. The site is well worth exploring!
– Kathleen Reale
Hidden Gluten: 4 Places and 1 Resource to Watch
[When you first go gluten-free, you typically focus on the obvious foods like bread and pasta. But it’s often hidden sources of gluten like soy sauce that throw you off course. We asked Shirley Braden of gluten free easily to share her tips on avoiding hidden gluten. Here they are, organized in 5 categories to help you stay safe!]
When The National Foundation for Celiac Awareness asked me to participate in this year’s May Celiac Awareness campaign, of course I said yes as I’m a huge fan of the NFCA and all its efforts. I said yes even though initially the subject matter didn’t excite me. Hidden sources of gluten. Yes, it’s a very important topic, but it’s one that’s not very exciting on the surface (no pun intended). However, not knowing where gluten can be hidden can give you major anxiety. There’s nothing as unfortunate as going merrily along and suddenly getting “glutened”!
The following are some frequent sources of hidden gluten … or sometimes not so much sources of hidden gluten as “overlooked”gluten. Note that the Food Allergen Labeling and Consumer Protection Act went into effect on January 2006, which ensured that wheat (as one of the eight major food allergens) must always be shown on applicable food product labels—either in the listing of ingredients themselves or after the ingredients list in a “CONTAINS:” statement. (Read more here.)
1. Grab-and-Go Foods
Candies ~ While there are many candies that are gluten free, many more contain gluten. Most folks are not surprised to learn that candies that contain cookie ingredients contain gluten, but they are surprised to learn that others like licorice (or similar; e.g., Twizzlers) contain wheat. Many other candies contain gluten in the form of barley for flavoring. Read labels and be wary of accepting or taking candy with no packaging.
Chips ~ Flavored potato chips (e.g., barbecued flavor, sour cream and onion) can contain gluten. Some new varieties of “whole grain” or “multi-grain” chips may also contain gluten. Don’t dip the chip without knowing that it’s gluten free!
“Formed” Products~ I asked my son for his input on products that contain hidden gluten and he said, “Anything that is mixed and then molded or shaped probably has gluten in it.” Great point. He talked about specific candies and some brands of beef jerky (for the latter, some brands also contain gluten via soy sauce for flavoring).
2. Cooking
Broth ~ The unsafe gluten ingredient that can be present in commercially prepared chicken broth, beef broth, or stock is usually wheat. Therefore, wheat will be shown on the ingredients label. Similarly, some chicken bouillon can contain gluten. Read the ingredients label.
Condiments~ There are many condiments that are gluten free, but sometimes gluten is used as a stabilizer and thickener, so read labels and do your due diligence. If you share a household with gluten consumers, it is imperative that separate condiments be maintained. It’s unrealistic to think that the members of your household who eat gluten will know or remember not to contaminate the mayo jar when they stick a knife inside the jar, spread mayo on bread, and then realize that they need more mayo. That same knife will go back in the mayo jar and the jar suddenly become cross contaminated and a source of gluten. Similarly, there are many who will touch the ketchup container right to the gluten-containing bun, bread, seasoned fries, etc. and the ketchup container then becomes a source of hidden gluten.
Kitchen Equipment ~ Toasters used for gluten-full bread, old pans and baking sheets, cutting boards, baking stones, and wooden utensils can all be sources of hidden gluten. (A black light that would show gluten would be so very handy, don’t you think?)
3. Eating Out
The opportunities for cross contamination are endless in restaurants, and even a gluten-free menu doesn’t guarantee a gluten-free meal. Every single individual must be fully trained on serving the gluten-free patron and keeping gluten-free ingredients/dishes free of gluten contamination. One poorly trained individual and/or one misstep is all it takes to provide an unsafe meal. But let’s focus instead on foods and dishes that may have hidden gluten in restaurants. The risk can also be greater when eating out because we don’t have ready access to ingredients listings.
Beverages~ This category includes non-alcoholic and alcoholic liquid refreshments. I was with a group of bloggers, most of whom were gluten free, at a food blogger conference a while back. During a break between sessions, we were sampling some of the vendors’ wares. We immediately asked if the beverages were gluten free. The answer was “Yes, these are.” What we didn’t pick up on was that there was an emphasis on the “these” and a specialized sweep of the company reps’ hands, indicating that only particular flavors of the brand were gluten free. We discovered this info after continuing to reading ingredients labels as we sipped.
