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Celiac disease Table of Contents Celiac Disease ............................................................................................................................................... 1 Social and Family Life.................................................................................................................................. 5 Finding Gluten .............................................................................................................................................. 5 Gluten-Free Home ........................................................................................................................................ 7 Gluten-Free Diet ........................................................................................................................................... 8 Gluten-Free Shopping ................................................................................................................................. 13 Gluten-Free Food Suppliers ........................................................................................................................ 15 Gluten-Free Outside the Home ................................................................................................................... 18 Travel .......................................................................................................................................................... 23 Celiac Support Groups ................................................................................................................................ 24 Gluten-Free Resources................................................................................................................................ 25 Gluten-Free Diet Quick Guide.................................................................................................................... 28 Gluten-Free Diet Ingredient Quick Guide .................................................................................................. 32 1 Celiac Disease Celiac disease is a type of autoimmune disease. When people with celiac disease eat gluten, their body reacts with an immune response that attacks the small intestine. The small intestine helps you absorb foods that you eat. It is between the stomach and large intestine (also known as the colon). This means that you don't absorb nutrients from food very well. Celiac disease affects 1 in 100 people worldwide. Damage Caused by Celiac Disease The small intestine is made up of small finger-like parts called "villi." These villi help absorb nutrients from your food. When you have celiac disease, eating gluten causes villi to become flat. When this happens, foods are not absorbed well. For example, in the tips of the villi is where lactose (milk sugar) from dairy products is absorbed. When your villi are damaged your body may have trouble absorbing lactose. As a result, you may not tolerate dairy products well. This may mean that you need to also follow a low lactose or lactose-free diet for a time. Gluten is a protein found mainly in wheat, barley, and rye. Many common foods like bread, pasta, cereal, soups, sauces, and more contain gluten. How Foods Are Absorbed Your small intestine's main role is to absorb nutrients from food, such as: · Iron · Calcium · B vitamins · Vitamin D · Fat, protein, carbohydrates Causes There is no known cause of celiac disease. Patients with a family history are more at risk for celiac disease. Celiac disease can occur at any age. If not treated, celiac disease can lead to other health problems. 1 Symptoms Common symptoms for children or adults include: · Diarrhea · Bloating/Gas · Low iron in the blood · Weight loss · Headaches · Changes in mood/irritability · Itchy skin rash · Canker sores inside the mouth · Constipation · Fatigue · Slowed growth in children · Joint pains · "Foggy" brain · Numbness in hands or feet · Poor focus or behavioral issues Some patients have "silent celiac disease." These patients may not have any symptoms of celiac disease. Diagnosing Celiac Disease Most often, patients need blood tests and/or a small intestine biopsy to diagnose celiac disease. Most tests require the patient to still be eating gluten. Your doctor will choose the best diagnosis method for you. If you or your child is diagnosed with celiac disease, other family members should also be tested. Treatment At this time, the only treatment for celiac disease is a life-long strict gluten-free diet. This diet will help your intestines heal and prevent problems like bone disease. Even eating a small amount of gluten may damage your intestines. Ask your registered dietitian or doctor if you will need vitamin or mineral supplements while your intestines heal. What to Expect After Your Diagnosis Adults, children with celiac disease and their parents may feel relief, sadness, anger, frustration and anxiety after being diagnosed. Over time, you will learn ways to help you cope. Doing research, using social support, and using resources can be helpful. At first, adults may feel powerless and alone. Taking control of the diet will give you power over the disease. Consult with a registered dietician (RD) after you are diagnosed. They can teach you how to start the gluten free diet. The RD will assess your diet, look at your eating habits and review any special needs. You need a balanced diet to help you heal and stay healthy. You should see a registered dietitian when you are diagnosed and at least yearly after that. Sometimes more frequent visits can be helpful. A dietitian will help you get started with the gluten free diet, teach you how to read labels and make sure your home is safe from cross contact. They can also suggest other changes to keep you healthy. The Celiac Disease Foundation's website www.celiac.org is a great tool and offers adult and pediatric follow-up care checklists. You Can Do It The hardest part of the gluten-free diet is getting started. Like any new task, it takes a while to get organized. The planning will get easier with time. Focus on the many tasty foods you can prepare. Fresh fruits and vegetables, fresh meat, poultry, fish, legumes, and most dairy products are gluten-free. 2 Foods which often contain gluten are now produced by many companies as gluten-free mixes and products. Prepared gluten-free foods are widely offered through local bakeries, grocery stores, health food stores, and mail-order companies. You can find support through newsletters, magazines, and local celiac groups. Refer to the gluten free resources in this binder. You can find other helpful resources at: · Gluten Intolerance Group (GiG) "Getting Started on a Gluten Free Diet" (www.gluten.org) · Celiac Disease Foundation "GlutenFree Living" section (www.celiac.org) · The Gluten-Free Diet 101-A Beginner's Guide to Going GlutenFree (www.celiac.com) · Beyond Celiac: Resources for Parents of Kids with Celiac Disease (www.beyondceliac.org) Follow-Up Care The gluten-free diet is the only treatment for celiac disease. Once you have learned the gluten-free diet and can read food labels, feel comfortable cooking and eating in restaurants, you will still need routine follow-up care. After you are diagnosed you should have your blood antibody (tTg) levels tested again in 3-6 months and at one year. Patients should see the doctor and have blood tests yearly. The tTg levels should decrease to a normal level in time. It takes time for the small intestine to heal. The goal is a negative antibody test. If the blood levels remain high, it is a sign that you are still eating gluten somehow. It can be hard to figure out the source, but the RD can help you find where hidden sources of gluten. Patients should also follow-up with the nutritionist yearly to review the gluten-free diet. The gluten-free diet is always changing as our food supply and food labels change over time. Your nutritional needs also change over time and these visits make sure that you are still meeting these needs. The RD will help you create a healthy eating plan to meet your needs. Talking to Your Child For a young child, keep it simple. Tell your child, "Mom/Dad and your doctors have figured out what has been making your tummy sick. Certain foods are made with something called gluten. When you eat foods that have gluten in them it makes you sick. We are so happy to finally know what has been making you sick. Now we can make you better! You can't eat anything with gluten in it, not even a crumb (show a crumb in your hand)." Explain that your child has new safe foods to eat. Have a few samples of some glutenfree snacks. It helps your child to see that he can still eat potato chips or Fritos®, glutenfree candy, etc. Tell your child that you are learning every day about more and more foods that are safe for him to eat. When telling an older child you should stick to facts a little more, but still be upbeat and positive. Tell your child, "we have good news! We found out what has been making you sick. It turns out you can't have gluten which is found in many of the foods you have been eating. The doctor says that once you stop eating gluten you will feel better. Many foods do not have gluten. You will have to be very