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Gluten-Free Diet

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Gluten-Free Diet. Who Needs it? Presented by: Nelda W. Malm , M.S. Ed.D . Registered Dietitian. Lots of Questions!. Who needs this diet? Who doesn’t? How do I know if I need this restriction? Is it fad or fact? What are the pros and cons? Does it work if I don’t need it? - PowerPoint PPT Presentation
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GLUTEN-FREE DIET Who Needs it? Presented by: Nelda W. Malm, M.S. Ed.D. Registered Dietitian
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Gluten-Free DietWho Needs it?

Presented by:Nelda W. Malm, M.S. Ed.D.Registered DietitianGluten Free Eating: Who needs this diet? Who doesn't? How do I know if I need this restriction? Is it a fad or fact? What are the pros and cons? Does it work if I don't need it? What are the risks? How do I plan such a diet? Will my cooking and eating out change? Where do I get the products?

1Lots of Questions!Who needs this diet? Who doesnt?How do I know if I need this restriction?Is it fad or fact?What are the pros and cons?Does it work if I dont need it?What are the risks?How do I plan such a diet?Will my cooking and eating out change?Where do I get the products?What do you know about Gluten-Free diets?Why are you here?Just 10 years ago, barely anyone knew what the word gluten meant, let alone gave any through to avoiding it. But now gluten-free-diet menus are all of the rage. High profile stars have been linked to the gluten-free lifestyle, which is said to contribute to increased energy, thinner thighs, and reduced belly bloat. Many celebrities like Lady Gaga, Kim Kardashian, and Miley Cyrus have decided to quit. Even Chelsea Clinton had a gluten free wedding cake in her super-secret wedding.

3What Chelsea Clintons Cake might have looked like

A protein found in the grains:WheatRyeBarley

What is Gluten?Actually a group of proteins and not a single component, but gluten is the general term.

What is it exactly: gluten is a protein found in the grains: wheat, barley, and rye. Most of us unknowingly love it, because gluten gives our favorite foods that special touch: it makes pizza dough stretchy, gives bread its spongy texture, and is used to thicken sauces and soups.

5Why is Gluten a problem?

Why avoid it?

Who can benefit from a Gluten-Free DietWhat do you already know?7Gluten is:An additive to many foodsA preservativeA protein found naturally in certain foodsA flavoringGluten is a protein found in wheat, barley and rye. These grains are processed and used as starches and binders in many processed foods. You can also find gluten in medicines, lip balms, and vitamins chewing gum and soy sauce.8Which is a symptom of gluten intolerancePoor circulationSore throatDiarrheaRinging in the earsCommon symptoms of gluten intolerance include diarrhea, cramping, bloating, gas, constipation and anemia.Unique rash called dermatitis herpetiformis. Intensely itch rash may show up on elbows, knees and buttocks.9Eating Gluten-Free is critical if you:Want to lose weightWant to cleanse your digestive tractWant to have more energyHave celiac diseaseThe only way to live symptoms free from celiac disease or a gluten intolerance is to always avoid foods with gluten. You may lose weight by eating gluten free doesnt mean calorie free. Eating fruits and vegetables is great, but make sure youre getting all the nutrients necessary for a healthy diet.10Which Grain does not contain gluten?RyeBarleyWhatQuinoa

Quinoa is a superfood from the Andes Mountains thats gluten free and very nutritious, with high levels of protein and amino acids. It is an excellent, inexpensive alternative to grain. Quinoa may be eaten cooked like rice or couscous. It can also be ground into a flour. Some gluten-free pastas are made from quinoa flour.11You can tell which prepared foods have gluten just by looking at them.TrueFalse