That gluten can be present in tea also surprises folks. Barley is the usual source. Holiday and specialty teas are more frequent sources of gluten than basic teas. Special scrutiny should be paid to teas with name that include “gingerbread” and “sugar cookie,” as gluten is used to achieve that baked good taste. Similarly, flavored coffees can sometimes contain gluten.
The biggest concern for alcoholic beverages typically is beer. Unless it is made from special gluten-free ingredients and/or processed to be gluten free, beer is off limits. I’ve seen this news come as a shock to gluten-free newbies. The health care professional who diagnosed them had warned them about pasta, bread, crackers and baked goods, but had forgotten to mention beer.
Dressings, Marinades, Sauces, and Soups ~ I was very surprised to learn that an area restaurant’s homemade Caesar dressing contained soy sauce (which, of course, contained wheat). If I had not notified my waiter of my dining needs and he had not been well informed on the restaurant menu and ingredients, I might have been “glutened.” Others have found that soy sauce has been used in all types of dishes, and in decidedly non-Asian fare. Soy sauce is often used in marinades, and beer may sometimes be used as well. Sauces and soups are often thickened with wheat-based flour versus naturally gluten-free thickeners such as cornstarch, potato starch, and tapioca starch/flour.
Egg Dishes ~ Some well-known chain restaurants add flour or pancake batter to scrambled eggs and omelets. One should always ask if either have been added when ordering egg dishes–even in the finest restaurants–just to be safe.
Salad ~ Of course, salad on its own is gluten free … lettuces and other salad greens, carrots, onions, tomatoes and the like are gluten free. However, many restaurants will make salad in a humongous bowl and then the wait staff will serve individual salads from that bowl. If the restaurant uses croutons in that bowl, you must ask for your salad to be made fresh, separately without croutons. (Note: If ever you receive a salad with croutons, or say a bread stick on top, hold on to it until the server replaces it, as restaurant staff have been known to simply pick out croutons or remove the bread stick.)
Water Used in Food Preparation~ Are you ordering steamed seafood? Does the restaurant use beer to steam to add special taste to its seafood offerings? If so, either you must abstain, or you must ask if the chef will steam your seafood in plain water in a separate, clean pot. (Do not assume on the latter.) Are you ordering steamed veggies for healthier fare? Be sure the restaurant doesn’t use the same water that it has used to boil its pasta in to also steam its veggies. This happens more often than you would think and not asking that question has gotten me “glutened” at least once.
4. Non-Food Sources
Please don’t stop your vigilance at food sources; consider the following.
Art Supplies~ Numerous art supplies—like mainstream brands of play dough and finger paint—contain gluten. Heidi at Adventures of a Gluten-Free Mom has an excellent post on gluten-free art supplies here. As Heidi says, little ones are notorious for putting their hands in their mouths.
Makeup and Lotions ~ Choose lipstick and facial lotions (or any product that could wind up in your mouth) that are gluten free. Deciphering the ingredients on these labels is not easy, so select products that have simple ingredients like coconut oil and shea butter or shop from a product line that is entirely gluten free.
Medications and Supplements~ Gluten is also sometimes present in medications. I’m talking about prescription and over-the-counter drugs, and vitamins and supplements. Alice Bast, founder and president of NFCA, states “When you look at the word gluten, think glue. It is often used as a binder.” NFCA is in the midst of a two-part study on Gluten in Medications, which was funded by a $50,000 grant from the FDA.
Pet Food~ Unless you are purchasing grain-free pet food, it most likely does contain gluten. Make sure to wash your hands after handling any pet food. This issue may even be more of a concern for the gluten-free child touching the pet’s food dish and then his/her mouth, kissing the family pet, etc.
5. The Gluten-Free Watchdog
Those are just a few sources for hidden gluten, but I’d like to share another component of the hidden gluten equation. As most of you know, there are no current standards for a “gluten-free” label in place in the U.S. at this time. The Food and Drug Administration’s proposed standard from a few years ago remains at less than 20 parts per million (ppm). Final passage of this amount has not occurred; the latest data from the open comment period held months ago is still being evaluated. We also know that we are seeing more and more products labeled “gluten free.” Does that mean such products really are gluten free?