careful about not eating any food that you do not know is safe. The smallest amount of gluten will keep you sick even if you don't feel as sick." 3 At this point, show your child a pile of good-tasting, safe, gluten-free foods. Finding where the gluten is hiding is a bit like a backwards treasure hunt. You have to read labels to see if you can find it under the many names that it can hide behind. Tell him that even a bit of gluten could make him sick and together you will become glutenbusters. As you learn about what is safe and what is not, it may take a while to find a safe version of all his favorite things. Remind him that when the label is unclear you will have to call the company to make sure that it is gluten-free before eating it. Meanwhile, show him a known gluten-free product. When telling an adolescent or teenager you should be honest and open. Perhaps they will be so happy to get rid of the symptoms that they will accept the news rather than reject it. Don't forget to go over the increased chance of getting other diseases if they don't follow the diet. Point out that almost all kids have something they have to deal with. Help your child to start reading labels and calling companies right away to learn about their favorite snack foods. It's their disease, so they need to take charge of it. Admit that at first, you both have a lot to learn. Talk about how to manage school and friends' homes. Work as your child's partner. Go online to celiac websites and food makers together. Have your child pick some things that look good and research the disease with him. Ask your teenager to download some ideas for you if they finds something interesting. Teens are ruled by the need to fit in. Try to allow your teen to have as much control over his eating as you can. Let him decide if he wants to eat before he goes out so he doesn't have to eat something different in public. It is normal for our children to pull away from us during this time. We must try to give our children the knowledge to make the right choices. The truth is that soon they will be going off to college and living on their own. Tell your teen that only he can make those choices about his health, and that you trust him. Offer to help find and make gluten-free foods. Have a teenager begin to cook at least one family meal a week. This will be good training for the cooking that will be part of his college life no matter how many care packages you send. Cheating All children may find it hard to follow the gluten-free diet. Kids are often away from their parents and make more choices about food on their own. Parties, dating and eating out can be hard to manage as a teenager with celiac disease. Parents can help by talking through social situations before they come up, finding gluten-free restaurant menus, snacks and talking to other parents about the diet. Parents can also discuss the long-term problems that can result from not sticking to a gluten-free diet. This includes malnutrition, increased risk of lymphoma, osteoporosis, miscarriage and psychiatric or neurological problems. Studies show that if your child consumes an amount as little as a bread crumb over the course of 30 days it can damage the small intestine. This can be with or without outward symptoms. It is vital for long term health to eat gluten free for life. 4 Social and Family Life Many social situations involve food. This may include birthdays, holidays, religious events, funerals, potlucks or social outings with friends. It will be hard at first, but soon you will be able to handle all of these once you're prepared. · Eat before you go in case there are not a lot of safe foods. · Always pack gluten free snacks for on-the-go. · Make events less about food when you can. · Educate friends with the basics so they feel comfortable talking about it with you. · If you know your host, contact them before the event to ask about foods being served so you can bring a dish or two. · For restaurant eating, review online menus before going or contact the manager in advance. Events such as birthday parties, sleepovers, camps and sporting activities can be hard and cause some anxiety for children. We offer some tips to help you prepare for these events. · Teach your child to read food labels (if they are old enough). · Involve the child in meal planning and grocery shopping so they know about safe foods and foods that contain gluten. · Role play situations that may occur to help prepare your child for when you may not be there. · Find "look-a-like" foods that your child can bring to "fit in," like Rice Krispie® treats or gluten free cupcakes. · Keep a positive attitude so your child can learn by example. · Contact the parent before the event to discuss food that your child can bring to the event or safe foods that the parent might offer. · Advocate or set the example that not all events have to be about food! Read a book for a birthday at school, go to a fun place for a birthday party or schedule events around non-food times when you can. Finding Gluten Reading the Food Label for Gluten Always read food labels for prepared and packaged foods. The word "gluten" is not often found in the ingredients, but rather is stated in other ways that you may not be aware of. Also, some foods may not state "gluten free," which means you have to look more closely at the food labels. FDA Gluten-Free Labeling Rule Any FDA controlled food labeled "gluten free" must be completely gluten free or cannot contain an ingredient that is: 1. A grain that contains (such as, spelt wheat). 2. Made from a grain that contains gluten that has not been processed to remove gluten, or 3. Made from a grain that contains gluten if the end product has 20 parts per million (ppm) or more gluten. FDA controlled foods are any besides meat, poultry, eggs, egg products, and alcohol. These foods include soups, sauces, cereal, bread, pasta, crackers, cookies and condiments. FDA foods also include dietary supplements. 5 Even though the gluten-free labeling rule is very helpful, companies are not required to test their product on a routine basis. They also are not required to make sure their factories are free of cross contamination. The FALCPA Act of 2004 All FDA controlled foods must be labeled if they contain any of the 8 top food allergens. These are milk, eggs, soy wheat, peanuts, tree nuts, fish and shellfish. Barley, malt, rye, oats and gluten are not covered by the original Act. If a product lists "wheat starch" or "contains wheat" on its label, a person with celiac disease would know not to eat that product. USDA Products The USDA controls meats, poultry and processed egg products. These products are not covered by the FALCPA Act or glutenfree labeling rule but, most companies still follow the rules. They also must list all proteins on the label in common words. If you have a question about a food, call the food maker and tell them to make their labels clearer. For more ingredient definitions, check the website http://www.glutenfreeliving.com.Read more about labeling laws here: http://www.beyondceliac.org Common Ingredients Oats Most people with celiac disease can safely eat oats. But, oats are often grown in the same fields as wheat and may be contaminated with gluten. We suggest certified gluten-free oats. A very small amount of people with celiac disease do not tolerate certified gluten-free oats. Those with newly diagnosed celiac disease should avoid all oats at first. Once your gut heals and you follow the diet, you can start eating certified gluten-free oats. If symptoms start again, then stop eating oats. Buckwheat Despite its name, buckwheat is really a fruit and does not contain gluten. Sometimes buckwheat is mixed with wheat. Only buy gluten-free 100% buckwheat products. Candy The contents in the candy are listed on the label. Licorice often contains wheat and this will be on the label. Candy makers do not always list all products used in dusting or packing. Some may use wheat flour. Call the candy maker if you are unsure. Dextrin Dextrin can be made from corn, potato, tapioca, sago, rice, arrowroot, or wheat. Avoid dextrin unless you are sure of the source. Maltodextrin is made from cornstarch, so it is safe. If the product is controlled by the FDA, wheat must be listed. Flavors Flavors are rarely made from grains that contain gluten. If wheat is used to make a flavor, "wheat" must appear on the label. Rye flavoring is mostly used in breads. Watch for barley malt flavoring. Most flavorings used are now corn based. Call the food maker if the label states natural flavoring. Malt Malt flavoring is most often made from barley, which is not gluten-free. Malt syrup, extract, and flour are not gluten-free. Liquid smoke often contains malt. If liquid smoke is an ingredient in an FDA controlled food, contact the food maker to ask if there is barley or malt in the smoke flavoring. Rarely, malt is made from corn. 6 Malt Vinegar Avoid malt vinegar until you know the source. Most malt vinegar comes from barley and is not distilled so it contains gluten. Distilled white, apple cider, balsamic, wine, grape, rice, and spirit vinegars are safe to use. Modified Food Starch This can be derived from corn, tapioca, potato, or wheat starch. The label should say if