Transcript Week 9 - Celiac- Fall 13 - Resource Sites

What is Celiac Disease?

Celiac disease (CD) is a genetically linked disease
with an environmental trigger.

Eating certain types of protein fractions, commonly
called gluten, sets off an autoimmune response
that causes damage to the small intestine.

1
http://www.youtube.com/watch?v=yGm
Wf0et4hg
Celiac Sprue Association
2011
By the numbers

2
Research is telling us that 1 in every 133
people in the United States may have celiac
disease
Celiac Sprue Association
2011
What are the symptoms?…over 300

Abdominal cramping/bloating

Mouth sores or cracks in the corners

Feet (Reduced fat padding)

Back pain (Such as a result of
collapsed lumbar vertebrae)

Abdominal distention

Muscle cramping (Especially in the
hands and legs)

3
Flatus (Passing gas)

Acidosis

Constipation

Gluten ataxia

Night blindness

Decreased ability to clot blood
Celiac Sprue Association
2011
What are the Symptoms…
4

Skin (Very dry)

Tooth enamel defects

Dehydration

Electrolyte depletion

Stools (Loose? Hard? Small? Large?
Foul smelling? Floating? Clay, Light
tan or Gray-colored? Highly rancid?
Frothy?)

Weakness

Energy loss

Weight loss

Fatigue

Diarrhea (See Stools below)

Nutrient Deficiencies
Celiac Sprue Association
2011
Symptoms in Children

How is the child developing?
–
–
–
Slowly
Not gaining weight
Losing weight

Older children:
–
–
–
–

Under age three:
–
–
–
–
5
–
Crankiness
Difficulty concentrating
Irritability
Personality changes
Poor memory
Growth failure
Diarrhea
Projectile vomiting
Abdominal bloating/distention
Celiac Sprue Association
2011
The Diet is the Prescription!
Gluten-Free Diet
6
Celiac Sprue Association
2011
Where is gluten found?...





7
wheat
barley
rye
oats (to a lesser extent)
(WBRO)
Celiac Sprue Association
2011
Hidden Sources of Gluten
The Three C’s – Content, Contact,
Contamination
Content - Foods













8
Contact – Other Items
Breading
Broths
Caramel coloring
Casseroles
Croutons
Flavors (artificial or natural
Foods injected with broth
Gravies
Modified food starch
Sauces
Soy sauce
Processed foods
-Cold cuts, deli foods, pre-cooked
foods, frozen foods
•
•
•
Celiac Sprue Association 2011
Manufacturing
•
Flour dust in air
•
Flour in conveyor belts
•
Flour on paper wrappers
•
Glued container seams
Business/Hobbies
•
Envelopes
•
Glue gun
•
Stamps
•
Play dough
Personal Care Items
•
Lipstick, make up
•
Lotions
•
Medications
•
Mouthwash
•
Shampoo’s/Soaps
•
Toothpaste
Cross contamination
Common scenario’s….
–
French toast?

–
Grilled hamburger/hotdog/chicken?

–
requires dedicated gf grill or gf pan, utensils, FRESH
GLOVES AND APRON
Deli sandwich?

9
need gf bread, separate egg batter, utensils, pan and/or
grill, FRESH GLOVES AND APRON
requires gf condiments, bread, cheese and meat, utensils
and prep surface, FRESH GLOVES AND APRON
Celiac Sprue Association 2011
Cross contamination
Common scenario’s…..
–
Toast?

–
Prep area?



–
Ideally have designated gf preparation area
requires fresh/new bucket of sanitizer and fresh cloth
wipe area from top to bottom
You?

10
requires dedicated toaster, single serve condiments
(butter, jelly, peanut butter)-can be portioned in back
of house from fresh product into souffle cups
fresh apron, fresh gloves every time you assist a gf
client
Celiac Sprue Association 2011
Label reading know how….
Food Allergy Labeling and Consumer Protection Act (FALCPA)
requires only top 8 allergens to be identified. Barley, rye and
oats and their derivatives are not required to be listed.
11
Celiac Sprue Association 2011
How to know if something is
Gluten-free?
The CSA Recognition Seal
< 5 parts per million of gluten
12
Gluten –Free Certification Mark
(Gluten Intolerance Group)
< 10 parts per million of gluten
Label reading know how….
A gluten-free diet means none of the following….

Wheat
–
(wheat flour, AP flour, wheat bran, wheat starch, wheat germ
and other forms of wheat:
-Durum -Emmer
-Kamut
-Triticale -Spelt
-Einkorn
-Seitan - Couscous -Faro
13
Celiac Sprue Association 2011
-Semolina
-Graham
-Bulger
What are healthy and tasty glutenfree grains?










Brown rice
Whole Corn
Millet
Teff
Sorghum
Wild Rice
Buckwheat
Amaranth
Quinoa
Gluten-Free Oats? Not
recommended till after 1 year on gluten-free diet
and then self-assessment and antibody testing
recommended
14
Label reading know how….
A gluten-free diet means none of the following….


Wheat
Barley
–


15
Barley malt extract
Rye
Oats (non-contaminated okay after 1 year if
approved by doctor)
Celiac Sprue Association 2011
Kitchen Smarts….



16
Wheat-free does not mean gluten-free
A trace of wheat, barley, rye or oats can cause
a reaction
Watch out for “malt”….made from barley
Celiac Sprue Association 2011
Kitchen Smarts

Gluten-free foods include:
–
–
–
–
–
–
17
Fresh salad (no croutons)
Fruits and vegetables
Milk
Meats, fish or poultry (no breading, no marinade)
Pure spices and herbs
Pasta and breads labeled gluten-free
Celiac Sprue Association 2011
Kitchen Smarts…GF foods to ?
Au jus
 Canned soups
 Malt flavorings
 Pre-coated foods
 Roux
 Bouillon
 French Fries

18



Pre-packaged foods
Sauces
Marinades
Celiac Sprue Association 2011
Kitchen Smarts



19
Request gluten-free listings from distributors
Check out local grocery stores for gluten-free
items – work with their dietitian
Purchase only gf condiments!
Celiac Sprue Association 2011
Kitchen Smarts for Preparation!
Separate area and items needed to avoid crosscontamination:
 Strainers
 Utensils, Parchment Paper
 Toaster Oven
 Designated Prep Area or Station
20
Celiac Sprue Association 2011
Kitchen Pantry Smarts!
Keep gf items in separate container
Keep gf items above other items
21
Celiac Sprue Association 2011
Tools: a poster for food service
employees
22
Kitchen Smarts
23

When in doubt –
leave it out!

Questions?
Celiac Sprue Association 2011
National & Local Support



Celiac Sprue Association (CSA)
PO Box 31700 Omaha, NE 68131-0700
Toll Free: 877-CSA-4CSA · Fax: 402-643-4108 ·
Email: [email protected]

24
www.csaceliacs.org
www.facebook.com/csaceliacs
www.twitter.com/csaceliacs
Celiac Sprue Association
2011