There is no way to tell by looking at cooked foods whether they are gluten free unless they are plainly cooked meats, fish, or vegetables. Look out for things like breading or sauces especially cream sauces. Read the labels and ask questions. When in doubt, dont eat it.12You cant drink alcohol if youre on a gluten-free dietTrueFalseThere is no gluten in distilled spirits like wine and hard liquor. Some wine coolers and bottled mixed-liquoir drinks have ingredients with gluten. Beer is made from grains that have gluten but there are gluten free beers on the market.13Which is a good gluten-free breakfast choice?Toast with butterScrambled egg and gritsBagel and cream cheesePancakes

Grits which are made from corn are gluten free. Regular bagels and pancakes made with wheat flour are a no-no, but gluten-free mixes are available. Unless its made with gluten-free bread, toast is off the breakfast menu.14What can you use to bake gluten-free?Rye flourBrown rice flourWhole wheat flourAll of the aboveWhich department should you spend the most time in when shopping for gluten-free food?Frozen, prepared foodsSnack foodsProduceCereal

Fruits and vegetables are naturally gluten free, so fill your grocery cart with as much as you want. Most frozen, prepared meals, snack foods, and cereals contain gluten.Most supermarkets have gluten-free products like bread, cookies, cereals, and even frozen prepared foods. You may have to ask for them.16Why is Gluten a problem?

Why avoid it?

Who can benefit from a Gluten-Free DietThree types of people who may not be able to eat products containing Gluten:People with Celiac DiseasePeople with Gluten sensitivity or intolerancePeople with wheat allergyCeliac Disease

gluten-sensitive enteropathyceliac sprueAn autoimmune disorder characterized by an abnormal immune response to the dietary protein gluten. The reaction causes severe damage to the intestinal mucosa and subsequent malabsorption. One problem, people arent always aware that they have celiac disease. In fact, a study published last year in the American Journal of Gastroenterology found that almost 80% of people with celiac disease dont know they have it. Celiac disease often has no symptoms for years and is often discovered because of the problems it creates, such as anemia or osteoporosis.

19DiarrheaSteatorrheaFlatulenceAbdominal pain and bloating, acid refluxUnexplained weight loss

AnemiaFatigueInfertilityEczemaJoint pain or achesLactose Intolerance

Symptoms of Celiac Disease:In the healthy intestine, the villi greatly increase the absorptive surface area.

In the healthy intestine, the villi greatly increase the absorptive surface area.

21In celiac disease, the villi may be shortened or absent, resulting in substantial reductions in nutrient absorption.

Prevalence of celiac disease in the U.s.

Experts once thought celiac disease was a rare disorder believed to affect one in every 10,000 people. But current data suggests that it affects 1 in 133 Americans. With increased testing and awareness, more people realized why they felt sick after eating a piece of bread, and food companies discovered a new market.Sales of gluten free products is a $6 billion/year industry.45,000 gluten-free products

24Gluten Sensitivity orIntolerance

Non-celiac-related sensitivity to glutenNow another problem is emerging and experts are referring to it as non-celiac gluten sensitivity. Gluten sensitivity can lead to similar celiac symptoms such as stomach cramps, diarrhea, and bloating. But unlike celiac, sensitivity doesnt damage the intestine. For years, health professionals didnt believe non-celiac gluten sensitivity existed, but experts are beginning to acknowledge that it may affect as many as 20 million Americans.

25Symptoms:Digestive symptoms: bloating, gas, IBS, acid reflux, diarrhea, constipationSkin: eczema or acneSkeletal: joint pain or achesBrain fog, migraines, headachesDepression, anxietyOngoing FatigueSomething is going on in the body that triggers these symptoms but you dont see damage to the intestine. Theres a lot of research going on now in this area but we dont jet know if there are any long-term consequences.26Wheat AllergyExperience Symptoms within a few minutes or hours of eating something with wheat

Symptoms Include:Swelling, itching or irritation of the mouth or throatHives, itchy rash or swelling of the skinNasal congestionItchy, watery eyesDifficulty breathingCramps, nausea, or vomitingDiarrheaAnaphylaxis