the source is wheat. If it just lists starch, it is cornstarch. Monosodium Glutamate (MSG) MSG is from corn, sugar, or beets used to enhance flavor in protein foods. It is glutenfree. Rice Syrup This flavoring is common and may contain barley malt, which contains gluten. Spices and Seasonings Pure spices are gluten-free, but seasoning mixes may have wheat starch or flour added. You may use dried lemon and orange peels. McCormick® carries a line of gluten-free flavors, extracts, and pure spices. Penzy's® spices are gluten-free, except their dips. Sourdough Bread Unless made with gluten-free flour, most sourdough breads are not gluten-free. Vegetable Gums These are used to thicken and stabilize. They come from natural sources (bushes, trees, seaweed). Examples are guar, locust carob bean, Arabic, furcelleran, ghaiti, karaya, tragacanth, and xanthan. These are glutenfree. Yeast Simply "yeast" brands in the U.S. are gluten-free. Brewer's yeast as a byproduct of beer is not gluten-free. If in the form of a supplement and made from sugar, it is gluten-free. Gluten-Free Home Let's move out of the kitchen and into other places in your home that might contain gluten. Non-food items do not follow the same labeling rules or laws. Medicines Many medicines have gluten fillers. Ask your doctor and pharmacist to check all prescriptions and over-the-counter drugs. Switching products might change the gluten status. Have your doctor write "no substitutions" on the prescription. Keep a bottle of something gluten-free for fevers and headaches on hand. Check the gluten status of name brands and generics. Contact the drug maker or ask your pharmacist to help you. You can also check www.glutenfreedrugs.com. Shampoos and Soaps There is rarely a need to buy gluten-free shampoo/soaps. Avoid getting it in the mouth. Gluten exposure occurs only when gluten is ingested. Toothpaste and Mouthwash Many younger children swallow toothpaste because they like the taste. There are many types of toothpaste that are gluten-free: Crest®, Colgate®, Pepsodent®, Aqua-Fresh®, Natures Plus Animal Parade®, and Tom's of Maine®, among others. Makeup Lipstick or lip balm used once daily does not have to be gluten-free. Use a gluten-free lip gloss if you or your child "eats" it or puts it on a few times a day. EOS®, Carmex®, and Blistex® are gluten-free. Check out www.glutenfreemakeupgal.com/ for glutenfree makeup reviews and tips. 7 Paste and Glue Some paste and glue can contain wheat products. If you do not eat the paste and wash your hands after using, you may use these products. Elmer's white school glue and glue sticks are gluten-free. Play-Doh® Play-Doh® is made from wheat flour so watch your children when they play with it. For younger children, make a gluten-free version (recipe in preschool section) or try Crayola Model Magic (GF). Wash hands after any art project. Pet Food A lot of pet food contains gluten. Wash hands after feeding pets. Do not leave pet food out where young children can eat it. Hidden Sources of Gluten · Ales/Beers · Breading/Coating/Croutons · Communion wafers (www.altarbreadsbspa.com) · Candy/Licorice · Broth/Bouillon/Soup bases · Roux/Sauces/Gravy · Hydrolyzed vegetable proteins · French fries/seasoned chips (fried in shared cooking oil) · Packaged fruit and nuts · Self-Basting poultry · Imitation bacon/seafood · Soy sauce · Marinades and seasoning mixes · Thickeners/stabilizers, such as in yogurts · Supplements · Flours in bulk bins Alcohol Beer most often contains gluten, so only choose gluten-free beers. Use caution when drinking "gluten-removed" beers or malt drinks. Liquors are distilled, which removes large proteins like gluten and should be safe. Beware of flavored alcohols and some ciders. Wine and sparkling seltzers are nearly always gluten-free. Gluten-Free Diet Eating Healthy on a Gluten-Free Diet For many reasons, keeping a healthy, balanced diet is important when eating gluten-free. First, you need good nutrition to heal the damaged intestine. Also, when foods like fortified cereal and wheat bread are removed from the diet, your intake of some nutrients like fiber and B vitamins may decrease. Lastly, gluten-free products, while mostly safe, may be higher in fat or sugar than products that contain gluten. Follow these tips to maintain a healthy, balanced, gluten-free diet. Choose Naturally Gluten-Free Foods · Buy plain chicken, beef, pork, turkey and season yourself · Fruits and vegetables in their plain form do not contain gluten · Dried beans, peas, and lentils · Potatoes, quinoa, and rice are gluten-free · Milk and plain yogurt Variety is Key · Eat as many food groups as you can in each meal · Eat different colors of fruits and vegetables Take a Multivitamin · If you are unable to eat a balanced diet · Make sure the vitamin is gluten-free and provides vitamins AND minerals, like calcium and iron if needed 8 · Ensure® and Boost® are gluten-free, as well as pediatric drinks, like Pediasure® Focus on Fiber · Read food labels to find fiber content · High fiber means 5 grams or more fiber per serving · High fiber foods include apples, pears, avocado, beans and lentils · Add fiber to meals by adding nuts, seeds, fruit, vegetables, brown rice, and quinoa Look for Calcium and Iron · Fortified in many foods that contain gluten, but not always in gluten-free foods · Food sources rich in calcium include dairy products, sardines, and leafy greens · Food sources rich in iron include beef, tofu, beans, cereals, and leafy greens Gluten-Free Meal Ideas Unless clearly marked "gluten-free," read food and labels with care to figure out the risk of gluten cross-contamination. See if the maker states "produced in a facility that uses wheat." If so, call the company and ask how they prevent cross-contamination. Breakfast · Eggs use clean butter as you prepare them · Bacon and sausages many brands are gluten-free · Homemade gluten-free French toast using gluten-free bread · Waffles Choose a pre-made gluten-free brand in the frozen food section · Pancakes use a gluten-free pancake mix and 100% maple syrup or check for gluten if you are serving them with a brand-name imitation syrup · Muffins or banana bread freshly baked or gluten-free brand · Cinnamon toast just toast some gluten-free bread, butter the toast and top with a little cinnamon sugar · Pre-made gluten-free muffins, bagels, English muffins, donuts, and donut holes can be purchased from mail order companies, health food stores, or grocery stores · Cold cereals there are a few gluten-free brands · Hot cereals rice cereal, certified gluten-free oats · Fresh fruit cups with or without gluten-free yogurt · Fruit smoothies made from fresh or frozen fruit, gluten-free yogurt, juice, or milk 9 Lunch · Lightly toast gluten-free bread for a sandwich and wrap it in tin foil to send to school · Sandwiches with gluten-free bread or corn tortilla with gluten-free deli meats or grilled cheese · Sloppy joes · BLT · Salads · English muffin gluten-free pizzas · Baked potato with melted cheese, butter, sour cream · Melted cheese over nacho chips and served with side of gluten-free salsa · Make your own "lunchable" take an empty plastic lunch box with a lid and fill it with gluten-free crackers, cheese, meat, and a glutenfree snack or treat · Gluten-free leftovers from dinner can be heated up at school or put into a thermos · Gluten-free pasta and cheese boxes can be bought, but you can make your own too · Hamburgers and hot dogs can be served with gluten-free French fries · Hard-boiled eggs or egg salad with or without gluten-free bread or roll · Meat rollups with cheese · Tuna over a salad or on a gluten-free roll or bread · Chicken breast or chicken salad over a salad or with a gluten-free bread or roll · Pizza make your own crust using a gluten-free mix or a gluten-free frozen crust · Salami and cream cheese rolled · Peanut butter and jelly on glutenfree crackers or bread Snack · Fruit snacks and fruit rollups many are gluten-free · Quesadilla with corn tortilla and shredded cheese or nachos with tortilla chips · Veggies and gluten-free dip · Fruit such as orange slices, apple slices with peanut butter. · Trail mix nuts, raisins, chocolate chips, or M&Ms® (avoid Krispie M&Ms). · Stove or airpop popcorn or a glutenfree microwave popcorn brand · Gluten-free pretzels · Homemade gluten-free Chex mix using Chex cereal · Nuts and seeds peanuts, cashews, walnuts, almonds, pumpkin or sunflower seeds, etc. · Gluten-free crackers and cheese slices · Rice cake with cream cheese · Peanut butter on celery (ants on a log) · Yogurt and yogurt tubes · Gluten-free baked goods (muffins, quick breads, cookies) Dinner · Any meat, poultry or fish (avoid seasoning packets unless they are gluten-free) grill, oven broil, bake, or roast · Beef stew or pot roast made with your own seasonings · Chicken nuggets (see recipes) · Fish sticks (see recipes) · Rice Oriental rice noodles or pad thai rice noodles are a good base for a gluten-free dinner, avoid pre-made flavored rice mixes · Potatoes roasted, mashed, baked, twice baked, au-gratin, etc. · Mexican food enchiladas and tacos 10 can be made with corn tortillas and served with rice and refried beans, but not all taco seasonings are gluten-free · Pasta use gluten-free noodles and top with