diet for celiac disease

...is to give people with food allergies and celiac disease more options to enjoy the culinary riches of the world, and ensure that their traveling and dining experiences are safer. To this end, the system was developed in a way such that all users can review and rate all establishments, quickly correct and update information and be alerted of changes. Still, it would be impossible for us to make sure that all information posted will be accurate all the time. We therefore urge you to always verify all information and inform any establishment about your dietary requirements. Also, meals can be prepared in different ways, restaurant staff and food suppliers can change, so the report of a positive experience by someone with the same dietary restriction at a particular place does not necessarily mean that you can dine safely at that place without taking some precautions. Here is a list with some tips which we believe should always be followed to ensure a safe dinning experience.

1. Plan ahead and check the menu in advance. Many restaurants now have their menus online, and some even have separate gluten-free and allergen-free menus. Checking the menu before can ensure you will have good and safe dining options, as well as facilitate the communication with the chef and restaurant staff.

2. Call in advance, preferentially not in busy hours. If possible, try to talk to the chef and explain your condition thoroughly. Calling in advance will enable you to detail the specificities of your needs, the necessary measures to prevent cross-contamination and therefore to know whether the restaurant can safely accommodate a meal for you. Also, some components that go into the dishes are prepared in advance, so calling ahead will give the restaurant time to better accommodate your needs and ensure that everything is prepared for you following a safe procedure (something which might be impossible during busy hours).

3. Avoid the peak hours. Eating a bit earlier than usual means staff will be able to pay more attention to your needs.

4. Always remind the staff about your dietary needs, even if you called in advance. Explain your restrictions politely and in detail, and make sure the waiters/waitresses know how serious your dietary needs are. Do not forget to mention the possibility of cross-contamination through kitchen utensils, surfaces, grills and frying oil and the need to check ingredient labels. If you are not sure that they understand the importance of being extra-careful, it is better to eat somewhere else.

5. Know what to avoid. You should always know other names for the food item that you cannot eat, and where it might be hidden. To this end, be familiar with the hidden sources of the offending food, read the menu carefully, and remember that not all ingredients of a dish are listed in the menu, so it is essential to ask the staff to check with the chef (or preferentially talk to the chef personally) if any ingredient containing the offending food may have been used. For example, if you cannot eat gluten be extra careful about sauces (wheat is usually used for thickening), processed food may have hidden proteins derived from egg, milk and soy, and if you are allergic to seafood/fish be extra careful about Chinese, Thai and Vietnamese food (they can contain oyster sauce and fish sauce). Asian dishes, pesto as well as desserts are usually also dangerous for people with peanut and tree nuts allergies. At the end of this list there are links to sites that provide information on hidden sources of the most common food allergens.

6. Take a chef card with you. Kitchens are busy and noisy environments, so the information about your food allergy may not be transferred with accuracy to the chef and the kitchen staff. Remember that there are many details that are important, many potential sources of the offending food and many procedures to follow to ensure that your meal is safely prepared, and it might be too difficult for a waiter/waitress to memorize all that information. One way to ensure that the kitchen staff and chef are aware of all the details of your food needs is to use a chef card, which is a personalized card on which you can write down your dietary needs, hidden sources of the offending food and suggest procedures to avoid cross-contamination. We have prepared a number of chef cards which you can customize to your needs and print. To view, choose and download the cards, click here.

7. Try to ask simple dishes, instead of dishes containing many ingredients, condiments and sauces.

8. Avoid buffets, self-service areas and sweet trolleys. Although there might be dishes that do not contain the food you cannot eat, it is easy for the wrong food to spread from one container to another (for example if people use the same spoons for different dishes).

9. Always take your allergy medications with you if you have a food allergy, .

10. Always acknowledge good service and thank the restaurant staff for the extra effort in accommodating your needs.

Below is a list of sites that give information on the most common hidden sources of the main food allergens.

INFORMATION ON HIDDEN SOURCES OF COMMON FOOD ALLERGIES

IN ENGLISH

1. PDF Brochures from Health Canada
2. Common Food Allergens (The Food Allergy and Anaphylaxis Network)
3. Food Allergy Information (the Food Allergy Initiative)
IN SPANISH

1. Alérgenos (Food Allergy and Anaphylaxis Network)
2. Asociación Española de Alérgicos a Alimentos
IN FRENCH

1. Sources possibles (Agence canadienne d'inspection des aliments)
IN ITALIAN

1. Alimenti pericolosi (Food Allergy Italia)
INFORMATION ON HIDDEN SOURCES OF GLUTEN

IN ENGLISH

1. Celiac Disease Survival Guide (National Foundation for Celiac Awareness)
IN ITALIAN

1. Il Prontuario In Internet (Associazione Italiana Celiachia)
IN FRENCH

1. Produits génériques Autorisés / interdits (l'Association Française Des Intolérants Au Gluten)
IN PORTUGUESE

1. Manual do Celíaco (Acelbra, RJ)
IN SPANISH

1. Guía de Alimentos e Medicamentos (ACELA, Argentina)
2. Alimentos que pueden contener glúten (FACE, España)
IN GERMAN

1. Verstecktes Gluten (Deutsche Zoliakie-Gesellschaft e.V.)

Celiac disease is treated by avoiding all foods that contain gluten. Gluten is what causes inflammation in the small bowel. When this is removed from the diet, the bowel will heal and return to normal. Medications are not normally required to treat CD except in occasional patients who do not respond to a gluten free diet.

