1. ANSWERS TO YOUR QUESTIONS IS GLUTEN FREE FOR ME? Kathy Egan, RDN/LDN National Nutrition Month March 2014

2. GLUTEN FREE IS EVERYWHERE! What’s all the fuss? It’s confusing Trendy – does that make it wrong?

3. I’M NOT GOING TO TELL YOU WHAT TO DO There are enough people trying to do that already.

4. LEARNING OBJECTIVES Describe & define gluten Understand gluten vs. food allergy Become more comfortable making diet choices

5. WHAT IS GLUTEN? A Protein found in: Wheat Barley Rye Oats, by contact

6. GLUTEN RELATED DISORDERS Celiac Disease (Celiac Sprue) Auto immune response The body attacks itself Mass General Hospital - What is celiac disease? Gluten Sensitive Enteropathy (GSE) (a.k.a. non celiac gluten sensitivity) Damages intestines, but in a different way Gluten Intolerance causes discomfort, but doesn’t do damage

7. GLUTEN IS NOT AN ALLERGEN Food allergy - immune response Food is as an invader Histamine reaction is typical To learn more about food allergies: FARE - Food Allergy Research & Education FARE - Food Allergy Research & Education

8. “GLUTEN FREE” DEFINED BY FDAFDA Manufactured foods - less than 20ppm 20 parts per million = 20/1,000,000 or.002% Example - ½ teaspoon flour in 220 pounds sugar

9. TOP FOOD ALLERGENS 90% of all food allergy reactions- Peanuts, tree nuts, milk, egg, wheat, soy, fish, shellfish (sesame seed) FALCPA Food Allergy Consumer Protection Act of 2004 Allergens must listed be in plain language About Food Allergies

10. IS GLUTEN BAD? YES, if you have: Celiac disease Gluten Intolerance Gluten Sensitive Enterapathy (GSE) Otherwise…. NO Gluten is just one of many proteins found in common foods. (It is possible to have a wheat allergy, but that’s different.)

11. FEELING BETTER WITHOUT GLUTEN? By avoiding gluten, you may consume: GREATER VARIETY HEALTHIER CARB FOODS FEWER PROCESSED FOODS LESS SUGAR, SALT & FAT MORE FRUITS & VEGETABLES ALL OF THESE HABITS WILL MAKE YOU FEEL BETTER

12. OTHER CAUSES? Out of balance gut flora Stress, emotional issues Irritable bowel syndrome Crohn’s Disease Colitis Chronic Fatigue Syndrome Lyme disease Fibromyalgia Poor diet Poor sleep

13. DIET CONCERNS Regular flour is enriched with vitamins Whole wheat is a good source of fiber Glutenous grains contain protein, iron & calcium GF flour is primarily white rice flour Low in fiber, vitamins, minerals & protein Higher calorie foods Short article in New York Times - "Before Going Gluten- Free - Make Sure It's Necessary" Short article in New York Times - "Before Going Gluten- Free - Make Sure It's Necessary"

14. JUST GO GLUTEN FREE? It’s expensive Uncertainty about real issue Can mask other physical or emotional issues Rise in orthorexia – preoccupation with “healthy” foods Interferes with social life & enjoyment of food

15. IS GLUTEN FREE HEALTHIER? YES Brown rice, quinoa, sweet potato, butternut squash Plain fruits and vegetables Meats, fish & poultry that are not breaded or fried Simple nuts & seeds NO GF cookies, cakes, breads, crackers, pretzels Made with rice flour – less fiber and nutrients Often higher in sugar and fat to improve flavor & texture Usually higher in calories

16. STOMACH ENZYMES ADAPT If you stop eating a food for a long time, you body will make less of the enzymes needed to digest that food. Gives a “false positive” for intolerance when you start eating that food again. nih.gov/ PubMed

17. WHAT IF …………? If you suspect you may have celiac disease or be gluten intolerant…. It is very important that you KEEP EATING gluten containing foods. A simple blood test can give your doctor important information, but only if you are still consuming gluten.

18. TALK TO YOUR DOCTOR IT’S THE BEST PLACE TO START

19. QUESTIONS? kegan@holycross.edu to request copy of this presentation. Thank you!