28Should you Go Gluten-Free

??Should you go gluten free?If you have celiac disease or gluten sensitivity, the answer is easy: Yes, you have to. But if you just want to give the diet a spin, know this: Its a giant pain in the butt. Giving up gluten may sound as basic as cutting out bread or eating less pasta, but this isnt just another version of the low-carb craze. Because gluten makes foods thick and tasty, it is added to everything from salad dressing to soy sauce to seasonings.29The Health Hype

Thanks to the increase in diagnosed celiac and gluten sensitivity cases, and the corresponding uptick in foods marketed to sufferers, gluten-free-diets have emerged from obscurity, and now the pendulum has swung completely in the other direction. With this popularity push, people have latched on to avoiding gluten as a cure-all for many conditions aside from celiac, including migraines, fibromyalgia, and chronic fatigue syndrome. While some have found relief, that doesnt mean a gluten-free diet will work in all cases.30Is it a speedy ticket to weight loss?

And then theres the idea that a gluten-free existence is the ticket to speedy weight loss. However, theres nothing magical about a gluten-free diet thats going to help you lose weight. Whats really at work: Gluten-free dining can seriously limit the number of foods you can eat. With fewer choices, youre a lot less likely to overeat. You cannot expect to lose weight with a gluten-free diet, unless it contains a lot of natural foods and lacks junk foods.

But it can back-fire too, because gluten-free doesnt mean fat-free or calorie-free.

Without gluten to bind food together, food manufacturers often use more fat and sugar to make the product more palatable. Consider pretzels: a serving of regular pretzels has about 110 calories and just one gram of fat. Swap them for gluten-free pretzels and you could get 140 calories and 6 grams of fat.

31Some Problems:Besides the hassle, you could end up with serious nutritional deficienciesGluten-free doesnt necessarily equal healthyNo grains means missed nutrientsGluten Red Flags

People on a gluten-free diet need a sharp eye for labels. Some ingredient red flags are obvious, like wheat, wheat gluten, barley, or rye. But some foods have stealth gluten. Two terms to watch for are: malt (made from barley) and hydrolyzed vegetable protein. While oats do not contain gluten, they may also increase symptoms, including abdominal pain, bloating and diarrhea.33Bouillon cubesCandy dusted with wheat flourCanned soupsCheese spreadsChocolate malt flavoringCold cuts, hotdogs, sausagesDip mixesDry sauce mixesDry roasted nuts & honey roasted nutsFrench fries or other fried foods in restaurantsGraviesPlaydough

Honey baked hamsSome ice creams and frozen yogurtsInstant teas and coffeesLip balms and lipsticksMayonnaiseSour creamSome toothpastesSoy sauceMalt, malt flavoring, malt vinegarDietary supplements including vitaminsCommunion wafersImitation bacon and seafoodItems that commonly contain hidden glutenSay Bye-Bye to BreadMostly

Perhaps the most difficult step in a gluten-free diet is bidding farewell to bread as you know it that includes white, wheat, marble, and rye. Also off limits are bagels, muffins, croissants, hamburger buns, scones you get the idea. Yes, even pizza. But dont despair. There are alternatives.35You Have Gluten-Free Bread Choices

Many health food stores and some major supermarkets now carry gluten-free products, including an assortment of breads. These are often made with rice or potato flour instead of wheat products. Just check the label ot make sure it says 100% gluten-free).36Lots of Cereals Have Gluten

Traditional breakfast cereals are another casualty for people on a gluten-free diet. Cream of wheat is obviously out, but so are many other favorites. Cheerios contains wheat starch while frosted corn flakes use malt flavoring. Read the list of ingredients and avoid any cereal containing wheat barley, rye or malt.37Enjoy Corn and Rice Cereals

Corn and rice-based cereals are good breakfast alternatives. Read carefully malt, texturized vegetable protein. Check the label.38Arrivederci, Pasta?

No matter the shape or name, most pasta is made out of wheat. So youll need to avoid spaghetti, macaroni, shells, and spirals when youre on a gluten-free diet. Except..39Dig in to Rice and Potatoes?