Gluten-free diet:
The following grains contain Gluten and are
NOT ALLOWED IN ANY FORM:
Wheat, rye, barley, kamut, einkorn, spelt and triticale
Frequently overlooked foods that often contain gluten
Breading
Imitation bacon
Broth
Imitation seafood
Coating mixes
Marinades
Communion wafers
Processed meats
Croutons
Sauces
Pastas
Stuffings
The key to understanding the gluten-free diet is to become a good ingredient label reader. If a food has questionable ingredients avoid it and find a similar product that you know is gluten-free. Foods containing the following ingredients are questionable and should not be consumed unless it is verified that they do not contain or are not derived from prohibited grains; these products are:
Unidentified:
Modified food starch Hydrolyzed vegetable protein (HVP) Hydrolyzed plant protein (HPP) Malt vinegar Soy sauce or soy sauce solids Brown rice syrup Dextrin Textured vegetable protein (TVP) Vegetable .

Be aware that medications may contain gluten ingredients. Gluten containing fillers may be in both prescription and over the counter medications. It is essential to ensure that any medications being taken are gluten free.
ALLOWED
Rice, corn, soy, potato, tapioca, bean, sorghum, quinoa, millet, buckwheat, tef and nut flours

Once a diagnosis of CD is established, these individuals need to remain on the gluten-free diet for the rest of their lives. While this may be difficult at first, patients usually adapt quite well over time.

Is there any other way of treating Celiac Disease?
No. There is no other treatment currently available. All patients with CD must remain on a strict gluten-free diet. Medications are not normally required. Supplemental vitamins, calcium and magnesium may sometimes be recommended but patients are advised to check with their physician about these supplements. Rarely steroids or other drugs are used to suppress the immune system but only in the most severe of cases.
What will happen if you don't adhere to the gluten-free diet?
Patients with CD who do not adhere to the gluten-free diet usually continue to suffer from symptoms such as abdominal pain, bloating, gas and diarrhea. In addition, these patients are at higher risk for developing complications of CD such as cancer of the small bowel and narrowings in the bowel due to inflammation.
What are other complications of Celiac Disease?
Other complications of CD that may be avoided by strictly following a gluten-free diet include tiredness, poor growth, decreased adult height, osteoporosis, bone pain, joint pain, difficulty having children, narrowing of the intestine, cancer of the esophagus (food tube) and small bowel, lymphoma (another type of cancer) and neuropathy (unsteady walking and confusion which may be severe).
© The American College of Gastroenterology
6400 Goldsboro Rd., Suite 450, Bethesda, MD 20817
Internet: www.acg.gi.org
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More information on Celiac Disease?
http://www.celiac.org/ http://www.csaceliacs.org/
http://clinicaltrials.gov/ct/gui/action/FindCondition?ui=D002446&recruiting=true http://www.naspgn.org http://www.med.utah.edu/pated/handouts/handout.cfm?id=874 http://www.celiac.com/cgi-bin/webc.cgi/st_main.html?p_catid=21 http://www.celiac.com/cgi-bin/webc.cgi/st_main.html?p_catid=16 http://www.causeyourespecial.com/aboutus.html http://www.allrecipes.com/directory/586.asp http://www.celiac.com

Asparagus Frittata Recipe
Heart Healthy Recipe Gluten Free Recipe
Frittata is an Italian version of an omelette. This easy asparagus cheese frittata is perfect for brunch or lunch. Pair it with a salad for a delicious low fat, low carb meal.
Ingredients
%u20221 1/2 lb asparagus, trimmed
%u20222 1/2 cups nonfat cottage cheese
%u20221 green onion, coarsely chopped
%u20221/2 cup chopped parsley
%u20221 egg
%u20223 egg whites
%u20221 tsp Dijon mustard
%u20222 oz part-skim mozzarella cheese
%u20221 1/2 tsp grated Parmesan cheese
Preparation

Preheat oven to 350°. Lightly coat a 10-inch quiche pan with nonstick cooking spray. In a steamer, steam asparagus until just tender, about 5 minutes. Remove from steamer and allow to cool. Reserve asparagus tips; chop remainder. In a blender or food processor, purée cottage cheese, green onion, parsley, egg, egg whites, mustard and mozzarella. Fold in chopped asparagus.
Pour mixture into prepared quiche pan. Arrange reserved asparagus tips on top. Sprinkle with Parmesan cheese. Bake for 35 minutes, or until set.

... first adult center with a multidisciplinary approach to celiac disease. Specialists of the Jefferson Celiac Center have a long history of excellence in the diagnosis and management of celiac disease as well as extensive experience in helping patients manage this lifelong condition. Our mission is to:

%u2022Improve diagnosis and management of celiac disease and associated conditions by centering your care around a core network of specialists
%u2022Advance scientific knowledge of celiac disease through extensive research and clinical trials
%u2022Educate physicians, patients and families about celiac disease
%u2022Support patient advocacy by increasing public awareness
Although it affects more than 3 million Americans, celiac disease is often misdiagnosed and misunderstood. Our team of physicians and pathologists who specialize in celiac disease and other digestive diseases will perform blood tests to determine if elevated levels of certain antibodies - that is, proteins that target the body's own cells or tissues - are present in your body. We will also take another type of blood test to check for IgA - something that occurs more commonly with celiac disease and can affect the reliability of the antibody testing.

Our Center has been among only a handful participating in the testing of promising new orally administered drugs, including medications to decrease or block the absorption of gluten. There is great promise of achieving a medication to moderate celiac disease at the cellular level.

Anthony J DiMarino, Jr., MD
Director, Celiac Center

Chair, Department of Gastroenterology