1. Recap from Nutrition Experts at 2015 CDF Conference & CDF Gluten Free & Allergy Free Marketplace Janelle Smith CDF Registered Dietitian Nutritionist May 20, 2015 12 pm PST

2. Today’s Webinar Recap the Nutrition Panel at the 2015 CDF National Conference o Shelley Case, BSc, RD – CDF Medical Advisory Board o Anne Roland Lee, EdD, RD, LD – Director of Nutritional Services, Schar USA o Yang Pan, PhD – Principal Scientist, PepsiCo Frito-Lay

3. Personal walk-through of the CDF Gluten- Free Allergy-Free Marketplace

4. Key Issues for Gluten-Free Foods: Safety & Labeling Nutritional Value Manufacturing Products

5. Safety of Grains It started with oats… Hernando et al 2008: Canada, Europe, & USA o 80% of oats were contaminated with gluten from a variety of wheat, barley, and rye Koerner et al 2011: Canada o 93.2% of oats contained from 20 ppm – 3800 ppm gluten o Doesn’t matter: organic vs conventional, Irish vs rolled

6. Koerner et al 2013: naturally GF starches & flours sold in Canada o 9.5% contaminated with >20 ppm gluten o 3 of the products labeled GF contained >20 ppm (1%) Thompson, Lee & Grace 2010: 22 grains, flours and seeds in US NOT labeled GF o 32% products contained >20 ppm gluten o Don’t rely on voluntary advisory statements: 57% of products containing > 20 ppm had no advisory statement Naturally GF Grains

7. Safety of Labels How are manufacturers doing? Sharma et al 2014 (USDA): Gluten detection in foods available in the US o Compared GF-labeled and naturally GF foods without label o 3.6% of labeled foods contained more than 5 ppm o 1.1% of labeled foods contained more than 20 ppm Foods without a GF label: o 25.8% contained >5 ppm o 19.4% contained >20 ppm o Those most likely to be >20 ppm: Contain oats Have advisory statements

8. Navigating Labels Anne Lee’s advice: o Always read ingredients, don’t assume based on labeling o Talk to quality assurance department: o “I am the head of the Smith household, in charge of procuring all ingredients. I am in need of verifying your procedures with the quality assurance department” o Not all tests for gluten are created equal – manufacturers should usually be using Sandwich R5 ELISA to include detection of barley

9. Nutritional Adequacy of Gluten-Free Diet Thompson (2005), Dickey & Kearney (2006), and Hallert, Grant, Grehn & Granno (2002) A gluten-free diet is most likely to be lacking the recommended daily values of: o Folate o Fiber o Iron o May also lack zinc and other B vitamins

10. Weight Gain Average gain is 20-25 lbs after initiating gluten-free diet Regardless of being underweight at the time of starting the diet Suspected to be due to increase in starches rather than whole grains and increase in fat content to produce texture

11. Improving Nutritional Value Beans and legumes for flours and starches Nut flours Oats, quinoa, millet, amaranth, teff, mesquite Use “whole grain” instead of “starch” whenever possible

12. Producing Gluten-Free Products Challenges to manufacturers: Changing industry standards o Ex: the recommended test to use o Cleaning and cross-contact procedures Changing definitions o FDA just recently established its definition o Clarification of the ruling still needed for: Hydrolyzed products (i.e. malt, fermented products) Alcohol Restaurants Changing ingredients o Companies that produce the ingredients must ensure they are gluten-free o Quantity of gluten-free ingredients must meet demand for large companies

13. Oatmeal Berry Bars with white bean flour Each square: 4 g protein, 3 g fiber, 28 mcg folate, 41 mg calcium 1 cup white bean flour (Bob’s Redmill) 1 cup uncontaminated rolled oats ½ cup packed dark brown sugar 1 ½ tsp xanthan gum ¾ tsp cinnamon ¼ tsp ground allspice ¼ tsp table salt ½ cup (1 stick) unsalted butter, melted 2 tsp pure vanilla extract, divided 2/3 cup berry preserves or jam Recipe from PulseCanada.com, developed by Carol Fenster and Shelley Case

14. Schar Penne Rigate with zucchini & shrimp Each serving: 5 g unsaturated fat, 16 g protein, 2 g fiber, 19% vitamin C, 13% iron 1 box Schar Multigrain Penne Rigate 1 medium zucchini ½ white onion, finely chopped ¼ cup white wine ½ small bunch chives ½ clove garlic 2-3 fresh mint leaves 2 tbsp extra-virgin olive oil ½ tbsp. red peppercorns 12 medium shrimp prawns Recipe from Schar.com

15. Dill-Encrusted Trout with whole grain medley Each serving: 13 g unsaturated fat, 18 g protein, 2% vitamin A, 3% vitamin C, 7% calcium, 12% iron 3 trout fillets 1 tbsp olive oil 2 tbsp hummus 1 tbsp fresh dill, chopped 1 tsp lemon juice ½ cup crushed Tostitos® Original Restaurant Style Tortilla Chips 1 cup wild rice 1 cup millet 1 cup quinoa Recipe from Fritolay.com

16. CDF Gluten & Allergy Free Marketplace

17. Celiac.org /Webinars Celiac.org /Ask