That’s what the Gluten Free Watchdog program is finding out. Founded and maintained by Tricia Thompson (The Gluten-Free Dietitian), the Gluten Free Watchdog program tests “gluten-free” products weekly.
The most important thing to know is that while most of the products that the Gluten Free Watchdog has tested are gluten free to less than 5 ppm gluten, a handful of products have tested well above 20 ppm gluten. These findings point to the scariest sources of hidden gluten of all—the ones with “gluten free” labels that you believe are safe. Please take a moment to check out the Gluten Free Watchdog Alerts page to see which products have tested positive for gluten at 20 ppm or above. I have not seen this information shared enough with the gluten-free public and folks are still consuming these products and getting ill. (Note: Only subscribers get the product testing reports immediately with the specific testing results.)
Finally, do your best to “stay safe out there.” For staying safe and living gluten free easily (gfe), I’m a huge proponent of real food that is naturally gluten free. There is no hidden gluten in the products that are ready to eat “as is” (obviously, cooking will be needed in some cases). Think meat, seafood, fruit, vegetables, and dairy. As they come in their natural forms (without processing or “additives”), these foods are gluten free all day long!
– Shirley Braden
Dinner with a Celiac Disease Expert
Some days, you just get lucky.
Two weeks ago, I had a fabulous chance to consult with an expert, learn something new and enjoy a delicious dinner in very good company.
The saying goes, if you want to learn about something, go to the source. Not often does the source come to you.
While traveling through the area on business, Scientific/Medical Advisory Board member Dr. Daniel (Dan) Leffler of the Division of Gastroenterology at Beth Israel Deaconess Medical Center in Boston, graciously took the time to swing through Philadelphia to meet with us. As a result, Dr. Richard Mandel, NFCA Board of Directors member, and I enjoyed a delightful dinner with Dan in an atmosphere where we could catch up on the latest research and exchange ideas about the state of celiac disease today.
Thanks to some sleuthing by my associate Kristin Voorhees, we landed at Devon Seafood Grille on Rittenhouse Square in Philadelphia. Let me tell you, it is the place to be!
Because Dan had to catch a plane that evening, we dined early — 4 PM. No, it wasn’t the Early Bird Special. It seems that Devon serves all day, so no worries there. The best part is that they have a separate and quite complete gluten-free menu. Actually, many of the items on their “regular” menu are gluten-free. And, the waiter was totally knowledgeable about what was gluten-free and what was not, down to the spices used in various dishes. Impressive and reassuring!
So, after diving into oysters selected from the current best across the country and enjoying the freshest of splendidly prepared seafood, we got down to the “what’s what” part of our get-together.
The big news is all about terminology.
That’s right, there are changes afoot concerning how we define and refer to celiac disease and other related disorders. Called the “Oslo definitions,” a newly released document composed by a team of 16 physicians from seven countries outlines the preferred terms, along with terms that they assert don’t best describe the condition under discussion. That’s right; some are in and some are out.
The goal here is to develop a common language which the entire scientific, academic and healthcare communities, along with the general public, can use to refer to this range of illnesses now going under a myriad of terms that can (and do) have different meanings to different people.
Note: The name “Oslo definitions” comes from the most recent International Coeliac Disease Symposium held in Oslo, Norway in June 2011 where new definitions were introduced and discussed. The review continued after this meeting resulting in the formal document that was released in February 2012. Yes, it is hot off the presses.
While not the law of the land at this point, this consensus document has the support of leading experts worldwide, including Dan Leffler who authored the paper on behalf of the impressive group based on months of studied consideration by these medical experts and researchers, all focused on the field of celiac disease.
No, I am not going to list all of the definitions here as there is quite a list of terms, most familiar to all of us, along with some that are not part of the lay person’s daily vocabulary. (Yes, that would be me.) Should you read the document, you will see gluten sensitivity and gluten intolerance joined with other descriptors such as latent celiac disease, gluten ataxia, pediatric classical and more.
The document defines celiac disease (or, as they write it in Europe, coeliac disease). Here it is: “a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals.”
It also recommends a new way to refer to the spectrum of illnesses that involve gluten. “‘Gluten-related disorders’ is the suggested umbrella term for all diseases triggered by gluten and the term gluten intolerance should not to be used.”