gluten-free sauce and add homemade gluten-free meatballs · Chili easy to make from scratch and cook in a crock pot · If you like casseroles, there are many gluten-free soups and ingredients you can use · Fresh meats or vegetables flavored in fresh herbs, gluten-free spices, or dressings · Vegetarian options using tofu, like stir fry · Pastas made from gluten-free flour (cold or hot pasta salads, casseroles) Dessert · Easy peanut butter cookies (see recipe section) · Chocolate chip cookies use tollhouse recipe and add gluten-free flour mixture · Ice cream with chocolate, caramel, or strawberry sauce with gluten-free whipped topping · Gluten-free cookies, cake, brownies make your own or there are tons of gluten-free brands · Chocolate fondue with fresh fruit or marshmallows to dip · Pudding or gelatin, check the label for gluten, as with any product · Fruit with fresh whipped cream · Cheesecakes with gluten-free crust Sample Meal Plans and Menu Options Many websites offer yearly subscriptions to meal plans. Sometimes these can help when you are first diagnosis to reduce prep time and grocery shopping. Many sites also offer ideas for school lunches and school snacks. · www.superhealthykids.com (look under the "meal plans" or "special diets" section) · www.eatingwell.com (look under the "diet and health" section) · www.celiacfamily.com (site with lots of ideas for families living gluten free) · www.emeals.com (meal plans and grocery lists) Kids Sample Meal Plan · Breakfast: scrambled eggs with shredded cheese, slice of gluten-free toast and ½ banana · Snack: trail mix--peanuts, raisin, dried cereal, mini chocolate chips · Lunch: yogurt, gluten-free granola, snap peas and carrots, salami bites or rolled up lunch meat, milk · Snack: apple and peanut butter · Dinner: hamburger/cheeseburger (with GF bun or no bun), oven roasted potatoes, lettuce salad or other veggie, milk Adults Sample Meal Plan · Breakfast: gluten-free Greek yogurt topped with almonds and fresh berries, coffee or tea · Snack: cottage cheese and pineapple · Lunch: salad with greens, tomato, avocado, feta cheese, olives, and gluten-free dressing, milk · Snack: hummus with fresh veggies · Dinner: gluten-free pasta with shrimp, broccoli, onions, and glutenfree sauce, glass of wine · Dessert: gluten-free chocolate chip cookie 11 Tips for a Gluten-Free Kitchen Some families choose the extreme, safe method of making the entire kitchen glutenfree. Other families go with the "separatebut-equal" approach to the contents of their cupboards. They feel that the person with celiac disease needs to learn what they can eat and how to deal with temptations. If you have both gluten and gluten-free going on at once, your kitchen may feel like a war zone. How to Prevent Cross Contamination Assign gluten-free areas. Keep one or more cabinets gluten-free. Having gluten-free items on a higher level will help prevent cross contamination. Some families keep one area of the counter gluten-free. This keeps it simple for caregivers and friends. These kitchen tools listed have been exposed to gluten. They should either be replaced (if total family eating gluten-free) or a separate one should be purchased and kept gluten-free. Make sure the tools look different so you can tell them apart. · Colander/Strainer · Flour sifters · Scratched nonstick pans · Silicone products · Toaster and waffle maker · Cutting boards · Storage containers · Rolling pins · Plastic spatulas or turners Glass, ceramic, high quality stainless steel and high-quality plastics are best for those with celiac disease. These are not unless they are only for gluten-free use: · Wooden cutting boards and utensils · Poor plastic containers and utensils · Scratched pots and pans · Cast iron · Pizza stoneware Use caution with condiments. · Use squirt bottles to prevent "double dipping" · Use color coded stickers for glutenfree screw top condiments like cream cheese, jam, and peanut butter · Enforce the "only dip once" rule Be prepared. · Prep meals days ahead of time. · Alert family/friends of the kitchen rules (i.e. materials allowed, hand washing, etc). · Plan weekly menus so that the family can be prepared. · Cook gluten-free food before cooking food that contains gluten. · Wash hands and clean counters often. Assign a special cleaning sponge as gluten-free. Baking Flour particles that contain gluten can stay in the air for 24 hours which can contaminate gluten-free foods that are sitting out. Use a thin sheet/towel to cover the hand or stand up-mixer and quickly throw it into the wash machine when you are done. Wait 24 hours after baking with flour that contains gluten before baking any gluten-free products. If you use a bread machine, it must be used only for glutenfree products. Most families schedule one day during the week to be their gluten-free baking day. Helpful Tips Use reusable non-stick toaster bags that can be used in toasters, toaster ovens and on grills when you travel. Check specialty food stores or online. www.Amazon.com stocks "Toast-It" toaster bags. These can also be used in homes where you only have room for one toaster. 12 Try to use as many gluten-free brands for the household as you can. Then the family member with celiac disease doesn't have to feel different. When baking gluten-free waffles, pancakes, muffins, cupcakes, bread, etc., freeze and label the extra in small freezer bags. How clean are your muffins tins, cookie sheets, and other pans? Nothing can replace careful cleaning, but using muffin cups, tin foil, or parchment paper can reduce cross contamination. Do not drink right from the milk jug. Think about your kitchen and chances for cross-contamination. Even cleaning the kitchen can be an issue. Are you using a dirty sponge? Keep counters clean. If you like to use a bread maker, buy a new one for gluten-free baking Keep the silverware drawer clean, as this is a common place in the kitchen for crumbs to gather. Gluten-Free Shopping Madison Area Grocery Stores and Bakeries Many of these stores will help you find gluten-free products. Stop at the customer service desk to ask for help. Aldi 2 Madison locations, Sun Prairie and Fitchburg https://www.aldi.us/ Costco Middleton and Sun Prairie locations https://www.costco.com/ Many GF products throughout the store. Pick `N Save Throughout Wisconsin Fresh Madison Market 703 University Avenue Madison, WI 53715 608-2877-0000 www.freshmadisonmarket.com Hy-Vee East 608-244-4696 West 608-277-6735 Fitchburg 608-273-5120 http://www.hy-vee.com/ Dietitian services include grocery store tours for those with celiac disease Metcalfe's Market Midvale Blvd - 608-238-7612 West Towne 608-829-3500 www.shopmetcalfes.com Metro Market 6010 Cottage Grove Rd. Madison, WI 53718 608-223-0939 www.metromarket.net Miller & Son's Supermarket Verona - 608-845-6478 Mount Horeb 608-437-3081 www.millerandsonssupermarket.com Madison Chocolate Co. 729 Glenway Street Madison, WI 53711 www.madisonchocolate.com 608-286-1154 Dane County Farmer's Market https://dcfm.org/ Trader Joe's 1810 Monroe St. Madison, WI 53711 www.traderjoes.com 13 Bloom Bake Shop 1851 Monroe St. Madison, WI 53711 608-509-7669 http://www.bloombakeshop.com/ Half their bakery case is gluten-free, and all of those items are baked at a separate time with full cleaning before and after! Willy Street Co-op 1221 Williamson Street, Madison, WI 608-251-6776 or 6825 University Ave, Middleton, WI 608-237-1201 www.willystreet.coop Whole Foods 3313 University Ave Madison, WI 53705 www.wholefoodsmarket.com Woodman's Sun Prairie 608-825-1511 West Madison 608-274-8944 East Madison 608-244-6630 http://www.woodmans-food.com/ The Conscious Carnivore 3236A University Ave. Madison, WI 53705 608-709-1418 http://conscious-carnivore.com They have GF brats and burger options. Penzey's Spices 3252 University Ave Madison, WI 53705 www.penzeys.com Gluten-Free Shopping Outside of the Madison Area Pick `N Save Throughout Wisconsin Ann's Gluten Free Foods Appleton 920-954-0832 www.annsglutenfreefoods.com Back to the Best Country Store Rubicon 920-625-2185 Costco Many locations throughout the state https://www.costco.com/ Downtown Grocery Wausau www.downtowngrocery.com Dick's Fresh Market River Falls, Osceola, & Amery Festival Foods (many cities) 920-273-0490 www.festfoods.com Free Market Appleton 920-968-1260 www.thefreemarketstore.com Fresh & Natural Market Hudson 715-377-9913 www.freshandnaturalfoods.com Gluten-Free Trading Co. Milwaukee, Pewaukee 262-369-8700 http://www.food4celiacs.com/ Good Harvest Market Pewaukee 262-544-9380 http://www.goodharvestmarket.com/ 14 Molly's Gluten-Free Bakery Pewaukee 262-369-1404 http://www.mollysglutenfreebakery.com/ Red Radish Natural Foods Neenah 920-720-3281 www.theredradish.com Sendik's Market Many locations www.sendiks.com Sheboygan's Nature's Best Sheboygan 920-452-6176 www.naturesbestmkt.com Slow Pokes Local Food Grafton 262-375-5522 www.slowpokesfood.com Spring Green General Store Spring Green 608-588-7070 www.springgreengeneralstore.com Stevens Point Area Co-op Stevens Point 715-341-1555 www.spacoop.com Woodman's Many locations Gluten-Free Food Suppliers Authentic Foods www.authenticfoods.com Makes many gluten-free mixes and flours. Bob's Red Mill Natural Foods www.bobsredmill.com Their gluten-free products