1. The Gluten Free Diet Keene State College Dietetic Interns
Andrea Cropley & Gabriela Espinoza

2. Objectives Define gluten
Identify who should follow a gluten free diet and how it relates to Celiac Disease
List at least 3 naturally occurring foods on the gluten free diet
Today we will be giving you an overview of the gluten free diet. During this presentation we will define what gluten is, identify who should follow the gluten free diet and how gluten relates to celiac disease, and to give you examples of naturally occurring foods on the gluten free diet. We have a few activities plus a tasty gluten free treat at the end. Before we go further into our presentation, we would like to know what you have heard about the gluten free diet.

3. What does gluten free mean to you?
Ask the participants what they know about gluten free or what they have heard.
What does gluten free mean to you?

4. What is Gluten? A protein found in wheat, barley, rye, and triticale.
Gives dough its elastic texture.
Acts as a glue to hold ingredients together.
References: Nutrition-Concepts and controversies
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5. Should you be Gluten Free?
Ask if anyone is on a gluten free diet?
Does anyone know why someone would follow a gluten free diet?

6. Celiac Disease
Chronic inflammatory condition resulting from an immune system reaction to gluten.
Signs and Symptoms
vomiting
diarrhea
abdominal bloating
Weight loss
Anemia
Fatigue
Headaches
Joint and muscle pain
3 million americans have celiac disease
18 million americans have a sensitivity to gluten
Some people may not be diagnosed with celiac disease but could have a sensitivity to gluten.
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8. Diagnosing Celiac Disease
Blood Test
tTG-IgA
Celiac disease antibodies
Biopsy
Small intestine
Gluten sensitivity vs allergy
Gluten sensitivity does not damage the small intestine but may still experience GI distress.
If blood test suggests celiac disease, a biopsy would be the next step to confirm the disease
A biopsy is taken from the small intestine in an outpatient facility. The biopsy will help physicians analyze the small intestine for any damage.
Patients who are going in for the biopsy test must NOT be on a gluten free diet, the test results may be altered.
Patients who have gone through tests and do not have celiac disease may still have a sensitivity to gluten. A sensitivity is when a patient cannot tolerate gluten BUT do not have celiac disease. When gluten is consumed= some may experience GI symptoms but will not have damage to the small intestine. An allergy to gluten will damage the small intestine. Can cause weight loss, vomiting, and anemia in severe cases. If not treated, can lead to malnutrition.
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9. Where is gluten found? Wheat, Rye, and Barley: Pasta Couscous Bread
Flour Tortillas
Cereal
Crackers
Beer
Gravies
Dressings
Sauces
Malt
Soy Sauce
Oats
references:
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10. Cross-Contamination Cross contaminated by wheat, barley, and rye
Occurs at home or in restaurants
Storage in the kitchen
Use separate cookware and appliances
Keep surfaces clean
Avoid “double dipping”
People who are not able to consume gluten need to look at the ingredients list for any possible cross contamination. Gluten can be cross contaminated by being mixed with wheat, barley, and rye. This can occur at home or in restaurants.
Store gluten free items on the top shelf to decrease chances of cross contamination
Do not use wooden spoons or cutting boards that have also been used to prepare foods that contain gluten. The wooden spoons and boards can harbor residual gluten. It is advised to use metal or plastic spoons.
Using separate toasters, waffle and bread makers can decrease chances of cross contamination.
Avoid “double-dipping”= Using a spoon or knife the first time is ok but once the utensil has touched a food item containing gluten, you can contaminate the container if the same utensil is used. For people with celiac disease, it may be safer to have their own jar of peanut butter, jelly, mustard, etc.
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11. The Scoop on Oats Oats themselves do NOT contain gluten.
Avoided due to cross-contamination with wheat, barley or rye.
Gluten Free oats are specifically produced.
Look for oats labeled “Gluten Free”

12. What Foods are Naturally Gluten Free?
Fruits
Vegetables
Meat and Poultry
Fish and Seafood
Dairy
Beans
Legumes

13. What Grains are naturally Gluten Free?
Quinoa
Millet
Corn
Potato
Flax
Chia
Rice
Nut flours
Tapioca

14. Nutrition Fact Label Key words to look out for: Oats Wheat Rye Barley
Malt
Brewers Yeast
Natural Flavorings
Part of the nutrition fact label is the ingredient list. This label will be able to tell you whether an item is gluten free. There are seven key words to look out for when looking at a label. We are now going to have you all look at two different ingredients labels to figure out which item is gluten free.

15. Option A
INGREDIENTS: WATER, TAPIOCA STARCH, BROWN RICE FLOUR, CANOLA OIL, EGG WHITES, POTATO STARCH, MODIFIED FOOD STARCH, TAPIOCA MALTODEXTRIN, DRIED CANE SYRUP, TAPIOCA SYRUP, YEAST, GUM (XANTHAN GUM, SODIUM ALGINATE, GUAR GUM), SALT, LOCUST BEAN GUM, CULTURED CORN SYRUP SOLIDS AND CITRIC ACID (MOLD INHIBITOR), ENZYMES. CONTAINS: EGG
Ask participants to identify if this bread is gluten free. What ingredients can you pick out of the ingredient list.

16. Option B
Ask participants to identify if this bread is gluten free. Have them pick out specific key ingredients.

17. Positives Negatives Alleviate symptoms of Celiac Disease
More energy
Alleviate digestive problems
Regain lost weight
Reverse Nutrient Deficiencies
Consists of healthy whole foods:
Fresh Fruits and vegetables
Meat and Poultry
Fish and Seafood
Dairy
Beans and Legumes
Consuming fewer products enriched with nutrients
Deficiencies in iron, calcium, thiamine, riboflavin, niacin and folate
Inadequate intake of fiber
Cost
Requires time and dedication
Potentially decrease the amount of beneficial bacteria in the gut which can negatively impact the immune system.
Gluten free products tend to be more expensive than gluten containing products
Following the gluten free diet takes time and dedication-required to closely look at nutrition fact labels for gluten ingredients.
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18. Not All Gluten Free Options are Healthy!

19. Which Foods Are Gluten Free?

20. Couscous Vs Rice

21. Baked Beans Vs Pasta

22. Corn Vs. Bagel http://www.chinwijaya.com/?page_id=50

23. Conclusion Gluten gives dough its elastic texture. Celiac disease
Choose naturally occurring gluten free foods.
Avoid processed gluten free products.

24. References