There is much more to this story, of course. You can get a quick summary in NFCA’s Research News.
In short, this was a very satisfying and interesting evening. We enjoyed delicious gluten-free food and learned about the latest thinking in the field of celiac disease.
Chalk one more up for “a good time was had by all”!
– Nancy
Related Content:
Could Those ‘Glutening’ Symptoms Actually Be Due to Sugar Alcohols?
GlutenFreeDrugs.com has become one of the top resources for information on gluten in medications. Clinical pharmacist Steven Plogsted is the man behind the site, and he’s been a huge help in spreading the word about NFCA’s Gluten in Medications Survey. Recently, Steve graced our inboxes when he responded to a listserv query about a particular medication. His response explained a mix-up related to sugar alcohols in certain medications, and we thought it was important information to share. So, we asked him to do a quick Q&A.
What are sugar alcohols?
Sugar alcohols are better known as the artificial sweeteners. They are not truly sugars or alcohols (chemicals with a specific type of carbon and oxygen bond), rather they are carbohydrates with a structure similar to sugars and alcohols and impart a sweet taste to the foods or drinks that to which they are added. Examples include sorbitol, mannitol, xylitol, maltitol and others.
Why are they used in medications?
They are used in medications as sweetening agents, general fillers, tablet coatings and as an emollient. Applied topically, they can act as a cooling agent on the skin like menthol.
Why should celiac and gluten sensitive individuals be aware of sugar alcohols in medication?
When taken in large amounts, sugar alcohols can cause significant abdominal discomfort, but it is not due to gluten. Celiac and gluten sensitive individuals who are on a gluten-free diet don’t need to be concerned about sugar alcohols affecting their disease. However, they should know that sugar alcohols could be the cause of some discomfort.
How are sugar alcohols causing confusion among manufacturers and gluten-free consumers?
One method of manufacturing these products is by purification of any starch, including wheat. Since they are highly purified, there are no gluten remnants remaining and therefore they are gluten-free. My feeling is that these manufacturers are taking labeling practices to the extreme and informing people that it contains gluten because it was derived from wheat. Since the manufacturers are telling consumers that their product contains wheat, individuals with celiac disease are avoiding those products.
If sugar alcohols can cause GI issues, are they actually safe to consume?
Taken in moderation, these are generally safe to consume. Anyone who consumes large amounts of the sugar alcohols will most likely experience GI symptoms since they act as an osmotic cathartic (laxative).
You encourage consumers to push manufacturers to explain why their product ‘may’ contain gluten. Why?
I encourage consumers to push manufactures to disclose the source of the gluten contamination in case they are claiming gluten contamination due to one of these sugar alcohols or other reasons. As an example, one company I called told me their product contained gluten. When I pressed them to disclose where the gluten was from, they told me it was from the corn starch. I explained to them that corn starch and corn gluten were OK, but they told me that to them, gluten is gluten, so they don’t differentiate what kind of gluten it is. They just tell the caller that it contains gluten.
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To summarize, if you experience GI issues as a result of taking a medication, gluten contamination may or may not be the culprit. Sugar alcohols can cause similar symptoms, so contact the drug manufacturer to learn more about the medication ingredients.
– Cheryl
*Don’t forget to take the Gluten in Medications Survey. The survey closes next Tuesday, Feb. 28!
Inquiring Minds Want To Know!
Some days, it seems that surveys are everywhere. We are surrounded by a knowledge gap that surveys are meant to fill allowing all of us to move ahead to a better world. Some seem immensely trivial and others of grave importance.
Over the past few weeks, I have been involved in the world of surveys. Specifically, I have been working on a survey targeting anyone and everyone who is gluten-free. The point is to find out what experiences the survey taker has had with medication. By that, I mean medication of all sorts—prescription, over-the-counter, supplements, the works.
Yes, this survey is part of NFCA’s work on the U.S. Food and Drug Administration (FDA) grant to study Gluten in Medications. We have written about this study on our CeliacCentral.org website, in our newsletter and more.
Right now, we are engaged in making sure that the distribution of this survey is as broad as possible so that we certainly gather as much insight as we can. The more responses we get, the more information we will have and, therefore, the more drugs we can test for gluten content and the more targeted that testing can be to reap the best, most noteworthy and effective results.