Say hello to rice and potatoes. Is there a problem with what you see here?40Most Crackers are Made of Wheat

Check out the ingredients label. Your mission? Find an alternative venue for your favorite cheeses. Be careful with the processed cheese foods.41Rev up munchies With Rice Cakes

Rice cakes can be the host for all sorts of spreads and dips. What about popcorn?42Beware of Breaded Foods

Check the ingredients, but the crunchy coating on most chicken nuggets and fish sticks is generally made from wheat flour.43Who Misses the Breading?

However, you dont need to hide the succulent charms of fresh chicken, fish, and beef under a bunch of bread. Go for lean meat without any additives and youll be eating right for a gluten-free diet. Do keep in mind that hot dogs and deli meats are processed, so check the ingredients for additives that might contain gluten.44Avoid Most Cookies and Cakes

While a gluten-free diet wont contain most traditional cakes, pies, cookies and other celebratory treats, there are still lots of ways to satisfy your sweet tooth.45Enjoy Sweet and Chewy Treats

Marshmallows, gumdrops, plain hard candies usually gluten free. Check with the bakery and perhaps order custom gluten-free cakes, pies and other treats.46Beer Contains Gluten Who Knew?

Unfortunately for fans of the six-pack, most beers are made with barley malt. There are some gluten-free beers on the market.47Cheers! You Can Still Raise a Glass

Wine and liquors are generally gluten-free, so you can still raise a glass and raise a toast, no matter what the occasion.48Theres So much More to Enjoy

Along with wine, potatoes, and rice there are so many delicious foods to enjoy on a gluten-free diet. However, on frozen or canned fruits and vegetables, check for additives that might contain gluten. Same goes for processed cheese spreads and flavored yogurts.49When Dining Out, Talk it Out

One of the biggest challenges in maintaining a gluten-free diet is decoding a restaurant menu. Dont be shy, Talk with your server or the chef and explain your dietary needs theyre there to satisfy you.50One ingredient foods:Fruits and vegetables

Meats, fish, chicken

Legumes, rice, corn

wineGluten-free products:Compare with regular product

Higher in sugar, calories, and salt

Read, read, readWhat Can I eat?51Disadvantages:Missing nutrientsHasselNot necessarily a weight loss dietNo proof that gluten-free helps with any other conditionsCan be expensive

PorkModerate amounts in all nutritious foods

Non-Grain Sources of Thiamin

Milk ProductsLiver

Non-Grain Sources of Riboflavin:

Protein-rich foods (milk, eggs, poultry, fish, nuts)

Non-Grain Sources of Niacin:

Leafy green vegetablesLegumesSeedsLiverOrange juice

Non-Grain Sources of Folate:

Non-Grain Sources of FiberHow much do we need?25 grams

Average American gets: 10

Why do we need it?Heart healthDiabetesGI healthCancerWeight management58Vegetables

Fruits

Fresh, frozen, and dried fruits have about 2 g of fiber perserving: 1 medium apple, b60Legumes

Many Legumes provide about 6-8 grams of fiber per serving: cup cooked baked beans, black beans, black-eyed peas, kidney beans, navy beans, pinto beansSome legumes provide about 5 g of fiber per c. serving: garbanzo beans, great northern beans, lentils, lima beans, split peas61Great things about a gluten free dietYou may feel betterYou may be more aware of our bodiesYou may eat very few processed foodsYou may eat a lot more whole foodsYour food horizons will broadenYou may become a better cookYou may gain confidence

62One More GrainReputable, Science-based websites:

www.mayoclinic.comwww.webmd.comwww.eatright.orgwww.glutenfree-diet.orgwww.familydoctor.org

Chart10.412.514.510.57

Percent

Sheet1PercentAfrican, Hispanic, & Asian Americans0.41People with 2nd Degree relative2.51People with 1st degree relative4.51Average population0.57To resize chart data range, drag lower right corner of range.


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