are made in separate milling area. Chebe Bread www.chebe.com All natural, gluten-free, gourmet mixes. Ener-G Foods, Inc. www.ener-g.com Makes a wide range of gluten-free products. Gillian's Foods, Inc. www.gilliansfoods.com Breads, rolls, breadcrumbs, etc. The Gluten-Free Mall www.glutenfreemall.com Over 40 glutenfree companies. Gluten-Free Trading Company www.food4celiacs.com Over 50 gluten-free companies. Kinnikinnick Foods www.kinnikinnick.com Breads, cookies, muffins, donuts, mixes, and more. The Really Great Food Co. www.reallygreatfood.com Many types of muffins, cakes, bread mixes and pastas. Mr. Ritt's Bakery www.mrritts.com They offer many options for gluten-free baked goods such as, cookies, cakes, biscotti, brownies, muffins, baking supplies and mixes. They offer shipping for some items. Thrive Market https://thrivemarket.com Lots of gluten free products and bulk baking products. Schar http://www.schar.com/us/ Many types of breads, rolls, bread mixes, pizza crust, pasta, and cookies. Gluten Free Palace http://www.glutenfreepalace.com/ Glutenfree products and gifts. Gluten Free Delivers http://glutenfreedelivers.com/ Daily deals, 15 coupons, and bulk offers on many glutenfree products. Medicine Use in Celiac Patients Many drug makers now make their products without gluten. Medicine makers are not required to list the specific ingredients on the label. Ask your pharmacist if gluten is contained in or has been contaminated with your medicine. You may need to contact the maker of the medicine. You can also check www.glutenfreedrugs.com. Sources of Gluten Wheat starch is the most common source of gluten used in drugs. It may be listed as just the term starch, which includes other sources such as corn and potato. Other sources of gluten that patients should check for on the label include: · Dextrin · Malt · Maltodextrin · Modified food starch · Pregelatinized starch · Pregelatinized modified starch · Natural flavoring · Hydrolyzed vegetable protein Celiac patients should assume that products listing starch on the label contains wheat starch unless they know the exact source of the starch. Since drug makers are not required to use a certain type of starch when making their product, many patients with celiac disease may have trouble with one brand yet be okay with some other brand because different fillers were used. What to Tell Your Health Care Provider Always tell your doctors and pharmacists that you have celiac disease and a wheat or gluten intolerance. They can make note of it. Generics Generic medicines may contain the same active agents to ensure the same response in the body, but they may vary in the amount and type of the other filler agents present. Generics are tested to look at active agents, but not the fillers. Most people don't care much about the fillers, but you do. Since these generics may be changed from one brand to another by your drug store for cost saving reasons, you have to be alert for these changes. Some people decide it's best to request a script from the doctor that includes the phrase: "Dispense as written, do not interchange." You should know though, that some drug plans may charge more if you insist on a drug that is not off their shelves. If it requires a special order, you may need to buy more than you really need. And it could take a while before it's ready for you to pick it up. Trouble Finding Gluten-Free Medicine Some drugs cannot be found in a gluten-free form. If your doctor cannot switch to a gluten-free choice, you may need to contact a drug store that can compound the medicine for you. These products are more costly and may require prior authorization from your insurance. There will also be a delay before you can pick up the drug because it will need to be made. Talk with your doctor about this choice. If you do decide to get a drug through a drug store that compounds drugs, be sure to give your complete list of other drugs used so they can check for problems with how the drugs might act when taken together. 16 Never stop a prescribed medicine without talking to your doctor first. Gluten-Free Supplements Food should be your major source of vitamins and minerals. If you are not able to eat enough or maintain a balanced diet, your doctor or dietitian may suggest supplements. Talk to your pharmacist about gluten-free options they carry. If not clearly labeled gluten-free, check with the maker before buying. Be careful as many gummy vitamins contain wheat. Bayer Healthcare does not add gluten to their products, though they cannot guarantee they are 100% gluten-free. Citrical, Flintstones chewables, One A Day, are examples. www.oneaday.com Freeda Vitamins entire line is gluten-free. www.freedavitamins.com Kirkman Labs has a website that allows you to filter for unwanted substances like gluten. www.kirkmanlabs.com Mead Johnson Nutritionals (Pediatric Drops) vitamin products (Poly-/ or Tri-/ ViFlor® and Vi-Sol® drops and tablets, and Fer-In-Sol® drops) are gluten-free. www.meadjohnson.com Nature Made has many items are glutenfree, clearly listed as gluten-free on the label. www.naturemade.com Nature Plus has a website that allows you to filter for gluten-free. Animal Parade Children's line is all gluten-free which includes tooth gel, infant drops, vitamins and shakes. www.naturesplus.com Church & Dwight Co. products are glutenfree: Calcium Gummy Bears, L'il Critters Gummy Vites, Vitafusion MultiVites (gummy vitamins for adults), Vitafusion Calcium, among others. www.gummyvites.com Solgar has a lot of products that are glutenfree. This includes prenatal and the child's chewable. www.solgar.com NOW Foods has 97% of its products that are "gluten-free." Gluten-free products are made on the same equipment as items that contain gluten, but are confident that they clean their equipment well. www.nowfoods.com Country Life Vitamins products are certified gluten-free by the Gluten Free Certification Organization (GFCO). www.countrylifevitamins.com Pioneer Vitamins tests every batch of final product to make sure it is less than 10ppm gluten. www.pioneernutritional.com 17 Gluten-Free Outside the Home Tips for Restaurants You should be able to enjoy dining out with if you take the proper caution. The food you eat at a restaurant is not in your control. You must take steps to ensure your meal is gluten-free and safe to eat. Call in advance and speak to the manager. They are more likely to meet your dietary needs if you call ahead. Ask about their gluten-free menu. Ask what steps they take to ensure your food is safe to eat. When you arrive introduce yourself to the manager. Thank them for taking the time to help you. Speak up about your dietary needs and don't be afraid to use the words "celiac disease." Most people know someone on a gluten-free diet, but may not be aware that people with a celiac disease need to totally avoid gluten. Tell your server that you have a severe reaction to wheat, rye, and barley. If you doubt that your server can meet your needs, ask for the manager. Simple dishes without coating or sauce are often the best choices. Don't assume that anything is gluten-free. Ask your wait staff to let the chef know that you cannot eat gluten because you will become ill. Make sure that there are no cross-contact risks. Ask questions such as "do you use clean or separate cookware and utensils for gluten-free food?" and "can you please change your gloves before touching my food?" Know your menu terms. These menu terms mean that wheat or gluten is most often present: au gratin; béchamel; beurre manie; cordon bleu; encrusted; dust; farfel; fricassee; fritter; gnocchi; pan gravy; marinade; Marsala; meuniere; piccata; roux; scallopini; soy sauce; teriyaki; tempura. Be grateful. Leave a good tip if you feel your needs were well met. A detailed review may help keep your favored restaurants around, and help others find a safe place to eat. Did you know that there is a certification program restaurants can complete to help them provide safe options for gluten-free diners? It is the GIG's Gluten-Free Food Service Certification Program (GFFS). This program trains restaurants to meet best practice standards for providing gluten-free meals. It also makes sure that these standards are being met. You can let your local businesses of this program. Local Restaurants We have listed some restaurants around Madison that provide gluten-free options. You can find a more complete restaurant list at the Madison Area Gluten Intolerance Group (MAGIC) website. www.glutenfreemadison.org Downtown · Bassett Street Brunch Club: Gluten free menu items are noted on the menu. · Greenbush Bar Gluten free pasta and pizza crusts, Bards Beer. · L'Etoile Restaurant Call ahead (608) 251-0500 for gluten free options. · Mooyah They have gluten free buns and lettuce wrapped burger too. · Nitty Gritty They have a GF menu, check the website. · The Old Fashioned has GF options, offers Udi's bread products for any other sandwiches. 18 West · Applebee's Check the website. · Curry in the Box Curry sauces are GF and vegan. · Eno Vino Wine Bar & Bistro Gluten free items are marked "GF" on the menu. · Hollander Grand Café Gluten free menu on the website. · Otto's Restaurant & Bar many items are gluten-free, and reviews state staff goes out of their way to meet special dietary needs. · Pasqual's Southwestern Deli Mole and red sauce are gluten free. Very allergy friendly. · Outback Steakhouse www.outback.com has a gluten-free menu at restaurant. East · · · · · · · · Banzo all Platters, Salads and Plates can be made GF. Meats and falafel are GF. Ask when ordering. https://banzomadison.com/ Bar Coralinni GF pasta, pizza crust and bread available. https://barcorallini.com/ Chili's email for gluten-free list guestrelations@brinker.com. Each location has allergen info. Ha Long Bay Many menu items are GF but not noted. Ask for help when you order. Outback Steakhouse www.outback.com. They have a GF menu. Red Robin call/email or check the website. Texas Tub's Taco Palace Many items on the menu are marked "gs" for gluten sensitive. Uno's www.unos.com. Lists gluten-free items under Nutrition. North · Benvenuto's Italian Grill GF menu, including GF pasta and sandwich buns. · Nau-ti-gal Call ahead for GF options. South · Bonfyre American Grille GF items are noted on the menu. · Rockhound Brewing gluten free items are noted as "GF" on the menu. They have gluten free buns and vegan options. Middleton · Biaggi's They have a gluten-free menu. Call ahead and they will make GF pasta. · Imperial Garden speak with a manager. Ask for GF soy sauce. · Roman Candle--offers GF crust and many options for toppings, salad dressings and more. Quick Service Restaurants · Chipotle Mexican Grill Look at the ingredient list on website. · Five Guys Burgers and Fries Burgers and most toppings are GF. You can order burgers with a lettuce wrap or in a bowl with no bun. · Noodles & Co. very allergen friendly. · Panera Bread GF list available. · Subway check website for allergens https://www.subway.com/enus/menunutrition/nutrition · Jersey Mike's Subs they carry Udi's GF sub rolls. When a GF sandwich is ordered they clean entire work space, change gloves and use dedicated condiments. 19 Party and Holiday Tips Easy to make gluten-free cakes and mixes are offered from many gluten-free food makers. Some good mixes are Betty Crocker GF mixes, Authentic Foods, Simple Mills, Krusteaz GF, Bob's Red Mill, Pillsbury GF and King Arthur Flour GF. Ice cream cakes can be a good choice and you can even make them yourself. If going to a party, ask the host what they are serving so you have some control in your choices. Offer to bring a pan of gluten-free lasagna. If pizza is on the menu, bring a couple slices of your favorite gluten-free brand, or better yet, homemade version. Udi's crust, Simple Mills pizza crust, and Mama Mary's gluten-free thin crust are good choices. If the host is having a piñata, see if you could gently check or offer to provide a few gluten-free candies, stickers or toys. Keep up with lists of gluten-free candy, found on Celiac.or and many blogs, for Easter, Christmas, etc. You or your child may prefer to eat at home before going to a social event. At school, work with the teacher to inform all of the parents in the classroom of how to help accommodate your child. Ask them to let you know if they are bringing in treats for the class. In a lot of cases the teacher will do this for you. To make it easy, keep a container of gluten free options with the teacher in the classroom for those surprise times. Keep a few pre-made frosted cupcakes in the freezer for unplanned parties. Store special foods at work or school. Preschool As a parent, your first mission is to create a gluten-free world for your child. Many classrooms hold hidden dangers. Sit down with the teacher before the school year starts. Give them information about celiac disease. Go to www.beyondceliac.org for tips about keeping your child safe at school. Talk about snacks and offer to supply a gluten-free snack list of brands that your child can have. Some teachers will send a letter home with the other kids in the class to ask parents to bring a snack based on the gluten-free list that you have given. Here is a gluten-free snack list: · Fresh fruit slices · Fruit cups · Cheddar cheese cubes · Pudding · Gelatin · Raisins · Popcorn · Corn chips · Veggies and dip · Yogurt (no toppings) · Popsicles · Mini muffins from any gluten-free mix · Gluten free crackers or pretzels For birthdays and holiday treats, make up gluten-free cupcakes with frosting and freeze. Be sure to get a list of birthdays for the class or ask to keep the cupcakes in the freezer at school. A lot of times when parents find out about a child in the class that has an allergy or intolerance they like to include the child and ask what they can bring in. Always stay open to talking with parents and teachers. Give the teacher a box of "just in case" cookies, snacks and treats. In many classrooms there is a sensory table in which sand, water, beans, etc. are placed 20 for the children to play with. Request that the teacher does not use wheat, barley, oats or rye. Children at this early age tend to put their fingers in their mouths. Suggest cornmeal, rice, etc. A popular preschool project is stringing cereal or noodles into necklaces and painting them. Ask if you can supple the gluten-free cereal (Cero's) or noodles. Also, play dough which is made from wheat is a standard item in every preschool. Request that the play dough in your child's class be made from cornstarch or rice flour and offer to make it. Play Dough Recipe 1 cup white rice flour 1 cup cornstarch 1 cup salt 2 cups water 2 Tablespoons cream of tartar 2 Tablespoons oil Food coloring Cook at medium heat until mixture starts to form a ball. Remove from heat and let cool then knead for at least 10 min. Place in Ziploc bag until ready to use. If your child is older or can remember to never put their fingers in their mouth, then you can tell the teachers that regular play dough if fine if your child washes their hands right after playing with it. Ask the teacher to help your child. Some schools bake with kids. To keep your child safe, go over the baking projects at the start of the year and suggest or supply a gluten-free option. If it is holiday time and they want to make cut out cookies, the Gluten-Free Pantry has an Old Fashioned Cookie Mix with a cut out recipe. School Age Children Talk with your school's administration, nurse and teacher as soon as you can. Your child's school may already have a plan in place for students with celiac disease. If not, you may need to talk to your school about celiac disease and the needs of your child both in the classroom and lunchroom. Your child will need to eat a gluten-free diet during school. Request a 504 Accommodation Plan (see more info about the 504 Plan below). This is a legal document that outlines accommodations for the child in the classroom such as: · Objectives and goals of the plan · Meals and snacks · Bathroom access · Classroom activities (art projects) · Field trips · Communication · Emergencies · Parental notification · Emergency contacts You can find helpful guides here: · www.celiaccentral.org · www.celiac.org Section 504 Under this law public schools must treat students with health problems in a way that offers them the same chances as other kids. This law says that students who have special needs must have them met within the classroom. It includes meeting needs of a special diet. You will need a doctor's note stating the disease, the symptoms, and needs of the diet. The note should state that this is a lifelong disease and that your child must follow the gluten-free diet. If your child does not follow the diet, he or she may become ill and then cannot be in school which will affect learning. 21 The guidance counselor will set up a meeting to make a plan. Parents are given district policy, parent and student rights, how to file a grievance, and a notice about meetings. Those who need to be present at the meeting will vary with the child's needs. A plan can sometimes be made for playdough and other arts and crafts. What might be in the plan could include: bringing in your own GF playdough, the teacher consulting you before cooking, art projects, fieldtrips, and parties, and giving gluten-free snacks and treats to be kept in the classroom. The plan is then written and signed by all present. No changes can take place without parents' okay. Here is an example plan: · Microwave access for heating up meals. · Gluten-free treats and snacks (that parent provides) left in classroom for snack time or last-minute need. · Access to bathroom, no limits. · 24-hour notice of plans for activities or treats that contain gluten. (So that parents can provide a gluten free option.) · Allow make up time for homework when absent due to gluten related illness. · Allowed to stay at school after vomiting or diarrhea unless there is a fever. Child will go home if it does not stop. · Have a change of clothing in the nurse's office (change with the seasons). Request that the plan is shared with the principal, counselor, nurse, classroom teacher, lunchroom staff, and any other staff who need it. Review with school staff and answer any questions. Most often, schools are open and happy to help you. If not, you can read more about filing a complaint at: · www.504idea.org · www.hhs.gov/ocr/504.html 22 Travel Gluten-Free Travel Tips Traveling can be hard for people with celiac disease. This is because you must avoid gluten at the airport, restaurants, the hotel, other peoples' homes, and other places where cross-contamination is more likely than at home. Traveling to other countries can be even harder. Here are a few tips to make your travel safe and easy: Do your research. Visit www.celiac.org and search "Celiac Policies Around the World." Find a local celiac disease support group or organization. They can make suggest options for lodging, food, and outings. Call the hotel, restaurants, and airline to ask how they can meet your dietary needs. Search www.gluten.org for restaurants that have gone through a certified gluten-free training program. Be prepared. Bring your own snacks when you travel. Some people bring their own ingredients for meals or ship a box of gluten-free foods to their hotel. Call the hotel and ask to have a fridge and microwave in your room. Bring reusable toaster bags to keep your bread gluten-free in the hotel toaster. Prepare a mini emergency kit complete with anti-diarrheal and headache treatments in case you are exposed to gluten. If staying at someone's home, make sure they realize your food cannot touch gluten. Gather your travel tools. Check out Triumph Dining. This is a service that makes gluten-free language cards that help restaurant staff figure out and meet your dietary needs. They also have restaurant and dining guides for purchase. The website www.glutenfreepassort.com also offers dining cards. You can get a free one at www.celiactravel.com/cards. Download smart phone apps to locate restaurants and grocery stores near your stay. Don't cheat yourself out of a vacation. Eating a strict gluten-free diet can be even harder when you're in a place you don't know. Don't let that get in the way of your health goals. Cheating can ruin your vacation, affect your health, and lead to feelings of guilt. Having a plan and sticking to it is the key to prevent cheating with gluten. Other helpful hints: · Check out www.glutenfreeliving.com and www.celiactravelguide.com for travel reviews. · Eat simple and fresh. Choose menu options with least ingredients. · Check out https://www.celiaccruise.com/ - they organize fully gluten free cruise trips for families and adults. Disney World Disney World is a true vacation for the parents of a child with celiac disease. When calling for reservations 407-939-3463 tell them what you need. All of the restaurants are great about getting you a gluten-free meal. You can also call 407-560-7830 and they will email you a packet. This has a list that tells what is gluten-free at the quick service counters, where you can get gluten-free brownies, cookies, crispy treats and pizza. 23 Celiac Support Groups Celiac Support Groups of Wisconsin and Illinois Listed below are most of the local active adult support groups in Wisconsin and Illinois. There is often a small fee to become a member, but it is well worth it. They provide valuable support and information. Contact information changes often, so look at their website or "follow" them on social media, for up-to-date information. Madison Area Gluten Intolerance Chapter (MAGIC) Email: newmembers@glutenfreemadison.org or search website for current president. Meets: Monthly, second Saturday of the month. Check website to be sure. Location: Meadowridge Library, Meadowood Shopping Center, 5726 Raymond Road, Madison www.glutenfreemadison.org We suggest you join this group if you live in the area. It is extra helpful for those that are recently diagnosed. New members receive a starter packet with great information on foods, education, restaurant, recipes, shopping and even gluten-free food! Membership is about $25 per year and is well worth it. Free newsletters can be accessed on their website, as well as recipes, restaurant reviews, upcoming events and travel. See contact information above. Manitowoc County Celiac Support Group Contact: Andrea Beschta Phone: 920-894-1629 Email: goldenbird@tm.net Meets: First Wednesday even-numbered months, except December, at 6:30pm. Location: Manitowoc County Office Complex 4319 Expo Drive, Manitowoc. GiG of East Central Wisconsin (Ripon, Green Lake, Markesan, Berlin) Contact: Al Klapperich, Branch Manager Phone: 920-748-4877 Meets: Third Saturday of odd numbered months Location: Ripon Public Library (Silver Creek Room) http://gigofecw.org/ Milwaukee Sprue Crew Contact: Bev Lieven Phone: 414-354-2354 Email: milcs@aol.com Meets: Quarterly (Sept, Nov, Feb, Apr), third Saturday of month around 1pm Location: Location changes Gluten Free Stevens Point Contact: Elaine Rubel Phone: 715-347-2417 Email: Glutenfreestevenspoint@gmail.com Meets: Quarterly. Location: Location changes. See website for more detail. http://glutenfreestevenspoint.weebly.com/ La Crosse Area Celiacs Contact: Mary Lou Balts Phone: 608-780-8564 Email: baltskml@centurytel.net Meets: Most months, see website: Location: Mostly 7th and King Street, downtown La Crosse. www.lacrosseareaceliacs.org/index.php Online Support Groups: There are many online support groups for those living with celiac disease. It is best to look for a website you can trust, such as those listed below. Support groups should not be used instead of seeking medical advice. · www.beyondceliac.org (section "About Celiac Disease") 24 · www.simplygluten-free.com (section GF 101) Gluten-Free Resources Websites When you go to a website to find out about celiac disease, check for date the website was last updated. If it is an older website, you may not be able to trust what it says. Also, if you are ever unsure if information is true or false, please ask your dietitian or doctor before making a decision. UW Health http://www.uwhealth.org The University of Chicago Celiac Disease Center www.cureceliacdisease.org North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition www.naspghan.org Children's Digestive Health and Nutrition Foundation www.gastrokids.org American Gastroenterological Association www.gastro.org National Digestive Diseases Information Clearinghouse www.niddk.nih.gov Celiac Disease Awareness Campaign http://www.celiac.nih.gov Beyond Celiac www.beyondceliac.org Canadian Celiac Association www.celiac.ca\ Celiac Disease Foundation www.celiac.org Other Trusted Gluten-Free Resources National Celiac Association--Advocacy, education, and resources for those with celiac disease. They have many chapters in Wisconsin and Illinois, like the MAGIC group. www.nationalceliac.org Gluten Intolerance Group (GIG)--Offers a lot of gluten-free tools. They founded the Gluten-Free Certification Organization which verifies gluten-free products. www.gluten.org Society for the Study of Celiac Disease-- A society focused on celiac disease research. www.theceliacsociety.org The Gluten Free Dietitian--Resources about celiac disease. http://glutenfreedietian.com Gluten-Free Blogs A blog with state-of-the-art gluten-free testing data. www.glutenfreewatchdog.org Gluten-free recipes and lifestyle from a mother's point of view. Voted Best Allergy Blog in 2018. www.raisingjackwithceliac.com/ A family centered blog about eating glutenfree together. This blog provides meal/menu planning. http://celiacfamily.com/ 25 Gluten-Free Recipe Websites www.glutenfreeonashoestring.com www.kumquatblog.com www.glutenfreerecipebox.com www.glutenfreetravelsite.com www.glutenfreeandmore.com www.glutenfreeliving.com www.glutenfreeresourcedirectory.com www.adventuresofaglutenfreemom.com www.simplygluten-free.com www.savorypalate.com Cookbooks How Can It Be Gluten Free Cookbook. America's Test Kitchen, First Edition, 2014. How Can It Be Gluten Free Cookbook Volume 2. America's Test Kitchen, 2015. Fenster, Carol, PhD. Gluten Free 101: The Essential Beginners Guide to Easy GlutenFree Cooking. Houghton Mifflin Harcourt, 2014. Lagasse, Jilly and Jessie. The Gluten-Free Table: The Lagasse Girls Big Bold Taste. Grand Central Life and Style, 2014. Hunn, Nicole. Gluten-Free on a Shoestring: 125 Easy Recipes for Eating Well on the Cheap. Da Copa Lifelong books, 2017. Ellgen, Pamela. The Gluten Free Cookbook for Families: Healthy Recipes in 30 Minutes or Less. Rockridge Press, 2016. Books Bower, Sylvia Llewelyn, RN., Sharrett, Mary Kay, MS, RD, LD, CNSD., and Plogsted, Steve, PhD. Celiac Disease: A Guide to Living with Gluten Intolerance. Second Edition. Demos Health, 2014. Green, Peter, and Jones, Rory. Gluten Exposed. William Morrow, 2017. Case, Shelley, B.Sc., R.D. Gluten-Free Diet A Definitive Resource Guide. Case Nutrition Consulting. Regina, Canada. 2016. (Note: also contains recipes.) Magazines Gluten-Free Living Magazine can be ordered at www.glutenfreeliving.com Simply Gluten-Free can be ordered at www.simpygluten-free.com Delight Gluten-Free Magazine can be ordered at www.delightglutenfree.com Gluten Free & More Magazine can be ordered at www.glutenfreeandmore.com Gluten Free Resource Directory has a free online magazine called "Food Solutions" www.glutenfreeresourcedirectory.com Gluten-Free Smart Phone Apps There are many great smart phone apps you can find today to make your shopping, dining, and gluten-free lifestyle easy. We have listed a few of the highest rated apps that you can download on iPads, iPhones, Androids, tablets, and other smart phones. Now Find Gluten Free -Free This app can help you have fun in the kitchen! It makes it easy to research new foods, find yummy recipes, keep track of your lists, and much more! Find Me Gluten Free - Free Find gluten-free friendly stores, such as fast food, bars, cafes, grocery stores and more! View menus, call, or get directions for each store. Filter options by price, rating, and distance. This is the highest rated gluten-free app on the market today! 26 Shop Well - Free View suggested food and products based on your health needs. It can help you if you have a gluten sensitivity, diabetes, or lactose intolerance. Options are ranked by a color scoring system to help you choose the best options. This app lists Nutrition Fact labels and ingredients. Scan barcodes of your favorite foods to see their details. It will allow you to create a shopping list too! The Gluten Free Scanner - $3.99 It works simply and fast, using your phone camera to scan the barcodes of the products you buy. They maintain the largest up to date database of food and drink products to detect the presence of gluten. Podcasts · Gluten Free You & Me · A Canadian Celiac Podcast Tax Deductions for Celiac Disease If you or your child has celiac disease and you itemize your deductions, you may deduct the extra costs due to gluten-free dietary restrictions as a medical expense. Step-by-step instructions on how to do so are available here: https://celiac.org/celiacdisease/resources/tax-deductions/ College Life Living a gluten-free life in college is hard for many reasons. The National Foundation for Celiac Awareness is a good resource for all things about college and celiac disease. Visit www.beyondceliac.org (search "Gluten Free In College Toolkit") and download the toolkit. The tool kit will tell you: · Where to go for support on campus · How to register with the Office of Student Disabilities · About your rights: The Americans with Disabilities Act and what the Lesley University settlement means for you. · About living with a non-gluten-free roommate · About dorm-friendly food 27 Food Item Grains and Flours Gluten-Free Diet Quick Guide Okay Need More Information Avoid · Almond · Low gluten flours · Amaranth · All flours which · Arrowroot starch contain; wheat, rye, · Artichoke barley & *oats · Buckwheat · Durum/Durhum · Corn starch wheat · Cornmeal · All purpose flour · Flax · White enriched flour · Hominy · Wheat flour · Maize · Montina® Flour · Wheat germ · Whole wheat flour (Indian Rice Grass) · Wheat starch · Millet · Wheat bran · Legume flours · Oat bran (peas, lentils, beans) · Bulgur · Potato starch & · Graham flour · Kasha · Quinoa · Kamut · Rice bran · Spelt · Rice flours · Triticale · Sesame · Matzo & matzo meal · Soy flour · Rusks · Sunflower · Semolina (wheat) · Tapioca starch · Farina · Teff · Einkorn · Sago · Emmer or Farro · Sorghum Breads · Breads made using only allowed flours (100% corn, rice, tapioca, soy, bean, nut, etc.) · Store-bought gluten-free baking mixes · Breads made with naturally gluten-free grains may be contaminated. Try to use certified glutenfree products. · All breads, rolls, etc. made with wheat, barley, rye, and *oats Cereals · Hot and cold cereals made from rice, soy, corn, amaranth, buckwheat, quinoa, and millet · Purity protocol oats · Hot and cold cereals which contain wheat, rye, barley, *oats, wheat starch, bran, graham, wheat germ, matzo, kasha, bulgur, barley malt, durham wheat, rusks, triticale 28 Food Item Meat and Other Proteins Noodles Crackers & Snack Foods Milk Okay · Fresh meat, fish, poultry and eggs · Plain nuts · Macaroni, spaghetti and noodles made from rice, corn, soy, potato, beans, peas, quinoa, buckwheat, or other allowed flours · Corn tortillas · Popcorn · Crackers made with allowed flours · Potato chips · Milk products: fresh, dry, evaporated or condensed · Plain yogurt Need More Information · Fish canned in oil, water or brine · Luncheon meats · Frankfurters · Prepared meat products · Marinated products · Self-basting poultry · Egg substitutes or dried eggs · Canned soups, chilies, stews · Dry roasted nuts · Imitation meat, bacon bits and fish · Sausages/bacon · Canned tuna · Textured vegetable protein · Flavored potato Tortilla chips (flour used as carrier for flavor) · Flavored rice cakes · Communion wafers · Sour cream · Whipping cream · Flavored yogurt/milk · Non-dairy creamers · Margarine · Store bought prepared milkshakes and chocolate drinks especially if it states malted · Frozen yogurt and ice cream · Soy and rice milks Avoid · Any meat or meat product which contains wheat, barley, rye, or *oats · Meat products that contain bread or grains that are not allowed: Swiss steak, meatballs, meatloaf, pot pies, quiches, most veggie burgers, etc. · Breaded meats, poultry or fish · Meats or poultry with gravy · Macaroni, spaghetti & noodles made from wheat, wheat starch, and other grains that contain gluten · Couscous · Products with wheat, rye, barley, bran, *oats, graham, wheat germ, barley malt, kasha, bulgur, matzo, triticale, wheat rusks, and croutons · All milk products which contains ingredients not allowed · Malted milk or milkshakes 29 Food Item Okay Cheese · Aged cheese · Cream cheese Fruits & fruit juices · Most all fresh, frozen, dried or canned fruit Vegetable s · Most all plain, fresh, or canned vegetables · Dried beans, peas, and lentils · Tomato puree and paste · White and sweet potatoes · Yams Need More Information · Cottage cheese · Cheese spreads · Imitation cheese · Blue cheese · Low fat or fat free cheese · Shredded cheeses · Thickened or prepared fruits and pie fillings · Dried fruits · Vegetables in sauces · Store bought prepared vegetables, such as baked beans · Some French fries Avoid · Cheese products which contain ingredients not allowed · Fruit products which contain ingredients not allowed · Battered dipped vegetables · Scalloped potatoes (which contains wheat flour) Fats Desserts Soups · Butter · Vegetable oil · Lard · Shortening · Pam® (original) · Special gluten-free cakes, cookies, and baking mixes · Honey · Coconut · Chocolate (check first) · Pudding · Gelatin · Homemade broth and soups made with allowed ingredients · Special gluten-free store-bought soups or broths · Salad dressings · Mayo · Margarine · Sauces · Ice cream · Frozen yogurt · Pudding/custard mixes · Sherbet · Candy · Jelly and jam · Frozen desserts · Icing · Powdered sugar · Marshmallows · Molasses · Canned soups · Soup mixes · Bouillon cubes and powder · Packaged suet · Gravy · Most store bought prepared cookies, cakes and other baked goods · Bread pudding · Ice cream cones · Licorice · Soups which contain ingredients not allowed 30 Food Item Drinks Other Okay · Plain tea · Plain brewed coffee · Hot chocolate made w/pure cocoa powder · Most carbonated drinks · Beer made with gluten-free grains · Balsamic, apple cider, distilled white and rice vinegar · Salt · Black or red pepper · Herbs · Ketchups · Pure spices · MSG if made in USA · Pure cocoa, pure baking chocolate · Carob chips and powder · Yeast · Baking powder and soda · Cream of tarter · Relish, olives, plain pickles · Pure vanilla · Aspartame · Maltodextrin Need More Information · Some soy and rice drinks · Instant tea and coffee · Flavored fruit drinks · Fruit juice · Root beer · Distilled alcohol wine, brandy and rum · Curry powder · Dry seasoning mixes · Gravy extracts and meat sauces · Yeast flakes · Extracts · Imitation flavoring · Mustard powder · Pickles · Soy Sauce · Modified food starch · Food starch · Dextrin thickeners Avoid · Beer, ale and lager · Malted drinks · Ground coffee with added grains · Most white pepper · Soy Sauce (there are some gluten free brands) · Worcestershire sauce unless company has been called · Malt vinegar · Gravy · Roux · Malt extract or flavoring · "Brewer's Yeast" 31 Gluten-Free Diet Ingredient Quick Guide Disclaimer: Gluten status of ingredients can change over time. (list last updated 2020) Gluten-Free Ingredients Acacia gum Agar agar Agave Amaranth Arabic gum Arrowroot Ascorbic acid Beta glucan Buckwheat Carrageenan Casein Cellulose Citric acid Cocoa Corn and "corn gluten" Cream of Tartar Flax and chia seeds Fructose Gelatin Glucose syrup Guar gum Plain herbs Hominy Honey Hydrolyzed soy Protein Lecithin Legume flours Locust bean gum Maltodextrin Millet Mono- and diglycerides Montina MSG Nitrates Oat gum Potato Psyllium Quinoa Rice Sesame Soba Sorghum Soy Spices (pure form) Silicone dioxide Starch (if just "starch", made from corn) Sweet potato Tapioca Teff Tofu (plain) Vanilla Vegetable gums Vinegar (unless malt) Whey Xanthan gum Yeast (except Brewer's yeast) Gluten-Containing/Avoid × Wheat × Barley × Malt (unless from corn) × Rye × Triticale × Breyer's yeast × Seitan × "Wheat starch" × Durum × All-purpose flour × White enriched flour × Wheat flour × Wheat germ × Wheat starch × Whole wheat flour × Wheat bran × Wheat nuts × Oat bran × Bulgar × Graham × Kasha × Kamut × Spelt × Matzo/Matzo meal × Rusks × Semolina × Farina × Einkorn × Emmer/Farro × Vital wheat gluten × Mir × Cereal binding 32 Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person's health needs are different, you should talk with your doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright © 2/2021 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#8187. 33blw0 Adobe PDF Library 21.1.177