Celiac Disease and Gluten Free Diets

Written by: Tracy Pritchard (MS, CNS, LDN)

September 13 is National Celiac Disease Awareness Day. This day is named after Dr Samuel Gee (born September 13, 1839) who was the first researcher to link celiac disease to the diet. It wasn’t until 1952 when scientists in England linked celiac disease with gluten specifically for the first time. Prior to this discovery, Aretaeus (a Greek physician) gave a description of this disease in AD100 calling it “koiliakos,” an abdominal infection. Bringing awareness to this condition is so important because many cases go undiagnosed in the United States. Researchers estimate that up to 83% of Americans with celiac disease are undiagnosed or misdiagnosed with other conditions.

Celiac disease is diagnosed through a combination of blood tests and an intestinal biopsy. Most people with celiac disease will have certain antibodies in their blood, but the test is only reliable if gluten has been regularly eaten. This can be a challenge for those who already gave up gluten and feel better, and have to weigh the pros and cons of reintroducing gluten for several weeks in order to get an accurate diagnosis.

Celiac disease is a chronic genetically based autoimmune disease where gluten triggers antibodies to attack the villi of the small intestine. It effects approximately three million Americans, or about 1% of the population. Over time these exposures damage the lining of the small intestine. This often leads to the malabsorption of nutrients resulting in anemia, fatigue, bone/joint pain, headaches, low vitamin D and vitamin B12, osteoporosis, and others. Celiac disease has been called “an invisible illness” due to the major impact it has on health. People with celiac disease have reported sacrificing major life events because of their dietary requirements, social anxiety and isolation, and symptoms of depression and brain fog. 

Approximately thirty eight percent of the population carries genes for celiac disease but only a small percentage develop it. The most common age to be diagnosed is age forty to sixty. It may  seem confusing why “all of a sudden” someone can no longer consume gluten without feeling ill. Sometimes it becomes active after surgery, pregnancy, childbirth and may be triggered by a viral infection or severe emotional stress. 

There are many people who complain that they do not feel well after consuming gluten who do not have celiac disease. This sensitivity has been called Non-Celiac Gluten Sensitivity (NCGS) and must be differentiated from celiac disease. People with NCGS may complain of bloating and diarrhea after consuming gluten, but they do not experience the compromised immune system of those with celiac disease. NCGS typically does not have the same negative impact on health like celiac disease; someone with NCGS may find some relief and symptom improvement simply by reducing gluten intake. Many are unaware that celiac disease can cause symptoms in parts of the body other than digestive system. Symptoms can vary from person to person, and some may not experience symptoms while gluten is damaging their small intestine. Symptoms other than digestive symptoms may include unintentional weight loss, skin symptoms, nervous system symptoms, and variety of other seemingly unconnected symptoms such as delayed puberty and infertility. 

We all know someone who has tried a gluten free diet, yet many misunderstand why those with celiac disease can’t consume any gluten, a protein found in wheat, rye, oats, and barley. Celiac disease is different than a food allergy such as a wheat or peanut allergy when the immune system overreacts to a specific protein in a food resulting in symptoms such as itching, hives, or even anaphylaxis. (Those with celiac disease do not get anaphylaxis). While both those with celiac disease or a food allergy need to avoid certain ingredients, that is the only thing they share in common. Celiac disease and wheat allergy are very different conditions with different health effects and treatments. Those with celiac disease need to completely avoid gluten for their entire life – even a crumb of gluten will produce symptoms that can last for hours or days. 

 “Gluten free” products seem to be everywhere these days; they are often higher in refined carbohydrates and sugars and are not always a better choice for those without celiac disease. It is important to understand that gluten free does not mean “grain free” or “healthy”. There are many gluten-containing whole grains that are suitable for those without celiac disease. There are also many inherently gluten-free whole grains that can be part of a healthy diet. It is important to learn how to read labels for gluten containing ingredients since they can go by many names. 

Gluten containing: barley, bulgur, cereal (whole wheat), couscous, crackers (rye), kamut, spelt

Gluten free: amaranth, buckwheat, grits (corn/soy), millet, oats (GF), quinoa, rice (basmati, black, brown, purple, red, wild, white), sorghum, teff

There are many common foods that contain gluten. These include baked goods such as cookies and muffins, beer, bread, cereal, crackers, flour tortillas, granola, pancakes pasta, and pastries such as pies and rolls. It has become easier to find gluten free pastas made from lentils or chick peas that include fiber and protein rather than just carbohydrates associated with traditional gluten-free pasta made with corn and rice. You can also find gluten free tortillas that do not contain glutenous flour – these are typically made with almond flour, rice flour, corn, or a gluten-free flour.

Challenge: 

• If you know someone who has celiac disease, consider hosting a gluten-free bake off. This is a tasty way to learn about safe food options. They will undoubtedly be grateful for the opportunity to participate in this event. Other friends who choose to avoid gluten for other reasons will also appreciate this! 

• When contributing food to a pot luck consider a gluten free version and label it accordingly so those with celiac disease know it is safe for them to eat.

Extra Resources:

National Celiac Association: https://nationalceliac.org/

Celiac Disease Foundation: https://eat-gluten-free.celiac.org/recipes/

Beyond Celiac: https://www.beyondceliac.org/

University of Chicago Celiac Disease Center: https://www.uchicagomedicine.org/conditions-services/gastroenterology/celiac-disease

“We’ve Got Your 6” - Years in the Making

Written by: Jennifer Voorhaar, LCSW-C

September 1, 2018, I opened the doors to Hope and Healing with a plan to offer therapeutic services to the community knowing that healing and overall health and wellness was the goal. I knew that I didn’t have all of the answers and I knew that traditional “talk therapy” wasn’t the only tool. What I didn’t know was what the next months and ultimately years would bring. 

When my team and I started preparing for this year’s anniversary, we wanted to focus on health, wellness and celebrating our community. It seemed only fitting to share the sentiment with our community that the pilots from WWI shared, which was, “I’ve got your 6” ie: “I’ve got your back”.  With that came the six elements of wellness that I’d like to touch on today. If you haven’t already, I’d invite you to listen to The WingSpace Podcast for a short 6 episode series related to each of these components. I could go on for pages and pages about each of these components below. Instead, I’d like to share with you what Hope and Healing offers to our community to help support each area of wellness. 

The 6 Components of Wellness (as defined by University of New Hampshire) are:

Emotional

“Being kind to yourself as you recognize and experience a wide range of emotions”

Social

“Building and engaging in trusting, respectful, and authentic relationships”

Intellectual

“allowing your brain both stimulation and rest for critical thinking, curiosity and creativity.”

Occupational/Financial

“Pursuing a career path(s) that supports your goals, professional growth, and success” and “being able to meet basic needs and manage money for short and long term goals”

Spiritual

“connecting to your inner and outer worlds to support you in living your values and purpose.”

Physical 

“Knowing your body and giving it what it needs for health, healing, and energy”

The first one on this list is pretty clear, right? When you think about mental health therapy, addressing emotional needs is a given for most of us. But now that you see the list, could you consider how Hope and Healing could work with you on your journey to healing, health and wellness in all of these areas? Let me paint a picture for you:

You find yourself in a crossroads with choices to make, mixed emotions and jumbled up thoughts. So, you engage in mental health talk therapy with a provider, at Hope and Healing, or anywhere really as long as you’re doing the work. And, the therapist begins to ask questions, seek clarification, find missing puzzle pieces and help you form alternative solutions to your problems. As you talk you address:

Emotions

Identifying, expressing and managing emotions, learning the power of no, finding contentment in life, developing coping skills for stress management and relaxation

Relationships

Explore relationship patterns, consider dysfunction and establish healthy relationships, explore hobbies and interests and learn healthy communication

Thoughts

Learn that our thoughts following and event lead to our emotions and our behaviors, consider how to retrain your brain, thinking, processing and problem solving

Safety and Security

Consider how we provide for yourself and your family, find meaning in the work you are doing, establish safe and stable habits, explore future goals and dreams

Spirituality 

Use your faith and spiritual practices as tools for healing, explore spirituality, purpose and meaning for your life and future

Physical

Explore how you feed, fuel, move and rest your body, consider the connection between physical wellness and emotional wellness

And as we grow into our 7th year, we are constantly looking at how we can address each aspect of wellness for overall health. Not only do we have mental health therapy services at Hope and Healing, we also have massage, yoga, fitness, aromatherapy and pelvic floor physical therapy, all of which address various aspects of wellness in their own way. 

I’d invite you to consider where you can join the Hope and Healing community. I’m all about mental health therapy for everyone but maybe you start by checking out our class offerings, following along on social media for free content, tricks and tips or even stopping in to check out our retail area which includes Aromatherapy products by Essential Blends, LLC, shirts, journals, fun and funky mental health stickers, tumblers and more! 

We’ve been here for 6 and would be honored to be here for many, many more to provide health, wellness and a sense of community because as always, “we’ve got your 6”.

Fueling for School: Balancing Nutrition And A New School Year

Written By: Tracy Pritchard (MS, CNS, LDN)

For most of us the new school year is right around the corner; or, depending on your location, you are already back to school. Instead of packing the pool bag with towels and snacks, it’s time to start thinking about schedules that may include school, sports, appointments and a variety of other commitments. Often times meal planning and preparation is reserved for dinnertime (which can be challenging itself!), but what about breakfast and lunch? And what about dinners when schedules are packed full of sports and other activities? 

We know many kids say they “aren’t hungry” early in the mornings or claim they just “don’t have time” for breakfast. School mornings are often rushed leaving kids to grab a bowl of cold cereal if any food at all! A majority of cereals are full of added sugars and don’t provide the fuel and nutrition needed for a full day of learning and activities. Kids need energy and brain power to get through the day. Research has shown that kids who eat breakfast are more like to have better concentration, creativity, and school attendance than those who do not. After skipping breakfast or eating a breakfast that contains as much sugar as a dessert, it’s no wonder some kids feel sluggish or tired and have a hard time focusing. Once at school, students also need to navigate lunch and snacks to stay fueled for the school day. 

Following are some nutritional tips to help your child do their best in school:

Simple – The new school year brings a lot of new things and unknowns. Food should be easy to eat and enjoy. If you like to make things from scratch try making a batch of your own muffins that you can freeze – this is an easy way to incorporate more fruits and vegetables and can be incorporated into a meal or snack. Examples include carrot, zucchini, banana, or pumpkin muffins. To keep the preparatory work from becoming monotonous, there are several shortcuts you will want to consider. These shortcuts may include options such as: frozen (protein) toaster waffles, boxed protein shakes or drinkable yogurts, precooked/peeled hardboiled eggs, and pre-cut fruit. Allocating just 5-10 minutes in the morning for a quick breakfast can set a student up for the rest of the day.  

Variety – A balanced meal contains some protein, carbohydrates/fiber, and fat. Kids may enjoy a rotation of snacks in the form of fruits, vegetables, nuts/seeds, and different proteins (animal proteins, beans/legumes, cheese, or yogurt). Try a mix and match option for your kids. First, setup a lunchbox station in the pantry and one in the refrigerator or freezer for perishable items. Then have your kids choose one thing from each category to create their own lunchbox. The categories might look like this:

1. Fruit, 

2. Veggie, 

3. Protein (meats, cheese, nut butter, yogurt), 

4. Grain (bread, pasta, rice, whole grain cracker) 

In addition to the variety found in those categories, variety may also be found in sandwiches. Just the different choices of bread can provide enough variety to keep this option an enduring food choice. Try different rolls, pita bread, flat bread/wraps, bagels, whole grain English muffins, or corn tortillas. Next consider varying the fillings which may include nut butter (look for natural versions where the ingredients are nuts and salt or just nuts), cheese (try different types and combinations), tuna, egg, bean spreads such as hummus, or some grated carrot, lettuce, and avocado. When packing for the school day, consider foods that are still appealing after several hours of storage in a lunch box.

Meal Prep - You do not need to spend a lot of time each day making lunches, rather choose one day to prep for the week. Use this time to wash and chop vegetables, portion dips, batch cook some chicken or eggs, etc. Then have your kids choose one thing from each category to create their own lunchbox. 

Leftovers – When planning dinners for the week, consider making extra so they can be used for lunches the next day. Too often kids skip lunch or consume ultra-processed foods that lack nutrients and call it “lunch”.  If you bake chicken for dinner one day, you can use it to make a chicken wrap for lunch the next day. 

Snacks – Packing nutritious snacks may help make busy schedules more manageable. Pick snacks that provide long-lasting energy over ultra-processed foods full of sugar and/or food colorings. Snacks may include whole fruits, string cheese, store- bought or homemade trail mix.  Some students bring a snack for a designated time during the school day, while others may also need extra snacks if they go straight to afterschool sports or activities. 

Feedback – When your kids come home ask them what worked well and what didn’t work well. Sometimes there is a taste/texture preference, other times kids may have trouble with packaging or consuming foods during the allotted time. For example, you may find that your child is more likely to eat an apple if it is sliced, but a whole apple always comes back untouched. Some foods may be too “messy” to deal with at school, while others foods are easy to pack. Prepare for some trial and error especially when trying new things. 

Drinks – Be sure to pack a water bottle to stay hydrated throughout the day. Consider using a water bottle your child is excited to use during the day. Some kids prefer water bottles with straws, while other kids may be more concerned about a water bottle that fits well in their backpack and is easy for them to refill on their own. 

Right when it seems like you have a handle on breakfast and lunch with all the tips provided, we also need to have a plan for dinners, too! Try to map out your meals for the week ahead. This requires looking at the activity schedule and being realistic about meals needed for the week. Some days may require “quick dinners” like chicken and rice or perhaps eating out. It may be easier to find a meal prep pattern and do some cooking over the weekend to relieve stress during the week. This would require time set aside to choose recipes, make a grocery list, pick a time to go shopping, and time to actually make and store the meals for the week. You can always use some time-saving hacks and choose recipes that save both time and energy in the kitchen by picking recipes with minimal ingredients, hands-off cooking methods (crockpot or sheet pan baking), and easy clean up. 

Now’s the time to consider which of these things you can incorporate into your routine. Remember to get your family involved as much as possible in the planning and preparation.