And, yes, this survey falls into the “gravely important” category.
So, I have been poring over lists of groups that are good candidates to distribute the survey. The NFCA staff has been sending out email notices about the survey like crazy and, then, regrouping to expand and improve our communications plan.
We know how important this research is to all who are gluten-free and who want to be certain that, in the process of trying to get well or stay healthy, they are not sideswiped into illness inadvertently. Whether someone takes one pill a day or 16, that individual doesn’t know how much gluten, if any, she is absorbing.
We also know that pharmacists are eager to help their patients. They need to know what is in the medication they are dispensing. People ask them questions; they want to know the answers. NFCA’s GREAT Pharmacists online training program is one way that we are moving the ball along that learning curve. This survey and the research that comes out of it will advance the Gluten in Medications program in a positive fashion.
So, back to the lists. This is a one-in-a-million chance to get it right!
– Nancy
Gluten-Free Tailgating (Plus a Giveaway!)
Congratulations Ashley Pelley and Schmidty! You are the winners of our Thai Kitchen gluten-free giveaway. Please email cmcevoy@celiaccentral.org with your mailing address to claim your prize.
When I think of tailgating food, most of it is, well, gluteny. For a morning game, it’s donuts and bagels. In the afternoon, the list consists of burger & buns, hoagies, and soft pretzels. Then there’s the beer, the cups that always seem to get mixed up, and the one friend who insists on touching everything while taking bites of his sandwich. It certainly doesn’t make it easy if you need to be gluten-free.
When Thai Kitchen contacted us about doing a fall campaign, it was the perfect opportunity to create a Gluten-Free Tailgating Guide to help everyone make going to a game less stress and more fun.
I’ll be honest, Whitney and I racked our brains for a few days while creating this guide. Sure, there were the usual food safety tips, like keeping meats and dairy in a cooler. But avoiding cross-contamination? That required some crafty thinking.
The guide is now posted in the Thai Kitchen Gluten-Free Recipe Box on our website. It even has a recipe for Curry Turkey Burgers with Pineapple Salsa, because if you volunteer to make the burgers (Warning: some people put breadcrumbs in their burger mix), you might as well impress the crowd.
Gluten-Free Giveaway!
We had such an overwhelming response to last week’s Thai Kitchen Gluten-Free Giveaway that I was thrilled to host another round. This week, we’re giving away the Thai Kitchen products needed to make Curry Turkey Burgers with Pineapple Salsa and Chicken Satay Skewers – another gluten-free recipe that’s great for the game. Here’s what you can win:
- Coconut Milk (for Chicken Satay Skewers)
- Fish Sauce (for Chicken Satay Skewers)
- Red Curry Paste (for Chicken Satay Skewers and Curry Turkey Burgers with Pineapple Salsa)
- Peanut Satay Sauce (for Chicken Satay Skewers)
- Sweet Red Chili Sauce (for Curry Turkey Burgers with Pineapple Salsa)
- 2 Thai Kitchen chip clips
- 2 Thai Kitchen pot holders
- Thai Kitchen coupons
- Tailgating Recipes
To enter, leave a comment sharing your best gluten-free tailgating tip. (We know how resourceful you all are!) We’ll randomly select 2 winners and announce them right here on Friday afternoon.
Gluten-Free Halloween: Are You Prepared?
I always start thinking about Halloween in August, then completely forget about it until – “Trick-or-Treat!” – it’s right at my doorstep. I cobble together a costume from whatever’s in my closet, and grab a quick bag of candy in hopes that kids will come, but not so many that I run out of supplies.
I could take a few pointers from our volunteer, Annsley. In her latest article, she offers some tips for making trick-or-treating a fun, not frustrating, experience:
- Establish a plan way before heading out to trick-or-treat. This is even more effective when you and your child can establish a plan together.
- Communicate the plan before trick-or-treating and explain why. Kids do better when they understand the reason. I always tell my daughter that X will make you very sick, and that seems to work.
For more of her tips, check out her How to Embrace Gluten-Free Halloween in the new Articles section on Kids Central. While you’re there, download the Gluten-Free Candy List 2011 from the Guides section and browse around to see all that Kids Central has to offer (www.CeliacCentral.org/kids).
Other helpful articles: